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PMT17-01544 City of Menifee Permit No.: PMT17-01544 29714 HAUN RD. �CCELh� MENIFEE, CA 92686 Type: Residential Addition MENIFEE Date Issued: OS/17/2017 PERMIT Site Address: 30877 OAK KNOLL DR, MENIFEE, CA Parcel Number: 364-340-007 92584 Construction Cost: $4,590.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL SOLID 12'X 40'ALUMAWOOD PATIO COVER W/ELECTRICAL 2 FANS,2 LED'S Work: Owner Contractor FRANK GRATACOS GUTTERS N COVERS CONSTRUCTION INC 30877 OAK KNOLL DR 1622 ILLINOIS AVE SUITE 14 MENIFEE,CA 92584 PERRIS, CA 92571 Applicant Phone:9516728022 SEAN DARE License Number: 945962 GUTTERS N COVERS CONSTRUCTION INC 1622ILLINOIS AVE SUITE 14 PERRIS, CA 92571 Fee Description city Amount($ Receptacle, Switch, Outlet&Fixture 6 141.00 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 7.05 $316.70 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 building 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_Bldg_Permit Template.rpt Page 1 of 1 BUILDING i SAFETY PERMIT/PLAN CHECK APPLICATION - 'Menifee DATE PERMIT/PLAN CHECK NUMBER 0119 - 0 i544 TYPE: O C MMERCIAL ESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA U SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK L Sod; 1 u lab 5 PROJECTADDRESS L (>,/ /j�,, ASSESSOR'S PARCEL NUMBER �Q�' �, �O IOD7LOT �_ TRACT V OWNER NAME 5F-L� Tl... Y ADDRESS Ga k- PHONE 2Sl EMAIL APPLICANT NAME ADDRESS S-e- PHONE -fie CLIO EMAIL CONTRACTOR'S NAME � ,� ve_�-s OWNER BUILDER? O YES 0 BUSINESS NAME/_ ADDRESS I&z O' Z/� ff�� PHONE / ' Z8 005R EMAIL �'(-Q.i'SI`TIUJ�.'� Q dCYc_• CONTRACTOR'S STATE LIC��NUUMBER 9yS 6:1Z LICENSE CLASSIFICATION IC/ VALUATIONS `ID SQ FT L SQ FT APPLICANTS SIGNATURE DATE Z U I CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION (/0 CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING RLANNING ENGINEERING FIRE GREEN W SMIP U INVOICE In Q PAIDAMOUNT AMOUNT 11 •7 OCASH 0CHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO v!rnijee Building & afery 0epDrunent d9?; ;lau;; i7d. rVlenl%ee, C.19/1 :)-1 62-6777 �.vw,�,v.ciryn;'menfeeus Inspuc;ion He•iuesr�in�e 9s'! 2=t;5-S>l. City Of Menifee LICENSED DECLARATION I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ 1, as owner of the property an exclusively contracting with licens Chapter 9 (commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044,Business and Professic Professions Code n my license is in full v Ve nd ffe1, Code:The Contractor's License Law does not apply to an owner of a prope License Clas License No. /rop( Expires _ Signature /' who builds or Improves thereon, and who contracts for the projects Witt licensed contractor(s)pursuant to the Contractors State License Law), WORKERS'COMPENSATION DECLARATION ❑ I am exempt from Iicensure under the Contractors'Slate License Law for ❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason: I have and will maintain a certificate of consent of self-insure 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 ht Policy# built as an owner-building if it has not been constructed in Its entirety-by licent contractors. I understand that a copy of the applicable law, Section 7044 of ❑ I have and will maintain workers' compensation insurance, as required by Business and Professions Cade,is avallablevpon request when this applicatiol section 3700 of the Labor Code, far the performance of the work for which this submitted or at the following Web site:htto:/lwww.leginfo.ca.gov/calawhtml. permit is Issued.My workers'compnensation Insurance carder and policy number are: Carrier .JZ�i�/Z dyY / /R-A0f' Property Owner or ut ooze Agent Date Expires -7 -3Z �— Policy# Name of Agent Phone# ❑ By my Signature below, I certify to each of the following: I am the prop( owner or authorized to act on the property owner's behalf. I have read I (This section need pot 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 ❑ 1 certify that in the performance of the work for which this permit is issued,I identified props for the inspection purposes. shall not emolov 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 shall fO With comply with those provisions. r ACity Business License# _ /� S 1 Date;_ _ Applicant; _ 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 /ENO 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 OYES 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, __,RNO SCHOOL? or repair any structure, prior to Its Issuance, also requires the applicant for the permit to rile a signed statement that he or she is licensed pursuant to the I HAVE READ THE HAZARDOUS MATERIAI provisions of the Contractor's Slate License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or DYES INFORMATION GUIDE AND THE SCAQMD PERMITTINC she Is exempt from Iicensure 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 ,. NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFET' a civil penalty of not more than($500).) ''\\ CODE SECTION 25505 25533 AND 25534 CONCERNINC ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL t EPORI'ING. compensation,will do( )all of or( )porting of the work, and the structure is PROPERyY O R AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Cdde; �� The Contractor's State License Law does not apply 10 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). EDGER & TRACK II IS ECTIQIV REQUIRE- City of Me ifee ullcling & Sa ty Dept. MAY 17 201 Receive i CITY OF ME - EIJILDING A D SAFETY DEPARTMENT FLAN APPROVAL REVIEWED E to pL DATE 'Approval of these plans shall not be construed to be a permit for,or an approval of,any violation of any provisions of the federal,state or city regulations and ordinances. This set of approved plans must be kept on the jobsite until completion. I In,Lewt e cw Ll zsR d Z Fav s I { LC-6.5 ISzq Zs)3 �a�e It 45go ✓ IJoT �05C