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PMT15-03730 City of Menifee Permit No.: PMT15-03730 _ 29714 HAUN RD. 4!-� A_> MENIFEE, CA 9258E Type: Residential Addition MENIFEE Date Issued: 12I01I2015 PERMIT Site Address: 30625 ALSTON LN, MENIFEE, CA 92584 Parcel Number: 364-310-005 Construction Cost: $3,814.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 12'x 34'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS, 3 SPOT LIGHTS Work: Owner Contractor MATHEW GARDNER GUTTERS N COVERS CONSTRUCTION INC 30625 ALSTON LANE 19069 VAN BUERN BOULEVARD#114 MENIFEE, CA 92584 RIVERSIDE, CA 92508 Applicant Phone:9516728022 KRISTY HENDRICKSON License Number: 945962 GUTTERS N COVERS CONSTRUCTION INC 19069 VAN BUERN BOULEVARD#114 RIVERSIDE, CA 92508 Fee Description Q1t rr Amount($) Receptacle, Switch, Outlet&Fixture 5 136.00 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 $304.65 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 building operations being caned 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 ❑ 1 am exempt from licensure under the Contractors'State License Law for thr 1 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 y license Is in full force and effe which I must have resided for at least one year prior to completion o License Class License o improvements covered by this permit, I cannot legally sell a structure that I have Expires Y Signature I built as an owner-building if it has not been constructed in its entirety by licenser 1/`- contractors. I understand that a copy of the applicable law,Section 7044 of thr WORKERS'COMPENSATION DECLARA ION 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: httoJ/wwwleoinfo.p.aov/plaw.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 orAuthodzed Agent Policy# ❑ By my Signature below, I certify to each of the following: I am the propert, ❑ 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 thir 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 complt permit is is ued.My workers'cem nation iniiuranre carrier and policy number are: with all applicable city and county ordinances and state laws relating to building 1Y1 I Construction.I authorize representatives of this city or county to enter the above Carder //�� identified r6p y ortheir pection�jp/ur/p�osse�s. r� Policy#'S wC,) U� Expires 7-23 `/� � �LCQkW'L--Date d' Property ner or Authorized Agent /Z (This section need not be completed if the permit is for �S "I one-hundred dollars($100)or less) City Business License# 1 ❑ 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'sf�ecHI don the Hazardous Materials Information Guide? Code,I shall f rthwith comply with those provisions. DYES ,18'NO 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 guidelines 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 proposed building or modified facility be within 1000 feet of the outer DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary o a school? LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES FNO 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 aterial re orting. OWNER BUILDER DECLARATIONS DYES X10 � 1 I hereby affirm under penalty of perjury that I am exempt from the Contrac—,. �m "n License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER R 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 firths and comply with she is exempt from Iicensure 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 EPKs 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 Contractors 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 Finn 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 properly an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Finn 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 Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee AM& DATE 1,;L11115 . PERMIT/PLAN CHECK NUMBER b TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA OSIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES �^ DESCRIPTION OF WORK POijbF S. PROJECTADDRESS S 815-k)Y 1 l ( .Q. l Dept, ASSESSOR'S PARCEL NUMBER %L `- 3\o --nr__)S, LOT TRACT DFC o I 21j; OWNER NAME r ''nn ADDRESS nnc (� F� a' -ceiv d PHONE "IS'-551- '19gg. EMAIL APPLICANT NAME r l ADDRESS 101nharen +�Vd# 2iv CG 250 PHONE EMAIL CONTRACTOR'S NAME U o OWNER BUILDER? O YES f<NO BUSINESS NAME ADDRESS f Yam' PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER gLJ5G(o LICENSE CLASSIFICATION VALUATION $ Ss 14 SO FT 4 90 L SO FT APPLICANT'S SIGNATURE DATE f� J CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE G PAIDAMOUNT G O t AMOUNT V 5 .U15 CASH O CHECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# OCREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES 0 NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92585 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 -D ::5 0a :;� 71 D J vi LE©GER a i RACK INSPECTION REQUIRED n to L C/ 7 O m Ljj _U City of Menifee LL Building & Safety Dept. LL DEC 0 1 2015 Received 40 r i I I l Ifz ' C16 i —3-q © O IfiYi"E-NIFEE — — IJILDING AND SAFETY DEPARTMENT LAN APPROVAL FEVIEWED BY l K �P1 '5 DATE ' pproval of these plans shall not be construed to be a permit for,or an a 3proval of,any violation of any provisions of the federal,state or city r gulations and ordinances. This set of approved plans must be kept on the j bsite until completion.