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PMT16-03210 City of Menifee Permit No.: PMT16-03210 29714 HAUN RD. '5A_CCr=LA> MENIFEE,CA 92586 Type: Residential Addition MENIFEE Date Issued: 09/2812016 P E R M I T Site Address: 29426 WOODEN BOAT DR, MENIFEE, Parcel Number: 333-700-041 CA 92585 Construction Cost: $2,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 252 SO FT SOLID ALUMAWOOD PATIO COVER, NO ELECTRIC Work: Owner Contractor CRAIG& DELAINA HATHAWAY PATIO GUY ALUMAWOOD CONTRACTOR 29426 WOODEN BOAT 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 guy. Amount 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 $168.65 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 bulliding 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. AkBidgPennit—Template.rot Page I of 1 City Of Menifee LICENSED DECLARATION 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 ag!my license is In full f5aa 9 If t Code:The Contractor's License Law does not apply to an owner of a property c�I P License Class License No. who builds or improves thereon, and who contracts for the projects With a Expires I L2-6 D (bignatu licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION 0 1 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 entirely by licensed Policy# contractors. I understand that a copy of the applicable law,Section 7044 of the 0 1 have and will maintain workers' compensetion 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:htti),Il�.leginfo.ca.gov/mlaw.htmi. permit is issued.My workers'compensation insurance carder and policy number are: Carder Property Omer orAuthorized Agent Date Policy# Explres�n q Name of Agent Phone# 0 By my Signature below, I carrify to each of the following: I am the property owner or authorized to act an 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 or county to enter the above- 0 1 certify that in the performance of the work for which this permit is issued,I identifil f r I a inspection urposes. shall not employ any persons in any manner so as to become subject to the workers'compensation laws of California, and agree he if I should become MT /9—/<\ subject to the workers'compensation provisions of tion 3700 of the Labor code,I shal)forthwith comply with those provisions. Propeity Omie or Authorized Agent Date Date; Applicant; kk&s�/ /City Business License# 44 U 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 MATERIAL OR A DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE,INTEREST,AND ATTORNEYS FEES nX9--9QUAl_ 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 Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION... _FR9M-THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address LJ-ttu- 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 DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable item(s)(Section 7031.5. Business and Professions Code: BE WITHIN 10DO FEET OF THE OUTER BOUNDARY OF A Any city or county that requires a permit to construct, alter, improve,demolish, 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 DYES INFORMATION GUIDE AND THE SCACIMD 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��THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE. SECTIqt�_?55 5 25533 AND 25534 CONCERNING 0 1, as owner of the property, or my employees with wages as their sole HAZARDOUS M RIAL AEPOffING. compensation,will do( )all of or( )porting of the work,and the structure is PROP R A GE not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, \J provided that the improvements are not intended or offered for sale.If.however, the building or improvement Is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). =a a VAU a ki LVA I IVA MAULM MCI I AR M e n ifee DATE PERMIT/PLAN CHECK NUMBER b TYPE: OCOMMERCIAL V/RESIDENTIAL OMULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN SUBTYPE: OADDITION OALTERATION �DEMOLITION OELECTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES_ DESCRIPTION OF WORK /Axal 0,-,bve� - & 4s4C- C--/g)c PROJECTADDRESS A94/a42 ASSESSOR'S PARCEL NU64RFD '7215"r 10D- QL� LOT TRACT OWNER NAME ADDRESS 01,q q a& WI) PHONE LON- q.QR- � 4-/78 EMAIL APPLICANT NAME � -,6 / :5 z�>A,97-2/I-) ADDRESS fir— PHONE ? EMAIL CONTRACTOR'S NAME OWNERBUILDER? OYES %ITO� BUSINESS NAME TZ ADDRESS L111 7 C( eAl 6:wz OL PHONE -q,.FMAIL Cj,�njr)p CONTRACTOR'S STATE LIC NUMBER 46 ?Aa LICENSE CLASSIFICATION VALUATION$ AD06 , f , SQ FT L SQ FT APPLICANT'S SIGNATURE DATE— DEPARTMENT DISTRIBUTION BUILDING PLANNING ENGINEERING FIRE � GREEN SMI P CITY OF MENIFEE BUSINESS LICENSE NUMBER INVOICE I AMOUNT I PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC [OWNER BUILDER VERIFIED C)YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building &Sofety Deportment 29714 Houn Rd. Menifee. CA 92586 951-672-6777 www.cityofmenifee.cis Inspection Request Line 951-246-6213 T' 444 41 5 L lb LEDGER & TRACK INSPECTION REQUIRED g:S If;:y -b City of Menitee L ��4N Ejuilding & Safety Dept. SEP 2 8 201b Received Mr: cm Ir hA) C!!Y OF MENIFEE Amaot.&(�A-FETY DEPARTMENT PP E R 0 vk� R EVIEWED DA "'I,of tbe.ie Plans xh,";n(,. �)P construed to be a permit for,3ran 5POP;:',Vj:i I,, 1nyVfQlat;t)n of fhe te(jeral,5 13 r�906110ns arid. tate ,rdiflonres. "e'Cl!-Voroved Plans must be epton e L jocisite urtil Completion. f) -T- LQ [9 - 3 �9- 7-q-7 g jw4Me—+Dt--TAr-rs 4 44-A�- Wgy 4 11 Ch 0 re" 4 gal 13-1 is