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PMT15-03562 City of Menifee Permit No.: PMT15-03562 29714 HAUN RD. '`ACCFl/_> MENIFEE, CA 9258E Type: Residential Addition MENIFEE Date Issued: 11/13/2015 PERMIT Site Address: 28170 LOOKOUT POINT LN, MENIFEE, Parcel Number: 333-393-036 CA 92585 Construction Cost: $3,625.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 300 SO FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 1 FAN Work: Owner Contractor FRANK FRANCO GUTTERS N COVERS CONSTRUCTION INC 28170 LOOKOUT POINT LN 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 QQrt Amount(SI Receptacle, Switch, Outlet&Fixture 1 116.00 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 General Plan Maintenance Fee-Electrical 1 5.80 $290.45 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 sic 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'Stale 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 1 acknowledge that,except for my personal residence it Professions Code anqny license is in full force and effef which I must have resided for at least one year prior to completion-o License Clas Lice Z_ improvements covered by this permit, I cannot legally sell a structure that I have Expires �a Signature (('t7 A built as an owner building if it has not been constructed in its entirety by licenses 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 is submitted or at the following Web site: ❑ I hereby affirm under penalty of e one of the fallowing declarations: htto:/Iw .leginfo.m.gov/calaw.htm]. I have and will maintain a certificatet of consent 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 properti ❑ 1 have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owners 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 compy permit is issued.My workers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and slate laws relating to buildinr ,—�,Annn construction.Weprizerepresentatives of this city or county to enter the aboveCarrier. U/1f�1� identified or the i specticyl purposes. Policy# ,t*—'I Expires —7 k5��� Date �7lrs T— Property ner or Authorized Agent (This section need not be completed if the permit is for City Business License# ✓J'S�J� one-hundred dollars($100)or less) ❑ 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 specified on the Hazardous Materials Information Guide? Code,I shall forthwith comply with those provisions. 1 ❑YES y�NO Applicant, Ee--- `mil 171� _ Will the init\en led 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 DYES 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 �PNO CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm that under the penally 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 I ne orting. OWNER BUILDER DECLARATIONS DYES 0 I hereby affirm under penally of perjury that I am exempt from the Contractor's &A Date License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWI JER OR AUTHORIZED AGENT next to the applicable item(s)(Section 7031.5. Business and Professions Code: EPA RENOVATION. REPAIR AND PAINTING fRRPI Any city or county that requires a permit to construct,alter, improve,demolish, 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 lioensure 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, owner of the properly, or my employees with wages s t www.epa.gov/lead or contact the National Lead Information Center at uctr sole 1-800-424-LEAD(5323). compensation,will do( )all of or( )porting of the work,and thee 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). ❑ 1, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Cenified 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 hidlds nr imnmvpe thprenn and whn rnntrprte fnr the nmiprte with a BUILDING & SAFETY PERMIT/PLAN CHECK • . . • � 'Menifee DATE %/ /,3 /cj PERMIT/PLAN CHECK NUMBER 15- TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA ("SIGN SUBTYPE: C ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O.MECHANICAL O NEW O P�L/UM/B}I,NJG, O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK r Gji Lf (tiC.C.I•I'I7 / -r 0 PROIECTADDRESS l �21'Q�Li/T�L 10-(L . 1I UL�II� �„�L^50�� ASSESSOR'S PARCEL NUMBER �,Y// � 'l'b�,JKJ LOT loA- TRACT 0-10 � OWNER NAME rLari rranm ADDRESS C)kt)U:f X.-f 1 1111� �- PHONE 0(51- n 6'-/4W EMAIL �^ APPLICANT NAME / u (ceS V ' /� p v ADDRESS /B IC, &q van , vd -t(l IV ggsz PHONE JS)-t j-7A- g0 aJ- EMAIIL,, CONTRACTOR'S NAME l(_Ow--S OWNER BUILDER? O YES >.NO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE UCNUMBER �L-I5�1(D O,,ccvv�� LICENSE CLASSIFICATION VALUATION$ 3(p2-S S FT 3 LSQFT APPLICANT'S SIGNATURE l G DATE 1 l /3 /S` CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION I.p log CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN l SMIP INVOICE I PAID AMOUNT AMOUNT I CASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK4 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES C ND DL NUMBER NOTARIZED LETTER O YES Q 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 — W � Z3R� 7 CA � V' 3 � �LE � —r i gSPE006N REQUIRED City of Menifee Building & Saiety Dept. NOV 13 2015 Received CITY OF MENIFEE HDUC)b BUILD11< _'; AND SAFETY DEPARTMENT PLAN APPROVAL REVIEWED BY( Ills . DATE 'Amoklil of these plans shall not be construed to be a permit for,or an apprnvai of,any vio;:;uon of any provisions of the federal,stile or city 20 regumbons and ordinances. This set of approved plans mus>Ibe kept on the jobsite until completion. I l5 is PLO