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PMT17-01480 City of Menifee Permit No.: PMT17-01480 29714 HAUN RD. Type: Residential Addition "/1CCELA�. MENIFEE, CA92586 $Yk— MENIFEE Date Issued: 05/10/2017 PERMIT Site Address: 31802 LIVINGSTON ST, MENIFEE, CA Parcel Number: 360-710-025 92584 Construction Cost: $5,800.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL ALUMUAWOOD SOLID PATIO COVER-490 SO FT.WITH ELECTRICAL-TWO FANS. Work: Owner Contractor JOSPEPH BERLIN GUTTERS N COVERS CONSTRUCTION INC 31802 LIVINGSTON ST 1622ILLINOIS AVE SUITE 14 MENIFEE, CA 92584 PERRIS,CA 92571 Applicant Phone: 9516728022 GUTTERS N COVERS CONSTRUCTION INC License Number:945962 1622 ILLINOIS AVE SUITE 14 PERRIS,CA 92571 Fee Description Ply Amount tEl 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_Bidg_Pernit_Template.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 ]loans Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professic Professions CocleV my license is in full a and elff:c. Code:The Contractor's License Law does not apply to an owner of a prope License Class License No. JrC�cpa� r V Expires who builds or improves thereon, and who contracts for the projects witt Signature-/ g _ --` licensed contractor(s)pursuant to the Contractors State License Law), WORKERS'COMPENSATION DECLARATION ❑ 1 am exempt from Ilcensure under the Contractors'State License Law for ❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason: 1 have and will maintain a certificate of consent of self4nsure 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 hi Policy# built as an owner-building if it has not been constructed in its entirety by Iicent contractors. I understand that a copy of the applicable law, Section 7044 of ❑ 1 have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available-upon request when this applicatioi section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:hfto:Uwww.leoinfo.ca.cov/calawhtml, permit Is Issued.My workers' comp/e�nsatio/1n Insurance carrier and policy number are: Carrier a �Pi�dy� O'La_p I Property caner or Authorized Agent Date Expires � �� Policy Name of Agent Phone# [I 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 I (This section need be completed if the permit is for application and the Information I have provided Is correct. I agree to com one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to build construction.I authorize representatives of this city or county to enter the abo ElI certify that In the performance of the work for which this permit Is issued,I Identified pro pe for the inspection purposes. shall not emoiov 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 property Own r or Authorized Agent Code,I �/'_�Appllcant: fo those provisions. r Data;_ _ _ 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 A HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE � � MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES /;S1N0 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 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, '�0 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 Slate License Law(Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAI Section 7000)of Division 3 of the Business and Professions Code)or that he or OYES INFORMATION GUIDE AND THE SCAQMD PERMITTINC she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENT: violation of Section 7031,5 by any Applicant for a permit subjects the applicant to UNDER THE STATE OF CALIFORNIA HEALTH AND SAFEr a civil penalty of not more than($500).) '\ CODE SECTION 25505 25533 AND 25534 CONCERNIN( ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL AEPORI'ING. compensation,will do( )all of or( )porting of the work, and the structure is PROPERT71 R AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply io an owner of a property X who, through employees' or personal effort, builds or Improves the property, provided that the Improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or Improved for the Purpose of sale). BUILDING & SAFETYPERMIT/PLANAPPLICATION v 1 , A.Menifee DATE PERMIT/PLAN CHECK NUMBER Mr 11-D 1 q 0 v TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME C>POOL/SPA O SIGN SUBTYPE: 'ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 19 scj Z PROJECTADDRESS �� 2ZLwin ASSESSOR'S PARCEL NUMBER 3�(V �I D L� LOT TRACT OWNER NAME ADDRESS "S ) oZ PHONE 09 Z)O L6l S I EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES O NO BUSINESS NAME�(,, ADDRESS P�U 22, ( w -*/ fernsC PHONE GJS1 q7-6 0gp `EMAIL �J65 rs k,[O CONTRACTOR'S STATE LIC NUMBER Sys 9(o 2. U LICENSE CLASSIFICATION VALUATION$ Q SO FT qo L SQ FT APPLICANT'S SIGNATURE DATE CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT AMOUNT O CASH O CHECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER 0 YES O NO Ot o/PA-I rr�e rf tn(nnq & MOoiy boo Sur r r �� J,r: , r'm W'szi r'�L �p f ' I 'v O W U LL u— �2��,�e O 0 w �:e_ CC r "1 Cr 06z ow Jt1 Cn City of Menifee Z Building & Safety Dept CITY OF ME IFEE MAY 1 0 2017 ENT Received PLAN APPROVAL REVIEWED B ?�P1 _?i e u 2- -r 1e o -"Approval of these plans shall not be construed to be a permit for in approval of,any violation of any provisions of the federal,state VcF c /�iR Fe C 9 2- r�yregulations and ordinances, This set of approved plans must be ept on i. 1 0 /r y jobsite until completion. •- /``?of