PMT16-02940 City of Menifee Permit-No.: PMT16-02940
__3 29714 HAUN RD. Type: Pool/Spa-Residential
<A—CCFL^-' MENIFEE,CA 92586
MENIFEE Date Issued: 0910212016
P E R M I T
Site Address: 30708 CARRIAGE HILL DR, MENIFEE, Parcel Number: 364-300-028
CA 92584 Construction Cost: $35,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL AND SPA, 224 SF
Work:
Owner Contractor
ALBORDA CUSTOM POOLS AND HARDSCAPE INC
30708 CARRIAGE HILL DRIVE 23522 SCOOTER WAY
MENIFEE, CA 92584 MURRIETA, CA 92562
Applicant Phone:9514534452
JEFF STOTTS License Number:864932
CUSTOM POOLS AND HARDSCAPE INC
23522 SCOOTER WAY
MURRIETA, CA 92562
Fee Description PAY Amount
Swimming PooUln-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
$524.35
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 Bldo Permit Template.rot Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improvestherean,and who contracts forthe 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 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 01—5-S License N . 1� 07 By my signature below I acknowledge that except for my personal residence
Expires 969-1 Signature in which I m ust have rizsided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structu re that I
WORKER'S COMPENSATION DECLA 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 a nd Professions Code,is available upon request when
compensation,Issued by the Director of Industrial Relations as provided for this application is submitted or atthe following website;
by Section 3700 of the Labor Code,forthe performance of work forwhicin
this permit is issued. www.Ieginfa.m.gov/mIaw.htmI.
Policy# Date
a I have and will maintain worker's compensation Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which u By my signature below I certify to each of the folloWing:I am the property
this permit is issued.My worker's compensation insura nce carrier a nd policy owner or authorized to act on the property owner's behalf.I have read this
num her 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 representatiiv�of this city or county to
Policy If 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 OWNER OR AUTHORIZED AGENT
A(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 If
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workeesAompensation provisions of Section 3700 of the Labor
Code,I shall forth" ! 'mply with those provisions. Will the applicant or future building occupant handle hazardous material or a
TKY-Ply-w—n-I
Applicant e Date q_;Z_ mixture containing a hazardous material equal to or greater that the
Z9t?K__ amounts specified an the Hazardous Materials Information Guide?
WARN4r7dLURE'_T4f0__>SECURE WORKEWS COMPENSATION COVERAGE IS n Yes a No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVI L FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construcrion or modification from South
ADDITION TO TH E 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 forguldellnes
CONSTRUCTION LENDING AGENCY u Yes cr No
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 tin e performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) oYes allo
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 uYes o No
Business and Professions Code).Any city or county that requires a permitto 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 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
•nd 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
•n Applica nt for a Perm it subjects the applica nt to a civil pena Ity 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 sale employees.For more information about EPA's Renovation Program visit:
compensation,will do I )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 Contractor's State License Law does not apply to an owner of a o 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 sale4 o No EPA Lead-Safe Certified Firm is required for this project bemuse:
n 1,as owner of the p ropertV 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.
Menifee
DATE L)�,2 PERMIT/PLAN CHECK NUMBERQVrMg -06ALAD
TYPE: 0 COMMERCIAL 0 RESIDENTIAL 0 MULTI-FAMILY � MOBILE HOME )6OOL/SPA 0 SIGN
SUBTYPE: OADDITION C)ALTERATION CDEMOLITION 0ELECTRICAL CIVIECHANICAL
9�NEW O- PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 1 0'
11UIIPng MrDaopt.
PROJECTADDRESS 419�"LA SEP 0 2 2016
ASSESSOR'S PARCEL NUMBER LOT TRACT Ror;,eived
OWNER NAME A i- f?�wl,,A A
ADDRESS _3c) ,?,Dg L?A/2./2 1 Ae,j� yl (14- 4
PHONE EMAIL
APPLICANT NAME I�U5 A 4 <0,4 1061
ADDRESS 2-;?-_S 1. 2- e7 L Ltg- A,-,m:
PHONE (2�E)) EMAIL
CONTRACTOR'S NAME OWNERBUILDER? OYESONO
BUSINESSNAME 1�7a5r2,,Z, AoLE AAA
ADDRESS r:�4&2YO^ ) eL4ZI-ir b'14 94 ,
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION sQ FT L SQ.FT
a,;Lq
Lau DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION cl"UF MENIFEE
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE
AMOUNT PAID AMOUNT 16OL1,161 OCASH O—CHECK# 0 CREDIT CARD VIWMC
PLAN CHECK FEES PAIDAMOUNT I 1 0 CASH 0 CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 No DL NUMBER NOTARIZED LETTER C YES 0 NO
City of Menifee Building&Safety Deportment 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us inspection Request Line 951-246-5213