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PMT17-00776 City of Menifee Permit No.: PMT17-00776 29714 HAUN RD. Type: Residential Addition '�ACCELA—> MENIFEE,CA 92586 MENIFEE Date Issued: 03/1512017 PERMIT Site Address: 28466 OASIS VIEW CIR,MENIFEE, CA Parcel Number: 340-260-024 92584 Construction Cost: $2,596.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 312 SQ FT LATTICE ALUMAWOOD PATIO COVER, NO ELECTRICAL Work: Owner Contractor BILL&SUSAN BRAUER GUTTERS N COVERS CONSTRUCTION INC 28466 OASIS VIEW 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 1622ILLINOIS AVE SUITE 14 PERRIS, CA 92571 Fee Description QtY Amount 1E1 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_Permit_Templale.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property 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 Professioi Professions CodeV my license is in full force and ffec Code:The Contractor's License Law does not apply to an owner of a proper License Clla�s/5 EJ�,,, License No. ' (gyp( who builds or improves thereon, and who contracts for the projects with Expires q/, ;? _ Signature _ licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ lam exempt from licensure under the Contractors'State License Law for ti ❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason: 1 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 constructed in its entirety by licens 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:htto•//www.leginfo.ca.cov/calawhtml. permit is issued.My workers' com/pee/7nsation Insurance carrier and policy number are: Carder .X!�u%Z L/Y.F / /Q' �' Property caner or ut ooze Agent Date Expires �� Policy# 5(r x1) 1 _ 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 tl (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 abo% ❑ 1 certify that in the performance of the work for which this permit Is issued,I Identified oparty 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 subject to the workers'compensation provisions of Section 3700 of the Labor operty Own r or Authorized Agent Dat Code,I shall forthwith comply with those provisions. r Date; _ Applicant; _ City Business License# 6,35555 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 HANDLEA HAZARDOUS MATERIAL ORA 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 OYES 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 penally 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, --RNO SCHOOL? 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 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 10 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole AZ HARDOUS MATERIAL AEPORYING. compensation,will do( )all of or( )porting of the work, and the structure is PROPERZ , 0y AUTHO QED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; l/.// The Contractor's State License Law does not apply to an owner of a property X — who, through employees' or personal effort, builds or Improves the property, provided that the Improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). BUILDIN i APP • ",Menifee DATE PERMIT/PLAN CHECK NUMBER 1 / V TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION 0 DEMOLITION O ELECTRICAL O MECHANICAL EW OPLUMBING ORE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK OAU ftj�L\ U��o OW --3 Nti ie..G-f►-i PROJECTADDRESS- 2�41db I Gar rn ..,_�� 9z ASSESSOR'S PARCEL NUMBER ✓�'Q 't)a�LOT :L 7 TRACT OWNER NAME /�'"YY'7�� ADDRESS PHONE 25.3 ZZ-` 'W30u EMAIL APPLICANT NAMEJieryc a, ADDRESS PHONE EMAIL EMAIL CONTRACTOR'S NAME -e IV �e, OWNER BUILDER? O YES NO BUSINESS NAME pp -� ADDRESS 1� 1,f V1v1 � gLnn, Ci PHONE TJ��Z� O�JB EMAIL IC COH'J CONTRACTOR'S STATE --LICNUMBER �L.�j�'j,(�Z LICENSE CLASSIFICATION VALUATION$ [��i I7 SO FT 31 Z L SO FT APPLICANT'S SIGNATURE - DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION .d SM CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN IP Yf INVOICE II_ c PAIDAMOUNT AMOUNT l J O CASH O CHECK# O CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO 1./yln1 Itv Lrrl >.ii i 0,1rn v ^I,': i1i.un: :;a ivlI mjPf'. tA ,L_?b City of Menifee Building R_ Safety Dept. MAR 15 20V Received � r __EDGER & T AGK V P EC o ION R OUIRED OF MEtW EE g SU9 DING AN SAFETY UPART ENT r 1 .I..A J APPRO A:L RE IEWED BY 7 �Q 'Approval of these plans shall not be construed to be a permit for,or an r approval of,any violation of any provisions of the federal,state or city WAMP regulations and ordinances, This set of approved plans must be kept on the jobsite until completion. 2'u6b oa->s '� 'uj') c 'Y- Ce `{y\ 9' &O_ CW gZS�q No rV(ec6V1 C� i�Z53 Z Z 133C)q N O-T TO 5CV�LE �auv-'I Z5i.b