PMT16-03080 City of Menifee Permit No.: PMT16-03080
29714 HAUN RD. Type: Pool/Spa-Residential
<A— A—> MENIFEE, CA 92586
CI-11 VIA- MENIFEE Date Issued: 0911912016
P E R M I T
Site Address: 32985 LAMTARRA LOOP, MENIFEE, CA Parcel Number: 372-331-018
92584 Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of 526 SO FT INGROUND POOL&SPA&FIRE PIT
Work:
Owner Contractor
JON&DANIELLE GILLETTE PACIFIC COAST POOLS INCORPORATED
32985 LAMTARRA LOOP 43020 BLACKDEER LOOP#106
MENIFEE, CA 92584 TEMECULA, CA 92590
Applicant Phone:9512960199
BRANDY CORAL License Number:852237
PACIFIC COAST POOLS INCORPORATED
43020 BLACKDEER LOOP#106
TEMECULA, CA 92590
Fee Description Qty Amount
Swimming Pooltin-Ground Spa 1 46T00
Plumbing Fixtures and Vents,fixtures 1 116.00
Building Permit Issuance 1 2700
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Plumbing 1 5.80
General Plan Maintenance Fee-Electrical 1 23.35
$644.15
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.
AkBidgPernut—Ternplate.rpt 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(com mending with section 7000)of Division 3 of the Business and 0 1 am exam pt from licensure under the Contractor's State License Law for
Professions Cod mo ense is in full force and effecL the following reason:
License Class _!)1c License No. By my signature below I acknowledge that,except for my personal residence
Expires Z,/JE7 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
ci 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
by Section 3700 of the Labor Code,for the performance of work for which this a R submitted or at the following website:
Pp=ov/mlaw.htmi.
this permit is issued. WWW le
Policy# Date �rt_l
a I have and will maintain worker's compensation insurance,as required by PROPERW OW 'UTFf'
NER OR A ORIZED AGENT
section 3700 of the Labor 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 owner's beha If.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# L P< Fires enter roperty for inspection purposes.
(This section need not to be completed is the permit is for one-hundred
dollars($100)or less 7= Date
PROPERINY OWNER OR AUTHORIZED AGENT
a I certify that in the performance of the work for which this permit is issued,
lshallnotempi any persons in any manner so as to become subject to the CITY BUSINESS UCENSE# 0;56(bLft��
worker's compra' don law I C fifornia,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subjectloth. -r�'r's consioeXt;on provisions of Section 3700 of the Labor
Code,I shall fo ly with those provisions. 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
A_-I_9__1 y amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes qNo,
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 HUNDRED THOUSAND DOLLARS($100,000),IN
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist
for guideli 595_
CONSTRUCTION LENDING AGENCY ri Yes ci*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 the performance of the work which this permit is issued outer boum!�y of a school?
(Section 3097 Civil Code) o Yes a No
OWNER BUILDER DECLARATIONS I have read the Hazardous material Information Guide and the SCAQMID
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California Healop"afety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazardous myterialyeporting.
checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5
Business and Professions Code).Any city or county that requires a permitto 0yes 0 No
construct,alter,improve,demolish or repair any structure,prior to its ��q/ _j�l Date
Issuance,also requires the applicant for the permit to file a signed statement PROPERTY O�NER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRPI
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.S by residence or childcare facility to be RAP-certified firms and comply with
a n Applica nt for a permit subjects the applica nt to a civil pena Ity of not more
than($sco). required practices.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 employee with wages as their sole 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,th rough 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 Imiject because:
cr 1,as owner of the property am 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 projeict does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
& SAFETY PERM IT/PLAN CHECK APPLICATION
's
-Menifee
DATE 61—P—LU, PERM IT/PLAN CHECK NUMBER WIG .
TYPE: OCOMMERCIAL ORESIDENTIAL 0MULTI-FAMILY OMOBILEHOME 0�v6DLIISPA OSIGN
SUBTYPE: OADDITfON OALTERATION OCEMOLITION OELECTRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
PROJECTADDRESS Q(M-kfA V 01 k
ASSESSOR'S PARCEL NUMBER tl�5( —019LOT TRACT
OWNER NAME
ADDRESS �2 Q Cj On k ow
PHONE dC) EMAIL
APPLICANTNAME 1\0�4
ADDRESS cl
PHONE EMAIL
CONTRACrOR'S NAME IWO OWNER BUILDER? 0 YES d,�O
BUSINESS NAME C,
ADDRESS
PHONE EMAIL j
CONTRACTOR'S STATE LIC NUMBER ES 2,?,Z---) LICENSE CLASSIFICATION C
VALUATION $ SOFT L SQ FT
APPLICANT'S SIGNATURE
DATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CIT OF ME FEE LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP 1 6�%
INVOICE PAIDAMOUNT
AMOUNT %� � 0 CASH 0 CHECK# OCREDITCARD VISAMC
PLAN CHECK FEES I PAIDAMOUNT I OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-677,v
www.cityofmenij'ee.cis Inspection Request Line 951-246-6213
0
ro
-n U) ;o -0 it
m
m -00
0
m 0
r-
+ m
0
m
------------
0- ---- --------- Z,%
%ZZ,
it
0 0� it
it
0 it
--4 C) it
09
z C) -0
0 0 t7 Z it
:i
-n it
it
it
n 0 it
m -a r- it
I�y :i
ol it
1-4 M 3
z n
0 7,�
it
it
0 it
it
Ln it
1-4
:i
z
it
it
it
1,
03 + it
M �-- ;,L----------
> co ------
z
m
-n -n Ul) Ul
> U-01
> Ln n
n n m m C)
m 7rs 0 1 ;r,
m M M P-4
co L-1 0 (j)
0 m
0 co
Z 00 n
0
o Z