PMT18-05309 City of Menifee Permit No.: PMT18-05309
AV 29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Addition
MENIFEE MENIFEE Date Issued: 11/01/2018
PERMIT
Site Address: 29895 BAY VIEW WAY, MENIFEE, CA Parcel Number: 340-500-023
92584 Construction Cost: $9,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of SOLID ATTACHED ALUMAWOOD PATIO COVER 12X9 AND 12X9 AND 12X10' LOUVERED EQUINOX
Work: 336 SQ. FT. NO ELECTRICAL
Owner Contractor
DAVID UTSO TRADER DAN'S INC
29895 BAY VIEW WAY 840 S ROCHESTER AVE STE C
MENIFEE, CA 92584 ONTARIO, CA 91761
Applicant Phone: 9093900555
DON DAUGHENBAUGH License Number: 517575
TRADER DAN'S INC
840 S ROCHESTER AVE STE C
ONTARIO, CA 91761
Fee Description Qty Amount 1$1
Building Permit Issuance 1 27.00
Deck/Patio, non-standard 1 133.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 2.00
General Plan Maintenance Fee-Building 1 6.65
$169.65
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 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 ❑I 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 License No.
By my signature below I acknowledge that,except for my personal residence
Expires Signature in which I 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
❑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 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.gov/calaw.html.
Policy# Date
❑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 ❑By 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 on the property owner's behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy# 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
❑I certify that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
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 with those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applicant Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes ❑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 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 Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ❑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) ❑Yes o No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes ❑No
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)
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 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($500). managers who do the paint-disturbing work themselves or through their
❑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.epa.gov/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 ❑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. ❑No EPA Lead-Safe Certified Firm is required for this project because:
❑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 out the RRP
Acknowledgement.
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 ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code a my license is in full force and effect. ` the following reason:
License Class se No. S`
By my signature below I acknowledge that,except for my personal residence
Expires 'T 3 Q Signature in which I 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 DEC O
have built as an owner-builder if it has not been constructed in its entirety by
❑I hereby affirm under penalty of perjury one o e 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 wvnv.leeinfo.ca.sov/calaw.html.
this permit is issued.
Policy q Date
ve 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 ❑By 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 on the property owner's behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
(��i with all applicable city and county ordinances and stale laws relating to
Carrier II (y / building construction.I authorize representatives of this city or county to
Policy nwa2 S 3 b� 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
❑I certify that in the performance of the work for which this permit is issued, ��
1 shall not emoloy any persons in any manner so as to become subject to the CITY BUSINESS LICENSE p
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's�yo rovisions of Section 3700 of the Labor
Code,I s orthwit those rovisions. /� Will the applicant or future building occupant handle hazardous material or a
Applicant Date ( mixture containing a hazardous material equal to or greater that the
amounts spec iei�on the Hazardous Materials Information Guide?
WARNING: U URE WORKER'S COMPENSATION COVERAGE IS o Yes
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 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 Air Quali Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guideli S
CONSTRUCTION LENDING AGENCY ❑Yes 2No
I hereby affirm that under the penalty of perjury there is a construction Will the propos d building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boun pry of a school?
(Section 3097 Civil Code) o Yes jz�o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for thea reason(s)indicated below by the hazardous ma o ng.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 6Y_e_i_ o No /
Business and Professions Cade).Any city or county that requires a permit to Date Z /
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY O D 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter 9(commencing with Section 700D)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 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($500). managers who do the paint-disturbing work themselves or through their
o 1,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.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-SOD-424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a ❑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:
o I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's 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.
