PMT16-03328 City of Menifee Permit No.: PMT16-03328
29714 HAUN RD. Type: Residential Addition
<A_CCELA_> MENIFEE, CA 92586
MENIFEE Date Issued: 10/11/2016
P E R M I T
Site Address: 27436 FAMILY CIR,MENIFEE,CA 92586 Parcel Number: 335-452-036
Construction Cost: $3,668.00
Existing Use: I &2 Family Residence Proposed Use:
Description of INSTALL 446 SF SOLID ALUMAWOOD PATIO COVER, NO ELECTRICAL
Work:
Omer Contractor
REBECCA SAUCEDO GUTTERS N COVERS CONSTRUCTION INC
27436 FAMILY CIRCLE 1622 ILLINOIS AVE SUITE 14
MENIFEE, CA 92586 PERRIS,CA 92571
Applicant Phone:9516728022
TIERRE AMANSEC License Number.945962
GUTTERS IN COVERS CONSTRUCTION INC
1622 ILLINOIS AVE SUITE 14
PERRIS, CA 92571
Fee Description Oty Amount($
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 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_Pemit Ternplaterpt Page I of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter!)(commencing with section 7000)of Division 3 of the Business and o I a in exempt from licensure under the Contractor's State License Law for
Professions Code and my license Is in full force and effect. the following reason!
License Class !,9-60AWIA--Uicense No. 9n5Q&2- By my signature below I acknowledge that,except for my persona I residence
Expires Signature in which I must have resided for at least one year priorto completion of
improvements covered by this permit.I cannot legallysell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
cz I hereby affirm under penalty of perjury one of the following declarations;I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website:
by Section 3700 of the Labor Code,for the performance of work for which www.Ieginfio.ca.gov/calaw.litmI.
this permit is issued.
Policy# PROPERTY OWNER OR AUTHORIZED AGENT Date
�saave and will maintain worker's compensation insurance,as required by
.ctran 3700 of the Labor Code,for the performance of the work for which 0 By My Signature below I certify to each of the following:I a in the property
this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act an the property owner's behalf.I have read this
number are: application and the infonmation I have provided Is correcL I agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Pollcy#SVA Expires C4/I-;(— enter the above identified property for inspection purposes.
(This section need not to be completed Is the permit iAIr one-bundred Date
dollars($100)or less PROPERTY OWN ER OR AUTHORIZED AGENT
u I certify-that in the performance of the work for which this permit is issued,
Ishallnotemolo any persons in any manner so as to become subject to the CITY BUSINESS UCENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith c ly with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified an the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVdAGE IS o Yes a No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ci Yes o No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) cz Yes a No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 0yes 0 No
Business and Professions Code).Any City or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWN ER OR AUTHORIZED AGENT
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 EPA RENOVATION,REPAIR AND PAINTING(RRP1
Utcense Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from Hcensure receiving compensation for most work that disturbs paint in a pre-1978
a nd the basis for the alleged exemption.Any violation of Section 7032.5 by residence or childcare facility to be RRP-certified firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves arthrough their
in 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at
not intendid or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a o An EPA Lead-Saft Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or Improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. ci No EPA Lead-Safe Certified Firm is required for this project because:
o 1,as owner of the property am exclusively contracting with licensed ,
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractoes State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
"Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: 0 COMMERCIAL )KRESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0— POOL/SPA C,SIGN
SUBTYPE: CADDITION OALTERATION ODEMOLITION OELECTRICAL OMECHANICAL
�&EW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK' )akM&�V og :v <;
W Ll Ll 110 bU
Agnifee
PROJEcTADDRESS
city at I
ASSESSOR'S PARCEL NUMBER 4slp-pbU LOT TRACT Building & ajety DePt
OWNER NAME'�,Qz e-CCa�,o,i,C-eA r) jyj 1 2016
ADDRESS 2:749,�� CA- WrtJ� 9 -e5&-6 aived
PHONE 95 26q K-4bHl EMAIL RE)C ,
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTORS NAME &I jda5 (,\j (owtv,!5 OWNER B�LILDER? 0 YES�^Cl
BUSINESS NAME
ADDRESS 2-4q-3)0 aK�Uj�d 6,C dlpvtdf�)- Ckq QzS!R-(0
PHONE I EMAIL i lk,,�s N(jzj� 041mk-(C)M
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION &VIf
A
VALUATION$ SQ FT L SO,FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT is -U� I Itov.. 0 CASH 0 CHECK# —CREDITCARD VISA/MC_
PLAN CHECK FEES I PAIDAMOUNT 1 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 No DLNUMBER NOTARIZED LETTER C YES 0 NO
City of Menifee Building& Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
wvvw.citvofmenJfee.us Inspection Request Line 951-246-6213
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CI'TY of MENIFEE E UJ
SUILDING A.ND SAIETY DEPA
PLO AppROVAL
'�Ak DATE
REVIEWED By
0 W,0(an city of Menifee
MU'de t be a Pelmit 'afety Dept.
$ions he lederal,state of City Building & D
ApPrOvai oi these Pla."I In",110,";
any%liolation Of am vo beKept On'hP
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tegu ation and O,dinances.
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