PMT15-00930 i
City of Menifee Permit No.: -00930
_ MENIFEE,
EE, C 92 Type: Pool/Spa-Residential
MENIFEE, CA 92586
MENIFEE Date Issued: 04/14/2016
PERMIT
Site Address: 29422 WILDCAT CANYON RD, MENIFEE, Parcel Number: 351-250-007
CA 92587 Construction Cost: $40,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL ONLY
Work: INSTALL SOLID ALUMAWOOD PATIO COVER WITH 2 FANS, 1 GFI SWITCH, GAS LINE FOR FIRE
PIT
Owner Contractor
ROSS&LINDA RAYMOND QUALITY CUSTOM POOLS INC
29422WILDCAT CANYON ROAD 30138 MARNE WAY
MENIFEE, CA 92587 MENIFEE, CA 92584
Applicant Phone: 9516799732
LYNNETTE STONE License Number: 795820
QUALITY CUSTOM POOLS INC
30138 MARNE WAY
MENIFEE, CA 92584
Fee Description GQ,ttv Amount I$1
$ ecz talc e SW'Cb�-� ��`�t&�iitUre a
Swimming Pool/In-Ground Spa 1 467.00
m
Deck/Patio, non-standard non-standard 1 133.00
REED„FLEE" y� 2:,.
SMIP RESIDENTIAL 1 6.00
$761.00
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 and my license is in full farce and effect. Code:The Contractor's License Law does not apply to an owner of a property I
License Class License No. who builds or improves thereon, and who contracts for the'projects with a
Expires Signature - licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ 1 am exempt from icensure 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
Section 3700 of the Labor Code, for the performance of work for which this which I must have resided for at least one year prior to completion of
permit is issued. - improvements covered by this permit, I cannot legally sell a structure that I have
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
GZ 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:hftP://Www,leginfo.ca.gov/calaw.html,
permit is issued.My workers'compensation insurance carrier and policy number are: -
Carrier 5�—_V-a_CI-e:5V Property Owner or Authorized—AgentDate
Expires Policy# CA 00 0 ,a\Ct71Lki
Name of Agent Phone# ❑ BY my Signature below, I certify to each of the following: I am the property
- 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 Property Owner or Au .i T' edA Code,I shall forthwith comply with those provisions. P Y p t; gent •c�--� Date
Date; ��\��� Applicant; City Business License#_�J
s
WARNING: FAILURE TO S CURE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNL WFUL, 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 FXNO 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 3097 Civil Code) WILL THE INTENDED USE OF THE BUILDING BY THE
APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name ❑YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
L0 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: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, 1"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
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 g':p INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS 1
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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation, will do ( )all of or( ) porting of the work, and the structure is PR E TY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or Improves the property,
provided that the Improvements are not intended or offered for sale. If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or Improved for the
purpose of sale).
: APPLICATION
Menifee
DATE L4 - I ,-(- cj PERMIT/PLAN CHECK NUMBER - O
TYPE: ^ COMMERCIAL 45 RESIDENTIAL "D MULTI-FAMILY % MOBILE HOME A POOL/SPA ')SIGN
SUBTYPE: ADDITION 'E-'ALTERATION DEMOLITION C ELECTRICAL G MECHANICAL
NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK �jg be)
W
PROJECTADDRESSa-'-
ASSESSOR'S PARCEL NUMBER `— o�fj� -('YQ� LOT TRACT
OWNER NAME n aa m y�
ADDRESS a 1 City at Menifee
t.
PHONE eS ( QO CA y EMAIL
APPLICANT NAMES„
ADDR Received
PHONE G-5 a -_q_j o� EMAIL LO VA 00 J.5 Z 9�eV_�
CONTRACTOR'S NAME klkcLk 1 rj-}O 10 OWNER BUILDER? ")YES ENO
BUSINESS NAME
ADDRESS
PHONE C EMAIL N
CONTRACTOR'S STATE LIC NUMBER __7 q S p �- LICENSE CLASSIFICATION
VALUATION$ L'f'C110 c) SO FT _ 1n33 t� L SQ FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE � PAID AMOUNT
AMOUNT OCASH %CHECK# :'.'CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT JCASH CHECK It C CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES NO. DL NUMBER NOTARIZED LETTER C? YES % NO
City of Menifee Building& Safety Department 29714 Houn Rd, Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
City of Menifee
y Safety Dept.
APR 14 2015
Received
& 6"' "Precut co w/eq a stone
6'z 9'waterfall wflwn(2 F.rfatlmgirrigasion
"wmg wall••
Plamter w/drip irrigation -�
/Pro-ast coping
6" Bw/sq 6'0" 6"Peesaet step w/stacked stove --�
U sv,
Add bib 4T z 3'wrought hear hmco
w�//7igatef�wn�
g7rot Y ff rCmlay w�vt tp
�) our angmg
Fl oatlsi ColorSgpes pebble interior
Redetepw c
Pro-cost 1
6" 0 0°
atlos&cum
3'6"
Planterw/d
e
Steps w/sleeve
36"fire-pitw/prooat -
wping&stacked atone
QA
Allumgam patio cover w
(2)tams
1445 sq.ft.color/textured
Remove grass&
crushed rock to (liffiff&electric for
BBQ
Add Hose bib here
6'x e'6"stucco
I Poolas h a PCC 2000 w/Ihp"i.
L _ _ _ _ _ _ _ _ _ _
A
Saw cot driveway for &
3"Drain line &curb _ _ Raymond Residence
core 29422wildeatcamyon
(over-flow connected to
1 i
CITY OF MENIFEE
BUILDING AND SAFE'
PLAN APPROVAL