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PMT18-01849 City of Menifee Permit No.: PMT18-01849 29714 HAUN RD. Type: Residential Addition <;�CCEL,f MENIFEE, CA 92586 MENIFEE Date Issued: 04/24/2018 PERMIT Site Address: 29843 ROCK ROSE CT, MENIFEE,CA Parcel Number: 340-403-019 92584 Construction Cost: $5,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL ATTACHED 560 SQ FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL,2 FANS,4 Work: LIGHTS Owner Contractor ALEJO E MARINAS 12760 ANDRETTO ST 29843 ROCK ROSE CT MORENO VALLEY, CA 92553 MENIFEE, CA 92584 Applicant Phone:9518672081 EDUARDO SALAZAR License Number: 18-PEOP-00014 12760 ANDRETTO ST MORENO VALLEY,CA 92553 Phone:9518672081 Fee Description Q-t( Amount($) Receptacle,Switch,Outlet&Fixture 6 141.00 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 7.05 $316.70 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 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 with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of y� Chapter9(commencing with section 7000)of Division 3 of the Business and Jtogym-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. By my signature below I 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 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. wtQ.le nfo.ca. ov calaw.html. _ s / Policy# Date `' o I have and will maintain worker's compensation insurance,as required by RO RTY(} R OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which ❑By my gn�ure below I certify to each of the following:I am the property this permit is issued.My workers compensation insurance carrier and policy owner orcadEhorized to act on the property owner's behalf.I have read this number are: application and the information I have provided is correct.I agree to comply Carrier with all applicable city and county ordinances and state laws relating to bu'IdTg construction.I authorize representatives of this city or coun 'to Policy# Expires ter t�e above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred / Date 7i dollars($100)or less < P !DER OR AUTHORIZED AGENT 1 ❑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 USINESS LICENSE# worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a mixture containing a hazardous material equal to or greater that the Applicant Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑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 District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes ❑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 boundary of a school? (Section 3097 Civil Code) ❑Yes o No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of Contractors License Law for thea reason(s)indicated below by the I hereby affirm under penalty perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes ❑No 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(RRP) 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($SOD). managers who do the paint-disturbing work themselves or through their o 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.epa.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. o 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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION w; Is, MENIFEE DATE: - Z j PERMIT/PLAN CHECK NUMBER p� PLANNING CASE NUMBER TYPE: COMMERCIAL 0"RESIDENTIAL <:' MULTI-FAMILY MOBILE HOME POOL/SPA SIGN SUBTYPE: ADDITION ALTERATION DEMOLITION ELECTRICAL MECHANICAL NEW 0 PLUMBING 0 RE-ROOF NUMBER OF SQUARES /f DESCRIPTION OF WORK PROJECTADDRESS �� c1 ���GC� n G �� ZIP CZS ASSESSOR'S PARCEL NUMBER! LOT TRACT OWNER NAME - Buildinge ADDRESS ? 14 PHONE EMAIL ewled APPLICANT NAME � Q,,i�p S � i ADDRESS I Z 7 6 tT l t'j GZS'� PHONE EMAIL -•• J. l `lw� CONTRACTOR'S NAME O NER BUILDER? A.- 'YES %NO I BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ SQ FT ��7 L SQ FT APPLICANT'S SIGNATURE i'�/� J DATE /I L CITYSTAFF USE ONLY � A low DEPARTMENT DISTRIBUTION ACCEPTED BY: CIT Y OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICE TOTAL .�Q GREEN SMIP --- OWNER BUILDER VERIFIED YES NO DRIVERS LICENSE# NOTARIZED LETTER YES NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 GvTy Op www.cityofinenifee.us MENIFEE LEDGER, TRACK INSPECTION REOURP, city of menifep- Building DePI. MENIFEE Received f , I , AND SAFETY DEPAR. . J,T `Lk APPROVAL 17 NE D BY DATE A these plans shall not be contbvWb be a, )r,or an ?P')L ;i any violation of any provisions d%fiedei city Qs and ordinances. This set of approved plus Sept on the ur-ifl completion. -SVIO VAT)O C<)u 1147 17 lrl (P—cm C4 InM voc�aos<! (A �JRI ve�,A, CALIFORNIA ALL— PURPOSE OSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. City of MenlEe State of California } APR 2 4 2018 County of jzwexJ e- } Received On MOY-0h N , 2O I k before me, Snuff Snyyl-e� r-afy,DL�� I\hu\-u ��Wg- (Here insert name aficIttitle of the officer) personally appeared fie. \O May-I nos , who proved to me on the basis of atisfactory evidence to be the person(s) whose n me(s)Qare subscribed to the within instrument and acknowledged to me that I she/they executed the same incp:f� her/their authorized capacity(ies), and that by 2/ch her/their signature(s) on the Instrument the person(s), or the entity upon behalf of the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. SKYE JANAE CAMPOS WITNESS my hand and official seal. C0MM.#2218211 Notary Public-California y RIVERSIDE COUNTY My Comm.&P.OCT.14.2021 io 2 otary ub Signature ' (Notary Public Seal) 0 � ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT ifneeded,should be completed and attached to the doctmrent.Acbwowledgments from other states may be completed for documents being sent to that state so long Q _ as the wording does not require the California notary to violate California notary /�1��h(�rt��C� - \ ( Z`�/lr law. (Title or description of attached document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signers)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. The notary public must print his or her name as it appears within his or her Number of Pages Document Dat J commission followed by a comma and then your title(notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. he/she/they is/are)or circling the correct forms.Failure to correctly indicate this ❑ Individual (s) information may lead to rejection of document recording. ❑ Corporate Officer . The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. El Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. ❑ Attorney-in-Fact Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. Other Indicate title or type of attached document,number of pages and date. ❑ Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). 2015 Version www.NotaryClasses.com 800-873-9865 Securely attach this document to the signed document with a staple. March 19, 2018 To Whom It May Concern: I, Alejo Marinas residing at 29843 Rock Rose Ct. Menifee, CA 92S84 is hereby authorizing Eduardo Salazar to obtain a permit for my AlumaWood Patio cover. Thank you very much. Sincerely Yours, Alejo Marinas See Attached Notarized Document Dated �1- d/ . ,-rA IFORNIAI' DRIVER LICENSE -- DL 03352300, GLASS C C'xP 03/31/2019 END NONE- - - l.rti MARINAS - FN ALEJO E - ' 29843 ROCK ROSE CT r 1; MENIFEE, CA 92584 DOB 03/31/1974 RSTR NONE --- --= 03311974 SEX _M HAIR_BLK EYES BLK ..HGT V-08" WGT ;170Ib ISS' DD o3io4/2014s35i8iBBFD/19 - "03104/2014 I Carl Putnam P.E. • 3441 Ivylink Place Lynchburg,VA 24503 Carl Putnam, P.E. City of Menifee February 3, 2017 Building Dept. Mike Adams APR 2 4 2018 United Duralume Products, Inc. 350 S. Raymond Ave. Received Fullerton, CA Dear Mike: I am the engineer of record for standard plan, United Duralume Patio Cover, Carport and Commercial En-gineering. These plans have been approved under the 2015 IBC as ICC Evaluation Service Report#2676. For these structures the 2016 CBC is identical to the 2015 IBC and it is acceptable to build structures within the scope of this plan under the 2016 CBC. It is acceptable for copies of these plans to be used to obtain building permits. I can provide an electronic version for comparison if desired. Please contact me at(434)384-2514 or at carlputnam(o-)comcast.net if you require further information. Sincerely, Carl Putnam, P.E. SS�NA G 6, 1 9 /� P. 301201 C I TgTFOFCALL O� JUN 09 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . .