PMT16-01129 City of Menifee Permit No.: PMT16-01129
29714 HAUN RD.
�A-CCEL/� MENIFEE, CA 92586 Type: PoollSpa-Residential
MENIFEE Date Issued: 04/1 412 01 6
PERMIT
Site Address: 27916 HURON CT, MENIFEE, CA 92585 Parcel Number: 333-741-030
Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of INGOUND POOL&SPA
Work:
Owner Contractor
LEONARD OCASLA PACIFIC COAST POOLS INCORPORATED
27916 HURON COURT 43020 BLACKDEER LOOP#106
MENIFEE, CA 92585 TEMECULA, CA 92590
Applicant Phone: 9512960199
BRANDY CORAL License Number: 852237
PACIFIC COAST POOLS INCORPORATED
43020 BLACKDEER LOOP#106
TEMECULA, CA 92590
Fee Description Otv Amount I51
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Electrical 1 23.35
$622.36
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 property who builds or improves thereon,and who contracts for the projects
I hereby affirm 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)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. ^^��� the following reason:
License Class Livens o. ghs6�5� By my signature below I acknowledge that,except for my personal residence
Expires Signature In which l must have resided for at least one year prior to completion of
improvements covered by this permit I cannot legally sell a structure that 1
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
this permit is issued.
www leginfo.ca goy/calaw.html.
Poli Date
I have and will maintain workers compensation insurance,as required by PROP RTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which 7y 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: �/ ��7� y�/C�,� application and the information I have provided is correct.I agree to comply
Cartier �t/��liV\�L J]Y > with ally - able city and county ordinances and state laws relating to
�t tttt building con ruction.I authorize representatives of this city or county to
Policy# (O 1 27_ Expires !)I I entertf e a ove iden'fled property for inspection purposes.
(This section need not to be completed Is the permit is for one-hundred Date
dollars($100)or less PROPERfY OWNER OR AUTHORIZED AGENT
❑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 CITY BUSINESS LICENSE#
workers comp sa'on laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION
subject to the rb rs compensation provisions of Section 3700 of the Labor
Code,I shall fo I ' compl with those provisions. , `_� Will the applicant orfuture building occupant handle hazardous material or a
_I Applicant Date L.� mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide.
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes dNNo
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($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3766 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ❑Yes No
I herebyaffirm thatunderthe penaltyof perjurythere 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 boundary of a school?
(Section 3097 Civil Code) ❑Yes ❑ Ie
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 under the State of
Contractors License Law for the reason(s)indicated below by the California Hea &Safety Code,Section 25505 and 25534 concerning
hazardous at orting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 /
Business and Professions Code).Any city or county that requires a permit to Dyes ❑ o - 1 IJ
construct,alter,improve,demolish or repair any structure,priorto its Date 1
PROPERLY OWN R OR AUTHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement
o that he r she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRP)
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( )all of or( )portion of the work,and the structure is www.epa.gov/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 owner of 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 sate. ❑No EPA Lead-Safe Certified firm is required for this project bemuse:
❑1,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.
SAFETYPERMIT/PLAN CHECK APPLICATION
Menifee
DATE PERMIT/PLAN CHECK NUMBER `Q
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O SIGN
SUBTYPE: O ADDITION O ALTERATION C DEMOLITION C ELECiRICAL gg uIIFy I�E�HS LDept.
C NEW CI PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK n� I
Received
n
PROJECTADDRESS p'-� j-,o ✓� - "1iaee6
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNERNAME /y�1
ADDRESS
p� V-L�`I-� �^
PHONE 1,5 `Q ?j� L,,Ja/� 0 EMAIL {�, WLSfL
APPLICANT NAME VJ
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? C YES
BUSINESS NAME r_)J /�..
ADDRESS D
PHONE 9:�q LQ ®i�l� EMAIL
CONTRACTOR'S STATE LIC NUMBER U 59/_5T - �LIICCENSE CLASSIFICATION
VALUATION$ a-Sr�� SQ FT O L SO FT /
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAIDAMOUNT �-y� ^�
AMOUNT 501' C CASH O CHECK R C CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECKR 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED C YES O NO DL NUMBER NOTARIZED LETTER C YES O NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6177
www.cityofinenifee.us Inspection Request line 951-246-6213
12" TILE FACE
TRAVERTINE
PROPOSED
CONCRETE
J RAISED
FACE TR
VC
PROPO
3.5' _ ~ CONCR
it io 6.5'
V
W
DRAINAGE TO THE
STREET EXISTING CALIFORNIA
ROOM
1'
EXISTNG HOME Q
r
City of Menifee
Building $ Safety Dept.
APR 14 2016