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pmt18-04855 City of Menifee Permit No.: PMT18-04855 29714 HAUN RD. Jr MENIFEE, CA 92586 Type: Residential Addition MENIFEE MENIFEE Date Issued: 10/05/2018 PERMIT Site Address: 28631 AMBORELLA WAY, MENIFEE, CA Parcel Number: 364-212-012 92584 Construction Cost: $6,400.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 615 SO FT ATTACHED SOLID PATIO COVER WITH 2 FANS Work: Owner Contractor ANDREA LARCK PATIO GUY ALUMAWOOD CONTRACTOR 28631 AMBORELLA WAY 41197 GOLDEN GATE CIR STE 108 MENIFEE,CA 92584 MURRIETA, CA 92562 Applicant Phone: 9513330056 ADAM TEST] License Number.872839 PATIO GUY ALUMAWOOD CONTRACTOR 41197 GOLDEN GATE CIR STE 108 MURRIETA,CA 92562 Phone:9513330056 Fee Description Qtv Amount fEl 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_Permit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property,who builds or improves thereon,and who contracts far the projects With a licensed contractor(s)Pursuant to the Contractors Stale 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 O I am exempt from licensure under the Contractors State Ucense Law for PmfaSADns Code an my license is in full force and effec n the following reason: 48 Ucense Class_ /J Lice �gse �. Or / p By my signature below l acknowledge that,except for my personal residence Expires Signature h/� Y /L.O%�L..0 jn� in which l must 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 contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure far 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.leginfo.ca.eov/calaw.lstml. Policy# Date a 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 o By my signature below I certify to each of the follosving:I am the property this permit is issued.My workers compensation Insurance carrier and polity owner or authorized to act on the property owners behalf.I have read this number are:�s � / application and the Information I have provided is correct.I agree to comply �'I/�+q,��i�i( with all applicable city and county ordinances and state laws relating to Carrier r / / building construction.I authorize representatives of this city or county to Policya ,iy(J��3�Expires_ 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, /� � Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE a 0 workers 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 �fof�tJh�with Jcomply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applican[L : \ // F(� / Date mixture containing a hazardous material equal to orgreaterihat the .... amounts spec red on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS O Yes a a UNLAWFUL,AND SHALLSUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building ANOCLVILFINES UP TOONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Alt Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY oyes o-No, I hereby affirm that under the penally 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) oyes ON� OWNER BUILDER DECLARATIONS I have read the Hazardous Material information Guide and the SCAQMD permitting checklist.I understand my requirements under the State or I hereby affirm under penalty of perjury lha[lam exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous mate al re orting. checkmark(s)I have placed next to the applicable Ltem(s)(Section 703L5 OYes O Business and Professions Code).Any city or county that requires a permit to � 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(RRP) Ucense Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(ARP)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 703L5 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 or not more required practices.This includes rental property owners and property than($500), managers who do the paint-disturbing work themselves or through their ol,as ownerof the property,or myemployeewith wages as theirsole employees.For more information about EPA's Renovation Program visit: compensation,will doO all of orO portion of the work,and the structure is www.epa-gov4ead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323), Cade;The Contractors State License Law does not apply to an owner of a OAn EPA Lead-Safe Certified Renovator will he 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 ofsale. 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 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 outthe RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: I�� 4j PERMIT/PLAN CHECK NUMBER PLANNING CASE NUMBER TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: Q16DITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING. O RE-ROOF NUMBER OF SQUARES /1 DESCRIPTION OF WORK _AjU_M &W00dG(T JD p7 y'-'Ctr['I PROJECTADDRESS /(n �1 /�y� �� (,{/GLG1. ZIP ASSESSOR'S PARCEL NUMBER ;J�L� ��12' oIZ LOT T@Tp OWNER NAME L�rdk Building Dept. ADDRESS Gv�rcci OCT 0 5 2018 PHONE q /- ,S '{,� aa�g EMAIL APPLICANTNAME P ADDRESS WN 7 U Mar Ar-t 9 PHONE g5/-333-&&15Z.O EMAIL a h GC 6j L'1 G CONTRACTOR'S NAME Q — [,yj1 j OWNER BUILDER? O YES O NO BUSINESS NAME ADDRESS �} G C Y G PHONE qS7- ,�j33—OUj� !!fi�t EMAIL (C ,� CONTRACTOR'S STATE LIC NUMBER 7)0 3 LICENSE CLASSIFICATION VALUATION$ G/ y(/U SO FT �� (J L SO FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITV OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING EN INEERING FIRE INVOICETOTAL 2a�� G EEN I� SMIP lr OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZEDLETTER O YES O NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (9S1)672-6777 www.cityofmenifee.us NIF