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PMT15-02835 I i City of Menifee Permit No.: PMT15-02835 29714 Type: Residential Addition P MENIFEE,EE, CA 92586 C 92 MENIFEE Date Issued: 0911412016 0 d PERMIT 4, 9 Site Address: 31170 GARDENSIDE LN, MENIFEE, CA Parcel Number: 372-280-024 92584 Construction Cost: $3,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL SOLID 350 SO FT ALUMAWOOD PATIO COVER W/ELECTRICAL 4 LIGHTS Work: Owner Contractor DAVID GONZALEZ SOCAL HOME IMPROVEMENT 31170 GARDENSIDE LN 16331 LAKESHORE DR#G161 MENIFEE, CA 92584 LAKE ELSINORE, CA 92530 Applicant Phone: 9512364282 TROY CRISWELL License Number: 930540 SOCAL HOME IMPROVEMENT 16331 LAKESHORE DR#G161 LAKE ELSINORE, CA 92530 _ Fee Description 0ty Amount 1$1 e Building Permit Issuance 1 27.00 e a n GREEN FEE 1 1.00 S E A General Plan Maintenance Fee ii!i-Building 1 6.65 $306.20 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 staled,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 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 and my license is in full force and effec which I must have resided for at least one year prior to completion of License Class License4o. improvements covered by this permit, I cannot legally sell a structure that I have Expires Signa re 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 WORKERS'COMPENSATION CLARA Business and Professions Code,Is available upon request when this application is submitted or at the following Web site: ❑ I hereby affirm under pen Ity of perjury one of the following declarations: http�//www.leginfo.ca.gov/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 Cade, 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 issue M worker 'compensatiop insurance carrier and policy number are: with all applicable city and county ordinances and statelaws relating to building `((. I construction.I authorize representatives t-i r county to enter t e above- ' Carrier /��h `'�/� g KS Identifi4prfor the inspectio ppPolicy# l y�/ �3 / Expires Date_P ar Authorized Agent (This section need not be completed if the permit is for Business License# one-hundred dollars($100)or less) //C� HAZARDOUS MATERIAL DECLARATION ❑ I certify that in the performance of the work for which this permit is issued, I 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'compens�Iw ,ions of Section 3700 of the Labor amounts s ecified on the Hazardous Materials Information Guide? Code, shall fort mn m y-c� s provisions. ❑ visionYES I0 ApplItant Date; / / Will the intended use of the building by the applicant or future building occupant require a permit for the construction or modification from South WARN FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist COII��dd ENSATION COVERAGE IS UNLAWFUL, AND SHALL forguideli as SZJ1ECT AN EMPLOYER TO CRIMINAL PENALTIES AND ❑YES �NO _ 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 boundary of a school? LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES EKNO 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 material reporting. ) OWNER BUILDER DECLARATIONS / 0 L Date I hereby affirm under penalty of perjury that I am exempt from the Contractor's !/ License Law forthe reason(s)indicated below by the checkmark(s)I have placed P RTY OWNER 0 AUTHORIZED AGENT next to the applicable item(s)(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: www,epa.gov/lead or contact the National Lead Information Center at ❑ 1, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323). compensation, 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 ❑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 Firm Certification No.: purpose of sale). ❑ 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 contractor(,)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. I BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE 1 PERMIT/PLAN CHECK NUMBER TYPE: '.) COMMERCIAL C RESIDENTIAL C% MULTI-FAMILY ".," MOBILE HOME : POOL/SPA SIGN SUBTYPE: " ADDITION O ALTERATION % DEMOLITION 0 ELECTRICAL MECHANICAL O NEW O PLUMBING -C RE-ROOF-NUMBER OF SQU TARES DESCRIPTION OF WORK PROJECTADDRESS �� O A. C 37, ASSESSOR'S PARCEL NUMBER LOT L.4G TRACT OWNERNAME 04),d Z, 1 -Z ADDRESS 3 U 0 7. q�..�-7 Syyt `^ PHONE _y5I , l /�` b / EMAIL APPLICANT NAME (b , ADDRESS PHONE EMAIL L CONTRACTOR'S NAME o( (qw Gti 7 OWNER BUILDER? " YES :/NO BUSINESS NAME nn / ADDRESS I Q331 Lwo- N PHONE qj l— �4 ` yw& EMAIL CONTRACTOR'S STATE LIC NUMBER 93q�ryo LICENSE CLASSIFICATION VALUATION$ �bb SO,FT 35d L SQ FT APPLICANT'S SIGNATUR DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITV OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGI EKING FIRE GREEN 100 SNIP O � 3 INVOICE PAID AMOUNT AMOUNT -- CASH E'CHECK# «CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT :.; CASH %CHECK# ++CREDITCARD VISA/MC OWNER BUILDER VERIFIED YES C; NO DL NUMBER NOTARIZED LETTER ct YES 'c` NO City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 EDDER �TRDAUIRED i��PECTiDN RE ,ry �S City of Menifee Building & Safety Dept. � SEP 1 '► 2015 Received CIT Y OF M NIFEE BUILDING AND SAFETY DEPARTM NT Pl,q APPROVAL r, �;y ' c,vd to'ee term t for,or an tap-.=,hall 10i h"C,Onit 'APProv. r' n�federal,state o "� approval of,anq violation of ao ' o` `1i (o eJ gaits regulations and ordinances. must be kept on the This s t of app P jobsite until completion. 1 4 I� Qav �UAIA,7., of- 1 2S� -C95r7