PMT16-03329 City of Menifee Permit No.: PMT16-03329
29714 HAUN RD. Type: Residential Addition
CIELA. MENIFEE, CA 92586
MENIFEE Date Issued: 10111/2016
P E R M I T
Site Address: 28778 DEL MONTE DR, MENIFEE, CA Parcel Number; 337-202-028
92566 Construction Cost: $2,462.00
Existing Use: I &2 Family Residence Proposed Use:
Description of INSTALL 12'x 2Z SOLID ALUMAWOOD PATIO COVER, NO ELECTRICAL
Work:
Owner Contractor
GUSTAVO CAICEDO GUTTERS N COVERS CONSTRUCTION INC
28778 DEL MONTE DRIVE 1622 ILLINOIS AVE SUITE 14
MENIFEE,CA 92586 PERRIS,CA 92571
Applicant Phone:9516728022
TIERRE AMANSEC License Number:945962
GUTTERS N COVERS CONSTRUCTION INC
1622 ILLINOIS AVE SUITE 14
PERRIS, CA 92571
Fee Description Qtv Amount
Building Permit Issuance 1 27.DO
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 othervrise 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-
AABldg_PennitTernpIate.rPt Page 1 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).
Chapterg(commencing with section 7000)of Division 3 of the Business and ci I am exempt from licensure under the Contractoes State License La.w for
Professions Code and my license is in full form and effect. the following reason:
License Class License No. CK('5Q(:2 By my signature below I acknowledge that,except for my personal residence
in which I must have resided for at least one year prior to completion of
Expires Signature Improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
o 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 wmrw.IegJnfo.ca.Rov/caI@w.htmI.
this permit is Issued.
Policy# PROPERTY OWN Ell OR AUTHORIZED AGENT Date
ave and will maintain worker's compensation insurance,as required by
�,Oection 3700 of the Labor Code,for the performance of the work forwhich o By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relatingto
Carrier building construction.I authorize representatives of this city or county to
Policy#'SWO— <8(;q7 Expires ci enter the above identified property for inspection purposes.
(This section need not to be com plated is the permit Is�Ir one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
a I certify that in the performance of the work for which this permit is issued,
Ishallnotemplo any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
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 forth fislons. Will the applicant or future building occupant handle hazardous material or a
_M��, Date mixture containing a hazardous material equal to or greater that the
Applicant — amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKERS COMPENSATION C6EI(AGE IS o Yes o 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 0 Yes 0 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) a Yes 0 No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQIAD
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 uYes a 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 OWNER 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(RRPI
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business a ad Professions Code)or that he or she is exem Fit&am licensure receiving compensation for most work that disturbs paint in a pre-1978
a nd the basis for th e alleged exemption.Any Violation of Section 7031.5 by residence or childcare facility to be RRP-certlfied firms and comply with
a n Applicant for a perm it subjects the applicant to a civil penalty of not mom required practices.This includes rental property owners and property
than($500). managers who do the pafnt-disturbing work themselves or through their
a 1,as owner of the property,or my employee with wages as their sale employees.For more information about EPKs Renovation Program visit:
compensation,will do( I all of or( )portion of the work and the structure is www.epa.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-80D-424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,th rough 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 bemuse:
n 1,as owner of the property am exclusively contracting with licensed .
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's 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
e n i f e e
DATE lol%% PERMIT/PLAN CHECK NIUMBER !R�mu obeQq
TYPE: 0 COMMERCIAL YRESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: 0 ADDITION 0 ALTERATION 0 DEMOLITION 0 ELECTRICAL 0 MECHANICAL
AEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES-
DESCRIPTION OF WORK 26q SoW
t�b
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME C .0,f='ty09naqt.
ADDRESS '2 BUIlaing
- cc 1 11 H16
PHONE EMAIL
LWL
APPLICANT NAME eceived
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME Csu A_�� cbqt-,.- OWNERBUILDER? OYES�00
BUSINESS NAME
ADDRESS lb*2Z-
PHONE CJfS� EMAIL
CONTRACTOR'S STATE LIC NUMBER q(4Sc�1.2- 13> LICENSE CLASSIFICATION &trv_f"
VALUATION$ SQ FT 2bg LSQFT
APPLICANT'S SIGNATURE ff�1,eZ"95""L D
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION SMIP CITYOFMENIFEE BUSINESS LICEME NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN
INVOICE
AMOUNT PAIDAMOUNT (Lo%.`ILV.� OCASH OCHECK# 0 CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK 41 C CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 No DLNUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menfee� CA 92586 951-672-5777
www.cityofmenifee,us Inspection Request Line 951-246-6213
CL
0
LEDGER & TRACK
iNSPECTION REQUIRED
Ci' Of MenItG(
E3 ullding'9 Safety I apt
OCT 1 12011
JO
�F MENIFEE
Q0 ,LDING AND SAFETY DEPARTME J
.4PPROVAL Qw
WED BY(-IARJN� V)I%Aittl
ATE
oval of these plans shall not be construed to be a permit for,I an
vd�of,any Wation of any provisions of the federal,statt-O"i:y
�i�Fi=p 7b-nces. This set of approved plans must be kep ontlie
&w4-UIA-0 C-W ceao A�,MPGI-O CVV—V
T�)a Ty%y��I�v ZW !A ��d�-La
L�V\ aki, ckl� 9 ZS%16 NOT- TOSC�F VCdJUL IV-Q b),
V* qeDl Cq3�4405