PMT15-02260 City of Menifee Permit No.: PMT15-02260
29714 HAUN RD, Type: Residential Addition
";F�A—> MENIFEE, CA 92586
MENIFEE Date Issued: 08/05/2015
PERMIT
Site Address: 28760 PORTSMOUTH DR, MENIFEE, CA Parcel Number: 339-162-004
92586 Construction Cost: $3,300.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 14'X 24'SOLID PATIO COVER W. 1 FAN
Work:
Owner Contractor
CHARLES PANNO WEST COAST SIDING&TRIM
28760 PORTSMOUTH DR. 675 LACEY OAK DIRVE
MENIFEE, CA 92586 CORONA, CA 92881
Applicant Phone: 9517353379
DANIEL ABEEL License Number: 615917
WEST COAST SIDING&TRIM
675 LACEY OAK DIRVE
CORONA, CA 92881
Fee Description Oft Amount I$1
Wlc:' f� tex 1zQ ne -$E, ,
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
P
$278.00
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_Permil Templatexpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION
I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions
Professions CQdq and my license is in full orce a dl¢effect. Code:The Contractor's License Law does not apply to an owner of a property
License Cla s Lice o. I who builds or Improves thereon, and who contracts for the projects with a
Expires 31 ( Signature licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensors under the Contractors'State License Law for the
❑ I hereby affirm under penalty of perjury one of the following declarations: following reason:
I have and will maintain a certificate of consent of self-insure for workers' By my signature below I acknowledge that, except for my personal residence in
compensation,issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of
Section 3700 of the Labor Code, for the performance of work for which this improvements covered by this permit, I cannot legally sell a structure that I have
permit is issued.
Policy# built as an owner-building if it has not been constructed in its entirety by licensed
contractors. I understand that a copy of the applicable law, Section 7044 of the
L�,_ I have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:htto'llwww.leainfo.m.Clov/calaw.html.
permit is issued.My wor cars'compensation insurance carder and policy number are:
Carrier C, C Property Owner or Authorized Agent Date
Expires
4-By my Signature below, I certify to each of the following: I am the property
Name of Agent Phone# owner-or authorized to act,,n the property owner's behalf. I have read this
(This section need not be completed if the permit is for application and the informa(i'on I have provided is correct. I agree to comply
one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building
construcfi9. I authorize re'resentatives of this city or county to enter the above-
certify that in the performance of the work for which this permit is issued, iden ifed property for the i spection purposes.
II not emolov any persons in any manner so as to become subject to the ,// C
workers' compensation laws of California, and agr a that if I should become
subject to the workers'compensation pro4is ins of action 3700 of the Labor
Code,I shall forthwith comply with thosLpro ions. Prop rly Owner or Au onzed Agent / p Date
City Business License#
Date; / Applicants
WARNI G: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000), IN ADDITION TO THE COST OF COMPENSATION, AYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE yy MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES /ej NO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE?
agency for the performance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address \0 DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS \ GUIDE LINES
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reason(s)indicated below by the checkmark(s)I have placed AYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s)(Section 7031.5.Business and Professions Code: LL BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, SCHOOL?
or repair any structure, prior to its 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 Contractor's State License Law (Chapter 9 (commencing with I HAVE READ THE hAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or AYES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any r CHECKLIST. I UNDERSTAND MY REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to NO UNDER THE STATE OF CAL TORN IA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
❑ I, as owner of the roe p p rty, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.I
compensation, will do( )all of or( ) porting of the work, and the structure is PROPERTY OW II IER OR AIJT ORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
BUILDING & SAFETY PERM IT/PLAN CHECK APPLICATION
Menifee
DATE / S PERMIT/PLAN CHECK NUMBER Z-Z (�
i
TYPE: O COMMERCIAL 4 RESIDENTIAL C MULTI-FAMILY C) MOBILE HOME C POOL/SPA C:SIGN
SUBTYPE: L)ADDITION C)ALTERATION " DEMOLITION :i ELECTRICAL C MECHANICAL
O NEW O PLUMBING ) RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK �. ��� VLSI Qt) Cwi( i \ ��
PROJECTADDRESS "L, �b� p(A �� �( ' ,)� cll
ASSESSOR'S PARCEL NUMBER /& Z - DO y LOT TRACT
OWNER NAME { S &AV16 City of Menifaa
Building & Safety Dept.
ADDRESS � (+j • ,nA h
PHONE L�ci- S 1 5 6 EMAIL AUG 0 5 2015
APPLICANT NAME tiIV,�{ 61 III Jfn
r yt
ADDRESS �1; 6,)1, I.
PHONE �f�`�G ,,nill�
_ EMAIL
CONTRACTOR'S NAME .w (aide 5idIl'n �✓� 4iC✓1 OWNER BUILDER? C YES %NO
BUSINESSNAME C61,* v1 jt�A
ADDRESS 0') toy pli
PHONE CjFl� - lJ - ��� EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ >I XXJ1 SO.FT LSQ FT
APPLICANT'S SIGNATURE, DATE
FCITY STAFF USE ONLY
DEP NT DISTRIBUTION CITY OF MENIFEEBUSINESS LICENSE NUMBER
B N PLANNING ENGINEERING FIRE GREEN SMIP �'/ Q
INVOICE
AMOUNT Z� PAID AMOUNT 2'7�/ SZS � ')CREDITCARD VISA/MC
G ?S C CASH CHECK#
PLAN CHECK FEES PAID AMOUNT !)CASH UCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED "YES 0 NO DLNUMBER NOTARIZEDLEfTER (D YES C NO
City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
WO � Q c) Cojec fi - fa4
1q `� -Zy\ S��1 r'�Iutr��4Dn� a, t
City of Menifee
Building & Safety Dept.
AUG 0 5 2015
Received
Ir
I I
Ql_
° Carl Putnam P.E.
3441 Ivylink Place .
Lynchburg,VA 24503 "
Ica ulnap I I , .
City of Menifee
Building & Safety Dept.
June 4, 2015 AUG 0 5 2015
Heath Morgan
Amerimax Exterior Home Products Received
28921 US Hwy 74
Romoland, CA 92585
Dear Heath:
My California PE registration was renewed in June 2015 and is currently valid u til 2017. All
previous documentation (plans, letters, calculations, etc.)that I approved conti ue to be
valid under the conditions specified in those documents.
If you require further information please contact me at(434) 384-2514 or at
carioutnam(a)comcast,net.
Sincerely,
Carl Putnam, P.E.
EIy��H
PUTNq�FF
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68139
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