PMT17-01725 City of Menifee Permit No.: PMT17-01725
29714 HAUN RD. T Residential Addition
�I-►CCELX. MENIFEE, CA92586 y�
°......`'"""' MENIFEE Date Issued: 06/01/2017
PERMIT
Site Address: 28646 MAHOGANY TRAIL WAY, Parcel Number: 333-690-028
MENIFEE,CA 92584 Construction Cost: $4,800.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 533 SF SOLID ALUMAWOOD PATIO COVER WITH 3 FANS, 2 OUTLETS,WILL BE BONDED
Work:
Owner Contractor
KETIH ERICSON KMPATIOCOVERS.COM INC
28646 MAHOGANY TRAIL WAY 19495 OAKVIEW LANE
MENIFEE, CA 92584 LAKE ELSINORE, CA 92530
Applicant Phone: 909B386779
ADAM MURVINE License Number:954365
KMPATIOCOVERS.COM INC
19495 OAKVIEW LANE
LAKE ELSINORE, CA 92530
Fee Description Oft Amount(Sl
Receptacle, Switch, Outlet&Fixture 5 136.00
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 6.80
$311.46
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 carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Marilee.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_Pennit Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code and
my license is in full force and effect. the following reason:
License Class 1 Ucen No.qq /Sit/-3 K By my signature below I acknowledge that,except for my personal residence
Expires /r re M Signatu -04,4'Onc, in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that 1
have built as an owner-builder if it has not been constructed in its entirety by
❑I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Cade,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website:
by Section 3700 of the Labor Code,for the performance of work for which
this permit is issued. www.leeinfo.a.eov/calaw.html.
Policy 8 Date
D I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which a By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
number are: application and the information I have provided is correct I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($300)or less PROPERTY OWNER OR AUTHORIZED AGENT
ci,rcerlffy that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE q
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith com/p]ly�with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant /-F�a��1 !-l�r1_1" Date G r mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 o Yes allo
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UPTO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCtionor modification
permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Airllnes
Qua
CONSTRUCTION LENDING AGENCY ❑Yes nNo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) o Yes c.No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item hazardous material reporting.$)(Section 7031.5 Ayes^D NIo d ��
Business and Professions Code).Any city or county that requires a permit to / t7c/L_ Date 6
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT
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 EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contactors
Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.¢ov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not Intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because:
n 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP role please fill out the RRP
Acknowledgement.
AMenifee
DATE / / 77 PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL CTRESIDENTIAL C MULTI-FAMILY O MOBILE HOME O POOL/5PA -SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES-
city f Menif e
DESCRIPTION OF WORK Z/IS-�c �f �33 -/S A J31Z.,/ . Ito Cokv, k, BAIQna Safety Dept.
CQII' t/"�'� Q...� z 66.-//I/�YJ_ �../-�( 44 /6u�l4J % • OO! L -4
PROJECTADDRE55 Z r e h0 q FU.,1 L4. �.g
ASSESSOR'S PARCEL NUMBER
II 2!06- LQgQ • Ca-$ LOT TRACT eCE)IV d
OWNER NAME b I�h E7F;�40„ -7- ^ ,/
ADDRESS 7 908 / 4 /f,,,,/ v xC•�}''`"-E' C'Y �j" ,I•L l
PHONE 55�� Cl yZ EMAIL
APPLICANT NAME /Ikr-IP4Ito CoV4T4• Gun a,e
ADDRESS �7 r��'J�4 C��a!,E'//�tL.� �n, L g k, El1'.kt� 9Z'1 a 0
PHONE 9°g Z'.,�3�p�J��LC ; �5 EMAIL _��
CONTRACTOR'S NAME��//�k` A�•b/q&i/U3, G, , T-tr, OWNER BUILDER? O YES V%NO
BUSINESS NAME /�.� ! >�q4A, C:3vel-j
ADDRESS ( I%°/J' C,q�-I/�pL„ L-•-1, _ 4 C 5
PHONE /�9 � Cr�Sqq EMAIL
CONTRACTOR'S STATE LIC NUMBER /S Y .?-C j LICENSE CLASSIFICATION
VALUATION$ 7'6e)v SO FT 53 3 L SQ FT
APPLICANT'S SIGNATURE- ' DATE L /
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT 5 OCASH OCHECK# OCREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 0CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
LEDGER & TRACK
HOMEOWNER INSPECTION REQUIRED CONTRACTOR
Keith Ericson KMPatioCovers.com,Inc
2864Vahogany Trail Way 19495 Oakview Lane
Menifee CA 92584 Lake Elsinore CA 92530
(951)704-0642 (909)838-6779
License#954365
Scope of Work:Install Solid Alum-a-wood patio cover,(533 sq/ft)with 3 ceiling fans and 2
outlets. .Cover will attach to single family home and concrete slab.
7
R City of Menifee
E i Building fl Safety Dept.
JUN 01 1017
r
Rece ived
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CITY OF MRIFEE i t
BUILDING AND SAFETY DEPARTMENT •
PLAN APPROVAL
REVIEWEDBY� �III�
ATE Q
'Approval of these plans shall not be construed to be a permit for,or an
approval of,any violation of an r ' '
regu FIRS and ordinances. This set of approv d p`5ns must be kept on the
jobsite until completion. 1
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