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PMT16-01886 City of Menifee Permit No.: PMT16-01886 29714 HAUN RD. �ACCELA7 MENIFEE, CA 92686 Type: Pool/Spa -Residential MENIFEE Date Issued: 06/15/2016 PERMIT Site Address: 31414 SHERMAN RD, MENIFEE, CA Parcel Number: 360-570-010 92584 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 410 SQ FT Work: Owner Contractor ANDREW CERVANTEZ PACIFIC COAST POOLS INCORPORATED 31414 SHERMAN RD 43020 BLACKDEER LOOP#106 MENIFEE, CA 92584 TEMECULA, CA 92590 Applicant Phone:9512960199 BRANDY CORAL License Number: 852237 PACIFIC COAST POOLS INCORPORATED 43020 BLACKDEER LOOP#106 TEMECULA, CA92590 Fee Description QtV Amount ISl 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 $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 carded on thereunderwhen 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 D I am exempt from licensure under the Contractor's State License Law for Professions Code C and my license is in full force and effect. s Z the following reason: License Class 4z�� License No. O7 vZ✓� By my signature below I acknowledge that,except for my personal residence Expires 9,11S 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 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 www.leainfo.ca.gov/calaw.htmL this permit is issued. Policy# I fiT Date PROPERTY OWNER OR AUTHORIZED AGENT D I have and will maintain worker's compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which D By my signature below I certify to each of the following:I am the property this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this number are: �pp application and the information I have provided is correct.I agree to comply Carrier �/}��d'L with all applicable city and county ordinances and state laws relating to q building construction.I authorize representatives of this city or county to La— Policy# �{�t Expires �S�(�P enter the above identified property for inspection purposes. (This sectro n d"& o�'ecompieted is the permit is for one-hundred PE��-� Date dollars($100)or less PRORTY OWNER OR AUTHORIZED AGENT � o I certify that in the performance of the work for which this permit is issued, — /-f/7�/�LY� 1 shall not am Ploy any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# ()<✓19V l ✓ workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,1 shall fort "th 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 an the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes .moo 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(SCAQM D)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes ❑Iro 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) a Yes o/Nb OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist.I understand my requirements under the State of California Health&Safety Code,Section 25505 and 25534 concerning Contactors License Law for the reason(s)indicated below by the hazardo checkmark(s)I have placed next to the applicable items)(Section 7031.5 t porting. I re Business and Professions Code).Any city or county that requires a permit to oyes D No, ff � Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWN R B 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 Contactors State EPA RENOVATION,REPAIR AND PAINTING IRRPI 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)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 D I,as owner of the property,or my employee with wages as their sale 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.eoa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a D 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 R was not built or Improved for the purpose of sale. O 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 III out the R R P Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE PERMIT/PLAN CHECK NUMBER �-f�� lJ O TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK VW V�pn PROJECTADDRESS %aj1MjAr-\ �FCX' "•L��O`( ASSESSOR'S PARCEL NUMBER ..nf/'� ' �1��QI(7 LOT ID TRACT /�✓'1�� OWNERNAME � ,V-V- ADDRESS S V OLCA n 'U� PHONE QSj- ?)2S_ EMAIL APPLICANT NAME (3V LA.I ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES CZAR BUSINESS NAME Y �, ADDRESS ZUILIG L: PHONE O`Gl'_1 EMAIL CONTRACTOR'S STATE LIC NUMBER �j�"ZZ?7� ^� LICENSE CLASSIFICATION L - VALUATION$ �S oc>7 SO FT L SO FT APPLICANT'S SIGNATURE DATE cnySTAFFUSEONLY DEPARTMENT DISTRIBUTIDN VF F MENIF E BUSI E S UCE E NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN ' SMIP INVOICE PAID AMOUNT AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0CASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER 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 951-245-6213 Owner:Andrew Cervantez Address:31414 Sherman Rd City: Menifee Phone:951.325.3743 EXISTING ONCRETE N 3'6 _ POOL 6' �X KED 27'g, RAISED BOND BEAM + 1211 STACKED STONE FACE C,1,y uF IViEi ii