The URL can be used to link to this page

PMT16-02026 City of Menifee Permit No.: PMT16-02026 29714 HAUN RD. �XCCELX-> MENIFEE, CA 9258E Type: Residential Alteration MENIFEE Date Issued 06/28/2016 PERMIT Site Address: 29358 GRANDE VISTA AVE,MENIFEE, Parcel Number: 340-542-012 CA 92584 Construction Cost: $7,500.00 Existing Use: 1 &2 Family Residence Proposed use: Description of REMOVE EXISTING TUB, REPLACE WIWALK IN JET TUB,ADD 1 NEW CIRCUIT, MINOR DRYWALL Work: Owner Contractor MARCO LUGO SAFE STEP WALK-IN TUB COMPANY INC 29358 GRANDE VISTA AVE 15262 PIPELINE LANE MENIFEE, CA 92584 HUNTINGTON BEACH,CA 92649 Applicant Phone:7143738545 DAVID BOYANER License Number: 983603 SAFE STEP WALK-IN TUB COMPANY INC 15262 PIPELINE LANE HUNTINGTON BEACH, CA 92649 Fee Description city Amount IS) Receptacle, Switch,Outlet&Fixture 1 116.00 Plumbing Fixtures and Vents,fixtures 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 5.80 General Plan Maintenance Fee-Electrical 1 5.80 $271.60 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 7G00)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for Professions Code an y license is In full force and gffjIrt. the following reason: License Class L�\en�s�N� C� By my signature below I acknowledge that,except formy personal residence Expire E'er�- Signature \V v, �/ In which I must have resided for at least one year prior to completion of Improvements covered by this permit.I cannot legallysell 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 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 webs8e: by Section 3700 of the Labor Code,for the performance of work for which www.ieginfo.ca.gov/calaw.htjil.permit is Issued. Policy g Date larhave and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT csection 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 worker's compensation Insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number are: fi application and the Information 1 have provided is correct.I agree to comply -,-e�til�.�.�. with all applicable city and county ordinances and state laws relating to Carrier building construction.I authorize representatives of this city or county to Polity 8 �1GU„Z L(- 1 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 ❑I certify that in the performance of the work for which this permit is Issued, 1 shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE g IJ uv worker's compensation laws of California,and agree that If I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I rthwith comp) th those provisions. /' Will the applicant or future building occupant handle hazardous material or a Appliwn - DateL IS.16 mixture containin�&a hazardous material equal to or greater that the amounts snarlfrd on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o 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($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 Man"ement District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelin s� CONSTRUCTION LENDING AGENCY a Yes q o I hereby affirm that under the penalty of perjury there is a construction Will the proposed ilding or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is Issued outer bound of a school? (Section 3097 Civil Code) o Yes ❑ o OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guideand the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that 1 am exempt from the California.Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)Indicated below by the ha3ardo s material reporting. checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 dV o Business and Professions Code).Any city or county that requires a permit to � I ) I ^ Date ` v construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER 0 THORI ENT Issuance,also requires the applicant forthe permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's 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 Contractor's State License Law does not apply to 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. ❑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 Contractor's 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 APPLICATION �p N Menifee DATE 6 L PERMIT/PLAN CHECK NUMBER I LO ' Oaoa TYPE: O COMMERCIAL XgESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION 0 ALTERATION O DEMOLITION �.ECTRICAL O MECHANICAL CNEW UMBING ORRE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK V` eS4 T &6-RI 2- ) pt PROJECTADDRESS � I - 4�� 2 ASSESSOR'S PARCEL NUMBER ��5* L(O '6Ltt),'O1�6T TRACT J� OWNER NAME ADDRESS n 1 PHONE 'fL�, �Q�' ��L�n� EMAIL APPLICANT NAME TX 6O- v- \ ADDRESS S�-(-L a"'e�` - �. PHONE /L(- 373, '6S-( S EMAIL CONTRACTOR'S NAME I/ OWNER BUILDER? O YES BUSINESS NAMES, \ GI,I I � C. O `/� S ADDRESS �J1 11lfif Il - `CL 1 c (/ PHONE �l�(• �� - �SZ� �� EMAIL .J� CONTRACTOR'S STATE LIC NUMBER (3 U 3 c 0 3 LICENSE CLASSIFICATION "J VALUATION$ ICJ SO FT SO.FT APPLICANT'S SIGNATURE `/ DATE cnySTAFFUSEONLY DEPARTMENT DISTRIBUTION B CITY OFFMMEf�1 E;7MNSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN ( SMIP i/'f '1 INVOICE 1 AMOUNT • PAIDAMOUNT OCASH O CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK 0 OCREDITCARD VISA/MC OWNER BUILDER VERIFIED 0 YES O NO DL NUMBER NOTARIZED LETTER O YES 0 NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-6 72-6 777 www.cityofinenifee.us Inspection Request Line951-246-6213 \ ? m0 Lto Bq - wk / $ \ & k � 7mQ �m � D- om � § / 55 � IR �4hfm Cc n PA cn0 00 / � Dc & Ey n@ Q \ k � � r m �z \ m� ° � t \ r / z 2 Rc rP � z in n ? � 0 r z n � 0 > G) w » 2 0 k s @ -0x @ w m c D m< n 2 2 k10@ q ƒ %( w bo Q m �CD � ® mT � 2 = 0 r f ■ � 22 _ \ \ k kwm > 2 2 mrm \ k m2 / m 2 CA) D � n � O _ m T O TI(o - 0 �034 C t-r