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PMT16-00085 City of Menifee Permit No.: PMT16-00085 29714 HAUN RD. Type: Residential Addition �!-�CCEL/!? MENIFEE, CA92586 MENIFEE Date Issued: 0 111 212 0 1 6 PERMIT Site Address: 29273 NECTARINE ST, MENIFEE, CA Parcel Number. 333-624-016 92584 Construction Cost: $2,278.00 Existing Use: 1 &2 Family Residence Proposed use: Description of INSTALL 216 SQ FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL,2 FANS&3 POSTLIGHTS Work: Owner Contractor ROBERT TAYLOR GUTTERS N COVERS CONSTRUCTION INC 29273 NECTARINE ST 19069 VAN BUERN BOULEVARD#114 MENIFEE,CA 92584 RIVERSIDE, CA 92508 Applicant Phone:9516728022 KRISTY HENDRICKSON License Number:945962 GUTTERS N COVERS CONSTRUCTION INC 19069 VAN BUERN BOULEVARD#114 RIVERSIDE,CA 92508 Fee Description ON Amount I$) 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 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 Permtt_Template.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 i Professions Code an y license is in full force and effe which I must have resided for at least one year prior to completion ( License Clas �—Lic s No. 4 5° improvements covered by this permit, I cannot legally sell a structure that I hav ' built as an owner-bullding If It has not been constructed in its entirety by license Expires Signature 1� contractors. I understand that a copy of the applicable law, Section 7044 of th WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application I submitted or at the following Web site: ❑ 1 hereby affirm under penalty of perjury one of the fallowing declarations: http://www.leoinfc.ca.aov/plaw.html. I have and will maintain a certthcate 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 orAuthorized Agent Policy# ❑ By my Signature below, I certify to each of the following: I am the properl ❑ 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 IN 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 compl permit is issued.My workers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to buildin �, n construction. authorize representatives of this city or county to enter the abovr Carrie chA idenfifie p pe ty for inspection pur oses. Policy tUCJ Expires -7-a3-ho - Dated Prape ner or Authorized Agent V (This section need not be completed if the permit is for City Business License# 5< one-hundred dollar;($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: 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 f with comply with those provisions. DYES 0 NO Applicant• �' �� WIII 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 checklis COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guldeli es 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 cute DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE bounds school? LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES I NO 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 6 Safety Code,Section 25505 and 25534 concerning 3097 Civil Code) hazardoury material reporling. OWNER BUILDER DECLARATIONS DYES I&INO •1a•l I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNIiR 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: ❑ I, as owner of theproperty, or m ern to employees with wages as their sole '�''epa.gov/lead or contact the National Lead Information Center at Y P Y 9 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 Finn 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(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 DATE 19 - ILO PERMIT/PLAN CHECK NUMBER PN�CIb. Q 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 PLUMBIN//G�� O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Sob Mum m o PROJECTADDRESS �""�jC 2 jj�.-e�0�-f� C��L.I'�AA IAI I ASSESSOR'S PARCEL NUMBER ��✓�� yO�� IlaOT � TRACT OWNER NAME Q ADDRESS Crx L` PHONE�R 00:5' a�J�y EMAIL APPLICANT NAME _ SC_-.A I ADDRESS 1`�I� UI,2� vC1 - 1q �� Z PHONE q51-�p��-�V U EMAIL CONTRACTOR'S NAME tj CLArC6 OWNER BUILDER? O YES O NO BUSINESS NAME ADDRESS PHONE �-^ EMAIL CONTRACTOR'S STATE �LIICQNUMBER gy�G�p�- LICENSE CLASSIFICATION B VALUATION$ SQV n L SO FT APPLICANT'S SIGNATURE DEPARTMENT DISTRIBUTION r� CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN 4 SMIP INVOICE PAID AMOUNT AMOUNT O)We OCASH OCHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED "YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 �61("�� t , � 39')� �• ((�� 000 City of Menifee _� _ Building & Safety Dept. LA JAN 12 2016 - o Received LEDGER & TRACK INSPECTION REQUIRN'i� CITY OF MENIFEE BUILDING >' AN A PROVAL REVIE ED B OW'(P DATE r.r. roval of hese plans shall not be construed to be a i�r� ape: rval of, y violation of any provisions of the fede ;s ate or city re .,iations a id ordinances. This set of approved plans must be kept on the job,ite until ompletion. It `t�2 I I 5� - - - - 20F r� 9