PMT15-02808 i
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City of Menifee Permit No.: PMT15-02808
.. 29714 HAUN RD. Type: Residential AdditionI
MENIFEE, CA 92586
MENIFEE Date Issued: 09/10/2015 II
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PERMIT
Site Address: 29515 MOORINGS CT, MENIFEE, CA Parcel Number:
92585 Construction Cost: $600.00
Existing use: 1 &2 Family Residence Proposed use:
Description of INSTALL 75' U/G GAS AND ELECTRIC LINE FOR FIRE PIT, 32' ELECTRIC LINE FOR SWITCH
Work:
Owner Contractor
DEBBIE TORRES SUBIC BAY POOLS AND LANDSCAPES
29515 MOORINGS COURT CONSTRUCTION
MENIFEE, CA 92585 37139 HIGH VISTA DRIVE
Applicant Phone: 9513238417
ELMER AGANA License Number: 889971
SUBIC BAY POOLS AND LANDSCAPES CONSTRUCTION
37139 HIGH VISTA DRIVE
MURRI ETA, CA92563 -
Fee Description (Qtyt Amount($1 -
Gas System 1 116.00
I er
GREEN FEE 1 1.00
e er P a sMain e a F n 1
$271.60
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_Templatexpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ I am exempt from licensure under the Contractors'State License Law for the
following reason:
I hereby affirm under penalty or perjury that I am licensed under provisions of
Chapter 9 (commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence in
Professions Co dp an m lid, is in full force and t which I must have resided for at least one year prior to completion of
License lass (di>?i Licen e !o. improvements covered by this permit, I cannot legally sell a structure that I have
Expires Signature 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
WORKERS'COMPENSATION CLARATION Business and Professions Code,is available upon request when this application Is
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one of the following declarations: http'/Iwww leoinfo.ca.gov/calaw.html.
I have and will maintain a certificate of consent of self-insure for workers'
compensation, issued by the Director of Industrial Relations as provided for by Date
Section 3700 of the Labor Code, for the performance of work for which this
permit is issued. Property Owner or Authorized Agent
Policy# ❑ By my Signature below, I certify to each of the following: I am the property
Elhave and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read this
section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. 1 agree to comply
permit is issued.My workers'compensation insurance carrier and policy number are: 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-
Carrier identified property for the inspection purposes.
Date
Policy# Expires
Property Owner or Authorized Agent
(This section need not be completed if the permit is for City Business License#
one-hun ed dollars($100)or less)
HAZARDOUS MATERIAL DECLARATION
I certify that in the performance of the work for which this permit is issued,I
shall not employ any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a
workers' compensation laws of California, and agree that if I should become mixture containing a hazardous material equal to or greater that the
subject to the w rkers'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide?
Code, I shall In comply with those provi ions. ❑YES ❑ NO
V �V
Applic? t; Date; � � Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES ❑ NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of a school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES El YES ❑ NO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist. I understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health&Safety Code, Section 25505 and 25534 concerning
3097 Civil Code) hazardous material reporting.
OWNER BUILDER DECLARATIONS DYES El NO
Date
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the reasons)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT
next to the applicable items)(Section 7031.5. Business and Professions Code:
Any city or county that requires a permit to construct, alter, improve, demolish, EPA RENOVATION REPAIR AND PAINTING(RRP)
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 The EPA Renovation, Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's Slate License Law (Chapter 9 (commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with
she is exempt from licensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031,5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500).) employees. For more information about EPA's Renovation Program visit:
v>ww.epa.govrlead or contact the National Lead Information Center at
❑ 1, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323).
compensation, will do( ) all of or( ) porting of the work, and the structure is
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however, Certified Firm Name:
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the Firm Certification No.:
purpose of sale).
❑ 1, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044, Business and Professions
Cade:The Contractor's License Law does not apply to an owner of a property
who builds or improves thereon, and who contracts for the projects with a
licensed contractors)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
�Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL `. RESIDENTIAL C MULTI-FAMILY i MOBILE H ME :? POOL/SPA Li SIGN
SUBTYPE: Q ADDITION ALTERATION ':i DEMOLITION ` ECFRICAL :i MECHANICAL
% NEW <%MBING " RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK S 5 ' y I
2°I515'
PROJECTADDRESS MOOI�rNbS�Crr..I micNl q
ASSESSOR'S PARCEL NUMBER 333 -J%O ft✓..+—\ LOT TRACT
OWNER NAME 'J uvt City of Menl e
�¢ ildin & Safety ept.
ADDRESS WC PIS f1$o 15
PHONE lq S��3z}}.3 -�4IT EMAIL
APPLICANT NAME L L UrL-P oAN/A Received
ADDRESSr _ 7156) i�y�oA sTA— � mu&_fLjtTA C/} G�
PHONE 1 OISI)� dy IT EMAIL ,,//
CONTRACTOR'S NA SU 3 I L �� L N Mf f_ OWNER BUILDER? �� ..�fES <"NO
BUSINESS NAME CMtfL IVA
ADDRESS //��i3 J3(� J I � fY%
PHONE "Isl ;1_5 0 IT (� q EMAIL
CONTRACTOR'S STATE LIC NUMBER I b J9� I LICENSE CLASSIFICATION M -L?
VALUATION$ SQ FT L SO,FT
APPLICANT'S SIGNATU DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN t7ci�
X
INVOICE
AMOUNT PAID AMOUNT \, SH iCHECK# Ci CREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT SH ".%CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED ""YES NO DL NUMBER NOTARIZED LETTER () YES C' NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-245-6213
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PLAN APPROVAL
REVIEWED BY. It
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'Approval of these plans shall not be construed to be a peimft for,or an
appro 1 of,any violation of any provisions of the federal,state or city
regulaions and ordinances. This set of approved plans must be kept on the
jobsite until completion.
DP-1NSWA>- 1 RC NT LAW N
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