PMT18-02840 City of Menifee Permit No.: PMT18-02840
29714 HAUN RD. Type: Residential Addition
MF MENIFEE,CA 92586
MENIFEE MENIFEE Date Issued: 0 6/1112 01 8
PERMIT
Site Address: 29383 LONGLEAF ST. MENIFEE, CA Parcel Number: 333-500-024
construction Cost: $5,899.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 18'x 17'SOLID ALUMAWOOD PATIO COVER, 1 FAN,6 LEDS,2 OUTLETS, 1 SWITCH
Work:
Owner Contractor
LISA ZAMBRANO GUTTERS N COVERS CONSTRUCTION INC
29383 LONGLEAF ST 1622 ILLINOIS AVE SUITE 14
MENIFEE,CA 92584 PERRIS,CA 92571
Applicant Phone:9519280098
CLYDE DARE License Number:945962
GUTTERS N COVERS CONSTRUCTION INC
1622 ILLINOIS AVE SUITE 14
PERRIS,CA 92571
Fee Description Q1t r Amount f$1
Receptacle,Switch,Outlet&Fixture 10 161.00
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
$329.65
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 a 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 3 License No. �L�5%�JZ By my signature below I acknowledge that,except for my personal residence
Expires Signature in which l must have resided for at least one year prior to completion of
improvem
R'S COMPENSATION DECLARATION ents covered by this permit.I cannot legally sell a structure that I
WORKE
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. www.leeinfo.ca.eav/calaw.html.
Policy# Date
X1 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 y signature below I certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carrier and polity owner or authorized 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 a �a 1 -}- r�� with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# N15V (t_!jC)o2 Aires IF) enterthe e e identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date Z /
dollars($100)or less
PROPERTY OWNEROR ALIT I1 RIZED AGENT
o I certify that in the performance of the work for which this permit is issued, (�
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthe i ly with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date l mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION CJVERAdE Is oYes WinUNLAWFUL,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($100,00IT),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)7 See permitting checklist
IN SECTION 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guid lines
CONSTRUCTION LENDING AGENCY 0 Yes P,
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 3000 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) 0 Yes
OWNER BUILDER DECLARATIONS 1 have red 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
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7032.5 h Jdou aterial reporting._, 2
Business and Professions Code).Any city or county that reqquires a permit to s I /
construct,alter,improve,demolish or repair any{u1jG10Jp2fbI�QB Date
issuance,also requires the applicant for the permits&Rnorg men[ PROPERTY OWNER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRP1
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 t o I re 8
receiving compensation for most work that disturbs paint in apre-197
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 withan Applicant for a permit subjects the applica a civil penalty pf not more required radices.This includes rental property than($500). q P p p rty owners and property
e��avec managers who do the paint-disturbing work themselves or through their
o I,as owner of the property,or my employee wit wages as eir 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 Contractor's 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. 0 No EPA Lead-Safe Certified Firm is required for this project because:
131,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contrectols 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.
�: . : SAFETY PERMIT/PLAN
M1 L
Menifee
DATE PERMIT/PLAN CHECK NUMBER 243 40
TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME 0 POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Lr-
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER ? 2 LOT TRACE
OWNERNAME ?�C, a,1Jgp1—q
ADDRESS el J
PH0NE� f n�5 �� EMAIL
APPLICANT NAME
ADDRESS � Z e� ZS
PHONE , al 00q EMAIL \l L'YS ry C] / C` LLL t I lOc��
CONTRACTOR'S NAME C� OWNER BUILDER? O YES NO
BUSINESS NAME
ADDRESS 22 925
-71
PHONE q EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ 6 g SQ FT c�Z y L SQ FTpp
APPLICANT'S SIGNATURE DATE IO If If
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT O CASH 0 CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER O YES 0 NO
City of Menifee Duildin9&Safety Department 29714 Houn Rd. wlenljee, CA 9,S86 951-612-6777
www.cityofinenifee.us Inspection Request Line 9.51-246-6213
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REVIEWED B PL
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DATE Lb—
'Approval of these plans$114 not be construed to be a permit for,or an approval of,any violation ofan ��
regulations and ordinances. This set of approved p aans must beral e kept on the jobsiteUntilcompletion. — ��h
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