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PMT16-02763 City of Menifee Permit No.: PMT16-02763 29714 HAUN RD. Type: Pool/Spa-Residential <��cCiEjLjA> MENIFEE,CA 92586 MENIFEE Date Issued: 08/2312016 P E R M I T Site Address: 25341 WILD VIEW RD. MENIFEE, CA Parcel Number: 358-460-014 92584 Construction Cost: $40,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA,575 SF,WITH 105' U/G GAS&U/G ELEC LINES FOR FUTURE BBQ Work: Owner Contractor JEREMY&SHARON DARROW 25341 WILD VIEW ROAD MENIFEE,CA 92584 Applicant License Number: JEREMY DARROW 25341 WILD VIEW ROAD MENIFEE,CA 92584 Phone:9512652336 Fee Description -Ott Amount Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 Inspections not specified 116 116.00 Inspections not specified 116 116.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 6.00 General Plan Maintenance Fee-Building 1 11.60 General Plan Maintenance Fee-Electrical 1 23.35 $768.95 The issuance of this permit shall not prevent the building official from thereafter requiring the correcrion of errors in the plans and specifications or from preventing building operations being carried on thereunder when in violalion 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 Ternplate.rpt Page I 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), Chapter!)(commencing with section 7000)of Division 3 of the Business and a I am exempt from ficensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. the following mason: License Class License No. By my signature below I acknowledge that,exceptfor my personal residence Expires_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 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 a nd will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon requut when compensation,issued by the Director of Industria I Relations as provided for this application is submitted or at the following website: by Section 3700 of the La bar Code,for the performance of work for which this permit is issued. www.Iegim1b.ca.aoy/caIaw.htmL Policy If �� A AA\.a�-� Date. n I haw and will maintain worker's compensation Insurance,as required by PROPERTY OWN ER OR AUTHORIZED AGENT section 3700 of the La bar 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 an the property owner's behalf.I have read this number are: application and the information I have provided is correct.I agree to comply Carrier with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# Expires enter the above identifieQnoperty for inspection purposes. (This section need not to be completed is the permit is for one-hundred \21� Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT o I certify that in the performance of the work for which this permit is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE It 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 shall forthwith comply with those 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? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS oYes ONO 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 H UNDRED THOUSAND DOLLARS($1013,000),1 N occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Ma nagement District(SCAQM D)7 See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY oYes ONO 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) Oyes ONO 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 reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Dyes o No 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 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPJ License Law(Chapter 9 corhmencing 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-certffied 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 a 1,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( 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 I-SOD-424-LEAD(5323). Code;The Contractor's 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. ci No EPA Lead-Safe Certified Firm is required for this project bemuse: *(as owner of the property a m 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. -a 11 .jdolk BU ILDING & SAFETY PERMIT/PLAN CHECK APPLICATION "." Menifee .9110021! DATE 15\az) PERMIT/PLAN CHECK NUMBER TYPE: OCOMMERCIAL &4ESIDENTIAL 0MULTI-FAMILY OMOBILEHOME VPOOLISPA OSIGN SUBTYPE: OADDITION C)ALTERATION ODEMOLITION OELECTRICAL OMECHANICAL eNEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK P801 JIVA I k) r-�.,te-rw V,,,,g2 . vmu& 6-6& J PROJECTADDRESS 2-5�:�4 [ %A/ kIIA '� j-t-W Yj. M�enkf(>C C.+ CjZC5'E59 ASSESSOR'S PARCEL NUMBER W—LVt00-0jU LOT TRACT OWNERNAME \'Da\ynVJ ADDRESS V\.eW g� - Mevi i-�eC CA q2-1;54 PHONE EMAIL APPLICANT NAME ADDRESS PHONE �8MAIL n! e Mfe CONTRACTOWS NAME Building & Sa ty Dept. OWNERBUILDER? QF`YES0NO BUSINESS NAME AUG 2 3 2916 ADDRESS 1 Ruceived PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ 40300 5 LSQFT APPLICANT'S SIGNATURE DATE IzLr�(, CITY STAFF USE ONLY ULPARTMENT U15THIBUTIUN T;, CI I y OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE AMOUNT ..I PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISAIMC PLAN CHECK FEES I PAIDAMOUNT 0 CASH 0 CHECK# OCREDITCARD VISAIMC OWNER BUILDER VERIFIED C YES ') NO DL NUMBER NOTARIZED LE7ER 0 YES 0 NO City of lVienifee Building&Safety Department 29714 HOUn Rd. Menifee, CA 92586 951-672-6777 www,cityof,menifee.us Inspection Request Line 951-245-6213 ----------- �41 19 ell zz 74 ta