PMT16-03206 City of Menifee Permit No.: PMT16-03206
29714 HAUN RD- Type: Residential Addition
'(7�CC.EIL�� MENIFEE,CA 92586
MENIFEE Date Issued: 0912812016
P E R M I T
Site Address: 28850 LOIRE VALLEY RD, MENIFEE, CA Parcel Number: 364-122-013
92584 Construction Cost: $3,800.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 490 SOLID ALUMAWOOD PATIO COVER WELECTRICAL 2 FANS,2 LIGHTS
Work:
Owner Contractor
JAIRO&MARTA MARTINEZ PATIO GUY ALUMAWOOD CONTRACTOR
28850 LOIRE VALLEY RD 41197 GOLDEN GATE CIR STE 108
MENIFEE, CA 92584 MURRIETA, CA 92562
Applicant Phone: 9513330056
LOIS MONTINI License Number:872839
PATIO GUY ALUMAWOOD CONTRACTOR
41197 GOLDEN GATE CIR STE 108
MURRIETA,CA 92562
Fee Description PbE Amount($
Receptacle, Switch,Outlet&Fixture 4 131.00
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
$299.65
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 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 Bldg_Permit Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION
I hereby affirm under penalty or perjury that I am licensed under provisions of 13 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 I'T9 a d ff t Code:The Contractor's License Law does not apply to an owner of a property
License Class jr, License No. who builds or improves thereon, and who contracts for the projects with a
Expiresle---21D J�;gnature
I licensed contractor(s)pursuant to the Contractors State License Law).
WORKER&COMPENSATION DECLARATION 0 lam exempt from licensure under the Contractors'State License Law for the
0 1 hereby affirm under penalty of pedury one of the following declanitions: following reason:
I have and will maintain a cartificate 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 complerion 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:http�L/v�—leoinfo.m.ciov/mlaw.htmi.
perinit is issued.My workers'compensation insurance carder and policy number are:
Carrier Property Owner orAuthorized Agent Date
Policy#
Expires
Name of Agent Phone# 0 By my Signature below, I cerfily,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 not be completed if the permit is for application and the information I have provided is correct. I agree to comply
one-hundred dollars(S1 00)or less) with all applicable city and county ordinances and state laws relating to building
construction.Athorize representatives of this cityorcounty to enterthe above.
0 1 cerrify that in the performance of the work for which this permit is issued,I identi
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 9
subject to the workers'compensation provisions of lion 3700 of the Labor
Code,I shal)forthwith comply with those proy isions. Property OwKer-crAuthorized Agent 0 Date
Date; Applicant;_ 11 City Business License# 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, DYES OCCUPANT HANDLE A HAZARDOUS MATERIALORA
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 AGEN 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 OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
--5ReM-THE SOUTH COAST AIR QUALITY MANAGEMENT:
Lender's Address LJwi3- 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 OYES 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, RtR---e&�L?
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 [JYES INFORMATION GUIDE AND THE SCAOMD PERM17ING
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 V__Jlb�THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not More than(S500).) C
0 1, as owner of the property, or my employees with wages as their sole
compensation,will do( )all of or( )porting of the work,and the structure is
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 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).
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
I fr-tl
DATE 42 PERMIT/PLAN CHECK NUMBER
TYPE: 'COMMERCIAL 9-RE51E)ENTIAL OMULTI-FAMILY OMOBILEHOME 0 PQOUSPA Q SIGN
SUBlYPt:: UADUIIIIJN UALIERATION L)f)EmCjLjTtoN uELECTRiCAL VMECHANILAL
Q�NtW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK �56LIb J�J4771)
CA 4L
(2,6 vc-s,
PROJECTADDRESS 8 La �/,44�,L
Qc
ASSESSOR'S PARCEL NUMBER LOT ;5LO TRACT o '44,*>-9
OWNER NAME
AUUKESS
PHONE EMAIL
APPLICANT NAME 2�) A�T/� A-Y
ADDRESS f4 C-
PHONE
6" 'f5) EMAIL
CONTRACTOR'S NAME s Vlq-0
BUSINESS NAME 1-,4 72
ADDRESS L/// '-?7 6� A-M�
PHONE
-F
CONTRACTOR'S STATE LIC NUMBER 46 '79.9 LICENSE CLASSIFICATION
VALUATION $ %38'OZ)� f . SO FT - 1-16 L SO FT
APPUCANT'S SIGNATURE DATE 9-A-7 -JJ�
MEE=
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE I gqlp5f I 1 0 CASH 0 C
' T PAIDAMOUNT
AMOUN HECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH (-)CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO OIL NUMBER NOTARIZED LETTER 0 YES � NO
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LEDGER & TRACK
L>P INSPECTION REQUIR :P
City of Menifee
Building & Safety Dept.
go.r-r - SEP 2 8 1 2016 4=0
L I i Y OF 1WENME—E Received pi(
J...Mj. e6liamte-' MJ9AMr)&U-AjV§ARTMENT
PLAIN APPROVAL
A Mon
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*Apoi oval of these Wars shaii not i�,rjed to be a PP(mit for,or, i
apProval of,any violation a'�I.: �. miV the feil(,.ral,state or city
regulations and ordj�'ces, lblsvt i'dpproved plans must be kept c the
jobsite-untji corri,,etion.
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