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PMT16-00166 City of Menifee Permit No.: PMT16-00166 29714 HAUN RD. Type: Residential Addition -ACCELAl7 MENIFEE, CA 92586 MENIFEE Date Issued: 01/21/2016 PERMIT Site Address: 29200 KINGFISHER CT,MENIFEE, CA Parcel Number: 364-240-040 92584 Construction Cost: $3,465.00 Existing use: 1 &2 Family Residence Proposed use: Description of INSTALL 17 X 30'SOLID ALUMAWOOD PATIO COVER WITH 1 FAN, 2 POST LIGHTS, 1 GFI OUTLET Work: Owner Contractor RUBY ARELLANO ALUMACOVERS OF CALIFORNIA INC 29200 KINGFISHER COURT 6185 MAGNOLIA AVENUE SUITE#23 MENIFEE,CA 925B4 RIVERSIDE,CA 92506 Applicant Phone:6269349200 PHILLIP GREEN License Number: 995932 ALUMACOVERS OF CALIFORNIA INC 6185 MAGNOLIA AVENUE SUITE#23 RIVERSIDE,CA 92506 Fee Description ON Amount 1$) Receptacle, Switch, Outlet&Fixture 4 131.00 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 $299.65 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 ❑ 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 /J License No. improvements covered by this permit, I cannot legally sell a structure that I have Expires Signature built as an owner-building if it has not been constructed in Its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the WORKERS'COMPENSATION DEC WC 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 declarations: hfto:/Ay%w.leainfo.m.goy/mlaw.htmi I have and will maintain a certificate of consentt 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 cerfify 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 this s ' n 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is cored. 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 building �y /7 construction.I authorize representatives of this city or county to enter the above- Carrier .SLyi'-Ze- identified property for the inspection purposes. Policy# 7�/�t�`�/ Expires - & "I Date Property Owner orAuthorized Agent (This section need not be completed if the permit is for 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 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'Gosation provisions of Section 3700 of the Labor amounts s Pacified on the Hazardous Materials Information Guide? Code,I shall forth o pi ith those provisions. ❑YESO Applicant; Date; � Will the intended use of the building by the applicant or future building occupant require a permit for the construction or modification from South W NIN F [LURE TO SECURE WORKERS' Coast Alr Quality Management District(SCAQMD)?See permitting checklist COMPENSATI COVERAGE IS UNLAWFUL, AND SHALL for guldelires SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND ❑YES O CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, WIII 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 ❑/,N0 CONSTRUCTION LENDING AGENCY I have redd the gZH ardoys Material Inform on G de and the SCAQMD I hereby affirm that under the penalty of perjury there is a construction lending permitting the i t.I u erstand my re an under the State of agency for the performance of the work which this permit is issued (Section CaliforniatN alt &S" ty Code,Sec' 505 and 25534 concerning 3097 Civil Code) hazardo dal porting. OWNER BUILDER DECLARATIONS ❑YES � — /- ,, //_(` I hereby affirm under penalty of perjury that I am exempt from the Contractor's 1 Date C/ tF License Law for the reason(s)indicated below by the checkmark(s)I have placed PR R . OWNER OR ALIT O IZED AGE T next to the applicable item(s)(Section 7031.5. Business and Professions Code: EP RENOVATION.REP R A INTING RRPI 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 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 property, or my employees with wages as their sole www.epa.gov/lead or contact the National Lead Information Center at compensation,will do( )all of or( )porting of the work,and the structure is 1-800-424-LEAD(5323). 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/.PERMIT/PLAN CHECK A. • • ."Menifee DATE 2 PERMIT/PLAN CHECK NUMBER ILO Lo TYPE: O COMMERCIAL RESIDENTIAL C MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION OALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 1-21,.jO S'O/� ,a d<9/U� '�✓�-�^ <`�-��° 'O✓9� /Ni' PROJECTADDRESS Gqla00 ASSESSOR'S PARCEL NUMBER ��Lty- a�Q'bC.(Q LOT TRACT OWNER NAME ADDRESS PHONE JO/- EMAIL City of Menifee q APPLICANT NAME //, ° Gj-��- building & y ep . ADDRESS ,rss' ayr PHONE EMAIL Rpceived CONTRACTOR'S NAME &VC41' �'�ll� �/'''9 OWNER BUILDER? OYES �010 BUSINESS NAME of O ADDRESS Jtir!>' /W ,a -C f/C -,�gS PHONE (p rLG • IpGG/- &L17 EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ '�`/VS' SQFT 3�� LSQFT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE ,,tt PAID AMOUNT 1- O AMOUNT ' t05 ' tcS OCASH CHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# 0CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O 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 3 73 6*1 3 ni cn r m � o � O m a o 0 m V1 � o � s -0:0 .nr3 � p rn � A a m W 3 3 n z � CD w 3 m m , OFFICE COPY