�bYl ��1�V1 nnruin H 02Vr- --.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: 1 p PERMIT/PLAN CHECK NUMBER OG *30
GRADING PLANNING CASE NUMBER OTHER RELATED CASES
TYPE: COMMERCIAL RESIDENTIAL C) MULTI-FAMILY MOBILE HOME POOL/SPA SIGN
SUBTYPE: ADDITION ALTERATION DEMOLITION ELECTRICAL MECHANICAL
4EW C PLUMBING RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK "'d ab7wj-eO�
t v
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS YES NO
rj
PROJECT ADDRESS ZIP Cl
ASSESSOR'S PARCEL NUMBER 340— 500-" 074-7 LOT TRACT
OWNER NAME J)cAV)� Lk SO
ADDRESS 20o UiN
PHONE q�0-76 m �;-0-'[".L cw 67 EMAIL
APPLICANT NAME r-A
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? C) YES NO
BUSINESS NAME
ADDRESS 0 C114 -e-A3r<,r 00,-I-01M CLA- Q17b �
PHONE -0 EMAIL
CONTRACTOR'S STATE LIC NUMBER V 7 LICENSE CLASSIFICATION
VALUATION$ AJ06 _-�Q FT L SQ FT
APPLICANT'S SIGNATURE DATE I
OTYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING_FIRE
INVOICE TOTAL GREEN7 CC,> SMIP
OWNER BUILDER VERIFIED YES NO DRIVERS LICENSE# NOTARIZED LETTER YES NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofmenifee.us
ENIF
AIZ
4 r a, ps-, y, # _ �a.,,,"•II
lna
__ �.�','r' ,+,- 'r' k• _ - wr- it,*r:-. NfR•s a'=s-:C.N%'� �:R.+ {T' ._ ^ ,.- } . r 1'r^^. -....,±•� t '.xi,.• -
''yll liY L ( R
P'+ 1
yl,
y
'r...+�_ i � 7 1.- -5f �+�o...3b'i`f`� _''�z�, � -_ - r - •C - _ - -f, r, F - �` _ �f '
� OP
;\ 's �.,�'�?1
- _- Jf• in'�..r��'r�"f-'°i'A.Y���J s�+rx J� .,�+ �'� L lt'a ,'tJ- 5_ ''i a,- '.,,:. '1;J 'Y.+ F -. ,� - - _f'
_ ._ti .F` � '- lr r_9i !.1 �' ?• � F •_jf�—•/, _ `l•Jl'_ __ _ ' � '�'Y�1� r _ �I:• �8
JT7. Y- ' t_+t a_ ifl ��'-' _- �5,1.. f s �'3 G I^ '?.
'•d• ,,,:,'� `� ter',-^�" -
r ,� "L�r � ,j, YJ -�".L f-f jf_ r Y'- t?5'•S ,j
-,• - •r�'v, - 4 �_r 5-
F,�.'a�� ' r
, ' 2 - i+i -fit � s' .,�r Y� :. � •f � 't�� - __ ,. � •�^}ri a'_ ,y 5 _ � _ - } _
It
- , "I- - ,r-=fK -`r-If 1y� I:+:�J ,? •-s 1 � a.-- r�i�. 14�:._ � , _ ' _ _ �' �,+ J'� ;5 YaY I. � -
• _ !., J .�i,_3 _� r _ ,,7,���tt iii ;q ? -,-14'_Vr�y�^"":°'':`-,I__ 4.�,�'+� r t J�`'J- , ... :.1 _ . - r•.1_ ` -
1 r 5'•(r l� '� ���� 1`-�'�j..i,�"t ':cyr- ,�4.Q.�_.� -Viz• Y;-j !�1`•�. 1_C+: 1 t n Y 7 _ - .- _Y
IAIl
J. 7- h_ 4`• , f� E•. �T.,S,�t,',l��r�'r -n^ 1T +�k a �' r'r-1i „R {_ z' -
-' i'. - J- ..1 _� - 1, rf , " t _ ry i-� ,�''� rl:- `6F I•'., .? •ILA
, i
J .[ }. f _ 5r _'J rJ7yyJ l• r �� -,
lv` f
I.� .i L'1 y rr j r S .• J: ~.r?,1 S Ty
iN, 1>=-.�z .. - a .-,.2 + `•••'a 'r- f _ '
�-a.t:1
IT,
1 J r} If +,y `� y C _ � 1j�' •' .L •- 3 � -- 4 ,r, I IFr � �Y :;, �z
I� y -- f r ,4 ag.,,y,f 1i-,rr _.SrJ K 1r'r�,' _ { 1 L1 �aF•'y �_z-, r d. y r %,ni�:. I�- ..... 1" �,.•4_,*� cirA �.,
L V
�?T`. } •.,{� "r" �'Jr � - s- '� � -^ r-ur:1�'r Y' -. „--. _ _ ._ - - + -�.
5 r;t^•A. W.*t J•- s `'t'rG �f_ , •1ti,' _ `r"i; h 5-f!^ r e.>r��f Tr, _ _' , _ - _ J, '•ta ` ,
• 1 'T%iy� I.r l 2'J'. f k :2. :'� `. _ - _ rs
i'. r. ,orb.,:`. y^" � .z yryTr�• 4- it -jh r 'T: . ,. 4• r ji f 4f iy '
_ 1 r -., _ t:r, J, _ _ - � e � ,, i y1 'f k � � ',4J _ 1 - . -•i.. r 'r��; - -� �•;`•
1 'z}, _ ik" n y, 41-.. - - ,Ir } 1 'i„ q� r}.- ,s 1 Tic.
