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PMT15-02712 1, City of Menifee Permit No.: PMT16-02712 29714 HAUN RD. �hGCEL.lra MENIFEE,CA 92586 Type: Residential Addition MENIFEE Date Issued: 09/01/2015 PERMIT I Site Address: 28432 BOARDWALK CT, MENIFEE, CA Parcel Number: 333-570-015 92585 Construction Cost: $1,892.00 Existing Use: 1 &2 Family Residence Proposed use: Description of AS-BUILT 228 SQ FT SOLID ALUMAWOOD PATIO COVER WITH 1 FAN Work: Owner Contractor BELINDA MIRANDA GUTTERS N COVERS CONSTRUCTION INC 28432 BOARDWALK COURT 19069 VAN BUERN BOULEVARD#114 MENIFEE, CA 92585 RIVERSIDE, CA 92508 !. Applicant Phone: 9516728022 KRISTY HENDRICKSON License Number: 945962 GUTTERS N COVERS CONSTRUCTION INC 19069 VAN BUERN BOULEVARD#114 RIVERSIDE, CA 92508 Fee Description Oft Amount is c e 6 , .. 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_Bldg_Permit Template.rpt Page 1 of 1 City Of Menifee 1 LICENSED DECLARATION ❑ I am exempt from licensure under the Contractors'State License Law for the following reason: I hereby affirm under penalty or perjury that I am licensed under provisions of Chapter 9 (commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence in Professions Code a my license is in full force and eff t. _ which I must have resided for at least one year prior to completion of License Class _Li(cenSlle/No. L improvements covered by this permit, I cannot legally sell a structure that I have Expires Signature G/"j built as an owner-building if it has not been constructed In its entirely by licensed / contractors. I understand that a copy of the applicable law, Section 7044 of the WORKERS' COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is submitted or at the following Web site: ❑ I hereby affirm under penalty of perjury one of the following declarations: http'//www lealnfo ca goy/calaw html. I have and will maintain a certificate of consent of self-insure for workers' compensation,issued by the Director of Industrial Relations as provided for by Date Section 3700 of the Labor Code, for the performance of work for which this — permit is issued. Property Owner or Authorized Agent Policy# ❑ By my Signature below, I certify to each of the following: I am the property ❑ I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read this section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to comply permit Is issued.My workers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to building j� construclio . at oriz representatives of this city or county to enter the above- Carrier S PC',y, 1 ..-7 identifed p,Frt i e inspe ion/purggses. / / Policy#.S ((.j�r O Expires !' '� i �I ( C^•/I/U�6ndi//Zb —Date T� Property 0 ner or Authorized Agent (This section need not be completed if the permit is for City Business License# one-hundred dollars ($100)or less) ElI certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION shall not employ any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a workers' compensation laws of California, and agree that if I should become mixture containing a hazardous material equal to or greater that the subject to the workers'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide? Code,I shall rthwirtthhlcomply with those provisions. _ El YES enNO Applican I ( t6(',�— Will the intendeduse of the building by the applicant or future building occupant require a permit for the construction or modification from South WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guideli s SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND El YES CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS \\ ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE bounda�ry�f^Ia school? LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑YES N@0 CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist. I understand my requirements under the State of agency for the performance of the work which this permit is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning 3097 Civil Code) hazardous at al reporting. OWNER BUILDER DECLARATIONS ❑YES IE�RORAUTHCO I hereby affirm under penalty of perjury that I am exempt from the Contractor'sLicense Law for the reasons)indicated below by the checkmark(s) have placed PROPERIZED AGENT next to the applicable items)(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, EPA RENOVATION REPAIR AND PAINTING(RRP) 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 The EPA Renovation,Repair and Painting(RRP)Rule requires contractors provisions of the Contractor's State License Law(Chapter 9 (commencing with receiving compensation for most work that disturbs paint In a pre-1978 Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with she is exempt from licensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their a civil penalty of not more than ($500).) employees. For more information about EPA's Renovation Program visit: El I, as owner of the property, or my employees with wages as their sale www,epa.gov/lead or contact the National Lead Information Center at compensation, will do 1-800-424-LEAD(5323). p ( ) all of or ( ) porting of the work, and the structure is not intended or offered for sale.(Section 7044, Business and Professions Cade; The Contractor's State License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this project who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If,however, Certified Firm Name: 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). Firm Certification No.: ❑ I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firm is required for this project because: contractors to construct the project(Section 7044, Business and Professions Code:The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who contracts for the projects with a licensed contractors)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. I & SAFETY PERMIT/PLAN CHECK APPLICATION A&Menifee nj DATE v' ( PERMIT/PLAN CHECK NUMBERQtY TYPE: O COMMERCIAL CI RESIDENTIAL * MULTI-FAMILY ; MOBILE HOME C) POOL/SPA ;50dinq of Menifee atety Dept. SUBTYPE: 0ADDITION 0 ALTERATION 0 DEMOLITION 0 ELECTRICAL 0 MECHANICAL r '0 NEW O PLUMBING �E; RE-ROOF-NUMBER OF SQUARES '''. `` SEP 1 2015 DESCRIPTION OF WORK S(� (� "i (�LA I �r - W' ived PROJECTADDRESS OLoL13q W6LtV, CJ ftnL - "I ASSESSOR'S PARCEL NUMBER •5"'��/n� LOT TRACT OWNER NAME �� Q1 '2be h ncf r � uL ADDRESS oL q J ZS PHONE "IJ4-00- y,Grig(Q EMAIL APPLICANT NAME � (�� 'u.l Q v / ADDRESS HOLM Q.{ (J \/d -� too.), Co 9M PHONE � '-��p2- byo o EMAIL CONTRACTOR'S NAME OWNER BUILDER? OYES 0 BUSINESS NAME p ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER q.({SCl(Q)-- LICENSE CLASSIFICATION VALUATION$ Q FT Jdb L SO FT APPLICANT'S SIGNATURE TE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER. BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE AMOUNT a ID AMOUNT — �i CASH '-CHECK# 'JCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT ::? CpSH i CHECK# C:CREDIT CARD VISA/MC OWNER BUILDER VERIFIED C YES G' NO DL NUMBER NOTARIZED LETTER c:) YES NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 N 07 N C)LI5� d cam_ a N = m o' 9' d a � rn H 0 Z _2 1v1 N O T rn rri e 11 m IO m a ' 0 CD I a a m 0 � goo CD (n m a < _ a ~ CD c m rri a n o � ' ~ m