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PMT16-02814 City of Menifee Permit No.: PMT16-02814 29714 HAUN RD. Type: Residenfial Addition 45ACCIELA> MENIFEE,CA 92586 MENIFEE Date Issued: 08/2612016 P E R M I T Site Address: 30317 SILICATE DR, MENIFEE, CA 92584 Parcel Number: 360-810-067 Construction Cost: $5,665.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 420 SO FT ALUMAWOOD PATIO COVER WELECTRICAL 2 FANS, 3 POSTUGHTS, 1 Work: SWTCH Owner Contractor JOHN EBERHARDT GUTTERS IN COVERS CONSTRUCTION INC 30317 SILICATE DR 19069 VAN BUERN BOULEVARD#114 MENIFEE, CA 92584 RIVERSIDE, CA 92508 Applicant Phone:9516728022 TIERRE AMANSA License Number: 945962 GUTTERS N COVERS CONSTRUCTION INC 19069 VAN BUERN BOULEVARD#114 RIVERSIDE, CA 92508 Fee Description Qtv Amount Receptacle, Switch, Outlet&Fixture 6 141.00 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 7.05 $316.70 The issuance of this pemit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing builiding operations being carded 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_Btdg_PennitTernp1ate.rpt Page 1 of 1 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 license( Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044,Business and Profession: Professions CodepM my license is in full 0 and effec Code:The Contractor's License Law does not apply to an owner of a proper� License Clas* IF-) License No. who builds or improves thereon, and who contracts for the projects with i Expires AN-q. - Signature �� I- licensed contractor(s)pursuant to the Contractors State License Law). - T� _��11 llr�11 _ WORKERS'COMPENSATION DECLARATION [I I am exempt from ficensure under the Contractors'State License Law for th, El I 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 h 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 ficanse- 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:htto,/A�.leginto.�.goy/calaw.htmI permilt is Issued.My workers'compensarion Insyrance carder and policy number are: Carrier 'ci cuo z;-& &AO)LO-P Property Owner orAulhorized Agent Date Expires 7/11 Policy# !iwa/) I zice )_ 0 By my Signature below, I certify to each of the following: I am the propert Name of Agent <Zk�0%f;� Phone owner or authodzed to act on the property owner's behalf. I have read thi (This section need not be completed if the permit is for application and the information I have provided is correct. I agree to compl 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 pro dy for lifle inspection purposes. shall not employ any persons in any manner so as to become subject to the PIP, workers'compensation laws of California, and agree that if I should become 7 subject to the workers'compensation provisions of Section 3700 of the Labor Code,I she forthwith comply with those provislo Property Ownor or Authorized Agent DO 9 I e Applicant; City Business License# 052L5E '7 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 kUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING ($100,000). IN ADDITION TO THE COST OF COMPENSATION, []YES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES KNO EQUAL TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS I hereby affirm that under the penalty of pedury 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 Nam []YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address 4NO FROM THE SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)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. _,RNO 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 provisions of the Contractor's State License Law (Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL Section 7000)of Division 3 or the Business and Professions Code)or that he or C]yES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from ficensure 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 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE. SECTION 25505 25533 AND 25534 CONCERNING as owner of the property, or my employees with wages as their sole HjAZARDOUS TERIAL AEPORING. compensation,will do all of or porting of the work, and the structure is PROPE4R , ER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; X The Contractor's State License Law does not applyto an owner of a property who, through employees' or personal effort, builds*or improves the property, Provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder Will have the burden of proving that it was not built or improved for the BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION _..."Menifee DATE PERMIT/PLAN CHECK NUMBER TYPE: 0 COMMERCIAL __�RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME OPOOL/SPA OSIGN SUBTYPE: ADDITION C)ALTERATION ODEMOLITION C) ELECTRICAL OMECHANICAL ZW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK e7_,�� 3�d,,Vas PROJECTADDRESS ASSESSOWS PARCEL NUMBER "50A-0biLOT TRACT 151*bJ0 OWNERNAME ADDRESS PHONE _ZC�26 EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME __tjeWl'_ J6frV\JkV\%e_Q OWNERBUILDER? OYESONO BUSINESS NAME C75��r,� ADDRESS CA q7S4A PHONE Cfj;� EMAIL CONTRACTOR'S STATE LIC NUMBER ':�LA,SCj(0'X LICENSE CLASSIFICATION VALUATION$ SQ FT LSQFT APPLICANT'S SIGNATURE DATE rA. DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE I PAIDAMOUNT I , AMOUNT 4ji kP.29 1 c)CASH 0 CHECK# 0 CREDIT CARD VISAIMC PLAN CHECK FEES I PAID AMOUNT I 1 0 CASH 0 CHECK# 0_CREDIT CARD VISA/MC OWNER BUILDER VERIFIED 0 YES 0 No DLNUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofmenifee.us Inspection Request Line 951-246-5213 LEDaR &-TRACK ��'.ISPEUTIOM REOUIRF-r� ity of Menifee Bull ng & Safety Dept. C11 ;Y OF MENIFEE AUG 2 5 2016 BULDING AND SAFETY DEPARTMENT Received P AN APPROVAL RE 1EWED ByAtl-910 DAITE *Ap� oyal of these Pldns shall n nstrued to be a permit for,or an A nt FYgc&)f M ifeeept S t le ,)F)yn app)�val of,any violation of ativ Pro Jons of the federal,state or city regu; wns and ordinances. Thil, set oflapproved plans must be kept on the jobsit until completion, 0 A mr 70 mkw\��m oof V� CrDI �qq 'Y4'Z6 1�CrT TC6CPCE-