PMT17-02474 City of Menifee Permit No.: PMT17-02474
29714 HAUN RD.
'5 ►CCEL/-> MENIFEE,CA 92586 Type: Residential Addition
MENIFEE Date Issued: 07/17/2017
PERMIT
Site Address: 30220 SUTTON CT,MENIFEE,CA 92584 Parcel Number: 364-370-054
Construction Cost: $3,500.00
Existing Use: 1 &2 Family Residence Proposed use:
Description of INSTALL 12'X 20'SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 1 FAN,4 RECESSED LED
Work: LIGHTS
Owner Contractor
MATT AMBRIZ PRO INSTALLATION
30220 SUTTON CT 43043 CAMINO CARUNA
MENIFEE,CA 92584 TEMECULA, CA 92592
Applicant Phone:7142348652
JONATHAN COLONNA License Number: 895950
PRO INSTALLATION
43043 CAMINO CARUNA
TEMECULA, CA 92592
Fee Description 01t rr Amount 1$1
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
$311.45
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 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_Bldg_Pernit_Templatexpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractors)pursuant to the Contractors State License Law).
Chapter9(commenting with section 7000)of Division 3 of the Business and o I am exempt from iicensure under the Contractors State License Law for
Professions Code and m license is in full force and effect. the following reason:
License Class 40 Licens r .J By my signature below I acknowledge that,except for my personal residence
Expires Z�/n7 Signature in which I must have resided for at least one year prior to completion of
Improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION TION
have bull[as an owner-builder if it has not been constructed in its entirety by
D 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 forworkers 7044 of the Business and Professions Code,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 www.leginfo.ca.gov/calaw.littril.permit is issued.
Policy g Date
❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which D By my signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carder and policy owner or authorized to act on the property owners 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
c� building construction.I authorize representatives of this city or county to
Policy f(/�{/7Jn Poli �Zz J .T� Expires go Ole enter the above identified property for inspection purposes.
11
(This section need not to be completed is the permit is for one-hundred
dollars($100)or less Date
PROPERTY OWNER OR AUTHORIZED AGENT
D I certify that in the performance of the work for which this permit is issued, +}_/4 J,/
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE N O6"
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code shall fart comply with those provisions. Will the applicant or future building occupant handle hazardous material ora
Applicant Date /7 mixture containing a hazardous material equal to or greater that the
amounts s ecified on the Hazardous Materials Information Guide?
WAR :FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS D Yes amounts
UNLAWFUL,AND SHALLSUBJECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant requires permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SC Lion or See cation ingfrom
checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Air
es
CONSTRUCTION LENDING AGENCY D Yes �No
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) D Yes T3'N0
OWNER BUILDER DECLARATIONS I have reja'd the Hazardous Material Information Guide and the SCAOMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractors 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 Rem(s)(Section 7031.5 hazardous material reporting.
Business and Professions Cade).Any city or county that requires a permit to oYes
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construct,alter,improve,demolish or repair structure,signets Its
issuance,also requires the applicant for the permit
Date
to file a signed statement 17
PIfRTY OWNER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION.REPAIR AND PAINTING IRRPI
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Cade)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in apre-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
than
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.gov/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 Contractors 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. ❑No EPA Lead-Safe Certified Firm is required forthis project because:
❑I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors 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.
APPLICATIONBUILDING SAFETY PERMIT/PLAN CHECK
Menifee
DATE PERMIT/PLAN CHECK NUMBER �O
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL [-]MECHANICAL
❑✓ NEW [-]PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 12 X 20 SOLID ALUMAWOOD PATIO COVER WITH 1 FAN AND 4 RECESSED LED LIGHTS
PROIECTADDRESS 30220 SUTTON CT.
ASSESSOR'S PARCEL NUMBER :NO q, 'J70'05�f LOT 0515 TRACT
PROPERTY OWNER'S NAME MATTAMBRIZ
ADDRESS 30220 SUTTON CT, MENIFEE,CA
PHONE (909)573-9199 EMAIL
APPLICANT NAME JONATHAN COLONNA
ADDRESS 43043 CAMINO CARUNA,TEMECULA 92592
PHONE (714)234-8652 EMAIL
CONTRACTOR'S NAME PRO INSTALLATION OWNER BUILDER? ❑YES❑J NO
BUSINESS NAME
ADDRESS SAME AS ABOVE
PHONE (714)234-8652 EMAIL
CONTRACTOR'S STATE LIC NUMBER 895950 LICENSE CLASSIFICATION D03,C61
VALUATION$ $3,500.00 SO FT 240 L SO FT
F
ANT'S SIGNATURE DATEENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
PLANNING ENGINEERING FIREGREEN SMIP E }� PAIDAMOUNTNT "✓� ' OCASH OCHECK iI CCREDITCARD VISA/MC
AN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER 0 YES C NO
City of Menifee Building& Safety Department 29714 HDun Rd. Menifee, CA 92586 951-672-6715
www.cityafinenifee.us Inspection Request Line 951-246-6213
i
city of Menifee LEGu r`R & TIICR�A�C9ffKC Building & SafetyI Dept. NSPE NI f'tEQUlRE` IUO [i'
JUL 17 2017
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CITY OF FAENIFEE
BUILDING AND SAFETY DEPARTMENT `a
PLAN AP ROYAL
I V
REVIEWJQ E�
'Approval of these plans shall not be construed to be a permit for,or an r
approval of,any violation of any provisions of the federal,state or city 1\
regulations and ordinances. This set of approved plans must be kept on the
jobsite until completion.
I