PMT18-01305 City of Menifee Permit No.: PMT18-01305
29714 HAUN RD. Type: Residential Addition
<ACCEUA MENIFEE, CA 92586
MENIFEE Date Issued: 03/23/2018
PERMIT
Site Address: 32581 HAYDEN RD, MENIFEE, CA 92584 Parcel Number: 360-311-007
Construction Cost: $5,549.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL ALUMAWOOD PATIO COVER WITH 2 FANS&6 LEDS
Work:
Owner Contractor
JOHN ARMSTRONG GUTTERS N COVERS CONSTRUCTION INC
32581 HAYDEN ROAD 1622 ILLINOIS AVE SUITE 14
MENIFEE, CA 92584 PERRIS, CA 92571
Applicant Phone:9516728022
GUTTERS N COVERS CONSTRUCTION INC License Number:945962
1622 ILLINOIS AVE SUITE 14
PERRIS,CA 92571
Phone:9516728022
Fee Description QtV Amount I$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 cantractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and D 1 am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full fo ce and effect the following reason:
License Class nse . CI�s� g m signature below I acknowledge except
Y Y 8 g p V Personal residence
Expires I� Signatur in which l must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
D 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 ofself-insure for worker's 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
this permit is issued. www.leginfo.ca.eov/calaw.html.
Policy# Date
&Xltave 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 0 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 own eh behalf.I have read this
number are: 1- r 1 application and the Information I have provided is correct.l agree to comply
Carrier `y0.�10Y1Q1 �ICt Y)[ll�U f 1Y'P with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
/
Policy# V� r,Y](,p 7.� Expres c �1Q' 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
0I certify that in the performance of the work for which this permit is issued,
Ishallnotemnlov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation la s of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the rkers mpensation provisions of5ection 3700 of the Labor
Code,Ishall hVA ° ith thos rovislons. Will the applicant or future building occupant handle hazardous material or
Applic t -Date 17 mixture containing a hazardous material equal to or greater that the
amounts spe . d on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS 0 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
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District See permitting mchecklist
IN SECTION 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Airlines
Q./ua
CONSTRUCTION LENDING AGENCY ❑Yes �
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 boundaryof a school?
(Section 3097 Civil Code) 0 Yes e
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 Law for the reason(s)indicated below by the California Health&Safety Code,Section 2550S and 25534 concerning
haz 'us m ial reporting.
checkmark(sJ I have placed next to the applicable item(s)(Section 7031.5 oy /
Business and Professions Code).Any city or county that requires a permit to C spate 1 �l /l I /
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT c YCcc�C`Y—c
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 IRRPI
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 disturbs paint in a pre-1978
d receiving compensation for most work that and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be R k that fied firms and comply With
than
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
01,as ownerof the property,or my employee with wages as theirsole employees.For more information about EPA's Renovation Program visit:
compensation,will do( I all of or( I 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-SDD-424-LEAD(5323).
Code,The Contractors State License law does not apply to an owner of a 0 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. 0 No EPA Lead-Safe Certified Firm is required for this project because:
0 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
, . MENIFEE
DATE: PERMIT/PLAN CHECK NUMBER i 1"' I 9
PLANNING CASE NUMBER
TYPE: O COMMERCIAL ID14SIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA C 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 Muri QT 11w Z y,^? E i_ S
PROJECTADDRESS 32 1 HaU Fi�n PA . ZIP Gj S
ASSESSOR'S PARCEL NUMBER 310 `b '3 1 1 'd 0) LOT TRACT
OWNER NAME hn MS�1-0n
ADDRESS 2s¢, O City
Building Dept
PHONE RSf- �3�-6LIS'� EMAIL
APPLICANT NAME tr Ctrs MAR 2 3 2018
ADDRESS Received
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES ONO
BUSINESS NAME }�--M
ADDRESS 1 �r10 S #� !S CP 925-71
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER lyy LICENSE CLASSIFICATION
VALUATION$ SQ FT L SQ FT
APPLICANT'S SIGNATUR DATE z�✓
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGIlykERING FIRE
INVOICE TOTAL14 32� , GREEN SMIP
OWNER BUILDER VERIFIED O YES O No DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofmenifee.us
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