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PMT16-02536 City of Menifee Permit No.: PMT16-02536 29714 HAUN RD. �I►CGELh7 MENIFEE, CA 92586 Type: Residential Addition um,......xu n. MENIFEE Date Issued: 08/0512016 PERMIT Site Address: 30354 SILICATE DR,MENIFEE, CA 92584 Parcel Number: 360-810-059 Construction Cost: $4,432.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL ALUMINUM PATIO COVER-504 SOFT SOLID 2 FANS Work: Owner Contractor WILLIAM GOLDSBY GUTTERS N COVERS CONSTRUCTION INC 30354 SILICATE DR 19069 VAN BUERN BOULEVARD#114 MENIFEE,CA 92584 RIVERSIDE, CA 92508 Applicant Phone: 9516728022 TIERRE License Number: 945962 GUTTERS N COVERS CONSTRUCTION INC 19069 VAN BUERN BOULEVARD#114 RIVERSIDE, CA 92508 Fee Description ON 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 property who builds or improves thereon,and who contracts for the projects I hereby affirm under penalty of per jury 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 o I am exempt from licensure under the Contractor's State License Law for Professions Cade and my license is in full force and effect. p4 the fallowing reason: License Class License No. —/NJ/b Z By my signature below I acknowledge that,except for my personal residence Expires Z 14 Signature /iI n/� 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 COMP NSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by D 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 workers 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 or at the following website: by Section 3700 of the Labor Code,for the performance of work for which www.leeinfo.ca.eov/calaw.html. this permit is issued. Policy# Date 4)have and will maintain workers compensation insurance,as required by `PROPERTY OWNER OR AUTHORIZED AGENT ction 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 workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this number are: a application and the information I have provided is correct.I agree to comply Qpn4 �� Q-;�� . 1 with all applicable city and county ordinances and state laws relating to Carrier ..�LIL 7s�n V .l 1 „All///��... -y building construction.l authorize representatives of this city or county to Policy#St.&3C IOW100k, Expires l enter thpbove identified property for inspection purposes. L, (This section need not to be completed is the permit is for one-hundred / /' Date J 16 dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is issued, �� Z I shall not emolov 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 compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. WIII the applicant or future building occupant handle hazardous material or Applicant Dale mixture containing a hazardous material equal to or greater that the amounts pecified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ayes UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL 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)7 See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forgu'deli es CONSTRUCTION LENDING AGENCY D Yes I;" I 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 school? / (Section 3097 Civil Code) ❑Yes grvo! OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist I understand my requirements under the State of I hereby affirm under penalty of perjurythat I am exempt from the Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 '�hcanszardous mat!r eporting. Business and Professions Code).Any city or county that requires a permit to i°"es D No C/ Date D construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT 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 Contractors 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 Iicensure 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 D I,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.eoa.eov/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 D 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 Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. D No EPA Lead-Safe Certified Firm is required for this project because: o I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RAP rule please fill out the RRP Acknowledgement & SAFETY PERMIT/PLAN CHECK APPLICATION AUG 0 5 2016 Menifee DATE S kj PERMIT/PLAN CHECK NUMBER ?M 0253 TYPE: G COMMERCIAL RESIDENTIAL G MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL ^. MECHANICAL O NEW O PLUMBING O(R�E,�--ROOlOF-NUMBER OF SQUARES DESCRIPTION OF WORK V.%1l_C� �j U PROJEcTADDRESSppC,� �Vq� ASSESSOR'S PARCEL tNUMBER O � tlIC) ' V� 1 LOT �� TRACT OWNER NAME 3' C),-VVV ADDRESS —'OLS� C &Y Aee 9 PHONE 9 ZS qS/�G p /b-3q�9 II EMAIL APPLICANT NAME ` 1 N ocYSJ n ADDRESS kC4 q � aV\ � \�C.l - PN Z V51d C) ZSdK PHONE EMAIL CONTRACTOR'S NAME ��A. � Gt.} V 4 I OWNER BUILDER? O YES ONO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER Z LICENSE CLASSIFICATION 7 VALUATION$ y L G SO,FT ;bq L SQ FFTT APPLICANT'S SIGNATURE DATE D 10 DEPARTMENT DISTRIBUTION CITY OF M ENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GRIEN SMIP 1 INVOICE -- l PAID AMOUNT G CASH G CHECK# O CREDIT CARD VISA/MC AMOUNT m PLAN CHECK FEES PAID AMOUNT GCASH 0 CHECK# G CREDIT CARD VISA/MC. OWNER BUILDER VERIFIED G YES O NO DL NUMBER NOTARIZED LETTER O YES G NO City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-6 72-6 7 77 www.cityofinenifee.us Inspection Request Line 951-246-6213 CITY OF MENIFEE BUILDING AND SAFETY DEPARTMENT City of Menifee Building & Safety Dept. ra 0-AN APPROVAL AUG 0 5 2016 0 0 REVIEWED BY Pk ?A 1 I(/ DATE Received l LL 'Approval of these plans shall not be construed to be a permit for,or an t [� !!�� U- appiovalof,any violation of any provisions of the federal,state or city LEDGER & E-r i ACK 0 regulations and ordinances. This set of approved plans must be kept on the INSPECTION ION REQUIRED jobsite until completion, n"J f/ M � i ❑ Q 3b` � n I L—r N I &6) INN VO 01'z5 b-5401 SOT "Co uLl.5