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PMT15-02309 City of Menifee Permit No.: PMT15-02309 29714 HAUN RD, Tt MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 0 8/1 012 01 6 i 1 PERMIT i I Site Address: 28387 INVERNESS CT, MENIFEE, CA Parcel Number: 340-110-017 92584 Construction Cost: $3,850.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 347 SQ FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 2 FANS Work: i Owner Contractor ANNE CORONA WEST COAST SIDING &TRIM 28387 INVERNESS CT 675 LACEY OAK DIRVE MENIFEE, CA 92584 CORONA, CA 92881 Applicant Phone: 9517353379 DANIEL SULLIVAN License Number: 615917 WEST COAST SIDING &TRIM 675 LACEY OAK DIRVE CORONA, CA 92881 Fee Description QQtr Amount l$1 c ichC�' e i u€:r 1- Building Permit Issuance 1 27.00 GREEN FEE 1 1,00 CSiID��T�{1' $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 builiding operations being carried on thereunderwhen 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 Co 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 LicQ s No.l_J�njj who builds or improves thereon, and who contracts for the projects with a Expires 4)411 Signature, licensed contractors)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ lam exempt from licensure under the Contractors'State License Law for the ❑ 1 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 acknowledge that, except for my personal residence in compensation,issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of Section 3700 of the Labor Code, for the performance of work for which this 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 4 I 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:htto://www.leoinfo.m.ciovlcalaw.html. permit is issued.My wo ers'compensation insurance carrier and policy number are: Carrier Property Owner or Authorized Agent Date Expires ( ( Policy# 0OWI 12" 1?_& TkBy my Signature below, I certify to each of the following: I am the property Name of Agent Phone# 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 appli le city a d county ordinances and state laws relating to building construct. uthoriz epresentatives of this city or county to enter he a6ove- I certify that in the performance of the work for which this permit is issued, I identified p r rty for t inspection purposes. shall not employ any persons in any manner so as to become subject to the workers'compensation laws of California, and agree that if I should become subject to the workers'compensation prov' s of ST 3700 of the Labor grope Owner or Authorized Agent Da e Code,I shall to hwith comply with those ovi ins. m C, City Business License# Date; (� I/ Applicant; WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL 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 HANDLE A HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES (�7�10 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 WILL THE INTENDED USE OF THE BUILDING BY THE 3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE - Lender's Name pYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address NO 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 reason(s)indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable item(s)(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, Q NO SCHOOL? or repair any structure, prior to its issuance, also requires the applicant for the t" 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 pYES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from Iioensure 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL I EPORI ING. compensation, will do( )all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION �� Lti6 Menifee DATE d I S PERMIT/PLAN CHECK NUMBER TYPE: % COMMERCIAL 4 RESIDENTIAL `) MULTI-FAMILY 'D MOBILE HOME (:; POOL/SPA C)SIGN SUBTYPE: C)ADDITION ALTERATION 0 DEMOLITION 0 ELECTRICAL <, MECHANICAL NEW ","' PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK i Xj ,r PROJECTADDRESS Vv 5 � C ASSESSOR'S PARCEL NUMBER —5qC — It()—dI, LOT TRACT OWNER NAME/ Inv),( ymn ADDRESS Z-p3 l w5 PHONE 0)51' EMAIL APPLICANT NAME 1 �h ADDRESS PHONE 01(� , �,� — I 1 EMAIL CONTRACTOR'S NAME (vj OWNER BUILDER? %YES'"NO BUSINESf I lSA^ NAME/ ADDRESS V 1 j PHONE 01,) 5e 1!!j EMAIL ^� CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION V VALUATION$ �0 Q FT 17 1 5 P L SO FT APPLICANT'S SIGNATURE DATE (tl It CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION I � SMIP CITY OF MENI2FEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN INVOICE PAID AMOUNT AMOUNT %CASH %CHECK# CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT :'CASH CHECK It :%CREDIT CARD VISA/MC OWNER BUILDER VERIFIED '.:YES 0 NO DLNUMBER NOTARIZED LETTER ') YES NO City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.citycfinenifee.us Inspection Request Line 951-245-5213 gtJ ,D (W<( city of Menifee Building & Safety Dept, UG 10 2015 ece�ved LEDGER & TRACK INSPECTION REQUIRED I r'l OF MENIFEE 1LDING AND SAF ARTMEN ..AN APPROVAL M REVIEWED By A DATE 0 "Approval of these plans shall not be constr ed to be a permit Ir,or an .1 approval of,any violation of any prov'sions o the federal,state r city _ regulations and ordinances. This set of appro ed plans must b kept on the jobsite until completion. y l'd 0£40-969-696 6ulplsiseaoIsom eb9ol9L06Env ° Carl Putnam P.E. 3441 Ivylink Place ., Lynchburg,VA 24503 ' ark utna , a June 4, 2015 Citg safety Dept. MenitGO Building Heath Morgan AUG i Q 2D15 Amedmax Exterior Home Products 28921 US Hwy 74 Romoland, CA 92585 Received Dear Heath: My California PE registration was renewed in June 2015 and is currently valid u til 2017. All previous documentation(plans, letters, calculations, etc.)that I approved Conti ue to be valid under the conditions specified in those documents. If you require further information please contact me at(434) 384-2514 or at carloutnamna comcast.net. Sincerely, Carl Putnam, P.E. ENCjN� ?LITNq� F gg139 13012017 .* CIVt �OF CP�10 UN �� 2Q15 . . . . . . . . . . . . . . . . . . . . . . . . . ° . .