'_ ♦r '`��d. �,dT r r i "� r_ . 2..e J , _ �1 - - v , i f" 'hh` oil
s�' - v► y''s er r _ '1� ?+ `r r ':T.,rL,r •� n _,*r J -
-- k a r of - -�' - -- =3}; i:- .r �'_� :r,� �.�>u ,.' �''a, .k,••+, -'1'r
ra
r •', _h '''J f f n u�R ,. R r �_T� `r<`.' ,++'�.mot!:.-" ,.,,P��K: ��
_.., r., � Y 7'st, x :•t,,,•,`P P'f r yr _ �I a
:- s. N �s�. r c•n•L. i' '_•. �Il r i r r' ".>�'•,F-r a rr
�a4fy::�r 'iG � T• ..r.l �'' 1: I k�tir'w ,TtI4;t•el
-
. i 1
IVI
-r J a�,J�I ��'n FJ� 'a1.?i�#.r l:1 Jh•'Ey 1...f E�i' J I I`"'.�°��W��' { `r y � � � { .y16 �T�R � - --_
'fir~ a li• fry J.� T'v. r24�r� 'r I� p tY�r r:'' r r_c-,r 'rye '•:•
• , a j'+ rl �m Ey J-.l L:c��r'."J:4'r'z„'1�- F��fS�i.}Yr I�I4kT^i�'- S{• -�i.r¢�•v ��.t• s � - 1 _,�lr.^�, .r T r`%y .� 4J +J' r RF IJ ,�,,
• -- y f ._ _ ti i L �` I� J a n- !� r~'J � J '.f C i� �} J r�: r
• tea, - •��.I �k, �- ^ ir,�,R$ s, #*ram• } r�'' ,• ra•j �. ,< �4-,� y.
R7f =.71 Yf � f{ `� ._4 - zrL
.. ` T ��y.�l:•:::. r�� .ham -¢..� n u•r'�4,. � Il�r � -i'� e , + :,ate r i 'T"T --�' .�r'���ef, �. .'f{�5 •5'.� ITS__ Ff zrc�JC':'.I;r'a,t F�J''i,'il.i.i'a�x,=`JW�-J"I+T'4t '- 'Ik}-i�'.�atL�F'�, _ ��P r �-,ti.i'-1,�g-C+ ict{;r=�::R`;i"#•t�i�_ _?� �rY`i}r.rvi'"r_. n,}raa yLK'.j ,.•.'I'a;n rr 1L t'3,• .F IT'}q •,•,:,F.,
', _T *�y�rZ�3,-'v 1,�f�5'a{4n�J.7f�C^ `G�+AC'-a rLt1y�`,+�+w•_•=� +�ILE—
p
�j44 -
MR-on
OLA
.',v!r-
.o
.1.
, r ,d G L ti"f••I '�- + r�r rr n-��'n�� �'.' �. 7�� 1*�S�'•1¢'�-f-_ r.*•- a �• s i
I - ,!, { 14. ,•�+ {• 'S1` -. - J y��_ �,I. I, - 'r r= it _ -- 'Cf = y� r •:
City of Manifee
Building Dept.
NOV 01 2018
OWNER "c Pary�klc' tab
ADDRESS �1?q ( , '1�� ceived
CITY IP PHO E
LOT NO. TRACT APN
CONTRACTOR
ROOMS-N' COVERS PROPOSED ADDIT ON(S) �
840 S ROCHESTER AVE #C
ONTARIO, CA 91761 I ZIX C/
LIC. B-517575
909-390-0555 G gel,, /2 x/1) .---
WORK COMP
ICW GROUP �ul�i
WSA5000386-07
EXP6/14/2019 LLJ
ry-
CD
Lu Cl-
Q
C/D
CITY OF MENIFEE r
AND SAFETY EPAR ILL 4!T `
PLAN APPROVAL
&)n Cam-.
DATE
`Appro these plans shall not be construed to be a ermit for,or an
appro aV`IV any violation of any provisions of the feder I,state or city
regulations and ordinances. This set of approved plans r iust be kept on the
S(cLb STREET
5 i�lc,t0!:01,411),vl:Al2iME Ot P6 t$!:.., i
2031i UN Gf,CoU2s nq x PC i� .....w.
..... s
s,
y r
i