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PMT18-00139 City of Menifee Permit No.: PMT18-00139 29714 HAUN RD. Type: Residential Addition 4�kCCEui�> MENIFEE,CA 92586 r.�.n� iSYrn-er MENIFEE Date Issued: 0111012018 PERMIT Site Address: 30276 COBURN CIR, MENIFEE,CA Parcel Number: 358-72M39 92584 Construction Cost: $5,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 13 X 40 SOLID ALUMAWOOD PATIO COVER WITH 2 FANS. Work: Owner Contractor THANA LE SUNSTATE LANDSCAPE INC 30276 COBURN CIRCLE 9901 INDIANA AVE#102 MENIFEE, CA 92584 RIVERSIDE, CA 92503 Applicant Phone:9517977000 SUNSTATE LANDSCAPE INC License Number:945375 9901 INDIANA AVE#102 RIVERSIDE, CA 92503 Phone:9517977000 Fee Description Oty Amount Isl Receptacle,Switch,Outlet&Fixture 2 121.00 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 6.05 $295.70 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 builli ing 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_Permit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contacts for the projects i hereby affirm under penalty of pedurythat l am under provisions of with a licensed contractor(s)pursuant to the Contractors State License taw). Chapter9(commencing with section 7000)of Division 3 of the Business and O 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_S G -7 License Olo. !G .3 -s By my signature below l acknowledge that,except for my personal residence Expires 3cO—/,Signature_ in which Imust have resided for at least one year prior to completion of WORKER'S COMPENSATION DEC ION improvements covered by this permit.I cannot legally sell structure that I 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 worker's 7044 of the Business and Professions Code,is ava0able 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 vrwsv.leeinfo.ca.eovlcalaw.html. this permit is issued. Policy# Date o 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 worker's 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 corred.I agree to comply Carrier )=12yZL'd--, A1,4 r lb-79-L— with all applicable city and county ordinances and state laws relating to /�� building construction.I authorize representatives of this city or county to W Pollcylt L%JfigGL 7IWS Expires_ —, '-('� _ enter the above identified property for Inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT o I certify that In the performance of the work for which this permit Is Issued, Ishallnotemolov any persons In any manner so as to become subject to the CITY BUSINESS LICENSE II worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's conpe sation provisions of Section 3700 of the Labor Cade,I shall forth ft� 1� th hose provisions. Will the applicant or future building occupant handle hazardous material or Applicant Date mixture containing a hazardous material equal to orgreater that the amounts specified on the Hazardous Materials Information Guide? WA :FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes o No UNLAWFUL,AND SHALLSUBIECTAN 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 modifxatfon from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 37060E THE LAB0R CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY oYes allo I hereby affirm that under the penalty ofperjury 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) a Yes o No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD i hereby affirm under penalty of perjury that l am exempt from the permitting checklist.I understand my requirements under the State of California Health&Safety Code,Section 25505 and 255M conceming Contractor's License Law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 OYes o No Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish orrepair 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 Contrecto's State EPA RENOVATION,REPAIR AND PAINTING IRRP) License law(Chapter9(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(5500). managers who do the paint-disturbing work themselves or through their O1,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.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 Contractor's State License Law does not apply to an owner of a oAn 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. o No EPA Lead-Safe Certified Firm Is required for this pmject bemuse: o I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's 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. 'a'�� • ®�° s+� ' � tl+<-. t�'�4 �a�F`y.,N rio"�Z { e � r+i DATE i i PERMIIT/PLAN CHECK NUMBER T V o I'Jq TYPE: O COMMERCIAL 49 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA ::?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 /3X 1JLIb G PROIECTADDRESS ,;?U272G ASSESSOR'S PARCEL NUMBER :.J'J O �otO' O39 LOT TRACT OWNER NAME rlo.4 (_ ADDRESS PHONE /p/G/- ]7S? - EMAIL APPLICANT NAME ADDRESS CWV'I - bt 2 1214adiV6 PHONE `2 EMAIL CONTRACTOR'S NAME = A/YJ,J'G P,C LA/G OWNER BUILDER? O YES t NO C�j liz BUSINESS NAME ADDRESS A v7 1F 7llLf �` S PHONE �s'/_, '7- ]GLP� EMAIL CONTRACTOR'S STATE LIC NUMBER %1/y3 2S LICENSE CLASSIFICATION GoZ VALUATION$ SQ FT S,Z a L SQ FT APPLICANT'S SIGNATURE �"+� ;�� DATE �LU //lam DEPARTMENT DISTRIBUTION I CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE Cy^-� PAIDAMOUNT AMOUNT G O CASH G CHECK it 0 CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH 0 CHECK 0 0CREDIT CARD VISA/MC OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO