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PMT17-04333 City of Menifee Permit No.: PMT17-04333 29714 HAUN RD. Type: Residential Addition �/-�CCEL/� MENIFEE, CA 9258E re...,.-..aM.R. MENIFEE Date Issued: 1 210 7/2 01 7 PERMIT Site Address: 26471 ADELINA DR, MENIFEE, CA 92584 Parcel Number: 380-612-008 Construction Cost: $4,899.00 Existing use: 1 &2 Family Residence Proposed use: Description of INSTALL 12'X 40'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS, 6 LED LIGHTS Work: Owner Contractor JACKIE BRAGG GUTTERS N COVERS CONSTRUCTION INC 26471 ADELINA DRIVE 1622 ILLINOIS AVE SUITE 14 MENIFEE, CA 92584 PERRIS, CA 92571 Applicant Phone: 9516728022 HEATHER NAREY License Number:945962 GUTTERS N COVERS CONSTRUCTION INC 1622ILLINOIS AVE SUITE 14 PERRIS,CA 92571 Fee Description QQt Amount 1$) Receptacle, Switch,Outlet&Fixture 8 151.00 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 7.55 $327.20 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 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 ism full fo/Ce and effect the following reason: License Class Caman{rl�/nse By my signature below l acknowledge that,except for my personal residence Expires 1 Signatur 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 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 70"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 webslte: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. www.IeRinfc,.ca.Roy/caIaw.htmI. P�olic�# Date &Yhave 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 polity owner or authorized to act on the property owners behalf.I have read this numberyar\e., 1 1_ r _L application and the information I have provided is correct.l agree to comply Caller `v0.K10Y\A1 1 Q Y 1 t 1 l�f Q f lY'P_ with all applicable city and county ordinances and state laws relating to �pp II 1-ZZ building construction.I authorize representatives of this city or county to Policy# V CI�C,C66 -n�0:/ Expnes C!(101 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 ❑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 lads of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the rkers 5mpensation provisions of Section 3700 of the Labor Code,Ishall hwith ith thus rovisions. Will the applicant or future building occupant handle hazardous material or Applic �-Date f 1-7 mixture containing a hazardous material equal to or greater that the amounts spa d on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes o 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 IN SECTION 37060E THE L ADDITION TO THE OF COST LABOR CODE,INTEREST,AND ATTORNEYS FEES COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist forguidelin-/es CONSTRUCTION LENDING AGENCY ❑Yes � 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 bounds f a school? (Section 3097 Civil Code) ❑Yes o 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.I understand my requirements under the State of Contractors License Lawfarthe reason(s)indicated below by the California Health&Safety Code,Section 2S505 and 25534 concerning haz ous m ial reporting. checkmark(s)I have placed next to the applicable items)(Section 7031.5 oY } Business and Professions Code).Any city or county that requires a permit to Date ` construct,alter,improve,demolish or repair any structure,prior to its PROPERTY 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 AIRPI 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 Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-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 ❑1,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.eoagov/lead/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 for this project because: o 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 BUILDING & SAFETY PERMIT/PLAN APPLICATION &I. Menifee DATE 19 PERMIT/PLAN CHECK NUMBER . QLA TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK PROJECTADDRESS vo ASSESSOR'S PARCEL NUMBER '5W- LPkZ,c l& LOT TRACT OWNER NAME (� C`f� _ City of Menitee Rpot ADDRESS Z�UyI UI PHONE �Cj, �O(] Gam — EMAIL DEC APPLICANT NAME mod ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES NO BUSINESS NAME Ks' I ADDRESS Kwgil, + Z 4-( PHONE �)S I C/z I3QOl f) EMAIL s iJ ��• y CONTRACTOR'S STATE LIC NUMBER ��jCj(p'JZ LICENSE CLASSIFICATION VALUATION$ (2301 Q FT Nov LSQFT APPLICANT'S SIGNATUR"b� DATE DEPARTMENT DISTRIBUTION CRY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE PAID AMOUNT AMOUNT OCASH OCHECK# 0CREDIT CARD VISA/MC P CHK FEES PAID AMOUNT OusH OCHECK# OCREDITCARD VISA/MC [�OWr�4E�RIBUILDERCVERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Nlenifee Building&Safety Deportment 29114 Haun Rd. Menifee, CA 92586 951-612-6771 www.cityofinenifee.us Inspection Request Line 9.51-245-5213 CITY OF MENIFEE BUILDING AND SAFETY DEPARTMENT City of Menifee PLAN APPROVAL Building Dept. DEC 0 7 2017 REVIEWED BY_�w �a @CeiVe ... TEC ��i *Approval of these plans shall ottz�rs ed,o eaaerr,i ryU �" �1 approval of,any violation of LE an provisions of the fede al,state !�i y t�Z s ter �Rry I y rn regulations and ordinances. Thi set of approved pans must he kept cn the INsPE�i d f� sh C (j jol,•site until completicn. REQUJRFD H r� s 1 i CW' fa y) Zb�t� 1 Prd��iv�a �C �ItSoJ S��d mackkpd t`nP Cc�, 01Zs<6'-f 2+aus S NoT "rO SCI4C