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PMT16-00121 City of Menifee Permit No.: PMT16-00121 29714 HAUN RD. Type: Residential Addition <A—CCIEG? MENIFEE, CA 92586 MENIFEE Date Issued: 0111512016 PERMIT Site Address: 25575 PELION RD, MENIFEE, CA 92584 Parcel Number: 339-281-001 Construction Cost $3,992.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL COMBO 360 SO FT SOLID/LATTICE ALUMAWOOD PATIO COVER W/ELECTRICAL 2 POST Work: LIGHTS Owner Contractor ROBERT GARCIA GUTTERS N COVERS CONSTRUCTION INC 25575 PELION RD 19069 VAN BUERN BOULEVARD#114 MENIFEE,CA 92584 RIVERSIDE, CA 92508 Applicant Phone:9516728022 SEAN DARE License Number.945962 GUTTERS N COVERS CONSTRUCTION INC 19069 VAN BUERN BOULEVARD#114 RIVERSIDE,CA 92508 Fee Description City Amount 151 Receptacle, Switch,Outlet& Fixture 2 121.00 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 $289.65 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 carded 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_Pe"it_Templale.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ lam 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 in Professions Code and my license is in full force and effect. which I must have resided for at least one year prior to completion of License Class ��(��(pZ U Improvements covered by this permit, I cannot legally sell a structure that I have Expires l��hb-17U((o Signaturee�o. built as an owner-building if it has not been constructed in its entirety by licensed contrectors. I understand that a copy of the applicable law, Section 7044 of the WORKERS'COMPENSATION DECLARATION 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 perjury one the following tions; htto://www.leginfo.ca.govicalaw.html. I have and will maintain a certificate of consentt for workers;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 fallowing: I am the property Ep 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 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 ( construction.I authorize representatives of this city or county to enter the above- Carrier identified property for the'As ,pection purposes. / Policy#�..✓�-(r�iC�(.�� Expires 2 U - Date / t1l!J6 Props -er-AWhorized-A nt C (This section need not be completed if the permit Is for �7 City Business License# one-hundred dollars($100)or less) ❑ I certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION shall not emolov 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 forthX4th comply with those provisions.. �/ DYES f�JNO Applicant; Date;7/Z//G yL/I/� Will the intended use of the building by the applicant or future building occupant require a permit for the construction or modification from South WAR G: 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 FNO 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 of a school? LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES I�JNO CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD 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 S Safety Code,Section 25505 and 25534 concerning 3097 Civil Code) hazardous material re 'n . OWNER BUILDER DECLARATIONS YES --ff''``'�'' I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date J�AJ 1 license Law for the reason(s)indicated below by the checkmark(s)I have placed PROP 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: ❑ I, as owner of the ro www.epa.govAead or contact the National Lead Information Center at p perty; 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 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 BUILDING SAFETY PERMIT/PLAN CHECK APPLICATION '`Menifee DATE PERMIT/PLAN CHECK NUMBER f -� 1'� cot 94 TYPE: ❑COMMERCIAL aESIDENTIAL []MULTI-FAMILY ❑MOBILEHOME POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION []ELECTRICAL ❑MECHANICAL fF?NE ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK C as (� PROJECTADDRESS 'ed I l qc f�� y ed ASSESSOR'S PARCEL NUMBER !b1A91 DO ' LOT —I TRACT OWNER NAME ,/� /} v In ADDRESS ' S I C PHONE I" 1L42- EMAIL APPLICANT NAME ✓1 ('� ADDRESS ,,\\ lI PHONE Q07-?, EMAIL CONTRACTOR'S NAME Sears- OWNER BUILDER? ❑YES O BUSINESS NAME Q C/ryay ADDRESS r ,,�SU&� /I111� ftr\ �� U •-✓"" PHONE 9�1 (�7Z �V L� _ EMAIL CONTRACTOR'S STATEL''IC NUMBER 94S%ol- - LICENSE CLASSIFICATION VALUATION$ 3q`��-I}} 2- SQ FT L SQ FT APPLICANT'S SIGNATURE DATECITY STAFF USE ONLY DEPARTMENT DISTRIBUTION f A I'0 CITY OF�1FjlIFE5 VSINF$S NSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN l SMIP U�/'/� 57 INVOICE PAIDAMOUNT AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OcSH OCHECKM OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES 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 N, d�C U, LEDGER & TRACK o o INSPECTION REQUIRED L4 City of Menifee Building & Safety Dept. JAN 15 2016 CI Y OF MENIFEE B ILDING AND SAFETY DEPARTMENT Received PI AN APPROVAL R VIEWED BIdU4 U»; c 'A n.ival.of these plans shop ^ot be construed to he a permit for,or an api I l -al of,any violation of amj provisions of the federal,state or city reg Pions and ordinances. This set of approved plans must be kept on the jo sue until completion. I Cl I f2 I I 1 I r EI'y I i Z 112 I I I r I Lcx tce. 1 _ s�i�c1 _ I Lai+iee _ 10, Ono g