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PMT17-01003 City of Menifee Permit No.: PMT17-01003 29714 HAUN RD. Type: Residential Addition �l-�CCELA? MENIFEE,CA 92586 MENIFEE Date Issued: 04/05/2017 PERMIT Site Address: 26268 ADELINA DR, MENIFEE,CA 92584 Parcel Number: 360-600-008 Construction Cost: $2,730.00 Existing use: 1 &2 Family Residence Proposed Use: Description of INSTALL 273 SO FT LATTICE ALUMAWOOD PATIO COVER, NO ELECTRICAL Work: Owner Contractor ALTIE HOLCOMB AAA ALUMINUM PATIOS INC 26268 ADELINA DR 1268 TRENTON AVENUE MENIFEE,CA 92584 CORONA, CA 92880 Applicant Phone:9517344729 PHILLIP GREEN License Number: 728413 AAA ALUMINUM PATIOS INC 1268 TRENTON AVENUE CORONA,CA 92880 Fee Description ON Amount($1 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 $168.65 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA_eldg Pennit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: 1 2 License Class �I�-BL/� f�.G,ryU 5€Illo. �2$`+(l By my signature below l acknowledge that,except for my personal residence � Expires -R/�J Signature J In which I must have resided for at least one year prior to completion of Improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION OECLARATIO have built as an owner-builder if it has not been constructed in its entirety by ❑I 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 website: by Section 3700 of the Labor Code,for the performance of work for which ,,,w,yy,leeinfo.ca.¢ov/calaw.html. this permit is issued. Policy# -' -2i9Cy Date 74-wave 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 ❑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: application and the information I have provided is correct.I agree to comply Carrier 1/-Fi1'�!1 y 0/Y/l�-f DWLt,, with all applicable city and county ordinances and state laws relating to p1 building construction.I authorize representatives of this city or county to Policy# ::�Ca6XCJW0_Expires /- � ' 2��r� enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is issued, `�G�G I shall not emolov any pers s i any manner so as to become subject to the CITY BUSINESS LICENSE# U J l workers compensation la s of lifomia,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to th orkers co pens ti rovisions of Section 3700 of the Labor Code,I shal hwith com ly wi th .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 an the Hazardous Materials Information Guide? WARNIN • ILURE TO SEC WORK R'S COMPENSATION COVERAGE IS ❑Yes No UNLAWFUL, ND SHALL SUBJE PLOVER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL FI ES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction applicant modification from South IN SECTION 3 06 OF T T LABOR CODE,TION,INTER DAMAGES AS PROVIDED FOR Coast Air Quality Management District.(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND AT FEES forgutdelines CONSTRUCTION LENDING AGENCY ❑Yes 10 No 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) ❑Yes p No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that lam 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 al Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardo s material r rting. Business and Professions Code).Any city or county that requires a permit to oyes o ' Date construct,alter,improve,demolish or repair any structure,priarto its PRO JER O j}T IORIZED 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 R OVATION RE AND PAINTING flRRPj 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 ❑I,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.ena.Rov/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 ❑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. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑I,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. BUILDING • PERMIT/PLAN CHECK APPLICATICIR City & S fetY Dept. nifee Building & Menifee 7 DATE +gp'p�3 PERMIT/PLAN CHECK NUMBER �� V 03 TYPE: >�'EOMMERCI ❑✓ RESIDENTIAL MULTI-FAMILY [:]MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL ❑NEW ❑PLUM�B/ING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK dl' X ! n G''e 'o ovv- Q/ PROJECT ADDRESS ry(i�LG{�I .y ASSESSOR'S PARCEL NUMBER 3(00- (000-OOHS LOT (0'5 TRACT PROPERTY OWNER'S NAME We, V i ADDRESS 940 I -L_ CA PHONE %o • 'Vl/. //1? ) EMAIL rJ APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME THOMASPHILLIPS OWNERBUILDER? ❑YES❑NO BUSINESS NAME AAA ALUMINUM PATIOS,INC. ADDRESS 1268 TRENTON AVENUE CORONA,CA 92880' PHONE (951)734-4729 EMAIL AAARAINGUTTERS82@GMAIL.COM CONTRACTOR'S STATE LIC NUMBER 728413 LICENSE CLASSIFICATION D031 D24 VALUATION$ SO FT L SQ FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION N CITY OFM 1FLE BUSINESS LIf,FN$�NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP o�%✓,�✓ INVOICE �j PAIDAMOUNT G AMOUNT CASH G CHECK# O CREDTf CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/Mc OWNER BUILDER VERIFIED G YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 60 Clty o ee Buldin Safe Dept. A R 05 017 EQGEk & TRACK SPEC-ION REQUIRE© cei4ed ao Poo a CITY OF M NIFElt BUILDING AND JAFETY DEPARTME T PLAN APPROVAL �U r REVIEWED BY DATE 'Approval of thug ans sh I not be construed to he a permit for,or% .,noroval of,anA ation of ai iy provisions of the federaWrr Aty !� regulations and Ord nances. T is set of approved plaqs must be ket on.tl�e jobsite until comp) lea ion. a 5 t .5 Pea iia a Y3 n4 MEM v �r O f f: '' 2GaGZf AJe� i14 p1 �t��y f-ee cA 9a�8�i-