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PMT17-02213 City of Menifee Permit No.: PMT17-02213 29714 HAUN RD. Type: Residential Addition <ACCEL/!� MENIFEE,CA 92586 MENIFEE Date Issued: O6/2a/2017 PERMIT Site Address: 28046 WINDSOR DR, MENIFEE, CA Parcel Number: 337-164-001 92586 Construction Cost: $4,110,00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 9 X 16 LATTICE ALUMAWOOD PATIO COVER LOCATED IN FRONT YARD Work: Owner Contractor GARY EVANS GUTTERS N COVERS CONSTRUCTION INC 28046 WINDSOR DR 1622 ILLINOIS AVE SUITE 14 MENIFEE, CA 92586 PERRIS, CA 92571 Applicant Phone: 9516728022 TIERRE ALMANSEC License Number:945962 GUTTERS N COVERS CONSTRUCTION INC 1622 ILLINOIS AVE SUITE 14 PERRIS, CA 92571 Fee Description city Amount($ 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 building 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_Pennit_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_.&infl my license is in full W e nd ffec Code:The Contractor's License Law does not apply to an owner of a prope License Cl as License No. p( r who builds or improves thereon, and who contracts for the projects with Expires _ Signature �t —(�� licensed contractor(s)pursuant to the Contractors State License Law), WORKERS'COMPENSATION DECLARATION ❑ lam exempt from licensure under the Contractors'State License Law for ❑ I 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 N Policy# built as an owner-building If It has not been constructed in its entirety,by licent 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 applicatioi section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:htto,llwww lealnfo.ca.aovlcalaw html. permit is Issued.My workers'compensatlo fia /1n Insurance carrier and policy number are: ss Carrier ,.X� (.PiZ L� YIQf'6-�_p Property Owner or ut onze gent Date Expires A Policy#SW(,j) itike 1._ Name of Agent Phone# ❑ By my Signature below, I certify to each of the following: I am the propE owner or authorized to act on the property owner's behalf. I have read I (This section need AQ 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 stale laws relating to build construction.I authorize representatives of this city or county to enter the abo ❑ I certify that In the performance of the work for which this permit is Issued,I identified prope or 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 orAuthodzed Agent Da.o Code,I shall D Hith comply with those provisions. - r p 65 Date; _ Applicant; _ J City Business License# S / 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, DYES OCCUPANT HANDLE AHAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE ''� �� MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES / N0 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 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 DYES 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, 7�RNO 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 State License Law (Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or DYES INFORMATION GUIDE AND THE SCAQMD PERMITTIN( she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTt 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( ❑ I, as owner of the properly, or my employees with wages as their sole HAZARDOUS MATERIAL AEPORfING. compensation,will do( )all of or( )porting of the work, and the structure is PROPER 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 apply4o an owner of a property X a 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 OWN' riDATE 7' Q PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL RESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O,ADDITION 0 ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK \� 1( yce rib -u.(ecfriC PROJECTADDRESS Zip \� ASSESSOR'S PARCEL NUMBER ?j sjI - Ifd+-U)OI LOT L01 TRACT OWNER NAME a ADDRESS 7 PHONE SOS bl�o EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAMEQ, OWNER BUILDER? 0 YES 0 BUSINESS NAME` /� ADDRESS ` O - �yV� /Q V/ C f'r CI IS-4-1 /� W PHONE q51 -/ Z5 e EMAIL pW.JtCS y W"�1COk_.Com CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION $ W ID SQ FT 1`iN L SO FT ((�� APPLICANT'S SIGNATURE DATE ZCJ DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE ��//--��[ PAID AMOUNT AMOUNT (0 ' OCASH 0CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH 0 CHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO -icy of PifBnij F•8 Eluihiulq & ';UJ;riy ovpur-r�neni -9 ;-t luu;i Rd. r!/1_niJEe, CA 91536 9�1 6:2 b77/ .V'NbH.CjfI/i,)�179E'llliF--•.L1512:(1PCfIU! Ij;'tj,;�.`r 1!iv'95 1-245-621 1 IF MENIFEE M AND SAFETY DEPARTM&N t APPROVAL h VED BY_ _ �� 0" 0 y 'these plans shall not be construed to be a permr: k, or an LEDGER RAC . ait, .:. any violation of a y provisions of the federal,state or city n R�, r V regui,rr Aordinances. T is set of approved plans must be kept on the ,,SSE TIO' REOU11 LL jobsm , completion. U. 0 Nau &"a k&Wa for R". tIisuawA D JUN 28 2017 C*et Lia-rise Pia rihn Dapwkr%ntl I IQ� L - - - — 1 Cam �alecn5 i�1vv�l..t�V.�nn��i��Alw IN�Uyni��ee 0A G'125iS� N U <:6-� r-�'o-T ,—ascyo�� o t tCFhca