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PMT16-03286 City of Menifee Permit No.: PMT16-03286 29714 HAUN RD. Type: Residential Addition <A—CCELA> MENIFEE,CA92586 MENIFEE Date Issued: 10/0612016 P E R M I T Site Address: 28403 FOX RIDGE CV, MENIFEE, CA Parcel Number: 333-571-016 92585 Construction Cost: $4,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 498 SF SOLID ALUMAWOOD PATIO COVER WITH 3 POST LIGHTS Work: Owner Contractor TOM&ADLYNN MYERS PATIO GUY ALUMAWOOD CONTRACTOR 28403 FOX RIDGE COVE 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 3 126.00 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 General Plan Maintenance Fee-Electrical 1 6.30 $300.95 The issuance of this pernnit 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 pe"it 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_Pennit Template.rpt Page I of I 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 pmject(Section 7044,Business and Professions Professions Code a my license Is in full lb a d ff t Code:The Contractoes License Law does not apply to an owner of a property License Class—Z7�License No. who builds or improves thereon, and who contracts for the projects with a Expires_te�- Z) (&gnature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION 0 lam exempt from licensure under the Contrackirs'State License Law for the 0 1 hereby affirm under penalty of pedury 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 permit is issued. improvements covered by this permit,I cannot legally sell a structure that I have Policy 9 built as an owner-building if it has not been constructed in its entrely,by licensed 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 motion 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:httE).,//www.leoinfo.ca.govicalaw.htmI permit is issued.My workers'compensation Insurance carder and policy number are: Carrier Property Owner or Authorized Agent Date Expire 57: Policy# 1p&�l �—' Name of Agent 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 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 dollar�—($100)or less) with all applicable city and county ordinances and slate laws relating to building construction.na thorize 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 identili y r a nspec on urposes. shall riot employ any persons in any manner so as to become subject to the workers'compensation laws of California,:ind agreeAhat If I should become subject to the workers'compensation provi on ton 3700 olf the Labor Code,I shal forthwit comply with those pro isions. Property Ow4ercrAuthortzed AgeW U -7 4q Date Date; Applicant; /City Business license# WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL 13ECLARATION 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 HANDLEA HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE,INTEREST,AND ATTORNEYS FEES NP*---EQ—UAI- 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 (Secton WILL THE INTENDED USE OF THE BUILDING BY THE 3097 Civil Code) APPLICANTOR FUTURE BUILDING OCCUPANT REQUIRE Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION.. Lender's Address --FROM-THE SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR OWNER BUILD R DECLARATIONS GUIDE LINES I hereby affirm under penalty of Pedury 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 1000 FEET OF THE OUTER BOUNDARY OFA Any city or county that requires a permit to construct, alter, improve, demolish, 11��v 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)or Division 3 of the Business and Professions Code)or that he or E]YES INFORMATION GUIDE AND THE SCAOMD PERMITTING she is exempt from ficensure 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 D Qj__jJWDER-THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODIE SECTI10 ?,1,,515,25533.AND 25534 CONCERNING lOUS M R AL P 0 1, as owner of the property, or my employees with wages as their sole HAZARD E ORTING. compensation,will do( )all of or( )porting of the work, and the structure is i R A GE not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property who, through employees' or personal effort, builds or improves the property, provided that the Improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or Improved for the purpose of sale). DATE 42 PERMIT/PLAN CHECK NUMBER P�,��,o - ?D- TvPE,. 0 COMMERCIAL elfi-ESIDENTIAL Q MULTI-FAMILY Q MOBILE HOME Q POOLISPA, 0 510 SUBIYPL: UALJIJIIION uALTERATION ODEMOLITIUN 0ELECTRiCAL QMECHANiCAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DES PTIONOFWORK / 7 z� It PROJECTADDRESS oaize>5 ASSESSOR'$PARCEL NUMBER —33 —,�]j 0\10 LOT LOt TRACT am F3 c) -2� f�y))ji�R-5 'U /L OWNER NAME k7-) Qf— 4—J AUUKESS 4 .0 n vz-,�7- I ng 1 vienife, PHONE LP )q - EMAIL euil&J", 8, Sakty D,p, APPLICANT NAME 4n, A,97-27 A2 OCT 0 6 2a.1-6 ADDRESS e c 61 ve—c) PHONE EMAIL CONTRACTOR'S NAME -77.1 OWNERBUILDER? OYESVW07 BUSINESS NAME 71 ADDRESS L/// ?7 41 J4-M� 9c w PHONE �. MAI!La-da in Ca)0 g2ad P vni=ro CONTRACTOWS STATE LIC NUMBER d6 C) LICEME CLAS51FIQATION VALUATION$ qboz) SO FT _ I q99 LSQFT APPLICANT'S SIGNATURE DATE C/,c*A-7 —J ,(v i­l 1 1 ' '1". - 11 1100 DEPARTMENWT DIST I ION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE- PAIDAMOUNT F AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYESO No DL NUMBER NOTARIZED LETTER 0 YES 0 Ng=�j Ll City of Menifee Lj3rTT'E; aiety Dept. iL\,1-7 n—r ilding & Safety Dept. 6 P% le-t 17- 1 LEDGER & TRACK OCT 0 6 2016 INSPECTION REQUIRE Fleceiver' ILI '7 jw 2, letAcmite, U9 )-rT-S CITY OF MENIFEE L6AFETY EPAJ !MENT "WV)qG LMPAFETY PLAN APPROVAL REVIEWED BY iiial *Approval of these plans shall nA rued to be a wM for,or M ap p royal of,an�violation of a ny p rovisi o of the W",90 or dtV isio d plaot MW be kept on the ofa regulations and O"dHnances. This set rove jobsite until completion I&M&OLDAGIe� ZM) 1 70 1 9 kL4 e'!, �0 wri TAF 2� t-A e—*wi aw -a 1 0 ja L �-J A—) MNJ L::-v WTI ockov - - 7 , � I I IN 4 11 CM toiden Moe wrek 4001? F-,O'x' )R )b2 4�- e__.b V G fjw-M��q. 9. qatba :ni L=- A Bbnw. sure-4 4-calls-V&S Loallve C-ZMP:140-soft. Azow- t 0.0-Ck 1-7