PMT16-03011 City of Menifee Permit No.: PMT16-03011
29714 HAUN RD. Type: Pool/Spa-Residential
'(;kCCELA> MENIFEE, CA 92586
C-111�pl:ht�— MENIFEE Datelssued: 09/1212016
P E R M I T
Site Address: 31423 WEST VIAND LN, MENIFEE, CA Parcel Number: 372-401-003
92584 Construction Cost: $35,200.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA 396 SO FT
Work:
Owner Contractor
CORY SORTINO I L P POOLS&MASONRY
31423 WEST VIAND LN 25184 WOLCOTT COURT
MENIFEE, CA 92584 WILDOMAR, CA 92565
Applicant Phone:9517579636
PATRICK FINN License Number: 886317
25184 WOLCOTT COURT
VIA LDOMAR, CA 92565
Fee Description P!Y. Amount I$)
Swimming Poolfln-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_Bldg_Permit Template.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 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;
Ucense Class C-S-3 c'?DC3 I ? By my signature below I acknowledge that,except for my personal residence
Expires A2_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
WORKERS COMPENSATION DECLARATION hive 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 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. ww%v.leRinfo.ca.Rov/calaw.htmL
Policy# Date
o I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the La bor Code,for the performance of the work for which a 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
numberare: 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 identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($3.00)or less PROPERTY OWNER OR AUTHORIZED AGENT
KI 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#
worker's compensation laws of California,and agree that If I should become HAZARDOUS MATERIAL DECLARATION
subject to tb�ker's compensation provisions of Section 3700 of the Labor
code,I s provisions. Will the applicant or future building occupant handle hazardous material or a
Applicanr Date 21��w mixture containing a hazardous material equal to orgreater thatthe
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ri Yes )ktlo
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 HUN DRIED THOUSAND DOLLARS($100,000),IN
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or madification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist
for guidelines
CONSTRUCTION LENDING AGENCY oyes P�o
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) ci Yes )r 0
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMID
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractoes License Law for the reason(s)indicated below by the California H50k&Safety Code,Section 25505 and 25534 concerning
hazard u
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 n'XiniteVal reporting.
Business and Professions Code).Any city or county that requires a permit to uYes 4ZJ.,� .. Date
construct,alter,improve,demolish or repair any Structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT
issuance,also req uIres 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(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
a nd the basis for the a fleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint In a pre-1978
an Applica nt for a permit subjects the applicant to a civil pena lty of not more residence or childcare facility to be RRP-certified firms and comply with
than($500). required pocrices.This includes rental property owners and property
managers who do the paint-disturbing work themselves or through their
o 1,as owner of the property,or my em ployee 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.gow'lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions I-BOD-424-LEAD(5323).
Code;The Contractoes 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. a No EPA Lead-Safe Certified Firm Is required for this project because:
cz 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 Upcense Law does not apply to an owner of a If your project does not com p ly with EPA RAP ru le please fi 11 a u t the RRP
Acknowledgement.
A�
"'wenifee
111111�—q I.,
DATE 9- / Z- /16c, PERMIT/PLAN CHECK NUMBER 17M(O-
TYPE: OCOMMERCIAL 'KRESIDENTIAL 0MULTI-FAMILY 0- MOBILEHOME >< POOL/SPA OSIGN
SUBTYPE: OADDITION OALTERATION ODEMOLITION OELECTRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 6 c ARAI
PROJECTADDRESS 3/ V -2,3
ASSESSOR'S PARCEL NUMBER LOT 61 TRACT
OWNER NAME
g_)(14 'IJ 0 e 77 A10
ADDRESS 4V&)j,-
,4� C4 IP2- -r9V
PHONE 9%f/-3�24-- ql;?o EMAIL 6SO/ZPAO Cd da Y-I;tl?11,
APPLICANT NAME -P/Wk—�
ADDRESS ZS-1,9 q &-b L C43M Cr- 6),1-1 /U/K PW'>r
PHONE '�J'-)- W�7- 96 3 EMAIL 1A �,- I
CONTRACTOR'S NAME _-Z'Ze & "ZINER BUILDER? OYE� )(NO
a)f S"f Iry r
BUSINESS NAME Q
ADDRESS 1A)IL)o1ft)A,
PHONE -W-17--%36 EMAIL
CONTRACTOR'S STATE LIC NUMBER Lix LICENSE CLASSIFICATION CT3
VALUATION$ SO FT 13 91c L SO FT
APPLICANT'S SIGNATURE DATE 12
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE N U MBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE
AMOUNT PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED ()YES 0 No DLINUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92585 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213