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PMT14-02942 City of Menifee Permit No.: PMT14-02942 29714 HAUN RD. �GCELA> MENIFEE, CA 92586 Type Pool/Spa-Residential MENIFEE Date Issued: - 11/05/2014 1 P E R M I Site Address: 28534 AUTUMN LN, MENIFEE, CA 92584 Parcel Number: 372-412-004 - construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 485 SO FT Work: Owner Contractor MARCUS J ORNELAS ALOHA POOL&DESIGN 28534 AUTUMN LN 41083 SANDALWOOD CIRCLE STE I MENIFEE, CA 92584 MURRIETA, CA92562 Applicant Phone: 9514539728 MARK KLINGSPORN ALOHA POOL& DESIGN License Number: 965927 41083 SANDALWOOD CIRCLE STE I MURRIETA, CA 92562 Fee Description q1t r Amount 1$1 ;B:u11jd7inPerm1t Issuance 1 2700 MDENTIAL 1 4.00 $499.00 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 tha am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed Chapter 9(commencing with section 7000 f Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions Professions Code nd my license is in full o ce and effect. Code:The Contractor's License Law does not apply to an owner of a property License Class License N lys't27� who builds or improves thereon, and who contracts for the projects with a Expires 6G Signature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DE RATION ❑ 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 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# contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code,is available upon request when this application is section 3700 of the Labor Cade, for the performance of the work for which this ❑ have and will maintain workers' compensation insurance, as required submitted or at the following Web site:htt '4www leainfo ca oov/calaw html. s permit is issued.My workers'compensation insurance carrier and policy number are: Property Owner or Authorized Agent Date Carrier Expires Policy# By my Si nature below, I certify to each of the following: I am the property Name of Agent Phone# owner or a horized to act on the property owner's behalf. I have read this (This section need not be completed if the permit is for application nd the information have provided is correct. I agree to comply one-hundred dollars t be c m less) with all appl able city and county ordinances and state laws relating to building constructo . I authorize representatives of this cit or county to enter the above- certify that in the performance of the work or which this permit is issued, I identified p �cth ion purposes. not employ any persons in any manner o astobecomesubject to thefhall kers' compensation laws of California, a d agree that if should become GC subject to the workers'compensation provis' of Section 3700 of the Labor Property w er or Authorized Agent Date Code, I shall forthwith comply with those r i ons. City Business License Date; 5 Applicant; WARNING: FAILURE T SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE I 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, ❑YES 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 70 EQUAL ER THAN THE AMOUNTS SPEC F ED ON THE TO OR ATHAZARDOUS MATERIALS CONSTRUCTION LENDING AGENCY 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 AYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address 0 ITO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR GUIDE LINES OWNER BUILDER DECLARATIONS PRINT NAME: I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the reason(s)indicated below by the checkmark(s)I have placed ❑YES 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, IF 0 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)of that he or AYES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. UNDERSTAND MY REQUIREMENTS violation of Section 7031.5 by any Applicant for a permit subjects the applicant to 0 UNDER THE TATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than ($500).) CODE 3 1 ATE 550RIAL ,PORTING D 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do( )all of or( ) porting of the work, and the structure is PROPS R-AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; X The Contractor's State License Law does not apply to an owner of a property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). }}��r� T1a�rT - I CITY O l�lE IIFILi' E PLC-No: P it o: ' 'O 29714 Haun Road Dale: Date: Menifee, CA 92586 Nosliq Phone: (951)672-6777 Amount: Amount: ro Fax:(951)679-3843 Ck#: Ck M i Building Combination Permit G s To Be Completed By Applicant Legal Description: tK �1 Planning Case: F: gL: Rt:- RProperly Address ,,S3 l9TL9rJ Assessor's Parcel Number, ' Project/Tenam Nome: Unit#: Floor#: Name: • n A q —. 4 Phone No. Fax No. Property Address: ��1 ,� �,( /� Unit Number Zi Code Owner �3 V J-i�1'Pl .� L /'1�h- p Email Address: Name: Phone No. Fax No. /IIII Lv( Applicant Address: Unit Number Zip Code Email Address: Name: Phone No. Fax No. Contractor Addr s: l��A"L D�a 6,� _ , CA Stag Zip Code �063 S 1 uuLv � Z ontrac ors rty us e s icense o. Contractor's City State of California License No. Classificatlon: U"�S'/oS- S Z Number of Squares: Square Footage Description of Work: L /, Cost of Work:$ Applicant's Signature O �a Date: J/ Sh Indicate As R-Recelved or N/A-Not Applicable 5 Completes sets of fully dim sioned,drawn to sale plans which Include: 1 set of documents which include ❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Gen Tech/Soils Report(on col only) ❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 6%x 11) ❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Structural Calculations ❑ 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` Revisionto Exisgng Permit' Required? YES NO 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 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 Required? Listed on Historic Resources Inventory CITY PLANNING STAFF ONLY APPROVALS: Costal Commis Arch.Review Board Landmark Comm. Planning Comm.Zoning Administrator Fee Exempt: City Project Elec.Vehicle Charger Landmark seisf bPetial Case: g. ORicialA mval Expedite Project(s): Child Care City Project Green Building ILandmark Affordable Housing For Statt Use Only Building/Safety Permit Specialist I City Planning Civil Engineering I EPW -Armin I Transportation Mgmt. I Rent Control THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY