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PMT17-02933 City of Menifee Permit No.: PMT17-02933 29714 HAUN RD. 4'Acci /17. MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 08/18/2017 PERMIT Site Address: 28855 SKYLARK ST,MENIFEE, CA 92584 Parcel Number: 333-631-024 Construction Cost: $7,945.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL SOLID 840 SQ FT ALUMAWOOD PATIO COVER W/ELECTRICAL, 3 FANS, 1 SWITCH,3 Work: LED'S Owner Contractor LINDA LOPEZ GUTTERS N COVERS CONSTRUCTION INC 28855 SKYLARK ST 1622 ILLINOIS AVE SUITE 14 MENIFEE, CA 92584 PERRIS, CA 92571 Applicant Phone:9516728022 SEAN DARE License Number: 945962 GUTTERS N COVERS CONSTRUCTION INC 1622 ILLINOIS AVE SUITE 14 PERRIS, CA 92571 Fee Description Qtv Amount lEl Receptacle, Switch, Outlet&Fixture 7 146.00 Building Permit Issuance 1 27.00 Deck/Patio, non-standard 1 133.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 2.00 General Plan Maintenance Fee-Building 1 6.65 General Plan Maintenance Fee-Electrical 1 7.30 $322.95 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_Tempste.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION f-herebyaffirm-under-penalty-or-perjury-lhat-l-am-licensed-under-provisionsof-----EH,-,s-owner-of-the-propertlran-exclusivety- ntracting-w"Icens Chapter 9 (commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professic Professions CodeV my license is in full a anC ffec Code:The Contractor's License Law does not apply to an owner of a prope License Clas License No. 7r F�cplres� _ Signature' s — who builds tr improves thereon, and who contracts for the projects wilt (.� licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ 1 am exempt from licensure 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 acknowled compensation,Issued by the Director of Industrial Relations as provided for by 9a that, except P for m y personal residence 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 1 hi Policy# built as an owner-building if it has not been constructed in Its entirety-by licem 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•l/wwwleginfo ca covlcalaw html. permit is Issued.My workers'compensation Insurance carder and policy number are: Carrier Property Owner or Aut ooze Agent A a Date Expires /. �� Policy# Sw�p�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 owners behalf. I have read I (This section need DQ 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 prope I for the inspection purposes. shall not t emnloy 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 Da..Code,I shall fo with comply with those provisions. _ 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 OR A DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE ' � MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES /<NO 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 ❑YES 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 OYES 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, 9NO SCHOOL? or repair any structure, prior to Its Issuance, also requires the applicant for the permit to rile a signed statement that he or she is licensed pursuant to the Provisions of the Contractor's State License Law (Chapter 9(commencing with 1 HAVE READ THE HAZARDOUS MATERAAI Section 7000)of Division 3 of the Business and Professions Code)or that he or OYES INFORMATION GUIDE AND THE SCAQMD PERMITTIN( she is exempt from licensure 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 penalty of not more than($500).) r \\ CODE, SECTION 25505 25533 AND 25534 CONCERNIN( ❑ 1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPWING. compensation, will do( )all of or( )porting of the work, and the structure is PROPAY,O ! R AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply io an owner of a property X -.�^ -,sue who, through employees' or personal effort, builds or improves the property, Provided that the Improvements are not Intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the ❑I lrn .of—i-i BUILDIN & SAFETY PERM IT/PLAN CH ECK APPLICATION . Me►�ifee DATE g PERMIT/PLAN CHECK NUMBER ri - VR+" TYPE: O COMMERCIAL RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME O POOL/SPA O SIGN SUBTYPE: 0 A DITION -ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL EW 0 PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK PROJECTADDRESS "OQj1s wL t ASSESSOR'S PARCEL NUMBER a73�j •IQ�j'�E��' LOT &4 TRACT OWNER NAME ADDRESS PHONE Li EMAIL APPLICANT NAME O.,v� C)f ADDRESS CL PHONE t/� \ EMAIL CONTRACTOR'S NAME `J� OJ \ OWNER BUILDER? O YES 0 BUSINESS NAME ADDRESS ( i n�gj � 1 - "��j "' �-ts-` PHONE q� 1 C17 B ��-/ C``]'' / EMAIL tJ CWt930 L� UJU�t�C CONTRACTOR'S STATE LILIGC}NUMBER C) ` 5 I�(02 LICENSE CLASSIFICATION VALUATION$ 1 L-1 S SO FT `' 0 L SO FT c APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ' LITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I $MIP INVOICE 11 Q PAID AMOUNT AMOUNT I� 0CASH .)CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT ^CASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES C) NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO L✓ VJ A4 !q_- r;'�r`u u] ��ul'f � '�.rL, �%nr '-.. . ;Lf.r; :(:r - -. _-Jig ' I '+ < ,�:'i: ".. i 7l%'..'Ifr i (N.. fS I y-r lei:• .i',r+;l gill . : .. ! ' t LED TRACK Building & Sdiaiy UPI- NSPECTION IRED AUG 10 201r Receiw` , it�c xuTY OF MENIFEE 12 BUILDING AND SAFETY DEPARTMENT PLAN APPROVAL I _ REV WEIED BY, 00 07 DATE "Approval of these plans shall not be construed to be a permit for,or an approval of,any vioiation of any provisions of the federal,state or city regulations and ordinances. This set of approved pbns'must bekept on the r jobsite until completion. zslsa S4ar1(� h\ev cf-, C A 92!;!�v Wiz.- lSw ►�h l