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PMT15-03155 City of Menifee Permit No.: PMT15-03155 29714 HAUN RD. Type: Residential Addition �CCEL/ MENIFEE,CA 92586 s t., MENIFEE Date Issued: 10/09/2015 PERMIT Site Address: 31019 MOUNTAIN CLIFF RD, MENIFEE, Parcel Number: 372-36D-020 CA 92584 Construction Cost: $5,700.00 Existing use: 1 &2 Family Residence Proposed Use: Description of INSTALL 13'x 50'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS,4 LIGHTS Work: Owner Contractor SCOTT PROTSMAN GUTTERS N COVERS CONSTRUCTION INC 31019 MOUNTAIN CLIFF ROAD 19069 VAN BUERN BOULEVARD#114 MENIFEE, CA 92584 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 QtV Amount f$1 Receptacle, Switch, Outlet&Fixture 6 141.00 Building Permit Issuance 1 27.00 Deck/Patio, non-standard _ 1 133.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 1.00 General Plan Maintenance Fee-Building 1 6.65 $309.65 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_Tempiate.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ lam exempt from licensure under the Contractors'State License Law forth. I hereby affirm under penalty or perjury that I am licensed under provisions of following reason: 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 it Professions Code and my license is In full force and effect. which I must have resided for at least one year prior to completion o License Class Licen No. improvements covered by this permit, I cannot legally sell a structure that I hav( Expires Signature uilt as an owner-building if it has not been constructed in its entirety by license( contractors. I understand that a copy of the applicable law, Section 7044 of th( WORKERS'COMPENSATION DECLA TON Business and Professions Code,is available upon request when this application is ❑ 1 hereby affirm under penalty of perjury one of the fallowing declarations: submitted or at the following Web site: I have and will maintain a certificate of consent of self-Insure for workers' hfti?:/Awm.leainfo.ca.govicalaw.html. compensation,Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code,for the performance of work for which this Date permit is issued. Property Owner orAuthorized Agent Policy# ❑ By my Signature below, I certify to each of the following: I am the property ❑ 1 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 carder and policy number are: with all applicable city and county ordinances and state laws relating to building �a /1 �-.-_ /) constructi .I authorize representatives of this city or county to enter the above- Carrier c`��/1 1�i I (J/lam identifi 'p rty fort ii�nspe 'on purposes. i1 /fir Policy 7x-�r^'I..ID�IUUVJ Expires - Y� ` �" /t Iti- Date ' U Property Owner or Authorized Agent (This section need not be completed if the permit is for O JS5� one-hundred dollars($100)or less) City Business License# ❑ 1 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 s ecified on the Hazardous Materials Information Guide? Code,I shall f with comply with those provisions. , jf� ❑YES I�NO Applicant, /� /�� Will the intended use of the building by the applicant or future building or modification from Soh WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Man gementt Districttruction(SCAQMD)?See permitting COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guideli es SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND OYES NO CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the p osed 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 OYES CONSTRUCTION LENDING AGENCY I have read a Hazardous Material Information Guide and the SCAQMD I hereby affirm that under the penalty of perjury there is a construction lending permitting ch cklist.I understand my requirements under the State of agency for the performance of the work which this permit is issued (Section California Health 8 Safety Code,Section 25505 and 25534 concerning 3097 Civil Code) hazardo s aterial reporting. OWNER BUILDER DECLARATIONS OYES O _ r I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the reasons)indicated below by the checkmark(s)I have placed PROPERTY OWNE OR 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-cer8ried 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 ❑ I, as owner of the roe www.epa.gov/lead or contact the National Lead Information Center at property,rty, or my employees with wages as their sole 1-800-424-LEAD compensation,will do( )all of or( )porting of the work,and the structure is (5323). 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 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 contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE IO- ''�� PERMIT/PLAN CHECK NUMBERrj - 3 TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOFF-NUMBEROFSQUARES DESCRIPTION OF WORK S011i Olu M (r C(i I7 R l E-CLOS L4 LIC4NS PROJECTADDRESS 0 un Ii -tom kd ( ASSESSOR'S PARCEL NUMBER 22� - 00- 0aL0 LOT TRACT OWNER NAME D tsm o /� �/ ADDRESS l ' j / (-' 1� nI O (- PHONE Q i Yu�D or�� 1 "-��F_ i1J`,IL' . Building & Safe e APPLICANT NAME Dept. �7 ADDRESS /y 0 i � vC' I w C a5b OCT 0 9 15 PHONE �I- 017-� (y� EMAIL CONTRACTOR'S NAME L-N zU C OWNER BUILDER? O YES NO viad BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER �i. l'I�p� LICENSE CLASSIFICATION VALUATION$ 15-�V lJ SQ FT X L SQ FT r APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE PAID AMOUNT AMOUNT2cq e5lO CASH O CHECK# O CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofTIenifee.us Inspection Request Line 951-246-6213 i City of Menif >. Building &Safety Dept. OCT 0 9 2015 0 LEDGER & TRACK ReceivE d U INSPECTION REQUIRE LL LL p CITY 0 MENIFEE BUILDI SIG AND SAFETY DEPARTMEN PLAN UPROVAL REVIEWED BY DATE O 'Approval f these plans shall not be construed to be a permi for,or an �� approval of any violation of any provisions of the federal,sta e or city regulations and ordinances. This set of approved plans must ie kept on the jobsite unti completion. ' I G xa _ O R _--01 C7 A 11. COO 1'.'`utFE►=,cam gZs�`i Sono (0si:)'o `f �llYFt[S