PMT17-01928 City of Menifee Permit No.: PMT17-01928
29714 HAUN RD. Type: Residential Addition
�AICCELA_ MENIFEE,CA 92586
SO— MENIFEE Date Issued: 06/16/2017
PERMIT
Site Address: 27541 POTOMAC DR, MENIFEE, CA Parcel Number: 336-350-027
92586 Construction Cost: $2,200.00
Existing use: 1 &2 Family Residence Proposed Use:
Description of SOLID ALUMAWOOD PATIO COVER WITHOUT ELECTRICAL-LATTICE ALUMAWOOD PATIO
Work: COVER WITHOUT ELECTRICAL 262 SO FR
Owner Contractor -
JAY FRENCH GUTTERS N COVERS CONSTRUCTION INC
27541 POTOMAC DR 1622ILLINOIS AVE SUITE 14
MENIFEE, CA 92586 PERRIS,CA 92571
Applicant Phone: 9516728022
TIERRE AMANSEC License Number:945962
GUTTERS N COVERS CONSTRUCTION INC
1622 ILLINOIS AVE SUITE 14
PERRIS, CA 92571
Fee Description Oft Amount 1$)
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
$168.65
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 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_Templalespl 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 4 e nd ffec Code:The Contractor's License Law does not apply to an owner of a prope
License Clas License No. (Pp( r 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
D 1 am exempt from llcensure under the Contractors'State 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 ha
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 available-upon request when this application
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:htto:llwww.leainfo.ca.00v/colaw.html.
permit is Issued.My workers'compensation Insurance carrier and policy number are:
Carrier �1/(.r/)L/Y d fit'? /0 La—P Property Owner orAuthonzed Agent pate
Expires 7 3Id Policy#S�(JCl i 4 —
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 B_oA 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 pr! 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 r Own or Authorized Agent Da..
Code,I shall fo with comply with those prov!sions. GJ -
r
Date; City Business License#
_ Applicant; _
WARNING: FAILURE TO SECURE WORKERS'
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL HAZARDOUS MATERIAL DECLARATION
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, OYES 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 <0 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 DYES 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 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, __;0,NO 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 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 ❑YES INFORMATION GUIDE AND THE SCAQMD PERMITTIN(
she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENT1
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($500).) \ CODE SECTION 25505 25533 AND 25534 CONCERNIN(
❑ 1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL fiEPOR1'ING.
compensation,will do ( )all of or( )porting of the work, and the structure is PROPERyY O R AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code; r ��`---
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or Improves the property,
Provided that the improvements are not Intended or offered for sale.If,however,
the building or improvement Is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
ournnm�r��ivi
BUILDING i SAFETYPERMIT/PLANAPPLICATION
x�
Menifee
DATE PERMIT/PLAN CHECK NUMBER MT I ~OI012
TYPE: ❑COMMERCIAL NRE51DENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ DITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL [:]MECHANICAL
IEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES .y,,
�DESCRIPTION OF WORK Ld MUM. l D Cover tu I+b no 'e�e�l l ( l
(-Q l e, atum Patio no -2I brwA
PROJECTADDRESS j g5yI pChMCIC, r• ent-CCJe C g1-586
ASSESSOR'S PARCEL NUMBER ✓✓LV' �'02
-17 LOT ' mot' TRACT
PROPERTY OWNER'S NAME Q h . a1 Vµet•ifee e t
ADDRESS S R,YY12 ovs above- ' OUVIdIR19`1
PHONE - p -L{ONLD• EMAIL ,UN
APPLICANT NAME J.er a, aVed
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? ❑YES NO
BUSINESS NAME
ADDRESS II 9- Utno *- 42591
PHONE q51- q26-CDGg EMAIL
CONTRACTOR'S STATE Lit NUMBER gLl5RLOZ LICENSE CLASSIFICATION
VALUATION$ Q SO FT 21_0Z I� L SO FT f
APPLICANT'S SIGNATURE DATE r(al �
DEPARTMENT DISTRIBUTION 00 CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN ( ' SMIP I '
INVOICE PAID AMOUNT
AMOUNT tD� O CASH v CHECKN O CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT QCASH 0CHECK& OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZEDLETTER D YES C NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
CITY OF MENIFE
CK
BUILDING AND FETY DEPARTMENT �NLED
p �� Q jRED
PLAN APPROVA
REVIEWED BY
DATE olzlvo .
*Approval of these plans sh II not be construed to be a permit for,or an
approval of,any violation o any provisions of the federal,state or city f`J�o
regulations and ordinances. This set of approved plans must be kept on the
jobsite until completion. `v
S
-�IOUS2
ro•S SGtyc` � tlr��- �U•S �'
� 7 -- - - - - -I- 12r OCU
U.
i� U.
O
City of Menifee
L Bu Iding & safety Dept.
JUN 16 2017
Received,
Jct French OLt.l.M. Pafito Cover
c 'q u1 Potomac Dr io.5x 1L1 -SoL. d
Menrfee, C14 gz58(, 1 I.5x 10 LaAAIce
(023 -�1t73- yo4(o YV 2(�2
no electrf cal
IV
aabo