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PMT18-03432 City of Menifee Permit No.: PMT18-03432 29714 HAUN RD. MENIFEE,CA 92586 Type: Residential Addition MENIFEE MENIFEE Date Issued: 07/10/2018 PERMIT Site Address: 29778 KILLINGTON DR, MENIFEE, CA Parcel Number: 338-284-009 92586 Construction Cost: $7,590.00 Existing use: 1 &2 Family Residence Proposed use: Description of INSTALL 12'x 38'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS,6 LED LIGHTS,2 POST Work: LIGHTS,2 SWITCHES, 1 GFI OUTLET Owner Contractor KELLI BLAND GUTTERS N COVERS CONSTRUCTION INC 29778 KILLINGTON DRIVE 1622 ILLINOIS AVE SUITE 14 MENIFEE, CA 92586 PERRIS, CA92571 Applicant Phone:9519280098 AMBER COLLINS License Number:945962 GUTTERS N COVERS CONSTRUCTION INC 1622ILLINOIS AVE SUITE 14 PERRIS,CA 92571 Fee Description City Amount($1 Receptacle,Switch, Outlet&Fixture 13 176.00 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 8.80 $353.45 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_Bidg_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 Chapter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from licensure under the Contractor's State License Law for Professions Code an my license is In full force and effect. the following reason: License C/lass L/ License No.`7 02- By my signature below I acknowledge that,except for my personal residence Expires `7 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 entirely by a hereby affirm under penalty of perjury one of the following declarations;I licensed contractors.I understand that 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 %-j%-A-i.leninfo.ca.gov/`calaw.htmi. this permit Isissued. Policyg V f ),,1 tp/oZ_s&3 Date V,2have 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 D By my signature below 1 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 owner's behalf.I have read this number are: n' r /' p application and the information I have provided is correct.I agree to comply Carrier 117a G4&71 l/�ihf�/, yG /'/rCi with all applicable city and county ordinances and state laws relating to Ex' - � building construction.I authorize representatives of this city or county to Polfry0 %' �23 ices C� enter the above identified property for inspection purposes. (This section need not to be completed is the permit Is for one-hundred dollars($100)or less Date PROPERTY OWNER OR AUTHORIZED AGENT D I millfy that in the performance of the work for which this permit Is issued, J"�sq I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If O 2%155• 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/w�ith those provisions. -Z� tom// Will the applicant or future building occupant handle hazardous material or a ApplicantL_/z'If��( �t /�� Date6/cY//O mixture containing a hazardous material equal to or greaterthat the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS D Yes 4-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 D DLLARS($100,000),IN occupant requires permit for the construction or modification from South ADDITION TOTHECOSTOABORCODE,INTER DAMADATTOGES AS ROVIDED FOR Coast Air quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CORE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY DYes ,rY.No I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within DODO 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 PAO OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of 1 hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 255D5 and 25534 concerning Contractors License law for the reason(s)Indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable items)(Section 7031.5 pFYRs Business and Professions Code).Any city or county that requires a permit to pate 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 fRRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRPj 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 D1,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 aAn 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 said 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. D No EPA Lead-Safe Certified Firm is required for this project because: D 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 Ucense Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP _ L _ au fvxc_�r 6 Ai a vea Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Aff MENIFEE DATE: Q /P� PERMIT/PLAN CHECK NUMBER Q5 eL PLANNING CASE NUMBER TYPE: O COMMERCIAL PRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O 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 A1141zimem Gt Wrl Cl/75 Sc.,J /- e //�� -7 ifee PROJECTADDRESS q7 / / ZIP Z Building D pt. ASSESSOR'S.PARCEL NUMBER LOT TRACT JUL �$ OWNERNAME e7 ed ADDRESS ��ii"/ / ��S J I/ PHONE C /LOV '(�� EMAIL APPLICANT NAME 1 / ADDRESS Z / / / / ryI 2- 1 C PHONE J EMAIL CONTRACTOR'S NAME Coyde OWNER BUILDER? O YES O NO BUSINESS NAME �� II�rJ ADDRESS )W 2� ��1',L'J� e— PH0NE ! f� �v�O c EMAIL CONTRACTOR'S STATE LIC NUMBER {Qp Z LICENSE CLASSIFICATION VALUATION$ -goSO FT 4/5(�o L SQ FT APPLICANT'S SIGNATURE ( DATE 11/6 AF CiTY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE Lb I INVOICE TOTAL GREEN SMIP OWNER BUILDER VERIFIED OYES 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 -91 ., www.cityofinenifee.us T -ENIFE3 City of Menifee Building Dept. LEDGER & TRACK JUL 10 tots INSPECTION REQUIRED T CITY OF MENIFEE rn C, BUILDING AND SAFETY DEPARTMEN. O PLAN APPROVAL �v REVIEWED BY D E- 'Approval of these plans shall not be construed t be a permit for,or an approval ot.any violationof any provisions of a federal;state or regulations and ordinances. This set of appr ed plans must be kept the l� jobsite until completion. 6 d � � �tilS C G / i waL = ,00�ot �- �' o YV�2v`l�e� � 2eg� 2.V-Irt)ULtO' Z?Db\- l49v�*S �30-t ToSCOt,E L *