PMT16-02964 City of Menifee Permit No.- PMT16-02964
29714 HAUN RD.
<A_CCIELA_"> IMENIFEE,CA 92586 Type: Residential Addition
MENIFEE Date Issued: 09/0712016
P E R M I T
Site Address: 28253 OVERLAND CT, MENIFEE, CA Parcel Number: 372-290-001
92584 Construction Cost: $4,625.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 500 SQ FT SOLID ALUMAWOOD PATIO COVER NO ELECTRICAL
Work:
Owner Contractor
RICHARD RODRIGUEZ GUTTERS N COVERS CONSTRUCTION INC
28253 OVERLAND CT 19069 VAN BUERN BOULEVARD#114
MENIFEE, CA 92584 RIVERSIDE,CA 92508
Applicant Phone:9516728022
SEAN DARE License Number. 945962
GUTTERS N COVERS CONSTRUCTION INC
19069 VAN BUERN BOULEVARD#114
RIVERSIDE, CA 92508
Fee Description PIZ Amount M
Building Permit Issuance 1 27.00
Deck/Patio, non-standard 1 133.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1.00
General Plan Maintenance Fee-Building 6.65
$168.65
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of emors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA_Bldg_PerrrtrtTempIate.rpt Page 1 of 1
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
-w
M"Menifee
DATE PERMIT/PLAN CHECK NUMBER RM16000N)L4
TYPE: 0 COMMERCIAL �SRESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME () POOL/SPA 0 SIGN
NA
SUBTYPE: DDITION OALTERATION ODEMOLITION OELECTRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER
—001 LOT TRACT 9, gC59 0�_
OWNER NAME _,��Oricks_A vllzlsc��Ckgj�cz
ADDRESS 'Z`%2,c:—)z) C&
PHONE qS� -7—Z(3 EMAIL
APPLICANT NAME
ADDRESS �(n-n ILI qz,<S;:Fl
PHONE q�Sl EMAIL
CONTRACTOR'S NAME OWNERBUILDER? CYESO�O
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ tA'Vl ZC-.) SO FT L SQ FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN 1`0 SMIP
INVOICE
AMOUNT 110e, Q2�5'1 PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES I PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menijtee Bailding&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
wwvv.cityofmenifee.cis Inspection Request Line 951-246-5213
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 CodeRn my license is in full fmpe and effecl Code:The Contractor's License Law does not apply to an owner of a propert.
who builds or Improves thereon, and who contracts for the projects With
Expires Signature licensed contractor(s)pursuant to the Contractors State License Law).
— 7--7-
WORKERS'COMPENSATION DECLARATION 11 1 am exempt from licensure under the Contractors'State License Law for th.
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 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 improvements covered by this permit,I cannot legally sell a structure that I hay.
permit is issued. n' its entirety by license.
Policy# built as an owner-buildIng if it has not been constructed I
contractors. I understand that a copy of the applicable law,Section 7044 of th,
El I 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:hUp,/Ayww.IeQ!nfo.ce.noy/ealaw.htmI
permit is issued.My workers'compensation insurance carder and policy number are:
Carrier Property Owner or Authorized Agent Date
5 Cha—p
Expires 7 -3/44 Policy#
1 0 By my Signature below, I certify to each of the following: I am the propert
Name of Agent Phone# owner or authorized to act on the property owner's behalf. I have read th!
(This section need=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 oi the work for which this permit is issued,I Identified property for tlIe inspection purposes.
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 Section 3700 of the Labor
Code.I shall forthwith comply with those provisions. PropertyOwn orAuthorlized Agent D
. f I City Business License
Date;___/, Applicant;, 7
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, OYES 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 K,� N 0 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 Name [1YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address 4NO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS
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 rile 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 .�,00 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than(5500).) CODE, SECTION 25505. 25533 AND 25534 CONCERNING
11 1. as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORING.
compensation,will do all of or porting of the work,and the structure is PROPER;FYPV/NER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply lo 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).
& TRAGK
IN SPECTIO NJUW I RE ED
Building & Safety Dept.
SEP 0 7 2016
vri
Received
CITY OF MENIFEE ETY DEPARTMENT
rn,'JILDING AND SAr
%IN APPROVAL
RIVIENMED BY r"
DA1
bp `0rued
*A �,,jval of these plans st--I'
11,Ot t�,e jedcral,state or :U
ap ifov3j of,any Violation Of 3""�ro"S'Ll ust be kent ul the
Tel uj�!:�Ojjs I Of aqpro'je�,illans M Q
Tid oHinmces- This set
�sile ,,til completicn.
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0\AtV\,N\n_& FA cooi,-CiA
200 qo6jo \j0JU?_ $ LOU