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PMT16-02781 City of Menifee Permit No.: PMT16-02781 29714 HAUN RD. Type: Pool/Spa-Residential <A—CCEL:A—> MENIFEE, CA 92586 MENIFEE Date Issued: 0812412016 P E R M I T Site Address: 28810 LOIRE VALLEY LN, MENIFEE, CA Parcel Number: 364-121-011 92584 Construction Cost: $50,000.00 Existing Use: Proposed Use: Description of INGROUND POOL SPA,475 SF,WTH U/G GAS LINE FOR FUTURE BBQ ISLAND Work: Owner Contractor STEVE CANALES QUALITY CUSTOM P60LS INC 28810 LOIRE VALLEY LANE 30138 MARNE WAY MENIFEE. CA 92584 MENIFEE,CA 92584 Applicant Phone:9516799732 HANNAH BARRETT License Number:795820 QUALITY CUSTOM POOLS INC 30138 MARNE WAY MENIFEE, CA 92584 Fee Description Otv Amount($ Swimming Poollin-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 7.00 General Plan Maintenance Fee-Electrical 1 23.35 $626.36 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 builicling 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 BldgPemit—Templateript 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 Contmcton State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ci I am exempt from licensure under the Contmctaes State License Law for Professions Code and my license is in full force and effect the following reason: License Class tS4 - i2l UcenseNo. -701SC61-0 By my signature below I acknowledge that,except for my personal residence Expires N1901 Signature— N in which I must have resided for at least one year prior to completion of ftitoL-= 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 workees 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.leRinfa.ca.eov/calaw.htmI. Policy# Date ave and will maintain worker's compensation insurance,as required by PROPERTY OWN ER OR AUTHORIZED AGENT C!nca,on 3700 of the Labor Code,for the performance of the work for which ct By my signature below I certify to each of the following:I am the property this permit is Issued.My worker's compensation insurance ca rrier and policy owner or authorized to act an the property owner's behalf.I have read this numberare: application and the information I have provided is correct.I agree to comply with all applicable city a nd county ordinances and state laws relating to Carrier vi-J a--i'�- building construction.I authorize representatives of this city or county to Policy If CA t 0 0 rJ 2 1 at-1 _Expires --7 enter the above lid , Ified property for Inspection purposes. (This section need not to be completed is the permit is for orie-hundred CL/-L9 )/6 dollars($100)or less —±jn - —Date PROPERTY OWNER OR AUTHORIZED AGENT ci 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# 00 3Q� worker's compensation laws of California,a nd agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shalvorthwith co th those visions. Will the applicant or future building occupant handle hazardous material or a Lt. mixture containing a hazardous material equal to or greater that the Applicant T-7"UP�S Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKEFVS COMPENSATION COVERAGE IS o Yes (NO UNLAWFUL,AND SHALL SUBJECr 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 Management District(SCAQMD)?Seepermitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY a Yes I�No I hereby affirm that under the penalty of perjury them 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 b d ry of a school? (Section 3097 Civil Code) a Yes �?N".a OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the 5CAQMD 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 civAzarclous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 10��Dpo Business and Fir ofesslons Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER(YR 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 Contrzictar'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 childc�ire facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil pena Ity of not more required practices.This includes renta I property ownem 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 EPXs Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.epa.guyllead or contact the National Lead Information Center at not intended or offered for sa le.(Section 7044,Business and Professions I-BOD-424-LEAD(5323). Code;The Contractor's State License Law dam not apply to an owner of a (3 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-Bu ilder 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 because: a 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractoes State Vicense Law does not apply to an owner of a If your project dam not comply with EPA RRP rule please fill out the RRP Acknowledgement. & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE ob 2.4 1 w PERMIT/PLAN CHECK NUMBER TYPE: OCOMMERCIAL ORESIDENTIAL 0MULTI-FAMILY �IMOBILEHOME -APOOL/SPA O-SIGN SUBTYPE: CADDITION OALTERATION C)DEMOUTION OELECTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK (71�itl T�l an,) cl� 0060 L5X��A f,,qtV nt A �jf,� BuIldina & 4i4w6ept. PROJECTADDRESS 'jc6C6jc, \/ojj9,jA �_V,�ljpu AUG 2 � 2016 ASSESSOR'S PARCEL NUMBER 2LO4. LOT T" ReCeived OWNER NAME Q 0,, nw& ADDRESS 'L,4-4w PHONE 9S') EMAIL APPLICANT NAME I_j, ADDRESS �pj?,4 -4,rtz PHONE c\rl. t�-jct-cj-732 EMAIL CONTRACTOR'SNAME J -� OWNERBUILD-ER? QYE�:2NO BUSINESSNAME (��OLA-+�A C,"G-�o ?Q 0 LS, Inc ADDRESS -�,c) j,;C& t-AQ,rjk UJ�66 r-kiLn%-� PHONE 'h!� I -kA-lcli JDi-1'6 7, EMAIL CONTRACTOR'S STATE LIC NUMBER -7cjSqt0 LICENSE CLASSIFICATION (-5,; - e) VALUATION$ 0 0 0 SO FT L SQ FT APPLICANT'S SIGNATURt�_��__ ---DATE S7AFFUSEONLY PF DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER PLANNING —rCp.- L��]_J_ BUILDING ENGINEERING FIRE rGREEN INVOICE PAID AMOUNT F AMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# OCREDITCARD VISAIMC OWNER BUILDER VERIFIED OYES 0 No DLNUMBER NOTARIZED LMER 0 YES 0 NO City of Menifee Building& Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.citVofmenifee.Lis Inspection Request Line 951-246-6213 0 L) Planter Area Steps New Concrete +12" LL sp. LL 3' ep .1T 0 38sf Grass Area New Concrete 475sf Reef 110, Light IN Bench BBC Isl I Lnd of anifee, 0 B i afety, Dept, Light a Existing Patio Existing Balcony ? Bench 9 4 2016 Concrete Deck 6'Deep Ivead urnp, oc New Concrete Pool Equipmen Canales Residenc ITY 0 MENIF 28810 Lorie Valle-P Menifee, Ca 925VUlLDIN N I D EW DEPAMENT 951-454-3975 PLAN Existing Driveway REVIEWED DATE *ApprO*O( An notbe constrimWiekiomilikkoran approvah�mw*Wm of any provisions of the tji64j6wdty regulafions and onfinances, This set of approved OaM must be kept on the jobsite until completion.