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PMT15-02558 City of Menifee Permit No.: PMT15-02558 29714 HAUN RD. Type: Pool/Spa-Residential MENIFEE, CA92586 e xswr P MENIFEE Date Issued: 08/21/2015 j PERMIT Site Address: 29592 PLEASANT PASEO CV, MENIFEE, Parcel Number: 333-560-007 CA 92585 Construction Cost: $20,000,00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 495 SO FT Work: Owner Contractor GREGORY SNELL ALOHA POOL&DESIGN 29592 PLEASANT PASEO CV 41083 SANDALWOOD CIRCLE STE I MENIFEE, CA 92585 MURRIETA, CA 92562 Applicant Phone: 9514539728 MARK KLINGSPORN License Number: 965927 ALOHA POOL&DESIGN 41083 SANDALWOOD CIRCLE STE I MURRI ETA, CA 92562 Fee Description Off! Amount isl 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 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. AP._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 70P.0)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions Professions Code and my license is in f II force and effect. Code:The Contractor's License Law does not apply to an owner of a property License Class G!'� ) License N 5 _Z'7 who builds or improves thereon, and who contracts for the projects with a Expires ( /-Y`- Signature licensed contractors)pursuant to the Contractors State License Law). WORKERS'COMPENSATION ECLARATION ❑ I am 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 ❑ 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:MID'//omm.leciinfo.ca.gov/calaw.html. permit is issued.My workers'compensation insurance carrier and policy number are: Properly Owner or Authorized Agent Date Carrier Expires Policy# Oy my Signature below, I certify to each of the following. , am the property Name of Agent Phone# owner or authorized to ct on the property owner's behalf. I have read this application and the inf I'mation I have provided is correct. I agree to comply (This section need not be completed if the permit is for one-hundred dollars($100)or less) with all applicable city Wrrid county ordinances and state laws relating to building _ construction.1 authorie.g representatives of this city or county to enter the above- NEY compensationtheperformance of the work for which this permit is issued,I identified proper for,jhe inspection purposes. �ot employ in the Wall emolov any persons in any manner so as to become subject to the ;y �- r laws of California, ancj/agree that if I should become t' ---'"` subject to the workers' compensation provisighs of Section 3700 of the Labor Property Owner o uthorized Agent D to Code,I shall fg hwith comply with those provisions. �.,. City Business License# Date; _Z_4� Applicant; WARNING: FAILURE T ` 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, 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 LINO 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 10 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 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, $40 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 R �A D 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 INFORMATIO: 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 10 UNDER THEttISTATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($501 CODE, SEC7�10N 25505, 25533 AND 25534 CONCERNING 1, as owner f the property, or my employees with wages as their sole HAZA US;MATERIAL REPORTING. c❑om ensaton, will do( )all of or( ) porting of the work, and the structure is PRO ERTY,D 'NER,OR.L#UTHORIZED AGENT not intended or off ered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X " who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If,however, \J the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). Menifee DATE PERMIT/PLAN CHECK NUMBER TIS- o2g TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY 0 MOBILE HOME POOL/SPA ' SIGN SUBTYPE: O ADDITION O ALTERATION � DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK. + e PROJECT ADDRESS G- SS1Z. els' .ASCU ASSESSOR'S PARCEL NUMBER S!33�5fo�--Cb"7 LOT 4 TRACT dL OWNER NAME // ' v liC�- G"b ADDRESS �"I S� � ' PHONE EMAIL \\ APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME �iO'�-� �d'JY�L. 0 � (�/� OWNER BUILDER? O YES 'AD BUSINESS NAME ADDRESS /�D '3 _<q1)-D7r'L-( J Cl/L. S'i PHONE /J _� " 27Z4-_ EMAIL /' ,r- CONTRACTOR'S STATE LIC NUMBER %(��7/� LICENSE CLASSIFICATION L"- VALUATION$ SO FT '�/�— L SO FT i APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION ^/yp CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT AMOUNT C%CASH vCHECK# :%CREDIT CARD. VISA/MC PLAN CHECK FEES PAID AMOUNT CI CASH %CHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED `%YES 0 NO DL NUMBER NOTARIZED LETTER O YES O 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 1 C ,- '4 v f" ljj ,n 1i Y 1.�, a ------------ le