PMT18-03090 City of Menifee Permit No.: PMT18-03090
29714 HAUN RD.
Ir MENIFEE, CA 92586 Type: Residential Addition
MENIFEE MENIFEE Date Issued: 0 6/2 012 01 8
PERMIT
Site Address: 30317 COBURN CIR, MENIFEE,CA Parcel Number: 358-720-031
92584 Construction Cost: $4,300.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL SOLID 12'X 39'ALUMAWOOD PATIO COVER W/ELECTRICAL,3 FANS
Work:
Owner Contractor
ERIC& PAUL WILSON ANGEUS PATIO COVERS&AWNINGS
30317 COBURN CIR 225 SPARKLER LANE
MENIFEE, CA 92584 PERRIS, CA 92571
Applicant Phone: 9514431659
IRENE GONZALEZ License Number:900657
ANGEL'S PATIO COVERS&AWNINGS
225 SPARKLER LANE
PERRIS,CA 92571
Fee Description City Amount 1$1
Receptacle,Switch, Outlet&Fixture 3 126.00
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 6.30
$300.96
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.rpl 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 01 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 Lice se No. /OC7 CO IT? By my signature below I acknowledge that,except
g p y personal residence
Expires " o Signature in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
01 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
by Section 3700 of the Labor Code,for the performance of work for which this application is submitted or at the following website:
this permit-. is//iis7ssuAedf. q Imo- /' www.leginfo.ca gov/calaw html.
Policy tJ 1`"7�V 1J�nL 1 �' �� 2 Date-
0 1 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 �crlly 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 an the property owner's behalf.I have read this
number aree:�/� application and the information I have provided is correct.I agree to comply
Carriers I 1 (� �-e "s l` 1�/j �� c�J S with all applicable city and county ordinances and slate laws relating to
�7c/ building construction.1 authorize representatives of this city or county to
Policy It UUWC G12�/O3Ex Tres Z�'
"1 p le enter he abov identified pr erty for inspection purposes.
(This section need not to be completed is the permit is for one-hundred dollars($100)or less DateO/ 2G 8
PR RTY OWNER OR AUTHORI2 AGENT
1-0<Cf rtify 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 g
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,Ishal orthwi c mply with those provisions. Will the applicant or future building occupant handle hazardous material or
Applicant Date � mixture containing a hazardous material equal to orgreaterlhat the
amounts specified on the Hazardous Materials Information Guide?
WARNING:F LURETO SECURE WOR ER'S COMPENSATION COVERAGE IS o Yes z NNo
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the apsilfcanl or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)7 See per,.mitting checklist
for gufdelt9es
CONSTRUCTION LENDING AGENCY o 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) 0 Yes e'No
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
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 7031.5 hazardous mated rreporting.
Business and Professions Code).Any city or county that requires a permit to pYes D No
�
construct,alter,improve,demolish or repair any structure,prior to its Date-L?� G`�
issuance,also requires the applicant for the permit to file a signed statement PROPERTY O) ER OR AUTHORIZED A
that he or she Is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING fRRPI
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
and the basis for the alleged exemption.Any violation of Section 7031.S by receiving compensation for most work that disturbs paint in a pre-1978
an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified firms and comply with
than($500). required practices.This includes rental property owners and property
managers who do the paint-disturbing work themselves or through their
a 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.eoa.eov/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 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. o No EPA Lead-Safe Certified Firm is required for this project because:
01,as owner of the property am exclusively contracting wfth 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 MENIFEE
DATE: ' oab PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O AADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
eNEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK Aver
1
i r
PROJECTADDRESS 7j��Jjl'�Stp�UrnC';rdto yai e ZIP
ASSESSOR'S PARCEL NUMBER LOT I TRACT 3 f0�'85
OWNERNAME _
ADDRESS 2 031 + Q a
PHONE q�5I ,v5 q`BgQ-EMAIL
APPLICANT NAME
ADDRESS �d`J �V m vrVi . -7-
PHONE qs/' y-3 JOCI7-7 EMAIL I cQ
t
CONTRACTOR'S NAME ` OWNER BUILDER? O YES O NO
BUSINESS NAME S Q Vey< r) ( .
ADDRESS �
PHONE - r! G EMAIL 17 G ,Cox-ii
r\
CONTRACTOR'S STATE LIC NUMBER � V L05 3- LICENSE CLASSIFICATION
VALUATION$ SO FT � U L SO FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL I B 00 Al s' 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.cityofinenifee.us
1
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