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PMT18-03608 City of Menifee Permit No.: PMT18-03608 29714 HAUN RD. tiff MENIFEE, CA 92586 Type: Residential Addition MENIFEE MENIFEE Date Issued: 07/20/2018 PERMIT Site Address: 27088 LONE STAR WAY,MENIFEE, CA Parcel Number: 335-501-009 92585 Construction Cost: $5,400.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 15'X 35'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS Work: Owner Contractor LARRY JOHNSON GUTTERS N COVERS CONSTRUCTION INC 27088 LONE STAR WAY 1622 ILLINOIS AVE SUITE 14 MENIFEE, CA 92585 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 rr Amount 1E1 Receptacle,Switch, Outlet&Fixture 2 121.00 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 6.05 $295.70 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_Pennit_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 contractors)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 Contractor's State License Law for Professions Code an license is in full force and effect. the following reason: License Clla/ss V License No.% �� By my signature below I acknowledge that,except for my personal residence Expires "rSigna[ure in which lmust have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that I 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 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 iisssssued. - -7 /'�� vn•Av.leginfo.ca.gov/calaw.html. Policy# It M AIt/-G/PZ3� Date JQI 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 O By my signature below l 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 ate: application and the information I have provided is conecL I agree to comply Carrier ��fl///l&7/! � with all applicable city and county ordinances and state laws relating to 1/fin / y Expires /�� building construction.I authorize representatives of this city or county to Policy# V"/ V Z✓ ,-3 ires enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT O I certify that in the performance of the work for which this permit is issued, O 2 CQ I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# J ••J workers compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comp those those provisions. �Z�7 Will the applicant or future building occupant handle hazardous material or Applicant l�/17/1p�( ��/�� Date6/W/ly 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 COVERAGE 1S o Yes ANo UNLAWFUL,AND SHALLSUBIECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant orfuture building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require apermit for the construction ormadifita[ion from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air quality Management District coct(SCtionor See ratio froing checklist IN SECTION 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airlines Qua CONSTRUCTION LENDING AGENCY oyes EZNo I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) o Yes PAO OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD I hereby affirm underpenalty of perjury that l am exempt from the permitting checklist.I understand my requirements underthe State of Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 255DS and 25534 concerning checkmark(s)I have placed nett to the applicable item hazardous material reporting.$)(Section 7031.5 0 Yes Business and Professions Code).Any city or county that requires a permit to 1 ��, C__.�— 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 IRRPI 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 lnapre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compeor nsation re facilityfmost RRP-hat diitued rbs ainicomplywRh than Applicant fora permit subjects the applicant toacivil 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 O1,as owner of the property,or my employee with wages as their sole employees.For moreinformation about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/fead or contact the National Lead Information Center at not intended or offered forsale.(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 sold within one year of Firm Certification No.: completion,the Omer-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: O I,as owner of the property am exclusively contracting with licensed contactors 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 hA b oufv\r coVea Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MEh"vIFEE P. LLJ DATE: 01 PERMIT/PLAN CHECK NUMBER PLANNING CASE NUMBER City ff }� TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPADgoDMaN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O M"I,44L2018 O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK �YIf17C/I� Wes/ ived PROJECT ADDRESS ��[ Q Lrj 0(5 S 0 r ,��(I�_ ZIP El J ASSESSOR'S PARCEL NUMBER :n_L>'0-e6N-OCR LOT TRACT OWNER NAME ,Y�J ADDRESS `7 Men L£3L) PHONE EMAIL y� APPLICANT NAME /J/ Q/ll,S ADDRESS Z //I/ /Cl S // � / 2, 91"J/ PHONE ` q2g Q(/ CJ EMAIL CONTRACTOR'S NAME / /� OWNER BUILDER? O YES ONO BUSINESS NAME �/�r,, y� GAT ADDRESS Z /l/G�! /T' I Z /-7 PHONE �jr1 � W�p EMAIL CONTRACTOR'S STATE LIC NUMBER ci J�(� LICENSE CLASSIFICATION VALUATION$ 6I qd o SQ FT 52 5 L SO FT APPLICANT'S SIGNATURE _DATE DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING- ENGINEERING FIRE INVOICE TOTAL I Cq�7(5. 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.cityofmenifee.us NIF EDGER & TRACK City of Menifee OSHA APPROVED �NSPECTiON REQUIRED Building Dept. LADDER REQUIRED AT . JUL 19 2018 FINAL INSPECTION Receives! CITY OF MENIF E BUILDING AND SAFET DEPARTMENT PLAN APPROVAL (� REVIEWED BY -*ct\ rtj� ATE v 'Approval of these plans si all not be construed to be a permit for,or an approval of,any violation any provisions of the federal.stale or city regulations and ordinances This set of approved plans mustbe kept on the jobsite until completion. O 9 la Posy IV -�22-