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PMT16-01765 City of Menifee Permit No.: PMT16-01765 _ 29714 HAUN RD. Type: Pool/Spa-Residential �/-�CCE-A—> MENIFEE, CA 92586 MENIFEE Date Issued: 06I08/2016 PERMIT Site Address: 25630 APACHE HILL CIR, MENIFEE, CA Parcel Number: 358-461-020 92584 Construction Cost: $25.000.00 Existing Use: Proposed Use: Description of INSTALL POOL&SPA 5 LIGHTS Work: Owner Contractor JONATHAN GREENBERG A CUT ABOVE CONSTRUCTION POOLS& 25630 APACHE HILL CIRCLE LANDSCAPE INC 26025 NEWPORT ROAD#A533 Applicant Phone:8007007754 CHRIS License Number:672202 A CUT ABOVE CONSTRUCTION POOLS&LANDSCAPE INC 26025 NEWPORT ROAD#A533 MENIFEE,CA 92584 Fee Description Qtt Amount I$1 Swimming Poot/ln-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 $522.35 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_Templale.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 contractors)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure underthe Contractor's State License Law for Professions Cod5 and inY.license is in full force and effect. the following reason: / - License Clas F'~ .J 'cerise 6� C-' By my signature below 1 acknowledge that,except for my personal residence Expires �� Signatur f 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 o I hereby affirm under penalty of perjury one of t I ' g 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 webshe: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. www.leeinfo.ca.Rov/calaw.html. Polity# Date e and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT ction 3700 of the tabor Code,for the performance of the work for which o By my signature below 1 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: ,IA 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 �7 building construction.I authorize representatives of this city or county to Policy# ,� L1 5(, Expires ent hQabov ed n�tifi d property for inspection purposes. (This section need not to be completed is the permits for one-hundred /) dollars($100)or less Date_6 PROPERTY OWNER O AUTHORI GENT a 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 LICEN # workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL RATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date 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 Dyes UNLAWFUL,AND SHALL SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES Will the in ended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($5(10,000),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 forguide`Clinn,,es CONSTRUCTION LENDING AGENCY ayes yo 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 o OWNER BUILDER DECLARATIONS I have rdthe 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 checkmark(s)I have placed next to the applicable Rem(s)(Section 7031.5 hazardous ma d re ortin . Business and Professions Code).Any city or county that requires a permit to es o N construct,alter,improve,demolish or repair any structure,prior to its Date issuance,also requires the applicant for the permit to file a signed statement hGPERTr6WNER AL4 RIZED AGENT that he or she is licensed pursuant to the provisions of the Contactors State EPA RENOVATIO REPAI NO PAINTING fRRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contactors Business and Professions Code) mor that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-1978 and the casts for the alleged exemption.Any violation it penalty of not o residence or childcare facility to be RRP-certified firms and comply with than Applicant forapermitsubjectsthe applicant toacivil penaltyofnotmore required pactices.This includes rental property ownemand property than($500). managers who do the paint-disturbing work themselves or through their o 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.eva.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 Contractor's State License Law does not applyto an owner of a o 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. o No EPA Lead-Safe Certified Firm is required for this project ben use: ❑I,as owner of the property am exclusively contacting with licensed contactors to construct the project(Section 7044,Business and Professions Code:The Contactors 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. e =BUILDING PERMIT/PLAN Dept. ,Menifee Received DATE PERMIT/PLAN CHECK NUMBER EMT Ike — O 1'1 TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL :; W O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK-^ C� / PROJECT ADDRESS G��(, a A ,, S Q� 412,664 A ASSESSOR'S PARCEL NUMBER 3%* IYG� I 2-QOT oil TRACT 1 3 ` OWNER NAME rCO� �-� � V� ADDRESS !� /_` ' G/�. PHONE I��IL�IU` ��7� EMAIL APPLICANT NAME (✓ ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES O BUSINESS NAME 1-3 - ,,,rr IG ,D� ADDRESS Z(a�Zs� !'V� �D PHONE ��'Z�y7JS'� EMAIL CONTRACTOR'S STATE LIC NUMBER LR-77 i;ZO C, LICENSE CLASSIFICATION VALUATION$ S FT `-}OLD L SO FT APPLICANT'S SIGNATURE - DATE t1j. - V r CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION 1L{,. CITY OF MENIfEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREENINVOICE 1 l SMIP ` PAID AMOUNT AMOUNT . .� O CASH 0 CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH 0 CHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 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