PMT16-03051 City of Menifee Permit No.: PMT16-03061
29714 HAUN RD. Type: Residential Addition
<A_CCIEL/�> MENIFEE, CA 92586
MENIFEE Date Issued: 09114/2016
P E R M I T
Site Address: 29091 CELESTIAL DR, MENIFEE, CA Parcel Number: 340-352-023
92584 Construction Cost: $4,485.00
Exisfing Use: 1 &2 Family Residence Proposed Use:
Descriptilon of ALUMAWOOD PATIO AS BUILT-540 SQ FT SOLID 2 FANS,6 POST LIGHTS
Work:
Owner Contractor
JAMES NGUYEN GUTTERS N COVERS CONSTRUCT10N INC
29091 CELESTIAL DR 19069 VAN BUERN BOULEVARD#114
MENIFEE,CA 92584 RIVERSIDE, CA 92508
Applicant Phone:9516728022
CARY RUKASIN License Number:945962
GUTTERS N COVERS CONSTRUCTION INC
19069 VAN BUERN BOULEVARD#114
RIVERSIDE,CA 92508
Fee Description QtV Amount
Receptacle, Switch, Outlet& Fixture 8 151.00
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 7.55
$327.20
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 Bldg Permil-Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and a I a m exempt from licensure.under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Clam /T License No. 4:? 11S 5116, 4/ By my signature below I acknowledge that except for my personal residence
Expires ignature 01� in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed In Its entirety by
a I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-Insure for worker's 7044 of the Business and Professions Code,Is available upon request when
compensation,issued by the Director of Industria I Relations as provid ed for this application is submitted or at the following website:
by Section 3700 of the Labor Code,for the performance of work for which
this permit is issued. wvvw.leginfo.ca.gov/caIaw.htmI.
Policy# Date
?gl have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHOR17ED AGENT
section 3700 of the Labor Code,for the performance of the work for which n By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property ownees behalf.I have read this
number are: application and the Information I have provided is correct.I agree to comply
Carrier -ne C ui,-, 71�C', with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy If Jt-C e oel a o r Expires —7 14,r enter the above identified prop f fnspecti.on purposes.
(This section need notto be completed is the permit Is for one-hundred C�_ 777 Date cl
dollars($100)or less PROPERTY OWNER ORALITHORIZED AGENT
certify that in the performance of the work for which this permit is Issued,
Ishallnotemplo any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workees compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future buildingpccupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to argreater that the
amounts sp cified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS a Ye! . 1210
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUN DRED THOUSAND DOLLARS($100,000),IN
ADDITION TO TH E COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
I N SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist
for guldel!�es
CONSTRUCTION LENDING AGENCY uYes dNo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit Is Issued outer boun ary of a school?
(Section 3097 Civil Code) 0 Yes 1;11
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
California Health&Safety Code,Section 25505 and 25534 concerning
Contra�toes License Law for the reason(s)indicated below by the hazard aterial reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 or
Business and Professions Code).Any city or county that requires a permit to ciYes No cl&�v 15��L Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT
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 Contra ctor's State EPA RENOVATION,REPAIR AND PAINTING QUIPI
License Law(Chapter 9(commencing With Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certifled firms and comply with
a n Applicant for a perm it subjects the a pplicant to a civil penalty of not more
than($500). required practices.This includes rental property owners and property
managers who do the paint-disturbing work themselves or through their
a 1,as owner of the property,or my employee with wages as their sole employees.For mom information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gay/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-BOD-424-LEAD(5323).
Code,The Contractoes State License Law does not apply to an owner of a n An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees!or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or Improved for the purpose of sale. a No EPA Lead-Safe Certified Firm Is required for this project because:
o 1,as owner of the property am exclusively contracting With licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
4"Menifee
DATE PERMIT/PLAN CHECK NUMBER Prwntv - Tm�l
TYPE: 01OMMERCIAL �(RESIDENTIAL CMULTI-FAMILY OMOBILEHOME 0 POOL/SPA 0 SIGN
SUBTYPE: ION OALTERATION ODEMOLITION CELECTRICAL OMECHANICAL
OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
PROJEcTADDRESS '2.('jQCj) 00-fe d )(�V' n1&Nj-,0P QJ-ZSc��j
ASSESSOR'S PARCEL NUMBER 3qO LOT TRACT
OWNER NAME
ADDRESS 2qoq I mk-VJ42e- CA Q z5ski
PHONE EMAIL
APPLICANT NAME je VV-e
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME OWNERB�LIUDER? OYES
BUSINESS NAME
ADDRESS I 6-Z7- -JJJIVUQ)�� CH 6)037-1
PHONE C�S\ lz�,* c�6(Z�,ZZ EMAIL QjtUer�; I�Cn\mvn oU:f1mk-ccjm
CONTRACTOR'S STATE LIC NUMBER J'z��Cj)o ;?- U LICENSE CLASSIFICATION rJ2, -Q;�,eyjf-v-Cj
VALUATION$ N.%5 SO FT L SO FT
I APPLICANTS SIGNATURE DATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION 511P CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GLEN
INVOICE PAIDAMOUNT
AMOUNT 2q I � (:JNCASH OCHECK# 0 CREDIT CARD VISA/MC
PLAN CHECK FEES I PAIDAMOUNT I I OCASH OCHECK# OCREDrrCARD VISAIMC
OWNER BUILDER VERIFIED 0 YES 0 No DLNUMBER NOTARIZED LETTER 0 YES 0 NO
City of IvIenifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
CRY of Menifeo
Building & Safety Dept.
SEP 14 2016
Received
LEDG
INSPECTION REQUIRED
)0
MENIFEE
'�qUILDING AND SAFETY DEPARTMENT '
PLAN APPROVAL
REVIEWED BY
I I DATE 40
'Approval oftheseplansshall not be construedto bea peritiftfor,oran
approval of,any violation of any provisions of the federal,state or city
regulations and ordina nces. This set of approved plans must be kept on the
jobsite until completion.
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