PMT16-02482 City of Menifee Permit No.: PMT16-02482
_ 29714 HAUN RD.
�/-�CCEL/7 MENIFEE, CA 9258E Type: Pool/Spa-Residential
MENIFEE Date Issued: 0 8/0 312 01 6
PERMIT
Site Address: 30395 STAGE COACH RD, MENIFEE, CA Parcel Number: 358-441-057
92584 Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA 480 SQ FT, INSTALL SOLID 270 SQ FTALUMAWOOD PATIO COVER
Work: E/ELECTRICAL 2 FANS, 123 L FT GAS LINE FOR FIRE PIT&BBQ
Owner Contractor
SCOTT&KATHY SEYMOUR PACIFIC COAST POOLS INCORPORATED
30395 STAGE COACH 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, CA 92590
Fee Description Qtv Amount is)
Receptacle, Switch, Outlet&Fixture 2 121.00
Swimming Pool/In-Ground Spa 1 467.00
Plumbing Fixtures and Vents,fixtures 1 116.00
Building Permit Issuance 1 27.00
Deck/Patio,non-standard 1 133.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Building 1 6.65
General Plan Maintenance Fee-Electrical 1 29.40
$905.05
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 Pennit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
With a licensed contractor(s)pursuant to the Contractors State License Law).
1 hereby affirm under penalty of perjury that I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractors State License taw for
Professions Code and tmylicense is in full force and effecctt�ZZ the following reason:
License Class License 71' u �� By my signature below I acknowledge that,except for my personal residence
Expires �/ Signature 11� 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
D 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.Ie2inIo.ca.Rov/calaw.htmI.
�3 r^
Policy If Date
❑I have and will main workers compensation insurance,as required by PROPE OWNER OR AUTHORIZED AGENT
f fa
section 3700 of the Labor Code,for the performance of the work for which o By my signature below I certify to each of the following:I am the property
this permit Is issued.My workers compensation insurance carder and policy owner or authorized to act on the property owners behalf.I have read this
number awe; application and the information I have provided is correct.1 agree to comply
Carrier C � with all applicable city and county ordinances and state laws relating to
r�/(� r7 �z building construction.I authorize representatives of this city or county to
Policy# ��//7 �l I `L Expires � ant he above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred 1
Date
dollars($100)or less
PR PE OWNER OR AUTHORIZED AGENT
❑I certify that in the performance of the work for which this permit is issued,
I shall not emolov 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 become HAZARDOUS MATERIAL DECLARATION
subject to the wort ers compensation provisions of Section 3700 of the Labor
Code,I shall fort wit comp) with those provisions. ,I Will the applicant or future building occupant handle hazardous material or a
Date $l 1.`4 mixture containing a hazardous material equal to orgreater that the
Applicant amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes o Nd 1
UNLAWFUL,AND SHALLSUBJECTAN 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 forgutdelines
CONSTRUCTION LENDING AGENCY o Yes D_t o^
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) D Yes o No
OWNER BUILDER DECLARATIONS I have read4Ke Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazardous materiaf�P rting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes oyo� 'r1J1 (�
Business and Professions Code).Any city or county that requires a permit to �� _Date "'---tll
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER(SR 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRP1
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 703LS 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
❑1,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.ena.eov/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 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 it was
not built or Improved for the purpose of sale. n No EPA Lead-Safe Certified Firm is required for this project because:
o 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
4�
4Menifee
DATE' PERMIT/PLAN CHECK NUMBER �Ib- Q
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME -J POOL/SPA O SIGN
SUBTYPE: :I ADDITION O ALTERATION 0 DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Q V' fiva
of-. _ 0 vd-
�y �� f ,_ n 1a'�L
PROJECTADDRESS ')05'q (A'L Ypaj
*
ASSESSOR'S PARCEL NUMBER 315%-�-06 / LOT �J� TRACT
OWNER NAME K
ADDRESS O C7
PHONE `-711./- W- U D�Q 3 EMAIL
APPLICANT NAME li
ADDRESS "h/
PHONE EMAIL
CONTRACTOR'S NAME ,p ( ✓ � C�949L�2 OWNER BUILDER? O YES OINO
BUSINESS NAME
ADDRESS
PHONE EMAIL is-t6
CONTRACTOR'S STATE LIC NUMBER 5�.�-7j� LICENSE CLASSIFICATION C S3
VALUATION$ �ZAC51 OW SQ FT j-'I Yju L SQ FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION OD CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP
INVOICE Q(J GJ PAID AMOUNT
AMOUNT W�' UCASH UCHECKN O[REDIT CARD VISA/MC
I.
PLAN CHECK FEES PAID AMOUNT 0CASH OCHECK# 0CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED U YES U NO DL NUMBER NOTARIZED LETTER 0 YES O 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
POOL COPING TO BE
POURED IN PLACE WITH STONE SEAT WALL
SQUARE FACE AND GROUPS STACK STONE FACT
1-5 WATERLINE TILE POURED CONCRET'
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BEAM WITH STACK
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