Loading...
PMT15-03345 City of Menifee Permit No.: PMT15-03345 29714 HAUN RD. Type: Residential Addition c <ACCEL/4� MENIFEE,CA 92586 MENIFEE Date Issued: 10/29/2015 PERMIT Site Address: 28387 PORTSMOUTH DR, MENIFEE, CA Parcel Number: 339-082-004 92586 Construction Cost: $2,724.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 10.5'x 31'SOLID ALUMAWOOD PATIO COVER Work: Owner Contractor ROBERT MOSS GUTTERS N COVERS CONSTRUCTION INC 28387 PORTSMOUTH DRIVE 19069 VAN BUERN BOULEVARD#114 MENIFEE, CA 92586 RIVERSIDE, CA 92508 Applicant Phone:9516728022 KRISTY HENDRICKSON License Number:945962 GUTTERS N COVERS CONSTRUCTION INC 19069 VAN BUERN BOULEVARD#114 RIVERSIDE, CA 92508 Fee Description Qtv Amount($) 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 $168.65 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 Bldg_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 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 an y license is in full force and effe which I must have resided for at least one year prior to completion-o License Clas Licen Z improvements covered by this permit, I cannot legally sell a structure that I have Expires 7 Signature j built as an owner-building if it has not been constructed in its entirety by licensee contractors. I understand that a copy of the applicable law, Section 7044 of the WORKERS'COMPENSATION DECLA TION Business and Professions Code,is available upon request when this application ie submitted or at the following Web site: ❑ I hereby affirm under penalty of perjury one of the following declarations: submitted or t the hftp://www.le-ginfo.ca.gov/calaw.html. site: 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 thie 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 buildinc construction. out prize representatives of this city or county to enter the above. Carrier ,w d identified p y for the i specti purposes. Policy#C,1w—1 l Expires -3 -+// I Date 7h Property cKvner or Authorized Agent (This section need not be completed if the permit is for ,):25��� one-hundred dollars($100)or less) City Business License# ❑ I 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 forthwith comply with those provisions. / DYES �NO Applicant, '(e-- � 1-7 /(� Will the intended use 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 guid lines 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 pr 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 DYES VNO 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 materi orting. OWNER BUILDER DECLARATIONS ❑YES 0 I hereby affirm under penalty of perjury that I am exempt from the Contractor's Rj., y1A Date License Law for the reasonI(s)indicated below by the checkmark(s)I have placed PROPERTY OW ER 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-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 ❑ I, 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 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 BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION r� o+ �! OrT28 DATE PERMIT/PLAN CHECK NUMBER U� C� TYPE: COMMERCIAL 0 RESIDENTIAL C: MULTI-FAMILY MOBILE HOME C; POOL/SPA 'SIGN SUBTYPE: 'ADDITION C ALTERATION ()DEMOLITION ` ELECTRICAL 0 MECHANICAL C) NEW O PLUMBING 11 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK I ClC_MdO PROJECT ADDRESS 04, u l� i��� � SIn �R� ASSESSOR'S PARCEL NUMBER 0� - WZ'( LOT TRACT OWNER NAME c 1� r SS j t� r1 ADDRESS O 1 '� lt�V ` �� Z PHONE I "�U �C� EMAIL APPLICANT NAME lS I`Cif r ,(� m'/�1 ADDRESS IClCIA L 1 " V --# PHONE -�� -�� - EMAIL CONTRACTOR'S NAME i OWNER BUILDER? C YES �CIuo BUSINESS NAME ADDRESS PHONE (� r EMAIL CONTRACTOR'S STATE LIC NUMBER "!� �' �j� LICENSE CLASSIFICATION VALUATION$ 2 ��1 S FT 2 0 L SQ FT G ` APPLICANT'S SIGNATURE �/ ATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN 1 SMIP 'INVOICE PAID AMOUNT AMOUNT 1 �� r� IX J CASH CHECK# CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT C:CASH %CHECK# %CREDIT CARD VISA MC OWNER BUILDER VERIFIED 0 YES C: NO DL NUMBER NOTARIZED LETTER C 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 71D :D Ui Ul z 0 0 D QA U— LEDGER & TRACK INSPECTION REQUIRED City of Menifeo Building & Safeaty Dep., c1r- — 0 OCT 28 2015 R e c e i Oh C, CITY OF-MIFEE BUILDING AND SAFETY DEPARTMENT PLAN APPROVAL P E VIEWED BY *Approval of these plans shall not be construed to be a permit for,or an approval of,any violation of any provisions of the federal,state or city regulations and ordinances. This set of approved plans must be kept on the jobsite until completion.