PMT17-04077 City of Menifee Permit No.: PMT17-04077
29714 HAUN RD.
<ACCEC? MENIFEE,CA 92586 Type: Residential Addition
MENIFEE Date Issued: 11/14/2017
PERMIT
Site Address: 29395 ESCALANTE RD, MENIFEE, CA Parcel Number: 351-25D-031
92587 Construction Cost: $6,980.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 12'X 44'SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 3 FANS, 1 SWITCH, 1 GFI
Work:
Owner Contractor
WILLIAM FLORES GUTTERS N COVERS CONSTRUCTION INC
29395 ESCALANTE RD 1622ILLINOIS AVE SUITE 14
MENIFEE,CA 92587 PERRIS,CA 92571
Applicant Phone:9516728022
HEATHER NAREY License Number.945962
GUTTERS N COVERS CONSTRUCTION INC
1622 ILLINOIS AVE SUITE 14
PERRIS, CA 92571
Fee Description Qyt Amount 1E)
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 carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise staled,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
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 contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)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 U se No �S' �o`L By my signature below l acknowledge that,except for my personal residence
Expires ( 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 DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
❑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.leginfo.ca.gov/calaw.htmi.
this permit is issued.
Policy# Date
❑I have and will maintain worker's 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, L `1 ` `^ application and the information I have provided is correct.I agree to comply
Carrier lVa"CI��QI L\QVI`\�1 4 with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy#1/9 W('9�2?�[G3 Explres '� enter the above identified property for inspection purposes.
(This section need not to he completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT I
D I certify that in the performance of the work for which this permit is.issued, ^�A%M
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# (J y
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to th orke� compensation provisions of Section 3700 of the Labor
Ca shall shall hw'I om ly with t se provisions. Will the applicant or future building occupant handle hazardous material or a
Applican Date �4 ( ! mixture containing a hazardous material equal to or greater that the
amounts sped on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE Is ❑Yes dNo
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 District(SCAQMD)?See permitting checklist
--INSEICTION 3706 OF-THE-LABOR CODE,INTEREST,AND ATTORNEYS FEES fairguideli—
CONSTRUCTION LENDING AGENCY oYes mivo
I hereby affirm that under the penalty of perjury there is a construction WIII 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 boun of a school?
(Section 3097 Civil Code) ❑Yes a
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
California Hea
Contractors License Law for the reason(s)indicated below by the al Safety Code,Section 25505 and 25534 concerning
h �ardou aterial reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 I� s to t
Business and Professions Code).Any city or county that requires a permit to Date l 1 1 1
construct,alter,improve,demolish or repair any structure,prior to its OPERTY OWNER OR AUTHORIZED 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(RRP)
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 contracto
rs
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
an 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
ci 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 ❑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:
❑1,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.
jeMenifee
DATE PERMIT/PLAN CHECK NUMBER ri-oqun
TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME C POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
EEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK A\ ` ^fi r �G� b6b(5zP
a )_SI-u I,-c I F.z-
PROIECTADDRESS 29 Ls co o qd-5"
ASSESSOR'S PARCEL NUMBER 1>61 ';I%) ON LOT 50 TRACT
OWNERNAME
ADDRESS f Q
PHONE J• l 3 ! [_,J ��3� EMAIL
APPLICANTNAME �(Ayryl� CiY�<
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME i�-Q�, OWNER BUILDER? O YES O
BUSINESS NAME
ADDRESS � L'
PHONE EMAILvk4:; / j (L\103 Lle fID/,CONTRACTOR'S STA�TEE�LIC NUMBER �C�S�-'J�j Z LICENSE CLASSIFICATION
VALUATION$ `//� SO FT L SQ FT I '1
APPLICANT'S SIGNATU DATE I -1 I
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION - CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP 56556
/
F `�
PAIDAMOUNT
AMOUNT INVOICE �II• CLASH CCHECKN OCREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 0CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES C NO DL NUMBER NOTARIZED LETTER O YES O NO
,'iry of Ader ) ••.4 Nun _. _ .. ,0!1 9"1 457t-b77:
City of Menifee
Building Dept. LEDGER & TRACK
Nov , 4 201111, N _ TICN REQUIRED
Received
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f. f rr MEIViFE
loft
CLI;LDING ANDS FETY DEPARTM NT 0
"LAN APPROVAL j+
V1EWED 5
DATE
'Aoproval of these plans shall not be c nstrued to be a permit for,or any
approval of,any violation of any provisi s of the federal,state or city
regulations and ordinances. This set of a roved plans must be kept on the
jobsite until completion.
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