PMT16-02488 City of Menifee Permit No.: PMT16-02488
29714 HAUN RD. Type: Residential Alteration
<�kCCEL/1? MENIFEE, CA 92586
MENIFEE Date Issued:
08/03/2016
PERMIT
Site Address: 28406 PEBBLE BEACH DR, MENIFEE, Parcel Number: 337-193-003
CA 92586 Construction Cost: $6,000.00
Existing use: 1 &2 Family Residence Proposed use:
Description of REPLACE TUB/SHOWER W/JACUZZI WALK IN TUB,2 DEDICATED 20AMP CIRCUITS
Work:
Owner Contractor
CAROL&DONALD HEIDLER DI-LAR INDUSTRIAL SUPPLY INC
28406 PEBBLE BEACH DR 1541 PARKWAY LOOP STE E
MENIFEE, CA 92586 TUSTIN,CA 92780
Applicant Phone:7145443100
GRANT HOFFMAN License Number:326317
DI-LAR INDUSTRIAL SUPPLY INC
1541 PARKWAY LOOP STE E
TUSTIN, CA 92780
Fee Description Oft Amount ISI
Receptacle, Switch,Outlet&Fixture 2 121.00
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 6.05
$276.85
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
with a licensed contractor(s)pursuant to the Contractors State License law).
1 hereby affirm under penalty of perjury that 1 am under provisions of
Chapter!)(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class 13 License�Nyg, 3 3y�i�- By my signature below I acknowledge that,except for my personal residence
Expires 1-311-17:: Signature in which l 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 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.leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy fi Date
XI 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 o 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 an the property owners behalf.I have read this
number are: application
application and the information I have provided is correct.I agree to comply
Carrier rzu,.f./�-S� N�'�'`d t1hL— with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# �r/90001A33QS/ Expires C/, ' 2-3—�� enter the o dentified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred ) Date �—
dollars($100)orless PROPERTY OWNER ORAUT RIZED AGENT
���222
o I certify that in the performance of the work for which this permit is issued, O
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE N
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,I shall fart t mply with t ' e provisions. / Will the applicant or future building occupant handle hazardous material or a
3�6 mixture containing a hazardous material equal to or greater that the
Applicant �� Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes CEN0
UNLAWFUL,AND SHALLSUBIECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicantor 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 guide nes
CONSTRUCTION LENDING AGENCY o Yes Y&Vo
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
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 hazardou mates orting.��J
checkmark(s)I have placed next to the applicable items)(Section 7031.5 oyes o �J,,r 6
Business and Professions Code).Any city or county that requires a permit to / %- Date �� 3-�
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR 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 IRRPI
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
o 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.epa.eov/lead or contact the National Lead Information Center at
not Intended or offered forsale.(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:
u 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/.PERMIT/PLAN CHECK APPLICATION
,ak"denifee
DATE ✓'"�J'l PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL * RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA C SIGN
SUBTYPE: O ADDITION C ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
ONE-W� E PLUMBING C RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
II.b ,7
PROJECTADDRESS OAqO(o C-� I` • S C; ��r��jb,
ASSESSOR'S PARCEL NUMBERS -�Q /3 LOT TRACT �Jlv
OWNER NAME
ADDRESS d�o GtU t.� eJ�i,L, Q. C• .2Sg
PHONE EMAIL
`�
APPLICANT NAME 2AX ( 4w)"J4k)
ADDRESS a I`� L� �, S G ; G
PHONE EMAIL
CONTRACTOR'S NAME r� - AX_R_ , CO OWNER BUILDER? OYES *NO
BUSINESS NAME 'T " p .S�• y�
ADDRESS ) 'S/ l,/ „/ ` �6 l 1L-/1 X0 !z O6
PHONE �17 ` 57Z{—J�b(� EMAIL g7
CONTRACTOR'S STATE LIC NUMBER 52 L 3 l 4 LICENSE CLASSIFICATION (.>
VALUATION$ L I COC) SQ FT I L SQ FT
APPLICANT'S SIGNATURE DATE — 31 CITY STAFF USE ONL Y
DEPARTMENT DISTRIBUTION CITYOFMEE]N_I,F EBUSINL55UCENSENUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN L SMIP O "✓�� J S
INVOICE 1_•� PAIDAMOUNT O
AMOUNT W O CASH CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DLNUMBER NOTARIZED LETTER O YES C NO
City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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5229 Walk-in 'Tub Combination, Whirlpool And Pure Air Bath Models
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COMBINATION WHIRLPOOL PUREAIR
Electrical :(Ozone)
tions Device Power Requirements Device Power Requirements Device Power Requirements
120V,5A,60Hz,50OW Motor, 120V,5A,60Hz,500W Motor,
Blower 60OW Heater NIA 600'W Heater
Pump/Moto 120V.7A,60Hz/(12OV,0.25A,60Hz) 120V,7A,60Hz/(120V,025A60Hz) NIP:
Heater 120V,12.5A,60Hz,1.5kW 12OV,12.5A,60H7,1.5kW NIA
Light 12OV,1.6A,60Hz WA WA
GFCI-Pmtected Circuits 'IWo Dedicated 120V,20A,60Hz One Dedicated 120V,20A,60Hz One Dedicated 120V,20A,BOHz
Dimensions
220 Ibs(100 kg) 203 Ibs 1(92 kg) 182lbs(83 kg)
Bath Weight(empty) .
Overall Dimensions(L)x(W)x(H) ST Lx 29.63"W x 37'H(1321mm L x 753mm W x Wri m H)
Drain Location Left Hand I Right Hand
Total Weight(Floor Loading) 780 lbs/75lbslfF
Operating Gallonage(Min-Max) 55(Min)163'(Max)US Gallons(208 L(Mtn)/368 L(Max)
A.Overflow Height 31.50'(800mm)
B.Drain Rough-In(From Side Wall) 10.75'(273mm)
C.Drain Rough-In(From Back Wall) 13.38"(340mm)
D.Drain Shoe Length 8.0'(203mm)
E.Rim Height 2"(51mm)
F.Deck Width' 4'(102mm) Note:Deck width reflects indicated area only.
G.Service Access Dimensions See illustration Below
H.Overall Height 37'(940mm)
Water Healer Capacity 50 US Gallons(182 L)
(Minimum Recommended)
r 1,
® ® +P ry C
To Combination Left-Hand Mo�etylo tMenifee DrainlOverflow
10.75"(B) Heater Buiiding & Safety Dept. Overflow
4"fl. Blower
___ AUG 0 3 2016
13.3 6" Pump/
(C) Hand ,o ' Motor 31.50°(A)
Held
' Received
Spout -, ' 2 2rJ_ Drain Bottom
ff " Drain 8.0"(D)
Service Access�G), 29.61' Service Access(G),' _
5.75'X 13.5 (Center) 22.0'x 13.5" 10.75"(B)
2.0°
52 (L)-- 27.25"— ,' 45.
22.0
Door 37" 427 16.62° �
r 12.87"
36.5" 33.84°
(H) 31.12° 17.63°
28.0' c
11II— 14.0° L 5.38° 28.63°—i 1.14
Front End Cross Section
a 2015 Jacuzzi Luxury asu. • Far additional information tali Customer Service 500.285-4002 • www.Jacuzzl.com
Referwina UationlnsWcgomindudedwghfaWrebefbmbeginninginstallaWn. Please mnfirm product availability and specifications before commencing with anirbstallatlon work. 65000E
PRODUCT SPECIFICATIONSAND AVAILASIUTYARE sUBJECTTO CHANGE WITHOUT NOTICE