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PMT15-03975 City of Menifee Permit No.: PMT15-03975 29714 HAUN RD. -f©CEL/�. MENIFEE,CA 92586 Type: Pool/Spa-Residential MENIFEE Date Issued: 1 212 812 01 5 PERMIT Site Address: 28805 MAHOGANY TRAIL WAY, Parcel Number: 333-680-045 MENIFEE, CA 92584 Construction Cost: $22,000.00 Existing Use: Proposed Use: Description of INGROUND POOL AND SPA 680 SO FT Work: Owner Contractor DENNIS ACUNA R L J ENTERPRISES 28805 MAHOGANY TRAIL WAY 661 SUNCUP CIRCLE MENIFEE, CA92584 HEMET, CA92543 Applicant Phone:9092614516 LEE BUGLARD License Number: 1007383 R L J ENTERPRISES 661 SUNCUP CIRCLE HEMET, CA 92543 Fee Description Oft Amount ISl Swimming Poollin-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 3.00 General Plan Maintenance Fee-Electrical 1 23.35 $521.35 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 ❑ lam exempt from licensure under the Contractors'State License Law for the I hereby affirm under penalty or perjury that I am licensed under provisions of following reason: 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 Code and my license is in full force and effect. which 1 must have resided for at least one year prior to completion of License Class C:—S 3 LicenseA4o. improvements covered by this permit, I cannot legally sell a structure that I have Expires_q_r,�".�I'7 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 DECLARATI Business and Professions Code,is available upon request when this application is submitted or at the following Web site: ❑ 1 hereby affirm under penalty of perjury one of the following declarations: htto:Nwww.leainfo.ca.aov/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 orAulhorized Agent Policy# ❑ By my Signature below, I certify to each of the following: I am the property ❑ 1 have 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 I 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- Carder identified property for the inspection purposes. Policy# Expires Date Properly Owner orAuthorized Agent (This section need not be completed if the permit is for City Business License# one-hundred 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 4workers'c mp nsation provisions of Section 3700 of the Labor amounts pacified on the Hazardous Materials Information Guide? Code,I shh c with those provisions. ❑YES 4 NO Applicant; Date; 42'ja'� Will the intended use of the building by the applicant or future building occupant require a permit for the consWction or modification from South WARNINFAILURE 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 kNO 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 DYES NO CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I understand my requirements under the Stale 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) h zardous material epo ' OWNER BUILDER DECLARATIONS > YFS NO �� I hereby affirm under penalty of perjury that I am exempt from the Contractor's r Date License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPER WNER OR AUTHORIZED AGENT next to the applicable item(s)(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(RRPI 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 State 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($500).) employees.For more information about EPA's Renovation Program visit: ❑ I, as owner of the roe www.epa.gov/lead or contact the National Lead Information Center at property,rty, or my employees with wages as their sole 1-800.424-LEAD(5323). compensation,will do( )all of or( )porting of the work,and the structure is not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's Stale License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this project who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, Certified Flan Name: the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved for the Finn Certificalion No.: purpose of sale). ❑ I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Finn is required for this project because: contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who contracts for the projects with a licensed contractor(S)Dursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP BUILDING & SAFETY • • APPLICATION City of Menifee Building & Safety Dept. Menifee DATE PERMIT/PLAN CHECK NUMBER �� p t� P9 AL O RESIDENTIAL O MULTI-FAMILY 0 MOBILE HOME y¢POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK _IVI! / PROJECTADDRESS .Z$ (JCS}, A a& 6LOV (7-fidt-1 2X L y'n ASSESSOR'S PARCEL NUMBER J�7��0`� — >• LOT TRACT �I ` b v OWNER NAME � ADDRESS &hD c PHONE I/ -'$C9'j,.f / EMAIL APPLICANT NAME .kJOt' ,� PLY / _-On ADDRESS E I /) PHONE Loj;-i/ ilI/ (, EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES YNO BUSINESS NAME kl) _ 5-acgw� 14561 lovg - F-L-3 ADDRESS U PHONE GILj Z / t) EMAIL 7 CONTRACTOR'S STATE LIC NUMBER /Op LICENSE CLASSIFICATION G' SJ VALUATION$ SO FT L SQ FT APPLICANT'S SIGNATURE DATE CrrYSTAFFUSEQMLV _.- DEPARTMENT DISTRIBUTION CITYOFM I E S 5ENUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN , SMIP F INVOICE 1 3� PAIDAMOUNT AMOUNT I I O CASH O CHECK# O CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT I O CASH O CHECK B O CREDIT CARD VISA/MC OWNER BUILDERVERIFIED OYES 0 NO DLNUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 sNou338la - - WtlaOtlla H1d30 100d ay,uo ldaA a4u°a sueld 10 aiebs'le apal pe io'io;Naiad a aq Old 101d df g; ¢z al ��,Mpux�anoa�uapa9aid�Ae1M�451lejaple�!4aMS _.�au�'6uuaaui6u3.jaod _ - s99l9'333.8 l,agxl .. 1N3W1 sl1ela aaueuuo;u - .-� I cn I _ l � t