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PMT17-00522 City of Menifee Permit No.: PMT17-00522 29714 HAUN RD. 'AICCELA_>. MENIFEE,CA 92586 Type: Residential Addition MENIFEE Date Issued: 0 2/2 312 01 7 PERMIT Site Address: 30669 LIME ROCK CIR,MENIFEE, CA Parcel Number: 364-300-024 92584 Construction Cost: $5,985.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 576 SQ FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 3 FANS,2 POSTLIGHTS, 1 Work: SWITCH,4 LED'S Owner Contractor JUDY BROWN GUTTERS N COVERS CONSTRUCTION INC 30669 LIME ROCK CIR 1622 ILLINOIS AVE SUITE 14 MENIFEE,CA 92584 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 ISI Receptacle,Switch, Outlet&Fixture 10 161.00 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 8.05 $337.70 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 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 1 am licensed under provisions of ❑ I, as owner of the properly an exclusively contracting with license Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044,Business and Professiol Professions Code�a my license Is in full a anC ffec��jj Code:The Contractor's License Law does not apply to an owner of a proper License Cl as �License No. ,7�(po� r who builds or improves thereon, and who contracts for the projects with Expires _ Signature _ licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ [am exempt from licensure under the Contractors'Slate License Law for It ❑ 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-building if it has not been constricted in Its endrelyby]loans contractors. I understand that a copy of the applicable law,Section 7044 of t ❑ 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:htlo:/Avww.leoinfo.ca aov/calaw html. permit is Issued.My workers compnensatio/1n Insurance carrier and policy number are: _ Carrier �(i�%�L fia. - j' Property Owner orAuthonze Agent Date Expires —7/ 3/ / Policy# Name of Agent Phone# ❑ By my Signature below, I certify to each of the following: I am the prope owner or authorized to act on the property owners behalf. I have read 11 (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($100)or less) with all applicable city and county ordinances and state laws relating to buildi construction.I authorize representatives of this city or county to enter the abok O I certify that in the performance of the work for which this permit is issued,I identified property for the inspection purposes. shall not employ any persons in any manner so as to become subject to the workers'compensation laws of California, and agree that if I should become _ �2 subject to the workers'compensation provisions of Section 3700 of tha Labor prope y Own r or Authorized Agent Dat Code,I shall forthwith comply with those provi;icn . Date; / Applicant; J City Business License �� .. 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 HAZARDOUS MATERIAL OR A DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES <NO 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 DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address NO FROM THE SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR OWNER BUILDER DECLARATIONS GUIDE LINES I hereby affirm under penalty of perjury 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 []YES 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, __�5ZQC SCHOOL? or repair any structure, prior to its Issuance, also requires the applicant for the permit to rile a signed statement that he or she is licensed pursuant to the ] HAVE READ THE HAZARDOUS MATERIAL Provisions of the Contractor's State License Law(Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or []YES INFORMATION GUIDE AND THE SCAQMD 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 04 0 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE SECTION 25505 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZ NDOUS MATERIAL AEPORIING. compensation,will do( )all of or( )porting of the work, and the structure is PROP /NER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The contractor's Slate License Law does not apply 90 an owner of a property •..��— who, through employees' or personal effort, builds or improves the property, provided that the Improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the Purpose of sale). BUILDING SAFETYAPPLICATION '°Menifee DATE PERMIT/PLAN CHECK NUMBER Wffn - W,5^ TYPE: O COMM RCIAL YRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O DDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Au Au. Nt!C t=a✓7 Z + v I5wiich I LEf 's PROJECTADDRESS 3oLb9 l��^ C,� r ASSESSOR'S PARCEL NUMBER v,JW^'�� D� LOT a55 TRACE �- OWNER NAME V e-J3 1VA /�, ADDRESS V/�e floc t- C( r e ln, ee_ `�/ zs 9-LI— PHONE (JIJs Lj ,\S �,)L5 1 EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME /^� /� I OWNER BUILDER? O YES O BUSINESS NAME J 7 0! �1 J id (ov-e—'�}5 f� /� �q n ADDRESS 'b{{`L(y, L��'lI(�T��(5 'R,!'I l �r(1 lam'1 ( PHONE GSI -7 L ) �V�//�� EMAIL ( Ven • �Q �C[`pm CONTRACTOR'S STATE LICC NUMBER %`I5 LICENSE CLASSIFICATION VALUATION$ SO FT L SQ FFTTJ 7 APPLICANT'S SIGNATURE "'z DATE Z Z CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION I(�4 /A CITY OF MENIFEE BUSINESS LICENSENUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE .j��•y PAIDAMOUNT AMOUNT ✓✓ O CASH O CHECK# O CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menrfee Building&So fer-y Depur hnerrt 29114 HDun Rd. Pilenifee, CA 92586 9;1-6/2-677/ vww.ci(yDfinenifee.us Insperbon `teryuest Line 951 246-62.13 CRY Z�I Building &f EDGER & TRACK Safety Dept.TRACK ASPECTION REQUIRED I_t_8 2 3 20V Received � f i Il2 I tAW OF MENIFkE (\ -DING ANDSAFETY DEPARTMENT v � N APROVAL I PF\41EWED BY DAT —:,oalrof thesrplansshail�oC o orstrued to be a permit for,or an gal of,any violation of anv pc,st ns of the federal,state or cdy 1 ^.ons and ordinances. This se:of a pro ied plans must be kept on the JUDY BROWN ALUMINUM PATIO COVER 30669 LIME ROCK CIR. •, 576 SQ.FT. SOLID MENIFEE, CA92584 --- «I L665 3 CEILING FANS 805-405-8659 _ POST LIGHTS / 1 SWITCHES NOT TO SCALE VALUATION $5q155