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