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PMT17-01737 City of Menifee Permit No.: PMT17-01737 29714 HAUN RD. Type: Residential Addition �A_CCEL/> MENIFEE,CA 92586 MENIFEE Date Issued: 06/02/2017 PERMIT Site Address: 25335 HITCH RAIL LN, MENIFEE,CA Parcel Number: 358-530-038 92584 Construction Cost: $2,739.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL SOLID 276 SO FT ALUMAWOOD PATIO COVER W/ELECTRICAL, 1 FAN Work: Owner Contractor JILLIAN GALGUERRA GUTTERS N COVERS CONSTRUCTION INC 25335 HITCH RAIL LN 1622ILLINOIS AVE SUITE 14 MENIFEE,CA 92584 PERRIS, CA 92571 Applicant Phone:9516728022 TIERRE AMANSEC License Number: 945962 GUTTERS N COVERS CONSTRUCTION INC 1622ILLINOIS AVE SUITE 14 PERRIS, CA 92571 Fee Description Oft Amount($l Receptacle,Switch, Outlet&Fixture 1 116.00 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 5.80 $290.45 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 Menifee.Except as otherwise stated,a permit for conslmction 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 I 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 end ffec Code:The Contractor's License Law does not apply to an owner of a props License Clas License No. W: C Signature _� __ who builds or Improves thereon, and who contracts for the projects wilt Expires _ 4 V ti �- licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION D lam exempt from Iicensure under the Contractors'Stale 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-Nsure 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 entirely 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 available-upon request when this applicalior section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:httol//www.leoinfo.m.govicalaw.html. permit is Issued.My workers'compensation Insurance carder and policy number are: Carrier 2`t'�/Z�. ��'�'/6f' Property Owner orAut ooze gent Date Expires�� Policy#.1 (iw l) i ike. 1. 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 owners behalf. I have read I (This section need !Lot 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 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 prop¢ for 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 Dr..o Code,I shall to tth comply with those provisions, _ v r City Business License# 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 []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, 'ENO 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 PERMITTING 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 penally of not more than($500).) r'\\ CODE SECTION 25505 25533 AND 25534 CONCERNIN( ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL I';EPORI ING. compensation,will do( )all of or( )porting of the work, and the structure Is PR—OPERTY'O kPbR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's Stale License Law does not apply 4o an owner of a property who, through employees' or personal effort, builds or Improves the property, provided that the Improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or Improved for the Purpose of sale). BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION "'Menifee DATE PERMIT/PLAN CHECK NUMBER ' l 1 01,5, TYPE: O COMMERCIAL XESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL EW OPLUMBING ORE-ROOF-NUMBER OF SQUARES C I -` DESCRIPTION OF WORK �/�NVA^� •p \j e_ �-6 ,su Id PROJECTADDRESS 25335 ? ASSESSOR'S PARCEL NUMBER ?I:E;$ —45,5D—O5? LOT _✓� TRACT OWNER NAME ADDRESS n-75 —Itb h L PHONE EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME VJ L OWNER BUILDER? OYES BUSINESS NAME nIJ♦ (�1 ADDRESS II(O] [L[ VLCOL ICI Ptv i C ( Z �I PHONE ` 5l 15 'E) QC)Cj EMAIL 4 e-6 •Ca CONTRACTOR'S STATE LIC NUMBER —/ ')&Z- LICENSE CLASSIFICATION 3 VALUATION$ Z--7 r^ SQ FT 2-710 L SO FT APPLICANT'S SIGNATURE DATE Ithl CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN ' SMIP INVOICE �(��''//�� PAID AMOUNT AMOUNT cgapv I I 1 0CASH 0CHECK II OCREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH 0 CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES 0 NO --Jti of rilenijre ov.::W.diyu/menriee.u5Inspec;l>n He_Ic.est Line 951 246-611 i SQL t LEDGER & TRACK INSPECTION REQUIR i� SR Jf�k OF MENIFE r( ANG AND SAF gA ENT APPROVAL _ Fan O -VED BY 0004 DA E City of Menifea Building & safety Dept. these plan;shall wi or ,. :;,,;, i to be a permit for,or an �• my violation ofanvarov',MIK , ne federal,state orcity JUN 01 2017 Id ordinances. This set o'approved plans must be kept on the mpletion. Received �t��12`r� lS'tc.�O��Y�(� I�l�,snuv�c,�.w�7d.-h c��Je✓ �,vu�ee CY'r�ZScgN - V31,+..�-e � �h, Lf51 28�-B1'23 f� 1 TuSL�'�� 2-T36j