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PMT15-02498 i I s City of Menifee Permit No.: PMT15-02498 g 29714 HAUN RD, Type: Residential Addition '�iGCIEJIL1' MENIFEE, CA 92586 MENIFEE Date Issued: 08/17/2016 PERMIT 1 Site Address: 29415 COTTAGE CT, MENIFEE, CA Parcel Number: 333-501-016 � 92584 Construction Cost: $3,200.00 Existing use: 1 &2 Family Residence Proposed Use: Description of INSTALL 360 SO FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 1 FAN Work: Owner Contractor LORRAINA KORDAKIS PATIO GUY ALUMAWOOD CONTRACTOR 29415 COTTAGE CT 41197 GOLDEN GATE CIR STE 108 MENIFEE, CA 92584 MURRIETA, CA 92562 Applicant Phone: 9513330056 LOIS MONTINI License Number: 872839 PATIO GUY ALUMAWOOD CONTRACTOR 41197 GOLDEN GATE CIR STE 108 MURRIETA, CA 92562 Fee Description Qtv Amount($1 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 $278.00 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 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_Bidg_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 an y license is in full f e and ffgst. Code:The Contractor's License Law does not apply to an owner of a property License Class License N �- who builds or improves thereon, and who contracts for the projects with a Expires (0 4i2 •/(*gnature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ I am 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 improvements covered by this permit, I cannot legally sell a structure that I have permit is issued. 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:httpJ/www.leginfo.ca.gov/ca aw html. permit is issued.My workers'compensation insur nce carrier and policy number are: Carrier /t D ' Property caner or Authorized Agent Date I I ^ Expires �� '— J Policy# ❑ By 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 applicable city and county ordinances and state laws relating to building constr ction.I authorize representatives of this city or county to enter the above- 0 1 certify that in the performance of the work for which this permit is issued,I identifi d p e for e-inspecti n 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 O subject to the workers'compensation provisions of Section 3700 of the Labor property Owner or Authorized Agent Date Code,I shall forthwith comply with those provisio s 0�� / ,^ City Business License# 44 Date; Applicant; - WARNING: FAILURE TO SECURE WORKER ' 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 OR A DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE IXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES nO 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 DYES A P MIT FOR THE CONSTRUCTION OR MODIFICATION OM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR GUIDE LINES OWNER BUILDER DECLARATIONS 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: ,8€SCHOOL? 1000 FEET OF THE OUTER BOUNDARY OF A 'N� SCHOO Any city or county that requires a permit to construct, alter, improve, demolish, DL? 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 DYES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from licensure and the basis for the alleged exemption. Any �NE-CKLIST. I UNDERSTAND MY REQUIREMENTS � violation of Section 7031.5 by any Applicant for a permit subjects the applicant to 6{4 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) P7qRK:i 4 CONCERNING❑ I, as owner of the property, or my employees with wages as their solecompensation, will do( )all of or( )porting of the work, and the structure is not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK �r: Menifee DATE - '�� PERMIT/PLAN CHECK NUMBER TYPE: "') COMMERCIAL CrITESIDENTIAL O MULTI-FAMILY O MOBILE HOME 0 POOL/SPA 0 SIGN SUBTYPE: ADDITION O ALTERATION 0 DEMOLITION O ELECTRICAL O MECHANICAL > NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK S Q L J L u PROJECT ADDRESS ASSESSOR'S PARCEL NUMBER LOT 4(4 TRACT Lk55 OWNERNAME / A.K ADDRESS CZ7774SEC PHONE 9 ��- ay . 2 /3g EMAIL APPLICANT NAME o4g, ADDRESS ,F G PHONE 9'sr��y .e EMAIL CONTRACTOR'S NAME /�� 4 n —r- ,r,5 OWNER BUILDER? C:YES "T BUSINESS NAME �- (J Foe c9- ADDRESS pI, = e -LZd E HURR, PHONE 9SJ- 333 - bacO/��,s� EMAIL m CONTRACTOR'S STATE LIC NUMBER _ p / o��a 9 LICENSE CLASSIFICATION VALUATION$ JOB SO FT 319JZ) L SO FT APPLICANT'SSIGNATUR DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN INVOICE I Q`•�; PAID AMOUNT AMOUNT OCASH %CHECK# C%CREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT CASH OCHECK# >CREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER Q YES ' NO City of Menefee Building& Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityafinenifee.USInspection Request Line 951-245-6213 'LEDGER & "RACK _ A5, is, INSPECTION REQUIRED I X X X x FM+I 1 �. D S n L yo . �D DL 1 ;ity of Menifee , ';p,ing & Safety Dept. AUG 17 2015 33 Wed 0 to D ril y EE � eii G AND SAFETY DEPARTMENT - t&wjg-nri'.�N r_`JiEUL' � 1 17/(S— � r approval of any viola,,,,,of ar '�oo;.�; � a pal,state ermit for,or an guiations and ordinances. This set of approveof d plans nsrmust be keptton tA� �re until completion. ' earn€.OWr#61� IMo ° rS.��D � C 1�1 � � LC @,p • $13� eery c-�v g*!1Rs � .D'�tRAri reo9uYufmgr (fie h7A �®RSA-kdS Wises 9oedengq4}ee„rc�e •►kw8 a01 '- I rn �N 1 F �"pJL `L�' ord: Sure+y .►� 5g1313S ' b85Yf 7