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PMT16-03207 City of Menifee Permit No.: PMT16-03207 29714 HAUN RD. Type: Residential Addition <A—CCFlUA—> MENIFEE,CA92586 MENIFEE Date Issued: 0912812016 PERMIT Site Address: 29213 STEAMBOAT DR, MENIFEE,CA Parcel Number: 333450-004 92585 Construction Cost: $3.900.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 490 SQ FT SOLID ALUMAWOOD PATIO COVER WELECTRICAL 2 FANS Work: Omer Contractor KEVIN&RACHEL CHAPMAN PATIO GUY ALUMAWOOD CONTRACTOR 29213 STEAMBOAT DR 41197 GOLDEN GATE CIR STE 108 MENIFEE, CA 92585 MURRIETA, CA 92562 Applicant Phone:9513330056 LOIS MONTINI License Number 872839 PATIO GUY ALUMAWOOD CONTRACTOR 41197 GOLDEN GATE CIR STE 108 MURRIETA, CA 92562 Fee Description Qtv Amount($ Receptacle, Switch, Outlet&Fixture 2 121.00 Building Permit Issuance 1 2TOO 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 $289.66 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_Permit Ternplate.rpt Page 1 of 1 City Of Menifee LICENSED DEC RATION 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 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 arld my license is in full fo a d If t Code:The Contractor's License Law does not apply to an owner of a property License Class License No. who builds or improves thereon, and who contracts for the projects with a Expires Le-6 D (Agnature licensed contractor(s)pursuant to the Contractors State Uicense Law). WORKERS'COMPENSATION DECLARATION [I I am exempt from licensure under the Contractors'State License Law for the 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 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 completion 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 13 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,ll�-leginfo.m.novlcalawhtml. permit is issued.My workers'oDmpensation Insurance carrier and policy number are: Carder Property Owner or Authorized Agent Date Expire Policy# Name of Agent Phone If 0 By my Signature below, I certify 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($100)or less) with all applicable city and county ordinances and state laws relating to building construction.Athorize representatives of this city oroounly to enter the above- 0 1 certify that in the performance of the work for which this permit is issued,I identi shall not emol 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 fion 3700 of the Labor Code,I shal)forthwith comply with those proN isions. Property Ow4er'orAuthorized Agent' U Date -7 4q Date; Applicant; I/City Business License# to 2,A5 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, []YES OCCUPANT HANDLEA HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE,INTEREST,AND ATTORNEYS FEES nN9---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 OYES A PERMIT FOR THE CONSTRUCTION OR MODIFIGATION.. —E41OWTHE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address D44e- DISTRICT(SCAQMD)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 OYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable item(s)(Section 7031.5.Business and Professions Code: BE WITHIN 1 ODO FEET OF THE OUTER BOUNDARY OF A Any city or county that requires a permit to construct, alter, improve, demolish, R��DL? 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 []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 0 lj��THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) COD CT 110 550 25533 AND 25534 CONCERNING 0 1, as owner of the property, or my employees with wages as their sole HAMDEN M .2RIALIAEPORTING. compensation,will do( )all of or( )porting of the work, and the structure is R A GE not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractoes State License Law does not apply to an owner of a property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). & SAFETY PERMIT/PLAN CHECK APPLICATION I-VI Men'fee DATE 42 PERMIT/PLAN CHECK NUMBER QMULTI-FAMILY 0MOBILEHOME OPQQUSPA OSION TYPE: QCOMMERCIAIL PJRSIQENTIAL SUBlYPt: UAL)L)IIIC)N uALTERATION uutmuLITiuN uELECTRiCAL -) MECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUAABER OF SQUARES--_ DESCRIPTION OF WORK YX'3,5- SDLjb 74L.4jf,�)YQI�06 7) ��L) VL=/t� I p"4s PROJECTADDRESS A 9, -5 Z,7Z-59472 6 noll:T T),� ASSESSOR'S PARCEL NUMBER VD4LOT L�) TRACT OWNERNAME AUUKESS PH()NF EmAll APPLICANT NAME Z5 nK Z)AP7 /A-) ADDRESS f4 IPHONE ?,6'1- q-17 EMAIL ,.b4 CONTRACTOR'S NAME /44 OWNERBUILDER? OYES -f -- - BUSINESSNAME — e477T-) L) V ADDRESS L111 1?7 q 6 J,I)El-V 0� A-M� 0--jpc, ,�E , /L/ /A — 1 . 9 ;0,1��z PHONE 9:V- 3 -40 L) S( MAI L QCI()0 Co�Q JA r�-o,W) p�pj c CONTRACTOR'$STATE LIC NUMBER 46 AR, LICENSE CLASSIFICATION JB VALUATION$ A S q sQFTp 419z) L SQ FT o7a ,,q; DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP I INVOICE CREDIT CARD VISA/MC T AMOUN PAIDAMOUNT OCASH OCHECK# N CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# OCREDITCARD VISAIMC OWNER BUILDER VERIFIED OYES 0 No DLNUMBER NOTARIZEDLETTER 0 YES 0 NO 117 5�1 3,D L LEDGER & TRACK JION REQUIRED c:tv of Menifee 3uildi)g & Safety Dept. &T, S SFP 2 8 2016 C? ieceived CITY OF MENIFEE� `44,90,AFETY DEPARTMENT rldv� 1C0 DATE Ceitfororan ap�,I',)Val Ot,afly 10101dOVIi W1 reg,ilations and ordinances. This set 5;j� ,,iam must be kept on the jo,usite until completion. 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