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PMT16-01170 City of Menifee Permit No.: PMT16-01170 29714 HAUN RD. Type: Pool/Spa-Residential �ACCELA? MENIFEE, CA 92586 MENIFEE Date Issued: 04/1 812 01 6 PERMIT Site Address: 28357 EBONY CT,MENIFEE, CA 92584 Parcel Number: 372-493-004 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INGROUND POOL AND SPA,300 SF Work: Owner Contractor RYAN BURD A CUT ABOVE CONSTRUCTION POOLS& 28357 EBONY COURT LANDSCAPE INC MENIFEE, CA 92584 26025 NEWPORT ROAD#A533 Applicant Phone:8007007754 CHRIS YOUNG License Number:672202 A CUT ABOVE CONSTRUCTION POOLS&LANDSCAPE INC 26025 NEWPORT ROAD#A533 MENIFEE,CA 92584 Fee Description OQt Amount 1$1 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 $622.35 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_Pennit_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 penaltyof 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 aandd my license is in full force and a ect. the following reason: License Class v 5--3 Li s No. By my signature below I acknowledge that,except for my personal residence Expires 20 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 folio arations: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 worker's 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 Yey,N,le&info.ca.eov/calaw.html. this permit is issued. Policy If 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 in 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: r 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#-(5:71 Expires ( enter the above identified property for inspection purposes. (This section need not to be completed is the permit I for one-hundred Date dollars($100)or less PROPERTY 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 compensation laws of California,and agree that if I should became HAZARDOUS MATERIAL DECLARATION subject to the wort sc mpensation provisions of Section 3700 of the Labor Code,I sh rt Ith pl ri those provisions. Will the applicant or future building occupant handle hazardous material or a Applican Date mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide. WARNING:FAILU TO SECURE ORKER'S COMPENSATION COVERAGE 15 ❑Yes ❑No UNLAWFUL,AND LL SUBJECT 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 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCNON LENDING AGENCY ❑Yes ❑No I hereby affirm that under the 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 boundary of a school? (Section 3097 Civil Code) ❑Yes ❑No 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 Health&Safety Code,Section 25505 and 25534 concerning ardous��pp teer al repor checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 DYe ❑ 10 Business and Professions Code).Any city or county that requires a permit to CDateconstruct,alter,improve,demolish or repair any stmcture,priorto its pROPE WNER 0 THO ED AGEN issuance,also requires the applicant for the permit to file a signed statementthat he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION PAIR AND PA 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 sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE L �j -I PERMIT/PLAN CHECK NUMBER emu ux-10 TYPE: O COMMERCIAL XESIDENTIAL O MULTI-FAMILY O MOBILE HOME POOUSPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION <EECTRICAL O MECHANICAL O NEW VPLUMB114G O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK JL PROJECTADDRESS 2bJ / L:�;7g 6Y ASSESSOR'S PARCEL NUMBER �jp�-(.�� -t�)u LOT TRACT OWNER NAME b ADDRESS 3 a enl ee_.City Safety Dept. PHONE /� Z-Z� EMAIL 8 2016 APPLICANT NAME cn'4 ADDRESS I L//y / ecerve PHONE �bCJ--d/.S=6,y( E� EMAIL CONTRACTOR'S NAME —A Q� La T— Gj A OWNER BUILDER? O YES KO BUSINESS NAME ADDRESS Z/&O Z5/ PHONE Z -2 /'J/^� r� EMAIL C CONTRACTOR'S STATE LIC NUMBER zZU-Z- LICENSE CLASSIFICATION C.' -S VALUATION$ 2sI QDO SO FT L SQ FT APPLICANT'S SIGNATURE DATE CITYSTAFFUSEONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP L INVOICE PAID AMOUNT AMOUNT OCASH OCHECK# "CREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH ,^,CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92586951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213