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PMT14-01364 City of Menifee Permit No PMT14-01364 29714 HAUN RD, Type: Pool/Spa -Residential 4ACCEL MENIFEE, CA 92586 MENIFEE Date Issued: 05/29/2014 PERMIT Site Address: 28459 FOX RIDGE CV, MENIFEE, CA Parcel Number: 333-571-012 92585 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INSTALL GUNITE POOL&SPA Work: Owner Contractor RICK FOWLER QUALITY CUSTOM POOLS INC 28459 FOX RIDGE COVE 30138 MARNE WAY MENIFEE, CA 92585 MENIFEE, CA 92584 Applicant Phone: 9516799732 ' QUALITY CUSTOM POOLS INC License Number:795820 30138 MARNE WAY MENIFEE, CA 92584 Fee Description Q�tr Amount I$1 :'Swimming Pool/In-Ground Spa 1 467.00 uBuilding Permit Issuance 1 27.00 aGREEN FEE _ 1 1.00 SMIP RESIDENTIAL 3. 0 0 1 $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 building 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 Code my license is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a property License Class C _License No. `7 ASrga� who builds or improves thereon, and who contracts for the projects with a Expires l t i I'i Signatures licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ 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: 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 it 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# contractors. I understand that a copy of the applicable law, Section 7044 of the ;R 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 Wa site:http1/www leginfp ca cov/calaw htmi. permit is issued.My workers'compensation insurance carrier and policy number are: e-f , y �Jer Y�e[ Pr a ner razed nt Date Carrier / Expires�4 Policy#_C � Cr`FI�f ❑ By my Signature below, I certify to each of the following: I am the property Nameof 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 construction.I authorize representatives of this city or county to enter the above- 0 1 certify that in the performance of the work for which this permit is issued, I identified property for the inspection purposes. shall not employ any persons in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become / subject to the workers'compensation provisions of Section 3700 of the Labor P Ow r or Authorized Agent Date Code, I shall forthwith comply with those provisions. City Business License# Date; Applicant; WARNING: 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, OYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A 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 INFORMATION GUIDE? I hereby affirm that under the penalty of perjury there is a construction lending 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 penally 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 OYES 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 OYES 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 SECDOUS MON 25505RIALI�E5533PORI, G D 25534 CONCERNING ❑ 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 O MENI ,EE PLCKNo: Permit No: 29714 Haun Road C - City of Menifee Date: Date: Menifee, CA 92586 Building & Safety Dept. Phone: (951)672-6777 Amount: Amount: TO ( ) MAY 2 9 2014 Fax: 951 679-3843 Ck#: Ck#: Building Combination P(Reived To Be Completed LApplicant Legal Description: Planning Case: F: L: Rt: R: Property Address: > i Assessor's Parcel Number. �' �V�_ - —I - Project(TenantName: Unit#: Floor#: Name: one No. Fax No. Ownnerty '�'ddress:a V if I Unit Number Zip Code f; Email Address: qy Name: :,T 7 Phone No. Fax No. Applicant Address: Unit Number Zip Code Email Address:,. Name: — , Phone No. Fax No. s. Contractor Address: 7 a City State Zip ode 04 Contractor s City Business 111censd Nu. ntraclor's Ci t f California UcenSp,No. Classification- Numher of Squares: Square Footage Description of Work: Cost of Wofjr: C�� [ qt Applicant's Signature Date: - o e etetl By,Clty Staff Only Indicate As R-Received or N/A-Not Applicable 5 Completes sets of fully dimensioned.drawn to sale plans which include: t 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&'h.x N) ❑ Foundation Plan ❑ Plumbing Plan ❑ Structural Calculations ❑ Cross Section ❑ 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" Ll RetrefiC Revislon to Existlng Permit' Required? YES NO Proposed Building Use(s): Existing Building Use(s): #Buildings: #Units: #Stones: Will the Building Have a Basement? Y of N Bldg.Code Occupancy Group Indicate Indicate if Indicate all Geo-tech.Haz.Zone At Project Sprmklered YES or NO Completion: Construction that apply: Coastal Zone Type(s): C of o YES or NO Noise Zone RegTY P 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 Elec.Vehicle Charger Landmark Seismic Retrofit Special Case:amg. OmcmI roval Expedite Project(s): Child Care Gity Project Green Building Landmark Arfordable Housing For Staff Use Only Building/Safety Permil Sic caalisl I City Planning Civil Engineering I EPWM-Admin Transportation Mgml. 1 Rent Control THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY PL k 0 � City of t e ullding & Safeafety Dept. Q � POW . MAY 2 9 2014 Equipment t Received _Esasdng Blodc Wall Spa PL +6" 6• peep u6: PL 0 Concrete (D O V W Dog L% LL Run 5' O n CITY OF MENIFEE BUILDING AND SAFETY PLAN APPROVAL REVIEWED BY *Approval of these plans shall not be cc P� f' � approval of,any violation of anyprovisii regulations and ordinances. This set of If.-)1 r��� (CA ; '�� jobsite until completion.