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PMT16-03086 City of Menifee Permit No.: PMT16-03086 29714 HAUN RD. Pool/Spa -Residential <A-CCF-L;�> MENIFEE, CA 92586 Type: 1;-1-11 Nod,— MENIFEE Date Issued: 09/2012016 P E R M I T Site Address: 30691 BUCKBOARD LN,MENIFEE, CA Parcel Number: 358-450-017 92584 Construction Cost: $35,000.00 Existing Use: Proposed Use: Description of INGROUND POOL AND SPA, 390 SF Work: Owner Contractor DEAN&SUZETTE HANSEN MAJESTIC POOL CONSTRUCTION 30591 BUCKBOARD LANE 31566 RAILROAD CANYON ROAD MENIFEE,CA 92584 STE 2#106 Applicant Phone: 9514456384 ERIC ROSENKRANTZ License Number.889638 MAJESTIC POOL CONSTRUCTION 31566 RAILROAD CANYON ROAD STE 2#106 CANYON LAKE, CA 92587 Fee Description ON Amount($ Swimming Pool/in-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 enors 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 othervrise 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. AABIdgPermit-Template.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 contractar(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and a I am exempt from licensure underthe Contractor's State License Law for Professions Code and my license is in full farce and effect the following reason: License Clam—/11�5 9 License No. By my signature below I acknowledge that,except for my personal residence Expires Li�_ a Anature In which I must have resided for at least one year priorto 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 a 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 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 at the following website: by Section 3700 of the Labor Code,for the performance of work for which this permit Is issued. www.leginfa.ca.gov/cal@w.htmI. Policy# Date a I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 37GO 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 behalf.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# Expires enter the above identified property for inspection purposes. (Mis section need not to be completed is the permit is for one-hundred dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT Date CbI ertify that in the performance of the work for which this permit is issued, Ishallnotemplo 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 the worker's compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply witl�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 Its Red on the Hazardous Materials Information Guide? M _RNI amoun A NG:FAILURE TO SECURE WC1RKER_ Zii L 'S r MPENSATION COVERAGE IS a Yes 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 ON E HUNDRED THOUSAND DOLLARS($100,000),IN 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,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQM D)?See permitting checklist for guidelines CONSTRUCTION LENDING AGENCY 0 Yes \.,:No I hereby affirm that under the pena Ity 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) a Yes "a OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 azarclaus aterial reporting. Business and Professions Code).Any city or county that requires a permit to 't -7) Date -Z 62-2-e-.214 construct,alter,improve,demolish or repair any structure,prior to Its issuance,also requires the applicant for the permitto file a signed statement PROPERTY OWNER OR AUTHORIZED AGENT that he or she is licensed pursuant to the provisions of the Contractoes 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 RAP)Rule requires contractors Business and Professions Code)or that he or she is exempt from licensure 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 childca re 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 u 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( )all of or( )portion of the work,and the structure is www.epa.Royllead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-80D-424-LEAD(5323). Code,The Contractor's State License Law does not apply to an owner of a ci An EPA Lead-Safe Certified Renovator will be responsible farthis 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 wrlithin 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. o No EPA Lead-Safe Certified Firm is required for this pmject because: in 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business a nd 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 BUILDING_& SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE PERMIT/PLAN CHECK NUMBERemy n wav TYPE: OCOMMERCIAL ORESIDENTIAL OMULTI-FAMILY OMOBILEHOME �2001./SPA "SIGN SUBTYPE: OADDITION OALTERATION ODEMOLITION CELECTRICAL OMECHANICAL *EW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES— DESCRIPTION OF WORK fPr2!� :j 1�?A crADDRESS Buildmg 061=�lee6t- PROJE QA-ew ASSESSOR'S PARCEL NUMBER LOT TRAWP 2 0 Z616 r;OWNER NAME ADDRESS gc P4 PHONE EMAIL APPL CANT NAME ADDRESS PHONE EMAIL CONTRAcrOR'S NAME - >� t7- OWNERBUILDER? OYESPINO BUSINESSNAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER 99�0139 LICENSE CLASSIFICATION VALUATION$ fa e,,w e) SO FT I/LIQ FT 12—1 I APPLICANVSSIGNATURE9!f DATE VngQ CITYSTAFFUSEONLY DEPARTMENT DISTRIBUTION CITYQFMENIFEEB BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE PAIDAMOUNT AMOUNT �5C;ILi.3CS I I OCASH QCHKK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES I PAIDAMOUNT I OCASH OCHECK# OCREDITCARD VISAIMC OWNER BUILDER VERIFIED 0 YES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building& Safety Department 29714 Houn Rd. illlenifee, CA 92586 9SI-672-6777 www.cityoftnenifee-us Inspection Request Line 951-246-6213 zo 0 C LL co a) CO co > 13 0 + m in cj� cu M -5 0 _0 C%j (2) -2 51 LO m 0 cu CY) o- U) + CL E 0 0 0 C) t5 " c c- co < F--] F-7