PMT18-02841 City of Menifee Permit No.: PMT18-02841
29714 HAUN RD.
AF MENIFEE, CA 92586 Type: Residential Addition
MENIFEE MENIFEE Date Issued: 06/11/2018
PERMIT
Site Address: 27097 FAN LN, MENIFEE,CA 92586 Parcel Number: 335-353-019
Construction Cost: $7.512.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL ATTACHED SOLID 13'X 36'ALUMAWOOD PATIO COVER W/ELECTRICAL 6 LED LIGHTS, 3
Work: OUTLETS, 1 DIMMER SWITCH
Owner Contractor
DONNA NUA GUTTERS N COVERS CONSTRUCTION INC
27097 FAN LN 1622 ILLINOIS AVE SUITE 14
MENIFEE, CA 92586 PERRIS,CA 92571
Applicant Phone: 9519280098
AMBER COLLINS License Number:945962
GUTTERS N COVERS CONSTRUCTION INC
1622 ILLINOIS AVE SUITE 14
PERRIS,CA 92571
Fee Description ON Amount($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
General Plan Maintenance Fee- Electrical 1 8.05
$337.70
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
1 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 o I am exempt from licensure under the Contractors State License Law for
Professions Code and my license Is in full force and effect. the following reason:
License Class �_ License No. qZ-� &2— By my signature below I acknowledge that,except for my personal residence
Expires N��Signature in which lmust 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 contactors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for workers 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.IeRInfo.ca.gov/calaw.html.
,Poolicy 8 Date
X;p I have 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 �Byfiy signature below I certify to each of the following:I am the property
this permit is issued.My workers 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 1 have provided is correct.1 agree to comply
Carrier t' 'a 'a }!RV-:{ with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or countyto
Policy N \15 mr_!i<i'2 ires iU enter the /eve identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred //y�
dollars($100)or less _ b AU ORIZED AGENT
Date
P
o I certify that in the performance of the work for which this j PROPERTY OWNEROR Is issued, tJ 56� 1
I shall not emolov any persons in any manner so as to becomea subject to the CITY BUSINESS LICENSE A
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 forthw'Mc Jy with those provisions. I Will the applicant or future building occupant handle hazardous material or a
Applicant Date ! mixture containing a hazardous material equal to or greater that the
amounts specified an the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION C VERA IS aYes W.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 use
permit a r thebuild ngconstructionbyecap or modification or future from South
ADDITION 73 THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 37060FTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guid lines
CONSTRUCTION LENDING AGENCY o Yes o
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) D Yes
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 25505 and 25534 concerning
ha;afdousgfaterial reportin . 2
checkmark(s)I have placed next to the applicable items)(Section 7031.5 /— s `v4�V L/ �/Business and Professions Code).Any city or county that requires a permit to Date / / / /-7
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(RRPI
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 apre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to beork thartifiedrbs paint
i 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 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.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 Ucense 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. o No EPA Lead-Safe Certified Firm is required for this project because:
a 1,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
LAN CHECK APPLICATION
+�Menifee
DATE PERMIT/PLAN CHECK NUMBER g
TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK L M '�G
PROJECTADDRESS --�702 7
w�✓
ASSESSOR'S PARCEL NUMBER ��9�—N 1 LOT TRACT
OWNER NAME
ADDRESS 7 I 7 -�41) C/
PHON EMAIL
APPLICANT NAME /'YJ/X'� C/ ✓7
ADDRESS j
� e.V G n z5
PHONE (fl Gj`Z� �Q I � EMAIL \.l. 2CSYV O\,I YS`'3L-l'' Ac)6k
CONTRACTOR'S NAME �' �S _ OWNER BUILDER? O YES NO
BUSINESS NAME G
ADDRESS Z ( �Yl e Tr CY1�r S
PHONE qS (\ qZ (J( EMAIL OCX 1 vk,
CONTRACTOR'S STATE LIC NUMBER Gy S q b Z LICENSE CLASSIFICATION
VALUATION $ 161 C� SQ FT L SQ FT/
APPLICANT'S SIGNATURE �� DATE �LJ I '/
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP ""
INVOICE R2�.'v PAID AMOUNT
AMOUNT 7! OCASH OCHECK# OCREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City Of Menifee Building&Safety Department 29714 Houn Rrl. Menefee, CA 92S86 951-612-6771
www.cjtyofmenifee.us Inspectio+: Request Line 95 Z-_246-62 1-3
City of Menifee
�&v\ U\r\e- Building Dept.
JUN ' 12018
Re c eived
CITY OF MENIFEE
BUILDING ANDS kFE7 Y DEPARTMENT
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'Approval of these plans shall,of be c(nstrued to be a permit for,or an
P at of a y violation
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approval of,any violation of an proViSi)ns of the federal,state or city
w
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5 an of I an T �®
.regulations and ordinances. Th'i set Of i Pproved plans must be kept on the
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