PMT16-03208 City of Menifee Permit No.: PMT16-03208
29714 HAUN RD. Type: Residential Addition
<^_CCELA_> MENIFEE, CA 92586
MENlFEE Date Issued: 09128/2016
P E R M I T
Site Address: 29357 BEACHCOMBER DR, MENIFEE, Parcel Number: 333-370-003
CA 92585 Construction Cost: $3,600.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 429 So FT SOLID ALUMAWOOD PATIO COVER WELECTRICAL 2 FANS
Work:
Owner Contractor
DUWAYNE CLAY PATIO GUY ALUMAWOOD CONTRACTOR
29357 BEACHCOMBER 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 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
$289.65
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 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.
Ao\_Bldg_Pemitt_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 a my license is In full flozg a of If I Code:The Contractor's License Law does not apply to an owner of a property
License Class—97�License No,. who builds or improves thereon, and who contracts for the projects With a
Expires Le.,:7-1 D i 19tignature licensed cantmator(s)pursuant to the Contractors State License Law).
WORKER&COMPENSATION DECLARATION o I am exempt from ficensure 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
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:hftv:l/www.leginfo,gg.gov/mlaw.htmi.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carder Property Owner or Authorized Agent Date
Expire 9�� Policy#
NameofAgent Phone# 0 By my Signature below, I certify to each of the following: I am the property
owner or authorized to act on the property owners 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(S100)or less) with all applicable city and county ordinances and state laws relating to building
construction.Athorize representatives of this city or county to enter the above-
0 1 certify that in the performance of the work for which this permit is issued,I identiri r a nspec.on urposes.
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 tion 3700 of the�bu, Property OwAr"Or Authorized Age ' 0 Date
Code,I shal)forthwith comply with those pro%isions. City Business License If 46;55-74q
Date; Applicant;
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, E]YES 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 N.Ne---rQ—UAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY 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 Nanne- OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION-
-SJIeM-THE SOUTH COAST AIR QUALITY MANAGEMENT:
Lender's Address DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS PRINT NAME
I hereby affim under penalty of perjury that I am exempt from the Contractor's
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, R!�-�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 Uimnse 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 OyES 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 E_JUDER-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 H
compensation,will do( )all of or( ) porting of the work, and the structure is P
not Intended or offered for sale.(Section 7044,Business and Professions Code; X
The Contractor's 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).
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 42 PERMIT/PLAN CHECK NUMBER
TYPE: OCOMMERCIAL V-'R'ESIDENTIAL OMULTI-FAMILY OMOBILEHOME Q POOL/$PA 0 SIQN
SUBlYPE: UAUDIIIUN uAuEKAiIC)N uutmuumm uELECTRICAL OMECHANICAL
el�'EW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES-.,-..,, - I I
DESCRIPTION OF WORK 1',5,X33 SoL /l) )aLLJ177,qLV,0b-b i;4-77-Z
Col1L:A - J�,rANS
PROJECTADDRESS A 9 B .'�-7 Z Q-q4! 0- g�&-)K
X t)Uob LOT TRACT
ASSESSOR'S PARCEL NUMBER �,W�
OWNERNAME
ADDRESS
PHIDW 24- 7116- 218?
APPLICANT NAME A.97--1 A--�
ADDRESS Z-F f4C-
P H 0 N E L) t 55 EMAIL
CONTRACTOR'S NAME OWNERBUILDER? OYES &1CO�
BUSINESS NAME E,4 T2
5
ADDRESS
9CR
PHONE r .41
CONTRACTOR'$STATE LIC IN LIM DER d6 LICENSE CLASSIFICATION
VALUATION$ SQ FT . L SO FT
Jrc;�lk,
A7FFi:,CA-NT`SSiGNAT%;RE
CITY STAFF USE ONLY
Ut:PAKTMt:NT L)15TKIBUTIUN SMIT7 I CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN 10 1
INVOICE -191 PAID AMOUNT 0 CASH 0 CHECK# OCREDITCARD VISA/MC
AMOUNT 1 0
PLAN CHECK FEES PAID AMOUNT OCASH ',L,CHECK# '--'CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 No DIL NUMBER NOTARIZED LETTER YES 0 NO
119
3c� /X 1.
City ot Menifee
L Lb Building & Safety Dept.
SEP 2 8 20`16
Received
wAhe, rrb 0 -6 i-E[)GPLR & TRAIC K
�,;,,)PEGTION REOU RED
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-aecm ica, �vl� FAP4S
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ILWAM 4- - I ,
bi SAFRYDEPARTMENT
P UA N' A
IFP�. ' 6 1 ET
REVIEWED KAIP��?6�1(0 40
DATE
of these plans shill not be construed to be a permit for,or an
.�rxolf,any violation of aw.,urwsions of the federal,state or city
regulations and ordinances. This set of approved plan�must be kept oAeQ
Obsite witil completion.
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