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PMT16-03740 City of Menifee Permit No.: PMT16-03740 29714 HAUN RD. Type: Residential Addition <A-CCELJ--,?,' MENIFEE, CA 92586 MENIFEE Datelssued: 1112112016 PERMIT Site Address: 27999 TATE RD, MENIFEE, CA 92585 Parcel Number: 336-510-007 Construction Cost: $2,500.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 290 SO FT SOLID ALUMAWOOD PATIO COVER WIELECTRICAL 2 FANS Work: Owner Contractor CARLOS&MARIA TECUATL PATIO GUY ALUMAWOOD CONTRACTOR 27999 TATE RD 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 City Amount Receptacle,Switch,Outlet&Fixture 2 121.00 Building Permit Issuance 1 27.00 DecklPatio, 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 6.05 $295.70 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 othervvise 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. AkB1dg_Permft-Ternplate.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION I hereby affinn under penalty or pedury 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 a my license Is in full fog a d ffV Code:The Contractor's License Law does not apply to an owner of a property License Class License Nc�4 t", who builds or improves thereon, and who contracts for the projects with a Expires f4p-Z (ffiignature_4�;�� licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION 0 1 am exempt from licensure under the Contractom'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 improvements covered by this permit I cannot legally sell a structure that I have permit is issued. built as an owner-bullding 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:http:fl�.leginfo.ca.aovlmlaw.htmI permit is issued.My workers'compensation insurance carrier and policy number are: Carrier Property Owner orAuthorized Agent Date Expire Policy# Name of Agent Phone# El 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 dollars($100)or less) With all applicable city and county ordinances and state laws relating to building construction.)lathorize 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 ldenfif�y fqr I a inspection purposes. 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 subject to the workers'compensation provisions of tion 3700 of the Labor Property OwAr'OrAuthorizedAgeW I' Date Code,I shal)forthwitp comply with those provisions. City Business License# 4q Date; Applicant; -1 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, []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 84B--�QUAL TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS I hereby affirin 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.. M-THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address 01`1`18�DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDE LINES OWNER BUILDER DECLARATIONS 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 EIYES 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. 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 []YES INFORMATION GUIDE AND THE SCAQMD PERM117ING 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 0 Y2__UNDER-THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than(S500).) C 1:1 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). DATE PERMIT/PLAN CHECK NUMBERTMI(O- OvD-740 TYPE; OCOMMEOCIAL VRE51DENIIAL 0MULTI-FAMILs 0MOBILEMOME OFOOLISPA -SIQN SUBIYPL: UAUUIIIUN UACfEKATION fjUkMOLIliUN UELECTRiLAL OMECHANKAL — a-91E-W OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES D ES C R I PTI 0 N OF WOR K I e-) 4 cA,Q Z6Ld) gLUM Zt)Z IlEg, A FqA�)Z ,) PROJECTADDRESS ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME ADDRESS PHONE EMAIL APPLICANT NAME A.9-F-J A-j ADDRESS ZE fiCl� PHONE Lj—17 EMAIL CONTRACTOR'4z NAME 0 YES (9<6' _NER BUILDER? BUSINESS NAME ADDRESS PHONE �EMAIL ClaoinC pad gwd CONTRACTOR'S STATE LIC NUMBER S LICENSE CLASSIFICATION VALUATION$ c�� , sQ FT n L SO FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION SMI 1(00 -TTYOF MENIFEE BUSINESS LICENSE NUMBER BUILDING PL4NNING ENGINEERING FIRE GREEN P INVOICE alls.-71 I AMOUNT 0 PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA�M PLAN CHECK FEES PAIDAMOUNT IC1,11 CIC.HECKff --CREDIT VRD VISAIMCd OWNER BUILDER VERIFIED OYES 0 No DL NUMBER ACR C! 01 meriftc) ty 7japt. LEDGER (& 'TRAU INSPECTION REQUIP ED So.rr . C�-'q Z) All! z&cmitt EAPL CITY OF MENIFEE -ABULW-SAN SAFETY DEPARTMENT PLAN APPROVAL ra L IbeL C �;m- REVIEWED BY Q1 DA" *Approval of these plans shall no+b,construed to be a permit 1! pproval of,any violation j)finy p, iviqfjp�of�he fpdrai,state !.lf regulations and ordinances, This set ot approijec,p), jobsite until completion. &rA4i0L,PA9*, Xt0Z) Ll 2)Ll- 99,5q a w4me-+b r- z 7 i; rf%,TtoqUy 4umqtk-Ak !g, CAR 72�r— L),47—L 4 It CM �olcjen Qvie C�IT-4e 41. fa ? 7-4TE /�,o 4 ) VL "wrfi:A�. CQ. cfa%ba M N ip bnd� L