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PMT17-01559 City of Menifee Permit No.: PMT17-01559 29714 HAUN RD. Type: Residential Addition <A_CCEL:A_ MENIFEE, CA 92586 MENIFEE Date Issued: 05/18/2017 PERMIT Site Address: 29153 GRANITE CIR, MENIFEE, CA Parcel Number: 340-171-002 92584 Construction Cost: $6,752.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 224 SF&180 SF LATTICE AND 170 SF SOLID ALUMAWOOD PATIO COVER WITH 2 FANS, Work: 3 POST LIGHTS,2 OUTLETS Owner Contractor AHMAD HUSSEIN GUTTERS N COVERS CONSTRUCTION INC 29153 GRANITE CIRCLE 1622 ILLINOIS AVE SUITE 14 MENIFEE,CA 92584 PERRIS, CA 92571 Applicant Phone:9516728022 CARY RUKASIN License Number.945962 GUTTERS N COVERS CONSTRUCTION INC 1622ILLINOIS AVE SUITE 14 PERRIS,CA 92571 Fee Description 01t r Amount f51 Receptacle, Switch, Outlet&Fixture 7 146.00 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 7.30 $321.95 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_eldg_Permit_Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION I hereby affirm under penalty or perjury that 1 am licensed under provisions of ❑ 1, as owner of the property an exclusively contracting with Iicens 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.Ea my license is in full e an ffec a Code:The Contractor's License Law does not apply to an owner of a prope License Clas License No. p( who builds or improves thereon, and who contracts for the projects wilt Expires _ Signature �' ---�� licensed contractor(s)pursuant to the Contractors State License Law), WORKERS'COMPENSATION DECLARATION ❑ I am exempt from licensure 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 hf 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 ❑ 1 have and will maintain workers' compensation insurance, as required by Business and Professions Code,is avallablevpon request when this applicatioi section 3700 of the Labor Cade, for the performance of the work for which this submitted or at the following Web site:httpl//wwwleolnfo.ca.gov/calaw.htmi permit Is Issued.My workers'comps satlon Insurance carrier and policy number are: Carrier ') A LT Lg—p Property Owner or Authorized Agent Date Expires Policy#SICI)1 zka '_ 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 e4t 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 prope for ttie 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 pro ert Own r orAuthorized ent Da.. Code,I shall fo with comply with those provisions. p y A9 _ r ,Data; Applicant; 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 HANDLEA HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE ' � MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES ,,, 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 OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address NO 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, �'N0 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 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 0 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFE r a civil penally of not more than($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNIN( ❑ 1, 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 PROPERTY O R AUTHORIZED AGENT � not intended or offered for sale.(Section 7044, Business and Professions Code; �l The Contractor's Stale License Law does not apply 4o 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). CUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION r Wenifee DATE 5I1$1vi PERMIT/PLAN CHECK NUMBER — Q' q TYPE: O COMMERCIAL XRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL NEW OPLUMBING ORE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORKC, 19j0 rjX PROJECTADDRESS ',n /� o e fee ASSESSOR'S PARCEL NUMBER 3� ' �"��' �� LOT TRACT Building & Sak ty Dept. OWNER NAME �' S e( d� 8 Z017 ADDRESSZqJ-53 -J PHONE qe,- / 3 ) + 402,b EMAIL ece ed APPLICANT NAME ADDRESS PHONE `` ``EMAIL CONTRACTOR'S NAME 'VJ-� ('j OWNER BUILDER? O YES 0 BUSINESS NAME ADDRESS I1�7�2 /��'V1-. C S p PHONE !s� 9j -b OC iG�l EMAIL L k (S CX �C.[Oyl CONTRACTOR'S STATE LIC NUMBER f y� �p.6 LICENSE CLASSIFICATION VALUATION $ L;452 SQ FT L SO,FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE (� PAID AMOUNT AMOUNT —` OCASH 0 CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAID.AMOUNT OCASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO Cicy o/arfenij:••e E3uiidinq & Su1,-:; ,,r,.rortment %9?14 Ilaun NU. rVlenljee, G4 92326 9 1-6/2-677/ vo- vv.citynjraeu:i e.us la-lpec6un Requesr Line 952-246-621 i C'I��/�4aC- Clf — Menifee �utldln9 Safety dept. MAY 18 2017 LEDGER ACK a �' INSPECTION REQUIRED / Q 1 for zap �. lw CITY F NIFEE tb BUILD FE-TY-DfPAR MMIENT mP� jai PLAN APPROVAL G1=Pust us- REVIEWED BY cAlfs -1 ice`.- auEIP DATE era v> '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 egnlationsand-ord'mantes:—fh nTt-ofappmvedplattsmastbekep (�41IMP obs4�'ipttt 7�(WTI ILVII LWt �aLh O CG,�r Z6i152 _W., Ci ( IgoeL2�h�e ,1-+00IAI�h e IMz Uv Qe� I Cl- qZSSN tf Zfans �bPbs+l qcq s a Q51 301 -q0610 Z 6u*leks �10T 7� S ALE VaWf �, 6—+G L