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PMT17-00939 City of Menifee Permit No.: PMT17-00939 29714 HAUN RD. -ACCELA> MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 0 3/2 912 01 7 PERMIT Site Address: 29635 ROCK CANYON RD, MENIFEE, CA Parcel Number: 340-461-027 92584 Construction Cost: $8,285.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 570 SQ FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 3 FANS, 5 POST LIGHTS, Work: 1 SWTCH Owner Contractor VALERIE BROWN GUTTERS N COVERS CONSTRUCTION INC 29635 ROCK CANYON RD 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 City Amount(El Receptacle, Switch, Outlet&Fixture 9 156.00 Building Permit Issuance 1 27.00 Deck/Patio, non-standard 1 133.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 2.00 General Plan Maintenance Fee-Building 1 6.65 General Plan Maintenance Fee-Electrical 1 7.80 $333A5 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 carded on thereunder when it 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 property who builds or improves thereon,and who contracts for the projects 1 hereby of con under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter!)(commencing with section 7000)of Division 3 of the Business and a I am exempt from licensure underthe Contractors State License law for Professions Code and my license is in full force and effecL /_ the following reason: LicenseClass. F:;, License No.��VJ� By my signature below I acknowledge that,except for my personal residence ExpiresL4 / "/KXt) Signature in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that I have built as an owner-builder if it has not been constructed in its entirety by a I hereby affirm under penalty of perjury one of the fallowing 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 workers 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 websile: by Section 3700 of the Labor Code,for the performance of work for which this permit Is issued. www.leeinfo.ca.eov/calaw.html. Policy# Date B l have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the labor Code,for the performance of the work for which o By my signature below I certify to each of the following:I am the property this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this number are: �rt� application and the information l have provided is correct.l agree to comply Carrier C.t(L (J��tJvs� with all applicable city and county ordinances and state laws relating to Y� building construction.I authorize representatives of this city or county to Policy#�ZL MT('d")( Expires enter the above identified property for inspection pu/rrimss`es. / (This section need not to be completed is the permit is for one-hundred DateuM� 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, Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,1 shall forthwith comply with those provisions. Will the applicant or future building Occupant handle hazardous material or a Applicant Date mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 OYes allo 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($10,000),IN occupant require permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air quality Management econt(SCtionor odipermitting checklist IN SECTION 3706 OF THE LIBOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airlines Qua CONSTRUCTION LENDING AGENIX oyes ONO I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is Issued outer boundary of a school? (Section 3097 Civil Code) aYes oNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD I hereby affirm under penalty of perjurythat I am exempt from the permitting checklist I understand my requirements under the State of Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed nett to the applicable item hazardous material reporting.$)(Section 7031.5 oyes o 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 PROPERTYOWNER 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING JRRP) License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most Work that disturbs paint In apre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence compensor ationre facilityfmost work thartisturbed painIcomplywith than Applicant for a permit subjects the applicanttoa civil penalty of not more required practices.This includes rental property owners and roe rty than($500). managers who do the paint-disturbing work themselves or through heir O1,as owner of the property,or my employee with wages as their sole employees.For more Information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-BOD-424-LEAD(5323). Cade,The Contractors State License Law does not apply to an owner of a O An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the Improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or Improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because: a 1,as owner of the property am exdusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's State License law does not apply to an owner of a If your project does not comply with EPA RRP rule please rill out the RRP Acknowledgement. Y: `,Menifee DATE PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME 0 POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK � ':S,Q c m 5bsk Q G9.-l� 5wl PROJECTADDRESS ASSESSOR'S PARCEL NUMBER 3L{O l LOT 1 U J TRACT OWNER NAME �— ADDRESS �j PHONE 6 ��^T JC)g8 EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES YNO BUSINESS NAME ADDRESS ZS� PHONE 051L*Zo �� EMAIL el5 nl 5 ILCo CONTRACTOR'S STATE LIC NUMBER qtL51qb LICENSE CLASSIFICATION VALUATION$ Z�� r SO FT _ P5'a"0 L SQ FFT/� APPLICANT'S SIGNATURE - DATE 2-q 3f DEPARTMENT DISTRIBUTION �n CITY OF�MMENIIE FB1UW LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN 60 SMIP ✓5551 INVDICE 2 PAID AMOUNT AMOUNT J 0CASH 0CHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# 0CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES 0 NO DL NUMBER NOTARIZED LETTER O YES O NO - r7t:;lclin'a : SE(I. :�,-r-�pnt m�r:d _ ru/ee•, Crl9:Sriya.i 67Z 6171 LEI4:7ER & TRACK City ofMeniteo Eullrliny & Safety D p'i. 4i 10PECTION REQUIRED MAR 2 9 201 OF NIE'N FEE .DING AND SAFETY DEPARTMENT R e .N APPROVAL VIEW r.� ED B DATE pproval of these pla is shall not be can trued to be a permit for,or an pproval of,any violat on of any pravisio s of the federal,state or illy regulations and ordin ces. This set of a proved plans must be kept on the jobsite until completi n. c� I r 14(it.wui,Luw Pa-h'y2)Ve� 29 �35 1�xi�C�vf oaf `Ed fi 5'10 0 I P-S'Dw� v'V�� fee C'w �Izs�l 3��s s �1515b lUy8 NOT T6 SC ftt-