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PMT17-03659 City of Menifee Permit No.: PMT17-03659 29714 HAUN RD. Type: Residential Addition 'ACML/-> MENIFEE,CA 92586 a-1 sm.. MENIFEE Date Issued: 1011212017 PERMIT Site Address: 25385 ROCKING HORSE CT, MENIFEE, Parcel Number: 358-541-008 CA 92584 Construction Cost: $3,871.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 12'x 17'SOLID ALUMAWOOD PATIO COVER WITH 1 FAN AND 12'x 11,SOLID Work: ALUMAWOOD PATIO COVER, NO ELECTRICAL Owner Contractor SUSAN RYAN SOUTHERN CALIFORNIA PATIOS 25385 ROCKING HORSE COURT 1787 PAMONA DR#B MENIFEE,CA 92584 CORONA, CA 92880 Applicant Phone: 9098161288 ANDREW POULLATH License Number: 948536 SOUTHERN CALIFORNIA PATIOS 1787 PAMONA DR#B CORONA,CA 92880 Fee Description QQrt Amount($1 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 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_Template.rpt Page 1 of 1 '•'or""'a41 ic4 spe,luoo o4m pue'uoaja41 sanoidwl�o soV�pesuaoll a yllm to suoisnozd.a un w plinq 04m Alradoud p e I Iey1 ti t Ja 333IN3W 30.LL)3 CITY OF MENIFEE LICENSED DECLARATION propertywho builds or improves thereon,and who contram for the prulem I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 70011)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect the following reason: License Class License No. S By my signature below l acknowledge that,except for my personal residence Exp�� f� ,�-Y O 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 1 WORKER'S COMPENSATION DECLARATION have built as an owner-builder If it has not been constructed in its entirety by o 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 for workers 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,.lezinfa.ca.eov/calaw.html. this permit is issued. Policy# Date K 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 ❑By my signature below I certify to each of the following:I am the property this permit Is Issued.My workers compensation insurance carrier 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 1 TF�f`-- 'r LN\ with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives ofthis city or county to Policy# a(ZS-Z. Expires_ � S b' I 'U enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred dollars($100)or less Date PROPERTY OWNER OR AUTHORIZED AGENT o I certify that in the performance of the work for which this permit is Issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 ofthe Labor Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date mixture containing a hazardous material equal to or greater that the amounts s ecified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes No UNLAWFUL,AND SHALL SUBJECT AN 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 require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management Dtstrict constSCtionor modification permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes `I(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 b undary of a school? (Section 3097 Civil Code) ❑Yes NNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist 1 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 item hazardous material reporting. $)(Section 7031.5 // Business and Professions Code).Any city or county that requires a permit to N Date construct,alter,improve,demolish or repair any structure,prior to its �Rt�pE OWNER OR Al1TH IZED AGENT 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRP) License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she Is exempt from licensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors receiving compensation for most work that disturbs paint in a pre-1978 and the casts for the alleged exemption.Any ntoto a ci of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a dull 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 o I,as owner ofthe 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 ofthe work,and the structure Is www.epa.eov/lead or contact the National Lead information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-BOD-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 for this 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 rule please fill out the RRP Acknowledgement BUILDIN & SAFETY PERMIT/PLAN 1 APPLICATION • f1 . _ CRy of ►,erliRfee IdIng& Safety nnni PERMIT/PLAN CHECK NUMBER TYPE: C;COMMERCIAL * ESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME O POOL/SPA OSIGN SUBTYPE: .. ADDITION O ALTERATION O DEMOUTION O ELECTRICAL O MECHANICAL O NEW O PLUMBING 0 RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WO V {lam s 'Z I ZX ol ,(c,,\ C�Je�I- 1 . L� r/ 1��a�1 PROJECTADDRESS dS -585 �e.�+do. NotV Coat OMA4&p ellSX9 ASSESSOR'S PARCEL NUMBER �y� Al . (bR LOT TRACT OWNER NAME 7Ue ( M ADDRESS `L.S3 S M�{SQ1`I' M�i,./I.YYc,C CA ZSu PHONE ( -9 o EMAIL APPLICANT NAME Pn&tAIV oaa c^ ,.Le O ADDRESS �~/ 7� D� x,fp„�" f��j /,c�glo. e� {�f., PHONE `719- Spa`-Z3a� EMAIL Amlxx. ect+ib5 CONTRACTOR'S NAME_04111. +� OWNER BUILDER? YES NO BUSINESSNAME ADDRESS yp, 1'7g-/ I��Q PHONE CF/1� !(� `'�. �5 EMAIL CONTRACTOR'S STATE LICNUMBER SS S3C� LICENSE CLASSIFICATION VALUATION$ 3.97( S FT L SO FT J APPLICANT'S SIGNATURE DATE (oj/-�L// 7 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY: PERMIT FEE O. rD SMIP GREEN 1� PLAN CHECK FEE INVOICE TOTAL OWNER BUILDER VERIFIED 0YES 0 NO DRIVERS LICENSE# _ `NOTARIZED LETTER <% YES 0 NO LEDGER & TRACK SLP- P-ujO'A ASPECTION REQUIRED ,510,h J*L ,2 x I qj cat x _ Poi pujjdjity of Menifoa ✓t I 9 $ Safety D pk CQil.a j 5� OCT I 20fi lic CITY OF MENIFEE BUILDING AND SAFETY DEPARTMENT r PLAN APPROVAL RELl1VI�EW D BY nn L A 'Approval of these plans shall not be construed to be a permit for,or an approval of,any violation of any provisions of the federal,state or city regulations and ordinances. This set of approved plans must be kept on t e jobsite until completion. i I � I I yy I —x — �- - — - - L�—I ir< r i r