PMT17-00940 City of Menifee Permit No-: PMT17-00940
29714 HAUN RD.
�CCELAl�. MENIFEE,CA 92586 Type: Residential Addition
MENIFEE Date Issued:
03/2912017
PERMIT
Site Address: 30196 SHORELINE DR,MENIFEE, CA Parcel Number: 364-021-037
92584 Construction Cost: $3,405.00
Existing use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 294 SO FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 1 FAN, 1 OUTLET
Work:
Owner Contractor
CINDY GALLAGHER GUTTERS N COVERS CONSTRUCTION INC
30196 SHORELINE DR 1622 ILLINOIS AVE SUITE 14
MENIFEE,CA 92584 PERRIS, CA 92571
Applicant Phone:9516728022
SEAN DARE License Number: 946962
GUTTERS N COVERS CONSTRUCTION INC
1622ILLINOIS AVE SUITE 14
PERRIS,CA 92571
Fee Description QQtr Amount fEl
Receptacle,Switch,Outlet&Fixture 2 121.00
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 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 carded 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 property who builds or improves thereon,and who contracts forthe projects
I herehyaffirm under penalty of perjury that 1 am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and a I am exempt from licensure under the Contractors State License Lawfor
Professions Code and my license is in full force and effect�i the following reason:
License Class/ 17 License No. ��l"f�� By my signature below 1 acknowledge that,except for my personal residence
ExpiresL / / 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 1
have built as an owner-builder if it has not been constructed in its entirety by
o 1 hereby affirm under penalty of perjury one of the following 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 webshe:
by Section 3700 of the Labor Code,for the performance of work for which t,�vw,leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy 8 Date
81 have and w1i1 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 l 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 an the property owners behalf.I have read this
number are: I application and the information I have provided Is coned.I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy ft Expires_ enterthe above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred ��M/� (�
dollars($100)or less Dat
PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit is issued,
IshallnotemoloV any persons in any manner so as to became 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 370D of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified an the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS a Yes D No
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($300,000),IN occupant require a permit for the construction car modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Managementhe District(SCAQM tionor See permitting from
checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES foastArQua
es
CONSTRUCTION LENDING AGENCY oYes allo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this perm it is issued outer boundary of a school?
(Section 3097 Civil Code) ❑Yes o No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjurythat 1 am exempt from the permitting checklist.I understand my requirements underthe State of
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item hazardous material reporting.$)(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 PROPERTY OWNER 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 IRRP)
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 a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This Includes rental property owners and property
than($500), managers who do the paint-disturbing work themselves or through their
col,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.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800.424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a oAn 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. a No EPA Lead-Safe Certified Firm is required for this project bemuse:
a 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: 0 COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA 0 SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK "L(�1ySl� (_DAK zy_y' pQ
�Cl
PROJECT ADDRESS
ASSESSOR'S PARCEL NUMBER Ml -Q37 LOT _ TRACT
OWNER NAME
ADDRESS p, 1� `/ ove �)V'
PHONE -4c 1 3o(os EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME /r -/ �7 OWNER BUILDER? 0 YES O
BUSINESS NAME
L- u4 '- Y - A) ovtr3
ADDRESS IOZZ. lino k. I (rP7_ Ce gl
PHONE ' c)z (JIJ' EMAIL GW Q9 japk COm
CONTRACTOR'S STATE LIC NUMBER �9�I5`bZ I LICENSE CLASSIFICATION
VALUATION$ 3LI05 SQ FT Z� L SQ F//T��
APPLICANT'S SIGNATURE �. DATE 2-I MFI(t 0
DEPARTMENT DISTRIBUTION CITYOF MENIFEE BUSIUJ/�S LICENSE NUMBER
BUILDING PLANNMG ENGINE NG FIRE GREEN ' SMIP �56� 1
INVOICE
AMOUNT PAID AMOUNT OCASH OCHECK# 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES O NO DL NUMBER NOTARIZED LETTER C; YES O NO
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I
ii EDGER & TRACK
INSPECTION REQUIRED
City o N eni e
3uilding & Safet Dept.
MAR 9 2 17
Cl F MENIFEE Rec 1V0d
BU LDING AND SAFETY DEPARTMENT
PLAN APPR0
REVIEWED BY r
DATE
*Approval of these plans shall not be cons rtA d to be a permit for,or an
approval of,any violation of any provisions of he federal,state or city
re ul do ed plans must be kept on the
jobsite until completion.
21 l s- DU4.
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