PMT15-02028 i
City of Menifee Permit No.: PMTIS-02028
29714 HAUN RD.
` MENIFEE, CA 92586 Type: Pool/Spa-Residential
MENIFEE Date Issued: 07/16/2015
PERMIT
i
Site Address: 30719 LAJOE ST, MENIFEE, CA 92584 Parcel Number: 360-434-007
Construction Cost: $20,000.00
Existing Use: Proposed Use:
Description of INGROUND GUNITE POOL ONLY
Work:
Owner Contractor
STEV&DAWN WITT QUALITY CUSTOM POOLS INC
30719 LAJOE STREET 30138 MARNE WAY
MENIFEE, CA 92584 MENIFEE, CA 92584
Applicant Phone: 9516799732
LYNN STONE License Number: 795820
QUALITY CUSTOM POOLS INC
30138 MARNE WAY
MENIFEE, CA 92584 -
Fee Description Qtv Amount l$1
Building Permit Issuance 1 27.00
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 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_Ndg_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 force and effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class CS3 B License No. 7 C{S who builds or improves thereon, and who contracts for the projects with a
Expires Signature_ licensed contractors)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensure under the Contractors'State License Law for the
❑ 1 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 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
NJ 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:http�//www.leainfo.ca.gov/calaw.htrni.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier L,Ve Property Owner or Authorized Agent Date
Expires '2I�Policy# CA-1 000n15_7N i
Name of Agent Phone# ley 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-
qq....I certify that in the performance of the work for which this permit is issued, I identified property for the i peation purposes,
shall not employ any persons in any manner so as to become subject to the �}s\
workers' compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the Labor operty Owner oO� t�iorized Agent Date
Code, I shall forthwith comply with those provisions. n
Date; "' " 1 - Applican ; (-'} City Business License#
WARNING: FAILURE �0. S.
RE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS iii UL, 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, DYES OCCUPANT HANDLE AHAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑k10 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 BYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address NO FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
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 DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable items) (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, EPO 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 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 '"0 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 REPORT ING.
compensation,will do( ) all of or ( ) porting of the work, and the structure is PROP 'OWNER ORAUTHORIZE A6[� ENT
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).
C & SAFETY PERMIT/PLAN CHECK A. • •
��Menife
DATE 1 - PERMIT/PLAN CHECK NUMBER
TYPE: Q COMMERCIAL Ci RESIDENTIAL ' MULTI-FAMILY } MOBILE HOME @ POOL/SPA - SIGN
SUBTYPE: 0 ADDITION w, ALTERATION % DEMOLITION 0 ELECTRICAL ':i MECHANICAL
O NEW �E% PLUMBIIN7G 0 RE-ROOF-NUMrBER OF SQUARES
DESCRIPTION OF WORK un � rp®1 - J Li 5
PROJECTADDRESS &D_I \ Q L.a De, S+-
ASSESSOR'S PARCEL NUMBERQ�'1.��,,,�( t�� LOT TRACT
OWNER NAME 54--2YP, DYX& D0,Wi Y1 W 1
ADDRESS 3 O-1 ( a1 Lo 02� JT
PHONE a`j1 `15� - 515Q' EMAIL Lluildin9
& Safety Dep
APPLICANT NAME JUL 16 2015
ADDRESS
PHONE EMAIL e
CONTRACTOR'S NAME 0.11} ,j�p OI-5 1M1 OWNER BUILDER? J YES <? NO
BUSINESS NAME J
ADDRESS ' z O I ?j 171AY Yl� �l�Q 1
PHONE "1 t5 � EMAIL C�N G I I N l U1--6 tY1 O a $ V-P f Q- , + h4?j
CONTRACTOR'S STATE LIC NUMBER �q C5 R DL D LICENSE CLASSIFICATION S
VALUATION $ `Lp1 0 O C) SO FT L SO FT
APPLICANT'S SIGNATURE ILL, DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN 1 SMIP
INVOICE PAIDAMOUNT
AMOUNT U�l *+CASH '%.CHECK# OCREDITCARD VISA/MC
HP
N CHECK FEES PAID AMOUNT oCASH ?:CHECK# 'CREDITCARD VISA/MC
UILDER VERIFIED ",YES Ci NO DL NUMBER NOTARIZED LETTER 0 YES C% NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-572-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
Property Line
N
EAsting 6'Block Wall
1
Qq*--51-1110
Pool
5'6" 3'6" Equipment
4'6" 22'7----------------------- �
3z &Safety Dept.
of Menifee
wildidi ng
JUL 16 2015
Received
M
M
1
Witt Residence 'n
30719 Lajoe St
Menifee Ca 92584
CITY OF MENIFEE
BUILDING AND SAFETY DEPARTMENT
PLAN APPROVAL
REVIEWED BY t ` ""i 11 °h-,�
DATE
*Approval of these plans shall not be construed to be a permit for,or an
approval of,any violation of any provisions of the federal,state or city
regulations and ordinances. This set of approved plans must be kept on the
iobsite until completion,