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PMT16-02766 City of Menifee Permit No. PMT16-02766 29714 HAUN RD. Type: Residential Addition <^—CCEU:A—> MENIFEE, CA 92586 SA— MENIFEE Date Issued: 0812312016 P E R M I T Site Address: 28029 MILL STREAM ST, MENIFEE, CA Parcel Number: 333-610-007 92586 Construction Cost: $5,500.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL=41 SOLID&9X21 LATTICE ALLIMAWOOD PATIO.2 FANS,2 LIGHTS Work: Omer Contractor MIKE HALL PATIO GUY ALUMAWOOD CONTRACTOR 28029 MILL STREAM 41197 GOLDEN GATE CIR STE 108 MENIFEE,CA 92586 M URRI ETA,CA 92562 Applicant Phone:9513330056 PATIO GUY ALUMAWOOD CONTRACTOR License Number:872839 41197 GOLDEN GATE CIR STE 108 MURRIETA, CA 92562 Fee Description QtV Amount 4$) Receptacle, Switch, Outlet&Fixture 4 131.00 Building Permit Issuance 1 27.00 DeckJPafio, 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 6.55 $306.20 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and spedfications or from preventing building 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 BidgPe"it—Template.rpt Page 1 of I City Of Menifee LICENSED DECLARATION I hereby affirm under penalty or perjury that I am licensed under provisions of 13 1, as owner of the properly an exclusively contracting with licensed Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044,Business and Professions Professions Code a my license is in full fog a d ff t Code:The Contractor's License Law does not apply to an owner of a property License Class_9!T License No. who builds or improves thereon, and who contracts for the projects with a Expires Le-_:2� J&-griature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION 0 ]am exempt from licensors under the Contractors'State License Law for the 0 1 hereby affirm under penalty of perjury one of the following declarations: following reason: I have and vvill maintain a certificate of consent of self-insure for workers' By my signature below I acknowledge that,except for my personal residence in compensation.Issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of Section 37DO of the Labor Code, for the performance of work for which this improvements covered by this permit,I cannot legally sell a structure that I have permit Is issued. built as an owner-building if it has not been constructed in its entirety by licensed Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the LI I have and Vill maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http,lhvww.leginfo-m.gov/mlaw.htmi permit is issued.My workers'compensation insurance carrier and policy number are: Carrier Property Owner orAuthorized Agent Date Policy# Expire E q Name of Agent Phone# 0 By my Signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this (This section need not be completed if the permit is for application and the information I have provided Is comect. I agree to comply one-hundred dollam-(S100)or less) with all applicable city and county ordinances and state laws relating to building construction.Athorize representatives of this city or county to enter the above- 0 1 certify that in the performance of the work for which this permit is issued,I idend shall not emolov any persons in any manner so as to become subject to the workers'compensation laws of California. and agree that if I should become subject to the workers'compensation provisions of i��fion 3700 of if.. TMMT� Code,I shal forthw! comply with those prov Isions. Property Owrfer or Authorized Agent- U Date Date; Applicant; City Business License# WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING ($100,000), IN ADDITION TO THE COST OF COMPENSATION, [1YES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MDCrURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES 9N9--rQ`UAL TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS I hereby affinirn that under the penalty of perjury there is a construction lending INFORMATION GUIDE? agency for the performance of the work which this permit is issued(Section WILL THE INTENDED USE OF THE BUILDING BY THE 3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION... ___FReM-THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR OWNER BUILDER DECLARATIONS GUIDE LINES I hereby affirm under penalty of pedury that I am exempt from the Contractor's PRINT NAME, License Law for the reason(s)indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable item(s)(Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A Any city or county that requires a permit to construct, alter. improve,demolish, 11!��L? 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 provisions of the Contractor's State License Law(Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL Section 7000)of Division 3 of the Business and Professions Code)or that he or E]YES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS Violation of Section 7031.5 by any Applicant for a permit subjects the applicant to 0��THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than(S500).) CODE,SECTIO, ...... .5533 AND 25534 CONCERNING 0 1, as owner of the property, or my employees with wages as their sole RDOUS M RIAL REPORTING. 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 who, through employees' or personal effort, builds or improves the propeft N—) provided that the improvements are not intended or offered for sale.If,however, 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 purpose of sale). Mentlee Safety De Z F 777M =2-2ni, 9 7016 Received DATE PERMIT/PLAN CHECK NUMBER u TYPE: OCOMMERCIAL ORESIDENTIAL OMULTI-FAMILY OMOBILEHOME 0 POOL/SPA 0 SIGN SUBTYPE: OADDITION OALTERATION ODEMOUTION DELECTRICAL 0, MECHANICAL @NEW OPLUMBING ORE-ROOP-NUMBEROFSQUAPES DESCRIPTION OF WORK -LA -A 141 Gr) L I b - !1 -/, a I I 14=)r-P 4L-Lim A - LAD66b amb , a FA-N-ozz, WC) PROJECTADDRESS k/ZddT. ASSESSOR'S PARCEL NUMBER (00 -00�hT TR ACT S41 �0 OWNER NAME kli�ILL ADDRESS -1sm PHONE EMAIL APPLICANTNAME ADDRESS PHONE EMAIL CONTRACTOWS NAME OWNERBUILDER? OYES ONO BUSINESS NAME 2a:�LkD ADDRESS P14ONE 0e) s-6 EMAIL fib 4ae-rOe OW17] CONTRACTOR'S STATE LIC NUM13ER ENSE CLASSIFICATION "V. -s-406 SQ IT L SO FT �LUATION$ s 1-1 RIJ1139 APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION Slip CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GRIEN INVOICE PAIDAMOUNT AMOUNT wo- �j I �_ CASH 0 CHECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES I PAIDAMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISAIMC OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LE17ER 0 YES 0 NO f Buiidirg& Soft,*v Dejp�rtmiem',1971 11 Rd. Men,�Me, CA 925'C95.1-C72 24C-6213 w 4 Build Y Of Menifee 11bl 9 & Safety Dept. / X G 2 3 2016 CE)iVed pt. J-X J, -1RAC K INSPECTION REQUIKI) D Z> L= L 9 2L 3�9 Will Z R;+1 z. . a L I 1� ��j - J"JI '15�GDO-11-YOFMENIFEE BUILDING AND SAFETY DEPA RT ENT REVIEWED BY DATE rora 'Approval of these plans shall not be �Tt � C458stq§d beaWmft*oran 0) ty aPP,oval of,any violation of a ny provjsions of th federal,state or city 1 ,3pp la ept on the regulations and ordinallices. This set of approve IM m7ust be kept on the jObsite until completion. s cl I — PC_=ZYMM y,y) 4� L 1- 0 guy 4UMIIU&4� C4 ch told %clfe a-Irck 4; Q ":� 1 ol � DA9 rn I LL 2 P,rY) CA. 4 a4R I c, 'y) _I 7—T