PMT16-02399 City of Menifee Permit No.: PMT16-02399
29714 HAUN RD. Type: Residential Addition
":A— MENIFEE,CA 92586
MENIFEE Date Issued: 0 712612 01 6
T
Site Address: 28834 PORTSMOUTH DR, MENIFEE, CA Parcel Number: 339-162-009
92586 Construction Cost: $6,600.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 490 SF SOLID AND 225 SF LATTICE ALUMAWOOD PATIO COVER WITH 2 POST LIGHTS
Work:
Owner Contractor
JAY JONES GUTTERS N COVERS CONSTRUCTION INC
28834 PORTSMOUTH DRIVE 19069 VAN BUERN BOULEVARD#114
MENIFEE,CA 92586 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 Oft Amount
- _. .. Fixture
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
00
General Plan Maintenance Fee- Building 1 6.65
-DI 1 - -
$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 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 it
Professions Code an ny license is in full force and effep. / which I must have resided for at least one year prior to completion-.o
License Clas Licen �( l 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 entirety by licensec
contractors. I understand that a copy of the applicable law, Section 7044 of the
WORKERS'COMPENSATION DECLA TION Business and Professions Code,is available upon request when this application it
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one the following declarations: htto://www.leeinfo.m.eov/calaw.html.
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 orAulhorized Agent
Policy# ❑ By my Signature below, I certify to each of the following: I am the properq
❑ 1 have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owners behalf. I have read thie
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 compll
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
construction. aul prize representatives of this city or county to enter the above
Carder 0{�1/ identified p ly for the i1 specti purposes.
Policy# Lel os d Lg Expires ��I �� caaas�— Date l lrs
—� Property OWner or Authorized Agent
(This section need not be completed if the permit is for p3CY•fc.
one-hundred dollars($100)or less) City Business License# JJJ
❑ 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 forthwith comply with those provisions.
1 DYES IAI NO
Applicant,41 Ee^,-- `'/171 Will the in1t`en led 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 15 UNLAWFUL, AND SHALL for guid Ines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES YJ NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the prbposed 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 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 Cade,Section 25505 and 25534 concerning
3097 Civil Code) hazardous maten. Ire orting.
OWNER BUILDER DECLARATIONS DYES �ryI
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 'u>y`- Date
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OM 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(RR-Pi
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
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 Stale 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 Firm 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
whn huilde nr imnrnvnc Ihn.en and whn rnnrrark fnr Iho nrnipMc ,uieh a
1
i
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICAT ION
DATE PERMIT/PLAN CHECK NUMBER -
TYPE: []COMMERCIAL ❑✓ RESIDENTIAL MULTI-FAMILY []MOBILEHOME POOL/SPA SIGN
SUBTYPE: ADDITION ALTERATION DEMOLITION ELECTRICAL ❑MECHANICAL
NEW []PLUMBING []RE-ROOF-NUMBEROFSQUARES
DESCRIPTION OF WORK ALUMINUM PATIO COVER, 490 SQ.FT.SOLID,225 SQ.FT.LATTICE.WI2 POST LIGHTS
Ulty at enI ee
PROIECTADDRESS 28834 PORTSMOUTH DR.SUN CITY,CA 92586 Building & Safety Dept.
ASSESSOR'S PARCEL NUMBER LOT TRACT JUL
PROPERTY OWNER'S NAME JAY JONES
ADDRESS 28834 PORTSMOUTH DR.SUN CITY,CA92586 Received
PHONE (951)639-7443 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 CONSTRUCTION INC. OWNERBUILDER? ❑YESQNO
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$ $6,600.00 SO FT 490 SOLID 1225 LATTICE L SQ FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE �d C� PAID AMOUNT Q�
AMOUNT _1J 1 1 CASH 0 CHECKri CREDFT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH C'CHECK# CREDITCARD VISA/MC
OWNER BUILDER VERIFIED '' YES v NO DLNUMBER N6TA012tDLETTER ^ YES C' NO
City of,V?enifee Building&Safety Department 29714 Houn Rd. Menifee, C4 92586 951-572-5777
www.cityofinenifee.us Inspection Request Line 951-246-6213
CL
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ON
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a INSPECTION REQUIR Q
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City of Menifee
t Bu ]ding & Safety Dept.
(D JUL 2 6 2016
Received
CITY
BUILDING AND SAFETY DEPARTMENT
PLAN APPROVAL
Q REVIEWED BY n n4�A� �r�la Il DATE
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U *Approval of these plans shall nct be construed to be a perm b Q y
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approval of,arty violation of any provisions of the federal,state or city
regulations and ordinances. This set of approved plans must be kept on the
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