PMT17-01558 City of Menifee Permit No.: PMT17-01558
29714 HAUN RD. Type: Residential Addition
'ACCELA? MENIFEE, CA 92586
l" r0l MENIFEE Date Issued:
OS/18/2017
PERMIT
Site Address: 29353 EL PRESIDIO LN,MENIFEE, CA Parcel Number: 340-550-013
92584 Construction Cost: $3,578.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 11'x 24 SOLID ALUMAWOOD PATIO COVER WITH 2 FANS
Work:
Owner Contractor
MATT BARLEY GUTTERS N COVERS CONSTRUCTION INC
29353 EL PRESIDIO LANE 1622 ILLINOIS AVE SUITE 14
MENIFEE, CA 92584 PERRIS, CA 92571
Applicant Phone:9516728022
CARY RUKASIN License Number: 945962
GUTTERS N COVERS CONSTRUCTION INC
1822 ILLINOIS AVE SUITE 14
PERRIS, CA 92571
Fee Description 0tv Amount($1
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 Mendee.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
hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, 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 a e and�c Code:The Contractor's License Law does not apply to an owner of a prope
License Cis License No. n
Expires _ Signature /cam-- who builds or Improves thereon, and who contracts for the projects wilt
�.� licensed contractor(s)pursuant to the Contractors State License Law),
WORKERS'COMPENSATION DECLARATION
❑ lam exempt from licensure under the Contractors'State License Law for
❑ 1 hereby affirm under penalty of perjury one of the following declarations: fallowing 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 h:
Policy# built as an owner-building if It has not been constructed in Its entirety-by licen:
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 Code,Is available-upon request when this appllcatloi
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:httpl//www.leoinfo.ca.upy/calaw.htmi
permit is Issued.My workers'compe sation Insurance carder and policy number are:
Carrier i� 'Z/. QJ' Property Owner or Aut ooze Agent Date
Expires*-5IZ Policy# 5wc1) 1 )
Name of Agent Phone# ❑ By my Signature below, I certify to each of the following: I am the propi
owner or authorized to act on the property owner's behalf. I have read I
(This section need Dot be completed if the permit is for application and the Information I have provided Is correct. I agree to cam
one-hundred dollars($100)or less) with all applicable city and county ordinances and slate 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 proReapfor the inspection purposes.
shall not employ 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 orAuthorized Agent D6.�Code,I shall fo INlth comply with those provisions.
r City Business License# �IJS�S 1
Date; _ Applicant; _
�: - r
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 MATERIALORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE � � MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES 1�NO 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 []YES 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 penally of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reason(s)Indicated below by the chackmark(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, '�O 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 State 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 [)YES INFORMATION GUIDE AND THE SCAQMD PERMITTIN(
she is exempt from licensors 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 r_01NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFET'
a civil penally of not more than($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNIN(
❑ I, as owner of the properly, or my employees with wages as their sole HAZARDOUS MATERIAL AEPOWtING.
compensation,will do( )all of or( )parting of the work, and the structure is PROPERyY O 7 R AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
r
The Contractor's State License Law does not apply 90 an owner of a property
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
purnnsa of carol
BUILDING i SAFETY PERMIT/PLAN
.Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL RESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHAN10ty Df Menife
XNI EW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES Building& Safety Opt,
DESCRIPTION OF WORK Ci� {� �,, MAY 18 20
47 7Z d
PROJECTADDRESS 6taj5N
2
ASSESSOR'S PARCEL NUMBER JLAO •650-ON'3 LOT TRACT
OWNER NAME Z 77^^
( 3 G ( S I Lav1 C f-zS
ADDRESS
PHONE _I' L)} �j'�j ��� EMAIL
APPLICANT NAME
ADDRESS
PHONE )EMAIL
r�J CONTRACTOR'S NAME (j �bv((_� OWNER BUILDER? O YES O
BUSINESS NAME i
ADDRESS Ib/LZ IiKvf pek_ S CYT %ZS
PHONE �rj/ G/Z � OU'l /}, EMAIL C ' + �/� O �/e
CONTRACTOR'S STATE LIC�NUMBER %ySC/�j�!/2- LICENSE CLASSIFICATION
VALUATION $ 35 � g SQFT Gyy LSQFT
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 OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER J YES 0 NO
-iey of Pilerrijse Sl.lildinq Lb fe:�y uepn,trneni _971 ;laun fim iVleni/ee, CA 92586 951-612 6111
:wt,vw.c.•'fyojmen:i`ee.Lis.lnsnec,'ioo RejuesT Line 95t-246-5213
City of Menlfee
Building & Safety Dept.
MAY 18 2017
�- L Received
LEDGER & TF ACK
SPECTION REQUIRED
CL
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'PL �
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CITY OF ME IFEE
BUILDING A . L
PLAN APPROVAL �]
REVIEWED BY �'ISII'l =Fain
DATE
'Approval of these plans shall not be construed to be'a permft foror an
approval of,any violation of any provisions of the federal,state or city
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