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PMT16-00852 City of Menifee Permit No.: PMT16-00852 29714 HAUN RD. �CCEL/-> MENIFEE,CA 92586 Type: Residential Addition MENIFEE Date Issued: 0 312 212 01 6 PERMIT Site Address: 27753 WHITTINGTON RD, MENIFEE,CA Parcel Number: 336-491-012 92584 Construction Cost: $3,550.00 Existing Use: 1 &2 Family Residence Proposed use: Description of INSTALL 300 SF SOLID ALUMAWOOD PATIO COVER WITH 2 FANS Work: Owner Contractor JOAN&MIKE DINGMAN GUTTERS N COVERS CONSTRUCTION INC 27753 WHITTINGTON ROAD 19069 VAN BUERN BOULEVARD#114 MENIFEE,CA 92585 RIVERSIDE, CA 92508 Applicant Phone:9516728022 REBECCA HALL License Number:945962 GUTTERS N COVERS CONSTRUCTION INC 19069 VAN BUERN BOULEVARD#114 RIVERSIDE, CA 92508 Fee Description Qtv Amount($) 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 builiding 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_Permit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. .J the following reason: License Class 13 License N I 2 By my signature below l acknowledge that,except for my personal residence Expires 4 20) Signature in which I must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by ❑I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon request when compensation,issued by the Director of Industrial Relations as provided for this application is submitted r at the following website: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. www.le ' w.h I. 7 f Policy# Date t51 have and will maintain worker's compensation insurance,as required by PROPERTY OW AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which ❑By my signature below I certify to each of the following:I am the property this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number are: �) application and the information I have provided is correct.I agree to comply Carrier St! Act j Os J with all applicable city and county ordinances and state laws relating to building tru n.I uthorize representatives of this city or county to Policy# Sa,r7�' i [Lf TOOL, Expires,�7(Z-3�((e enterte ei nti property for inspection purposes. (This section need not to be completed is the permit is for ane-hundred Date 3 •ZZ•(,a dollars($100)or less PROPERTY dKNERWAOR15RIZED AGENT ❑I certify that in the performance of the work for which this permit is Issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers mpensation provisions of Section 3700 of the Labor Code,I shall forthwith co 1ply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date 'S'71• 16 mixture containing a hazardous material equal to or greater thatthe amounts specified on the Hazardous Materials Information Guide? WARNING:FAIL ETO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes .9lp UNLAWFUL,AND SHALL SUBIECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND OVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguideli es CONSTRUCTION LENDING AGENCY ❑Yes :Jo [hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) ❑Yes a(No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist I understand my requirements under the State of California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the ha ardous material re rtin;. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ❑No Business and Professions Code).Any city or county that requires a permit to Date �•LZ•16 construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNE OR ORIZ DAGENT issuance,also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contactors State EPA RENOVATION,REPAIR AND PAINTING(RRP[ License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their ❑1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within One year of Firm Certiflmtion No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑I,as owner of the property am exclusively contacting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contactors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION 4LMenlfee DATE 03/22/2016 PERMIT/PLAN CHECK NUMBER P TYPE: [-]COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA El SIGN SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION [-]ELECTRICAL [-]MECHANICAL ❑✓ NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK ALUMINUM PATIO COVER,300 SQ.FT.,SOLID,ATTACHED,2 CEILING FANS,3 FOOTINGS PROJECTADDRESS 27753 WHITTINGTON RD (� ASSESSOR'S PARCEL NUMBER LOT TRA7q City of Menifee foil PROPERTY OWNER'S NAME UOAN&MIKE DINGMAN ADDRESS 27753 WHITTINGTON RD.MENIFEE,CA92585 ,..p PHONE (310)390-5477 EMAIL '"'�eceived APPLICANT NAME REBECCA HALL ADDRESS 19069 VAN BUREN BLVD.#114-247, RIVERSIDE,CA 92508 PHONE (951)672-8022 EMAIL CONTRACTOR'S NAME OWNER BUILDER? ❑YES©NO BUSINESS NAME GUTTERS N COVERS ADDRESS 19069 VAN BUREN BLVD.#114-247,RIVERSIDE,CA 92508 PHONE (951)672-8022 EMAIL CONTRACTOR'S STATE LIC NUMBER 945962 LICENSE CLASSIFICATION B VALUATION$ $3,550.00 FT 300 LSQFT APPLICANT'S SIGNATURE DATE 2- - 1111, DEPARTMENT DISTRIBUTION 11 CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP Is INVOICE PAID AMOUNT AMOUNT ^CASH CCHECK# :CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 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 1 MEN MEN 1 ■ ■■■1airry ' ■ " ■f� '�i'■Q 1 im _ • ry�n��INA �_�: j d �■■!