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PMT16-02740 City of Menifee Permit No.: PMT1 6-02740 29714 HAUN RD. Type: Pool/Spa-Residential <A—CCELA—> MENIFEE,CA 92586 MENIFEE Date Issued: 0812212016 P E R M I T Site Address: 29133 STEAMBOAT DR, MENIFEE, CA Parcel Number: 333-443-012 92685 Construction Cost: $35,000.00 Fxisting Use: Proposed Use: Description of INGROUND POOL&SPA Work: Owner Contractor KYLE&CRYSTAL ACKERMAN POSEIDON POOL AND SPA CONSTRUCTION INC 29133 STEAMBOAT DR 38340 INNOVATION COURT MENIFEE,CA 92585 BLDG H STE 804 Applicant Phone:9512862198 DAVID THEISSEN License Number. 1008129 POSEIDON POOL AND SPA CONSTRUCTION INC 38340 INNOVATION COURT BLDG H STE 804 MURRIETA,CA 92563 Fee Description ON Amount I$ Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 5.00 General Plan Maintenance Fee-Electrical 1 23.35 $524.36 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_B1dg_Perrnit Ternplate.rpt Page 1 of I 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 contmctor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ci I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and e ect I the following reason: License Class C -�_; I Me — 10, By my signature below I acknowledge that,except for my personal residence Expires lotsf Signature -1 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 a I hereby affirm under Pena Ity 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 La bor Code,for the performance of work for which this permit is issued. www.IeftInfo.ca.gov1caIaw.htmI. Policy If Date PROPERTY OWNER OR AUTHORIZED AGENT a 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 o 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 ownees behalf.I have read this number are: application and the information I have provided is correct.I agree to comply with all applicable city and county ordinances and state laws relating to Carrier building construction.I authorize representatives of this city or county to Policy# 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 OWN ER OR AUTHORIZED AGENT ) certify that in the performance of the work for which this permit is issued, 11-all not employ any persons in agy manner so as to become subject to the CITY BUSINESS LICENSE If workees compenpllon,laws of 1241iform"ad agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the k e �sation provisions of Section 3700 of the Labor Code,I shall f t se provisions. Will the applicant or future building occupant handle hazardous material or a mixture containing a hazardous material equal to or greater that the Applicant Date amounts specified on the Hazardous Materials Information Guide? WARNI!Td��IWJRE TO SECURE WORKEWS COMPENSATION COVERAGE IS o Yes *No 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 modilication 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 guidelines CONSTRUCTION LENDING AGENCY oyes ftfo 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 bou dary of a school? (Section 3097 Civil Code) 0yes 0 a 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 Contractor's License Law for the reason(s)indicated below by the hazardous material repowng---- checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,prior to its PROATY OWN ER 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 Contractoes State EPA RENOVATION,REPAIR AND PAINTING IRRP) 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 a Ileged exemption.Any Violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply wlith 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,vAll do( )all of or I )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 Contnactoes State License Law does not apply to an owner of a 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. 0 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 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.