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PMT16-00990 City of Menifee Permit No.: PMT16-00990 _ 29714 HAUN RD. Type: PooVSpa-Residential �ACCFCA- MENIFEE, CA 92586 MENIFEE Date Issued: 04/04/2016 PERMIT Site Address: 27101 REDRIVER DR, MENIFEE, CA Parcel Number: 335-501-001 92585 Construction Cost: $45.000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 412 SQ FT Work: Owner Contractor BLAIZE&KIM FRENCH QUALITY CUSTOM POOLS OF RIVERSIDE INC 27101 REDRIVER DR 11361 DEER GLEN RD MENIFEE, CA 92585 YUCAIPA, CA 92399 Applicant Phone:9097909601 TERRIE WALKER License Number:825138 QUALITY CUSTOM POOLS OF RIVERSIDE INC 11361 DEER GLEN RD YUCAIPA, CA 92399 Fee Description gtv Amount ISI Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 6.00 General Plan Maintenance Fee-Electrical 1 23.35 $625.35 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_Bidg_Permft Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects I herebyaffirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)4Division 3 of the Business and a I am exempt from licensure underthe Contractor's State License Law for Professions Code and my license is In full fo and ff¢e�c[. ,C the following reason: License Class L L53 By my signature below I acknowledge that;except for my personal residence Expires Signature In which I must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder if It has not been constructed in its entirety by ❑I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure for workers 7044 of the Business and Professions Code,is available upon request when compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which www.tepinfo.ca.gov/calaw.htmi.permit is issued. Policy# Date ❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which ❑By my signature below I certify to each of the following:I am the property this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this number are: application and the information I have provided is correct.I agree to comply Carrier with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# Expires enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT PM certify that in the performance of the work for which this permit is issued, shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# workers compensation laws of Califomia,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply t1 with those provisions. / u / Will the applicant or future building occupant handle hazardous material or a ApplicamrLr �,�'+I I�PI— Date "I--I .1{� mixture containing a hazardous material equal to or greater that the amounts spec�ified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE Is ❑Yes UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($300,000),IN occupant requires permit for the construction or ct modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SC ion or See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes 4No I hereby affirm that underthe penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boun of a school? (Section 3097 Civil Code) ❑yes 6No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements underthe State of CaliforniaContractors License Law for the reasons)indicated below by the Califo Health al Safety Code,Section 25505 and 25534 concerning haz pus material reporting. checkmark(s)I have placed next to the applicable items)(Section 7031.5 1 Business and Profession Effes ❑No[ode).Any city or county that requires a permit to E�G No Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their ❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( I all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an ownerof a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. C & SAFETY PERMIT/PLAN CHECK • • • • "Menifee DATE PERMIT/PLAN CHECK NUMBER f&- 0019,O TYPE: O COMMERCIAL 4t RESIDENTIAL O MULTI-FAMILY O MOBILE HOME 4rPOOL/SPA O SIGN SUBTYPE: 01ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK PROJECTADDRESS ASSESSOR'S PARCEL NUMBER Z S5✓501-001 LOT 49 TRACT asscony OWNER NAME i ADDRESS PHONE EMAIL APPLICANT NAME - q ADDRESS PHONE 95j -`J�`7-93yJ EMAIL - • ' &g r\Q co CONTRACTOR'S NAME OWNER BUILDER? OYES ONO BUSINESS NAME ADDRESS PHONE qo q-7L/ - g6DjI EMAIL CONTRACTOR'S STATE LIC NUMBER �jl,�j LICENSE CLASSIFICATION VALUATION SO FT 41 Z L SQ FT APPLICANT'S SIGNATURE DATE rNSTAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN / SMIP lY 1 .T vvSL INVOICE 22 PAIDAMOUNT AMOUNT SvC OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O 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 '— - - - — - - - - - L - i f i � r i � r - _ T ( ( -E r SAFETY DEPART ENT kL 4 -1 DATE shAu „„on tn hp a permit for,Oran