PMT16-02811 City of Menifee Permit No.: PMT16-02811
29714 HAUN RD. Type: Residential Addition
<A_CC_IELX1' MENIFEE,CA 92586
MENIFEE Date Issued: 08/26/2016
P E R M I T
Site Address: 28259 LOS CIELOS ST,MENIFEE, CA Parcel Number: 336-211-020
92586 Construction Cost: $1,500.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL ALUMINUM PATIO COVER 100SQFT SOLID
Work:
Owner Contractor
BRIAN FRICK GUTTERS N COVERS CONSTRUCTION INC
28259 LOS CIELOS 19069 VAN BUERN BOULEVARD#114
MENIFEE, CA 92586 RIVERSIDE, CA 92508
Applicant Phone:9516728022
TIERRE License Number: 945962
GUTTERS N COVERS CONSTRUCTION INC
19069 VAN BUERN BOULEVARD 9114
RIVERSIDE, CA 92508
Fee Description Qtv Amount
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
$168.65
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherv0se stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA Bldg_Perrn1tTemplate.rpt Page 1 of 1
City of M nifee
Building & S )ety Dept.
AUG 2 2016
Received
I :DG�:R & TRACK
E EC-4W gEQUIRE)
A
r'"ry OF MENIFEE
G AND SAFETY DEPARTMENT
N Al"PROVAL
PIVIEWEDBY
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1,Lit,aj V dINN of any provisions of the WeW,sW or city
�)11�'A 12111111111im. IhIS se,of approved Mans must be kept on the
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City ot Menifee
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION safety Dept.
AUG 2 6 201b
"Menifee
PPRAWlarl
DATE PERMIT/PLAN CHECK NUMBER b
TYPE: 0 COMMERCIAL �4ESIDENTIAL CMULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN
SUBTYPE: OADDITION OALTERATION ODEMCILITION OELECTRICAL OMECHANICAL
XNEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER ?>*3(0 6 2-D LOT 70 TRACT 1453 N 2-
OWNER NAME t)\'-1 1�fjj C,
ADDRESS 2'0'Z�>Cj Ci e,� ',-)k�_n CL3&4 M 9 ZsSLo
PHONE '60S q-s-41� EMAIL
APPLICANT NAME V,--, V'� CJO,�PA
ADDRESS 16Z-L A-\�e_ Sj�_&*fLj V6yv�s CK qZ�5=r/
PHONE % CIS) EMAIL
CONTRACTOR'S NAME U OWNERBUILDER? OYES,"O
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER 9(�JS962_ LICENSE CLASSIFICATION
VALUATION$ SQ FT LSQFT
APPLICANT'S SIGNATURE INQ,� DATE
CITY STAFF USE ONLY
IJLPARTM%NT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GkEN 5 IP
INVOICE PAIDAMOUNT �
AMOUNT 151�5. (Of' I OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES , PAIDAMOUNT CASH 0 CHECK# 0 CREDIT CARD ViSA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of AAenifee Building& Sofety Deportmeot 29714 Houn Rd. Meoifee, CA 92596 951-672-6777
www.cityofmenifee.us Inspection Request U170 951-246-6213
City Of Menifee
LICENSED DECLARATION
I hereby affirm under penalty or perjury that I am licensed under provisions of 0 1, as owner of the property an exclusively contracting with licensec
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044,Business and Profession!
Professions Codepr
. �d my license is in full and effec Code:The Contractor's License Law does not apply to an owner of a propert�
License Clasq J-_2 License No. 1. :� who builds or Improves thereon, and who contracts for the projects with i
Explres_q/,0�7 _ Signature licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
Ei I am exempt from licensure under the Contractors'State License Law for th-
D 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 4
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 c
Section 3700.of the Labor Code, for the performance of work for which this
permit is issued. improvements covered by this permit. I cannot legally sell a structure that I hav�
Policy# built as an owner-building if it has not been constructed in its entirety by license-
contractors. I understand that a copy of the applicable law, Section 7044 of th,
0 1 have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this applIcation 1
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:hftpi//www.leginfa.m.aov/calaw.htm].
permit is issued.My workers'compensation insyrance carder and policy number are:
C 1�i Property Owner or Authorized Agent Date
arrier , )Z�� A?Aa La
Expires__7AVd' Policy 1)
Name of Agent Phone# 0 By my Signature below, I certify to each of the following: I am the propert
owner or authorized to act on the property owner's behalf. I have read th!
(This section need D_ol be completed if the permit is for application and the information I have provided is correct. I agree to compi
one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to buildin
construction.I authorize 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 identified pmpWy for ttie inspection purposes.
shall not employ 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 Section 3700 of the Labor 7
I a praval _T
Code,I shall forthwith comply with tho, Props Own r or Authorized Agent DatV
Date;—el-'N )'(a_ Aippficar(t,.�"&Z��_ City Business License
I � /0
WARN[ : 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, OYES 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 ;, <NO EQUAL 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
3097 Civil Code) WILL THE INTENDED USE OF THE BUILDING BY THE
APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name []YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address 4NO FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
" DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
QWNER 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 EYES 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. 7;9�0 SCHOOL?
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
I HAVE READ THE HAZARDOUS MATERIAL
Provisions of the Contractor's State License Law (Chapter 9 (commencing with
Section 7000)of Division 3 of the Business and Professions Code)or that he of EIYES 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 ,�,00 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE SECTION 25505 25533 AND 25534 CONCERNING
0 1. as owner of the property, or my employees with wages as their sole HAZAKOOUS MATERIAL AEPOWYING.
compensation,will do( )all of or( ) porting of the work. and the structure is PROPER ER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code:
The Contractor's State License Law does not apply Ao an owner of a property X
Who, through employees' or personal effort, builds*or improves the property,
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).
�AASA- W-se.-
P-0- BOX 1107 WuTyieta CA 92564-1107 * 25190 3-fancock Ave. Suite A
951-698-4030 * .TaX 951-698-4469 * yoCanda@sCammgmt.com
ww-w.sCammgmt.com * www.facebook.com/51-ANNanagement
(We&&V the 9*4e�x Peemzelawd Awe -1987
Sun City Hermosa CCC
August 23,2016
Brian Frick
28259 Los Cielos Road
Menifee, CA 92586
RE. ArchitecturalApplication
Acet. #: 102600241 Property: 28259 Los Cielos Drive
Dear Homeowner(s):
Thank you for your interest in improving the community and your home. We are happy to
announce that upon review of your Architectural Application on August 21, 2016 the
Architectural Committee has APPROVED your request to install the patio cover, as stated on
your application.
All improvements must be completed within 90 days of approval.
We would like to thdnk you for your improvement within the Sun City Hermosa CCC. Enclosed
you will find a copy of your approved application.
By Direction of the Board of Directors,
Sincerely,
Yolanda Lam,Manager
Cerdfied Community Association Manager
As Agent for Sun City Hermosa CCC
cc: Board of Directors
21024