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PMT16-02784 City of Menifee Permit No.: PMT1 6-02784 29714 HAUN RD_ 'EXCCELA—> MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 08/24/2016 P E R M I T Site Address: 28581 PLANTAIN ST, MENIFEE, CA Parcel Number: 333-491-001 92584 Construction Cost: $5,700.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 660 SCI FT SOLID ALUMAWOOD PATIO COVER WELECTRICAL 3 POST LIGHTS Work: Owner Contractor PAUL HAMILTON PATIO GUY ALUMAWOOD CONTRACTOR 28581 PLANTAIN ST 41197 GOLDEN GATE CIR STE 108 MENIFEE,CA 92584 MURRIETA, CA 92562 Applicant Phone: 9513330056 LOIS MONTINI License Number:872839 PATIO GUY ALUMAWOOD CONTRACTOR 41197 GOLDEN GATE CIR STE 108 MURRIETA, CA 92562 Fee Description Qtv Amount($) Receptacle.Switch,Outlet&Fixture 3 126.00 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 6.30 $300.95 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 BldgPermit—Ternplate.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION I hereby affirm under penalty or pedury that I am licensed under provisions of 1, as owner of the property 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 aW my license is in full f0f d IT Code:The Contractor's License Law does not apply to an owner of a pmperly License Class License No. ig a� �14 who builds or improves thereon, and who contracts for the projects with a Expires te-Z D I L&gnature 5 2 licensed contractor(s)pursuant to the Contractors State License Law). WORKER&COMPENSATION DECLA ION 0 1 am exempt from ficensure under the ContradDIS'State License Law for the 0 1 hereby affirm under penalty of perjury one of the following declarations: following reason: I have and will 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 3700 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 0 1 have and will 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�.h1to"/Avww.Ieoinfo.ca.gov/caIaw.htmI. permit is issued.My warkers'compensation insurance carder and policy number are: Carrier Property Owner or Authorized Agent Date Expire Policy# 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 aDt be completed if the permit is for application and the information I have provided is correct. I agree to comply one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building cimstruction.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 identi yf a inspection urposes. shall not emplo 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 tion 3700 of the Labor Code,I shal)forthwith comply with those prm isions. Propedy or Authorized Age��t' Date Date: Applicant; I/City Business License# 10 4q 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, EIYES OCCUPANT HANDLEA HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS I hereby affirm 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... —SR9WTHE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address ONEY— DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR OWNER BUILDER DECLARATIONS GUIDE LINES I hereby affirm under penalty of perjury 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, 022--semou 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 nYES INFORMA11ON GUIDE AND THE SCAOMD 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($500).) CODE, SECTIO 25505. 25533 AND 25534 CONCERNING NG. 0 1, as owner of the property, or my employees with wages as their sole RDOUS M RIAL REPOW compensation,will do( )all of or( )porting of the work,and the structure is I R A GE 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 property, \J 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). BUJI-DI NG & SAFETY PERM IT/PLAN CHECK APPLICATION DATE 3 PERMIT/PLAN CHECK NUMBER TYPE: 0 COMMERCIAL 0 RESIDENTIAL 0 MULTf-FAMILY 0 MOBILE HOME 0 POOL/SPA 0 SIGN SUBTYPE: 0 ADDITION 0 ALTERATION 0 DEMOLITION 0 ELECTRICAL 0 MECHANICAL #NEW OPLUMBING 0 RE-ROOP-NUMBER OF SQUARES_ DESCRIPTION OF WORK 0�77DO-Z' 2 +13-r L194TS PROJECTADDRESS I/jpl / p J ASSESSOR'S PARCEL 190MOER LOT 'R-�' TRACT Z)l 4-615 OWNER NAME ADDRESS / -0�1 1 '�;4,94 11/0 0 1 �fA ' PHONE z1b cR kMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNERBUILDER? 0YESdNO BUSINESS NAME ADDRESS :yl/ 9// PHONE CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION SQ FT Z) L SO FT APPLICANT'S SIGNATURE(-:F rij- DATE �3 DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE AMOUNT PAIDAMOUNT =OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMQUNT I 1 0 CASH 0 CHECK# 0 CREDIT CARD VISA/Mc [OWNER BUILDER VERIFIED YES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO Mer.ifee. CA9251'�- Requej Li e '61 2 213 L x / qO ' I an, --e :r X�� S b L IL L;EDGER 4 RACK -N PECTION REQUIRED k,;)4- P'h to LArm L&T-. b-P Somr , 6 to r) F MENJFEE MNLj OM�EPARTMENT 11#4 FfE =1 5 ej;E'IA&�W4 LD I *Approval of these plans shall not be!.omtrued to be a permit for,or i I app.oval of,any violation of any prov7sions of the federal,state or city regulations and ordinances. This set of approved plans must be kept c t the jobsite until completion. Wft�Me.+D r.,X:!aAr—D lit I PL, 7a br%41. S 4 ZO, 3-1 j_S YY) N I I:-- C--C— Wark "MP-4MIX3440 WILOC.