PMT14-01009 City of Menifee Permit No.: PMT14-01009
29714 Type: Pool/Spa-Residential
�' MENIFEEEE,, CA 92586 C
MENIFEE Date Issued: 05/06/2014
PERMIT
Site Address: 25122 HIGH PLAINS CT, MENIFEE, CA Parcel Number: 358-490-001
92584 Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of SHOCKCRETE POOL&SPA WITH A FIREPIT
Work;
Owner Contractor
AVI SCHWARTZ A CUT ABOVE CONSTRUCTION POOLS&
25122 HIGH PLAINS COURT LANDSCAPE INC
MENIFEE, CA 92584 26025 NEWPORT ROAD#A533
Applicant Phone: 8007007754
A CUT ABOVE CONSTRUCTION POOLS &LANDSCAPE INC License Number: 672202
26025 NEWPORT ROAD#A533
MENIFEE, CA 92584
Fee Description
(3ty Amount is
S I I a I -tir.i na 00
Building Permit Issuance 1 27.00
ESE
SMIP RESIDENTIAL 1 3.00
$498.00
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_Permit_Template.rpt 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 Cod and y license is in ull force and effect. Code:The Contractor's License Law does not apply to an owner of a property
License CI s Lice o ZZ who builds or improves thereon, and who contracts for the projects with a
Expires I Signal a licensed contractor(s)pursuant to the Contractors State License Law).
WORKER 'COMPENSATION DEC RATIO
❑ lam exempt from licensure under the Contractors'State License Law for the
❑ I hereby affirm under penalty of perjury one of the following declarations: following reason:
1 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 1 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. built as an owner-building if it has not been constructed in its entirety by licensed
Policy# l3�)3�5)_ contractors. I understand that a copy of the applicable law, Section 7044 of the
❑ 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:httE),//www.leciinfo.ga.ciov/calaw.htmI.
permit is issued.My workers'compensation insurance carrier and policy number are:
(' Property Owner or Aut orized Agent Date
Carrier {-I,( 2
Expires 6 Policy# J!7/ J3b
❑ By my Signature below, I certify to each of the following: I am the property
Name of Agent Phone# owner or authorized to act on the property owner's behalf. I have read this
(This section need not be completed if the permit is for application and the information 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
constru I authorize representatives of this city or county to enter the above-
---I certify that in the performance of the work for which this permit is issued,I i 1 d pro rty for th inspection purposes.
shall not employ any persons in any manner so as to become subject to the (^ �ny f
workers' compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the Labor Owner Aulhoriz gent Date
Code, I shall forthwith comply with those p vi ' S.
t� City Business U nse#
Date;
WARNING: FAILURE TO SE URE IRS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLA UL, A SHALL
SUBJECT AN EMPLOYER TO CRIMINAL IES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($700,000), IN ADDITION TO THE COST OF COMPENSATION, DYES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑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 ❑NO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reasons)indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s)(Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, ❑NO 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 I HAVE READ THE HAZARDOUS MATERIAL
provisions of the Contractor's State License Law(Chapter 9 (commencing with
Section 7000)of Division 3 of the Business and Professions Code)or that he or DYES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any 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 CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE, SECTIONOUS 25505RIAL 25533
553 AND 25534 CONCERNING
HAZAR❑ I, as owner of the property, or my employees with wages as their sole
compensation,will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF ME I EE PLCK No: Permit No:
City of Menifee O
29714 Haun Road Building & Safety Dept. Date: Date:
Menifee, CA 92586 �
Phone: (951)672-6777 MAY 0 6 2014 Amount: Amount:
rX7
Fax:(951)679-3843 Ck#: Ck#:
Received
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F:
Property Address: S-I Z {k'IV G� Assessor's Parcel Number.
�i / IN Q — (00
ProjecUfenant Name: C Unit#: Floor#:
J CAW NIL-T-L
Name: Phone No. Faz No.
st d�vllf�2
Property Address:
Owner 2 5'l2 C,� Unit Number Zip od 5';C3
Email Address:
Name: 0*4s P11'on
Np.`�� 57�0 Faz No.
Applicant Address: Unit Number
Email Address:
Name: � � D� PhonWN 7X� �S Fax No.
Contractor Address CI[y State?-WGIA Ac-3� - Zi Code L
U� zs�
Contractors Uity,Busness License o. Contractor State of California License No. I Classificalion:�,
3
Number of Squares:
Square Footage 203
Description of Work: IA Cost of Work:$ _
Applicant's Signatur s
Date:
To Be Completed.By City Staff Only
Indicate As R-Received or N/A-Not Applicable
5 Completes sets of fully dimensioned,dra sale plans which include: 1 set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Gen Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8'%x 11)
❑ Structural Calculations
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration` Addition` Means)Methods
Work Type: Repair* Retrofit` Revision to Fxisting Permit' Required? YES NO Id
Proposed Building Use(s): Existing Building Use(s):
#Buildings: #Units: #Stories: Will the Building Have a Basement?
Y of N
Bldg.Code Occupancy Group Indicate Indicate if YES or NO Indicate allHGeolte- ch.Haz.Zone
At Project Construction prneredthat apply: Coasal Zone
Completion: Type(s): C Of O Noise Zone
Required? YES or NO
Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. Planning Comm.Zoning Administrator
Fee Exempt: City Project I JElec.Vehicle Charger Landmark Seismic Retrofit Special Case:Bldg.
OffcialA royal
Expedite Project(s): Child Care city Project Green Building Landmark Affordable Housing
For Staff Use Only
Building/Safety Permit Specialist City Planning I Civil EngineeringI EPWM-Admin I Transportation Mgint Rent Control
THANK YOU FOR HELPING US CREATE ABETTER COMMUNITY