PMT16-02933 City of Menifee Permit No.: PMT16-02933
29714 HAUN RD. Type: PoollSpa-Residential
<A-CCELA-> MENIFEE,CA 92586
W.— MENIFEE Date Issued: 09102/2016
P E R M I T
Site Address: 29884 BOATHOUSE CV, MENIFEE, CA Parcel Number: 333-600-043
92585 Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA 311 SQ, GAS&ELECTRIC LINE FOR FIRE PIT&BBQ
Work:
Owner Contractor
JOHN STANDISH ALOHA POOL&DESIGN
29884 BOATHOUSE CV 41083 SANDALWOOD CIRCLE STE I
MENIFEE, CA 92585 MURRIETA,CA 92562
Applicant Phone:9514539728
MARK KINGSPORN License Number:965927
ALOHA POOL&DESIGN
41OB3 SANDALWOOD CIRCLE STE I
MURRIETA, CA 92562
Fee Description P-ty Amount($
Receptacle, Switch,Outlet&Fixture 1 116.00
Swimming Pool/In-Ground Spa 1 467.00
Plumbing Fixtures and Vents,fixtures 1 116.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Plumbing 1 5.80
General Plan Maintenance Fee-Electrical 1 29.15
$766.95
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 carded on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as othemise 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_Pernnit Ternplate.ript 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 Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and 0 1 am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full rce and effect. the following reason:
0 , --r
License Claw 5 —? fense No. By my signature below I acknowledge that,except formy personal residence
Expires Signature In which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
in 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 Labor Code,for the performance of work for which
this permit is issued. www.leginfo.ca.gay/calaw-htmi.
Policy If Date
ci I have and will maintain worker's compensation insurance,as re quired by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which "y my signature below I certify to ea ch of the following:I am the property
this perm it is issued.My worker's compensation insurance carrier and policy o ner or authorized to act on the property owner's behalf.I have read this
numberare: loplicationRrid the Information I have provided is correct.I agree to comply
'th 11 T
Carrier wi a I)Jcablecityand county ordinances and state laws relating to
building 't"iction.I authorize representatives of this city or county to
Policy# Expires enter N ircove identified property for inspection purposes
(This section need not to be completed is the permit is for one-hundred
dollars($100)or less Date
certify that in the p rformance of the work for which this permit is issued PRCIqIRT�OWNER OR—AUTHORIZED AGENT
x 11 1 L
I�hall not employ any ersons in any manner so as to become subject t( ESS LICENSE If o3 S�
worker's compensati n laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the work s compensation provisions of Section 3700 of the Labor
Code,I shall forth h comply with those 7 isions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
'S
WARNINS.FA RE TO SECURE WORKER'S COMPENSATION COVERAGE IS ci Yes o
1 .1 1
UNLAWFUL,A SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AN D CIVIL FINES UP TO ON E HUN DRED THOUSAND DOLLARS($100,000),IN Will the intended use of the building by the applicant or futu re build Ing
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant req uire a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,I NTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCACIMID)?See permitting checklist
for guichf4es
CONSTRUCTION LENDING AGENCY 0 Yes 01qo
I hereby affirm that underthe penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency forthe performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) o Yes 0
OWNER BUILDER DECLARATIONS I have ret the Hazardous M erial Information Guide and the SCAQMD
M
permitting checklist.I under tand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the Ve
'tar
Y
California Health&Safety ode,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the ode
md""ui reponme
0
tOWNER UT�
'0"'uu
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material repo ng.
Business and Professions Code).Any city or county that requires a permit to "Yes
construct,after,improve,demolish or repair any structure,prior to its Date
issuance;also requires the applicant for the permit to file a signed statement w6—PERnWNER UTHORIZED AGENT
P OF
P E TION
TION. EPAIR AND PAINTING(RRP)
that he or she is licensed pursuant to the provisions of the Conhactoes State EPA RENOVA EPAIR
License Law(Chapter 9(commencing With Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting RRP)Rule requires contractors
and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-1978
an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified firms and comply with
than($500). required practices.This includes rental property owners and property
managers who do the paInt-disturbing work themselves or through their
o I,as owner of the propeft 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.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 Contraictoes State License Law does not apply to an owner of a
property who,through employees'or personal effort,builds or improves the o An EPA Lead-Safe Certified Renovator will be responsible for this project
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
completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.:
not built or improved for the purpose of sale. a No EPA Lead-Safe Certified Firm is required for this project because:
0 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 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
& SAFETY PERMIT/PLAN CHECK APPLICATION -wr,�
M e n i f e e
DATE PERMIT/PLAN CHECK NUMBER
TYPE: OCOMMERCIAL ORESIDENTIAL OMULTI-FAMILY OMOBILEHOME OOL/SPA 0 SIGN
SUBTYPE: �ADDITION OALTERATION ODEMOLITION OELECTRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES—
DESCRIPTION OF WORK )2F— j
PROJECT ADDRESS Z 0 �L�
ASSESSOR'S PARCEL NUMBERI��(o LOT TRACT
OWNER NAME
ADDRESS
PHONE EMAIL
APPLICANT NAME L 0,Pqrl-4J
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME k-A OWNER BUILDER? 0 YES
BUSINESS NAME
ADDRESS C4-0 b 0 04 Y2-- �S
PHONE "S- -�63-4�7zY EMAIL LICENSE CLASSIFICATION 3
CONTRACTOR'S STATE LIC NUMBER 96, S -)7 C�5--
VALUATION$ SO FT L SO FT
I �
APP LICANT'S SIGNATURE DATE
MENIF E
DEPARTMENT DISTRIBUTION CITY OF�A BUWESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE � GREEN SMIP 06
ICE J(�r
INVO O.C1 45' PAIDAMOUNT CASH 0 CHECK# 0 CREDIT CARD VISAIMC
AMOUNT
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISAIMC
OWNER BUILDER VERIFIED 0 YES 0 No DLNUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.citycfmenifee.us Inspection Request Line 951-246-6213
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