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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 Ali, UM L4 L� X/ x 4- /// bL 11 S^L 11 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 VIEW�J�B *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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