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PMT15-02084 l City of Menifee Permit No.: PMT15-02084 29714 HAUN RD, Type: Residential Addition !'9k�CMA> MENIFEE, CA 92586 amem�nu sw""`° MENIFEE Date Issued: 0 7121/2 01 5 PERMIT Site Address: 29945 OAKBRIDGE DR, MENIFEE, CA Parcel Number: 338-312-002 '. 92586 Construction Cost: $3,000.00 Existing Use: 1 &2 Family Residence Proposed use: Description of INSTALL 11'x 31'SOLID ALUMAWOOD PATIO COVER WITH 2 LIGHTS Work: Owner Contractor DANA&RENEE RIKER CLASSIC ALUMAWOOD COVERS 29945 OAKBRIDGE DRIVE 39450 BONAIRE WAY MENIFEE, CA 92586 MURRIETA, CA 92563 Applicant Phone: 9512942804 DAVID ABEEL License Number: 986793 CLASSIC ALUMAWOOD COVERS 39450 BONAIRE WAY MURRIETA, CA 92563 Fee Description Q!yt Amount($ e Building Permit Issuance 1 27.00 D GREEN FEE 1 1.00 f .. $283.00 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing building operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA_Bldg Permit_Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions Professions Code and my license is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a property License Class 0—L `(' Lice ns �_F(�7Q"6 7 93 who builds or improves thereon, and who contracts for the projects with a Expires Signatur _ licensed contractor(s)pursuant to the Contractors State License Law), WORKERS'COMPENSATION DECLARATION ❑ 1 am exempt from icensure under the Contractors'State License Law for the ❑ I hereby affirm under penalty of perjury one of the following declarations: following reason: I have and will maintain a certificate of consent of self-insure for workers By my signature below I acknowled e that, except for m compensation,issued by the Director of Industrial Relations as provided for by 9 P y personal residence in Section 3700 of the Labor Code, for the performance of work for which this which I must have resided for at least one year prior to completion of permit is issued. improvements covered by this permit, I cannot legally sell a structure that I have Policy# built as an owner-building if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the ❑ 1 have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http://www.Ieqjnfo ca eov/calaw html, permit is issued.My workers'compensation insurance carrier and policy number are: Carrier S 7-/f7"I< TUIi0 Property Owner or Authonzed Agent Date Expires - (6 Policy# Name of Agent Phone# ❑ By my Signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this (This section need not be completed if the permit is for application and the information I have provided is correct. I agree to comply one-hundred dollars($100)or less) with all applicable city and county ordinances and stale laws relating to building construction. I authorize representatives of this city or county to enter the above- ❑ I certify that in the performance of the work for which this permit is issued, I identif d property for e inspection purposes. shall not emolov any persons in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become 7 _ t 7 subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those p visi s/.J Property Owner or Authorized Agent Date Date; 7 `/7 — (J Applicant s% City Business License# WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL HAZARDOUS MATERIAL DECLARATION SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING ($100,000), IN ADDITION TO THE COST OF COMPENSATION, AYES OCCUPANT HANDLEAHAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES QA EQUAL TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE? agency for the performance of the work which this permit is issued (Section 3097 Civil Code) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT 10 DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR OWNER BUILDER DECLARATIONS GUIDE LINES I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME: License Law for the reasons)indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable items) (Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A Any city or county that requires a permit to construct, alter, improve, demolish, t�WO SCHOOL? or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL Section 7000)of Division 3 of the Business and Professions Code)or that he or oEirES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from licensure and the basis for the alleged exemption. Any (—" CHECKLIST. I UNDERSTAND MY REQUIREMENTS violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than ($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZAR OUS MATERIAL REPORTING. compensation, will do ( ) all of or ( ) porting of the work, and the structure is PROP TY NER OR SHORIZED AGENT not intended or offered for sale.(Section 7044, Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or Improved for the purpose of sale). BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION 4 Wenifee DATE — 7 - (S PERMIT/PLAN CHECK NUMBER - C� TYPE: C) COMMERCIAL ESIDENTIAL C1 MULTI-FAMILY 0 MOBILE HOME `:> POOL/SPA 0 SIGN SUBTYPE: :ADDITION O ALTERATION O DEMOLITION 0 ELECTRICAL 01 MECHANICAL ONEW OPLUMBING RE-ROOF-NUMBER OF SQUARES / I DESCRIPTION OF WORK City of Menile pp I fet Dept. PROJECT ADDRESS 2- t('S ��C/ r, R I b&,�F P- q jUL 5 ASSESSOR'S PARCEL NUMBER Q)-?j�, -rn� LOT TRACT OWNER NAME ,U,A- 4 R edema I kerr Receev d ADDRESS Z9 KS— OAKt3 'tf DAL /�r2�i'•cf'�`� PHONE 3/D - Fp9 - D F6 f' EMAIL APPLICANTNAME `�Q '(- ADDRESS mek)"'A�e PHONE F©S- 7-?'?- -P.76Y EMAIL CONTRACTOR'S NAME 19IJ050t)d V0V 19'(< * OWNER BUILDER? 0 YES 0 NO BUSINESS NAME C SS C c n 0-j lf�� ADDRESS 3 Sb Qt,,0411\e. A-) ,�q fRL)V/ of PHONE fLI- � ?Y-c'S3 37 EMAIL CONTRACTOR'S STATE LIC NUMBER 296 7 V LICENSE CLASSIFICATION VALUATION$ -USA SO FT L SO FT APPLICANT'S SIGNATURE DATE - IS DEPARTMENT DISTRIBUTION CITY OF MENINIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN '^ SMIP INVOICE PAID AMOUNT AMOUNT +^'CASH CHECK It Ci CREDITCARD VISA/MC P LAN CHECK FEES PAID AMOUNT OCASH O CHECK 9 OCREDITCARD VISA/MC [OWNER BUILDER VERIFIED CJ YES -0 NO DL NUMBER NOTARIZED LETTER YES ") NO City of Menifee Building& Safety Department 29714 Hann Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 0cu/n) C jti C_ OpJ 7AAC—COP, DAB 3P, q i "C— 3�: Key C L4SSr'C /gtu,a-c '06160 a i '-JS- ®fI)c 39ys_D W ,91P >_ n1ex), `Fee c<< 9z_s86 rrl 001,'�q 7,d cc, zs b .3 LL 310 - 99R - 0 O City of Menifee IZSN Building & Safety Dept. W ).,LEDGER & TRAGIC eceiVed 0 , IISPECTION REQUIRED ELF-CTi2t"2- 3`1 __CITY OF MENRt D BU WING AND SAFETY DEPARTMENT 11 PI N APPROVAL TEViEWED BY aD E �qval of these plans shall not be construed to be a permit for,or a �Aoval of,any violation of any provisions of the federal,state or city r gulations and ordinances, This set of approved plans must be kept o the j bsite until completion.