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PMT16-03787 City of Menifee Permit No.: PMT16-03787 29714 HAUN RD. <A-CCELA�." MENIFEE,CA 92586 Type: Residential Addition MENIFEE Date Issued: 11/2312016 P E R M I T Site Address: 31731 YALE LN, MENIFEE,CA 92584 Parcel Number: 360-710-037 Construction Cost: $2,171.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 240 SQ FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 1 FAN Work: Owner Contractor GWENDOLYN JONES GUTTERS N COVERS CONSTRUCTION INC 31731 YALE LN 1622 ILLINOIS AVE SUITE 14 MENIFEE, CA 92584 PERRIS, CA 92571 Applicant Phone:9516728022 SEAN DARE License Number:945962 GUTTERS N COVERS CONSTRUCTION INC 1622 ILLINOIS AVE SUITE 14 PERRIS, CA 92571 Fee Description aty Amount Receptacle, Switch,Outlet&Fixture 1 116.00 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 5.80 $290.45 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 buillding 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_Permit_Template.rpt Page 1 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 licens( Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044,Business and Professiot Professions CadeR55 my license is in full a and effec Code:The Contractor's License Law does not apply to an owner of a propel License Clas �.L2 U N who builds or improves thereon, and who contracts for the projects with icense o Expires�� — Signature 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 9 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 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 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 he Policy# built as an owner-bulldlng If it has not been constructed in its entirety-by licens contractors. I understand that a copy of the applicable law, Section 7044 of I 0 1 have and will maintain workers' compensation insurance, as required by Business and Professions Code,Is available-upon request when this application section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:h[tol/Avvw.leuin-fo.ca.qovlcalaw.htmi, permit is Issued.My workers'compensation Insurance carrier and policy number are: Carrier 19- a i4-a 1712 Aa LQ-P Property Owner or Authorized Agent Date Explre._�*l Policy#15wo,1) I-elk—kA 0 By my Signature below, I certify to each of the following: I am the pmpe Name of Agent Phone# owner or authorized to act on the property owner's behalf. I have read ti (This section need not be completed If the permit is for application and the information I have provided is correct. I agree to coml one-hundred dollars($1100)or less) with all applicable city and county ordinances and slate laws relating to buildi construction.I authorize representatives of this city or county to enter the abo% D I certify that in the performance of the work for which this permit is issued,I identified property for tile inspection purposes. shall not emol any persons In any manner So as to become subject to the workers'compensation laws of California. and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply With those provisions. Property 0�njlro�rAuthorizedAgent Daba, Date;B Awl& — Applic City Business License# 635!�55 JG: 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 kUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING ($100,000), IN ADDITION TO THE COST OF COMPENSATION, OYES 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 KNO EQUAL 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 OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address _XN 0 DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR OWNER BUILDER 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 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. SCHOOL7 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 EIYES INFORMATION GUIDE AND THE SCAOMD 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 -_,060 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING 0 1, as owner*of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPOWYING. compensation,Will do( )all of or( )parting of the work, and the structure is PROPER�YPV/NER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply io an owner of a property X Z who, through employees' or personal effort, builds'ar improves the property. provided that the Improvements are not intended or offered for sale.If,however. the building or improvement is sold within one year of completion,the Owner- Builder Vill have the burden of proving that it was not built or improved for the DUmOSe of SRIP.1 BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION DATE PERMIT/PLAN CHECK NUMBER TYPE: 0 COMMERCIAL KRESIDENTIAL OMULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN SUBTYPE: OADDITION OALTERATION OIDEMOLITION OELECTRICAL OMECHANICAL ANEW OPLUMBING 0 RE-ROOF-INUMBER OF SQUARES_ DESCRIPTION OF WORK Alum�\A(I(AAP, --c)C( PROJECTADDRESS �b-fleln ASSESSOR'S PARCEL NUMBER 5(00— 'ji0-0'b'7LOT 'I TRACT —,501 q�*A- OWNER NAME otu vi ADDRESS '31-4-3� q&-- 6 PHONE 313 3b* -jo-�ICJ EMAI\L� APPLICANT NAME ADDRESS PHONE EMAIL CONTRAcToR'S NAME OWNERBUILDEL? OYEsl,+O BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER OlLr3 2- LICENSE CLASSIFICATION 9-6oiend VALUATION$ 2)�'fl SQ FT 24(-) LSQFT APPLICANTS SIGNATURE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF NIENIFEE BU51NESS LICENSE NUMBER BUILDING P.LANNING ENGINEERING FIRE I GREEN SMIP I IfV INVFO—ICFE—[� AMOUNT jo PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASK OCHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO City oflillenifee Budding ,9K Suf&y 0epciament29114 HUL111 Hd. Menil--el CA 92586 931-612-6111' !.vww.citYofmenifee.u5 inspeccion Request Line 951-246-621.3 LEDGER & TRACK :)PECTION REQUIRED A 0 7,S r c ty of Meniteo ouildi ig & Safety D)pt. I OV 2 3 20il F E)CE)iVe J CITY OF MENIFEE BUILDING AND SAFETY DEPARTMENT PLAN APPROVAL REVIEWE Y )�4� -.9 1 DATE 'Approval of these planssha;�nw �Pnstruedtobea permitfororan approval of,any violation of any v)visjons of the federal,state or city regulations and ordinances. This set of approved plans must be kept on the jobsite until completion. 0 A F-a n Jovle-s -ko 62)�ff V P* 29D rJ D-T TO