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PMT16-01167 City of Menifee Permit No.: PMT16-01167 29714 HAUN RD. Type: Residential Addition �A_CCEL/? MENIFEE, CA 92586 MENIFEE Date Issued. 0411812016 PERMIT Site Address: 29453 LONGLEAF DR, MENIFEE,CA Parcel Number: 333-500-028 92584 Construction Cost: $4,500.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 516 SQ FT SOLID ALUMAWOOD PATIO COVER WIELECTRICAL 2 FANS Work: Owner Contractor CLIVE CALDER GUTTERS N COVERS CONSTRUCTION INC 29453 LONGLEAF DR 19069 VAN BUERN BOULEVARD#114 MENIFEE, CA 92584 RIVERSIDE, CA 92508 Applicant Phone: 9516728022 REBECCA HALL License Number:945962 GUTTERS N COVERS CONSTRUCTION INC 19069 VAN BUERN BOULEVARD#114 RIVERSIDE, CA 92508 Pee Description 9!Y Amount 1E1 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 General Plan Maintenance Fee-Electrical 1 6.05 $295.70 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 it 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 Professions Code an y license is in full force and effect. which I must have resided for at least one year prior to completion License Class Uce o. N Z improvements covered by this permit, I cannot legally sell a structure that I hat Expires `L/Zo I lb Signature built as an owner-building if it has not been constructed in its entirety by IicensE contractors. I understand that a copy of the applicable law, Section 7044 of if WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application submitted or at the following Web site: ❑ 1 hereby affirm under penalty of perjury one of the following declarations: htt • r.le i fo. ov/calaw.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 or Authorized Agent Policy# ❑ By my Signature below, I certify to each of the following: I am the proper )9�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 th 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 comp permit is issued.My workers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to buildln construction.I auth rize representatives of this city or county to enter the above Carrier &O—i W ✓I_� aNn nu.e. identifis action purposes. Policy# SL.vr. (C :LLoto� Expires 7 ha-insp j�31 /& Date Z— ZS-Ib Property eror Authorized Agent c (This section need not be completed if the permit is for City Business License# one-hundred dollars($100)or less) HAZARDOUS MATERIAL DECLARATION ❑ 1 certify that in the performance of the work for which this permit is issued,1 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 E 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 h 'th omply with those provisions. OYES.-�NO Applicant: Date; 2-2q-- V, 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 guideli es SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND ❑YES, 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 of a school? LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑YES,'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&Safety Code,Section 25505 and 25534 concerning 3097 Civil Code) hazardous material reporting. OWNER BUILDER DECLARATIONS ,t:JYES ❑NO I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date 2-2r7—16 License Law for the resson(s)indicated below by the checkmark(s)I have placed PROPEIT[YIlAiNER 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(RRPI 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 EPNs Renovation Program visit: ❑ I, as owner of the roe www.epa.gov/lead or contact the National Lead Information Center at property,rty, 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 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 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. �h BUILDING SAFETY PERMIT/PLAN CHECK APPLICATION &�i 1 e DATE PERMff/PLAN CHECK NUMBER (" 1 I '�O� O'I TYPE: []COMMERCIAL QRESIDENTIAL []MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA []SIGN SUBTYPE: ❑ADDITION []ALTERATION []DEMOLITION [—]ELECTRICAL []MECHANICAL ❑NEW ❑PLUMBING ORE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK ALUMINUM PATIO COVER,SOLID,516 SQ.F7.Wt 2 CEILING FANS PROJECT ADDRESS 29453 LONGLLEAF DDR.MENIFl!EE�E,CA 92558Q84 11 ASSESSOR'S PARCEL NUMBER J -✓�� V� V LOT 4�2S TRACT 3�45 PROPERTY OWNER'S NAME CLIVE CALDER ADDRESS 29453 LONGLEAF DR.MENIFEE,CA 92584 PHONE (951)434-9818 EMAIL APPLICANT NAME REBECCA HALL ADDRESS 19069 VAN BUREN BLVD.#114-247,RIVERSIDE,CA 92508 PHONE (951)672-8022 EMAIL CONTRACTOR'S NAME GUTTERS N COVERS OWNER BUILDER? ❑YES❑✓NO BUSINESS NAME 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$ $4,500.00 k SOFT 516 L SQ FT APPLICANT'S SIGNATURE yy DATE a�,� // w ,d 1 iL ' �_ 1L a '� 4 rti�,,,7y i I - ry �.•) ,� 3i el'.fs`a i, .�'. , 3t. vJ'r A`.�'�k 1a�14�c,. 1 dr�i„I'm,iw13*Ni'h �, ,. x.." 7'',Y '�. ., " +r, xl ',€ix1F.4'Il DEPARTMENT DISTRIBUTION �� CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE 1 ;;� �-7 AMOUNT PAID AMOUNT CASH %CHECKN ,u CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT •C,CASH O CHECK O CREDITCARD VISA/MC OWNER BUILDER VERIFIED YES O NO DL NUMBER NOTARIZED LETTER O YES G NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 vInymcityof nenifee.us Inspection Request line 951-246-6213 City of Mentfee J Building & Safety Dept. d APR 18 2016 I MACK �,±� REQUaREr l i Z` S` r^ d as I V Q.�-- - I`Q a Ib% > 15.— C,""' CF MENIFEE ,i AND SAFET`! DEPARTMENT r f'l.i'-,i APPROVAL A r r REVIWED BYI� 50 DATE I Of these plans Shai: „r;lraed to 5e a permit for,or an any violatior r.r on ; �, si .r:,Of the federal,state or city _ FAN and ordinances. This set of approved plans must be kept on the CI COVe.- 2C>�-IS 3 Lov) � l i'hwkv-t C IA-q 1V6q P: q5t Ll- q gb1b ��. (mac SCALL V(y-9ue: "5za.-