PMT16-03223 City of Menifee Permit No.: PMT16-03223
29714 HAUN RD. Type: Pool/Spa-Residential
<A-CCIELA> MENIFEE, CA 92586
MENIFEE Date Issued: 09/3012016
P E R M I T
Site Address: 30181 CALLE BELCANTO, MENIFEE, CA Parcel Number; 364-101-012
92584 Construction Cost: $44,100.00
Existing Use: Proposed Use:
Description of INGROUND GUNITE POOL&SPA 372 SQ FT
Work:
Owner Contractor
EDDIE MOORE&JENNY PHER CAL/PACIFIC POOLS&SPAS ING
30181 CALLE BELCANTO 17024 VAN BUREN BLVD STE C
MENIFEE, CA 92584 RIVERSIDE, CA 92504
Applicant Phone: 9517762002
GARY SOPER License Number:652876
CAL/PACIFIC POOLS&SPAS INC
17024 VAN BUREN BLVD STE C
RIVERSIDE, CA 92504
Fee Description Qtv Amount(S)
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 2.00
SMIP RESIDENTIAL 1 6.00
General Plan Maintenance Fee-Electrical 1 23.35
$525.35
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 bullicling 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-Ternplate.rpt Page 1 of 1
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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 contnctor(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 underthe Contractors State License Lawfor
Professions Code and my license is in full force and effect. the following reason:
6 r2-.5'7�
License Class— CS�3 License By my signature below I acknowledge that,except for my personal residence
Expires 8131117 Signature ::� Jn which I must have resided for at least one year primto 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
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. www.leginfo.ca.goy/calaw.htmi.
Policy# Date
o 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 o 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: applintion and the information I have provided is correct.I agree to comply
Carrier S�-Z-Jdl y1v ,4/47 ( 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 4f-1-7 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,
Ishallnotempi anypmm1ssma.y-a r so as to become subject to the CITY BUSINESS UCENSE# C) 355(15
ligi_�
worker"compensatio laws of California,a d agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to th�e rker's mpensationpr isions of Section 3700 of the Labor
f. hwH
Code,I s7hl ort ith corn with se provisions. Will the applicant or future building occupant handle hazardous material or a
Ari'l-atnt net. 9-A- mixture containing a hazardous material equal to or greater that the
amounts spyg'fied on the Hazardous Materials Information Guide?
W' N
RNI r U:RETOSECURU ORKER'S COMPENSATION COVERAGE IS
)SH To L CU Yes
UNLAWF LANDSH:ALLS CT AN EMPLOYER TO CRIMINAL PENALTIES Wilithei trended use of the building by the applicant or future building
C"
0
AND CIVIL NES ONE HUNC RED 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
Coast Ai�Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguid .
CONSTRUCTION LENDING AGENCY o Yes 7N,
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 bouv"9 of a school?
(Section 3097 Civil Code) a Yes 0�w
OWNER BUILDER DECLARATIONS I haw read the Hazardous MazpAarrn`fc1m-)ion Guide and the SCAQNI D
I hereby affirm under pena Ity of perjury that I am exempt from the permitting checklist.I un y rect I ements under the State of
Contractor's License Law for the reason(s)indicated below by the California Health&Sa ecti 5505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5. hazarclou ria I r rting.
Business and Professions Code).Any city or county that requires a permit to 0yes cie ff Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OW G
/)M-rO-R AUt
issuance,also requires the applicantforthe permittofile a signed statement R%0IRIZEDA ENT
A
that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENC R A D PAINTING JRRP)
License Law(Chapter 9(oommencing with Section 7000)of Division 3 of the The EPA Ren.��bcut.R�. .d 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 7031.5 by residence or childure facility to be RRP-certified firms and comply with
an Applic:ant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($500). managerswho clothe paint-disturbing work themselves orthrough their
ci 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( I portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(S323).
Code;The Contractor's State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not Intended or offered for Certified Firm Name:
sole.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. 71aA Lead-Safe Certified Firm Is required for this project bemuse:
a 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
M e n i fe e
DATE 9- PERMIT/PLAN CHECK NUMBER
TYPE: OCOMMERCIAL �OESIDENTIAL CMULTI-FAMILY OMOBILEHOME bj+bOL/SPA OSIGN
SUBTYPE: OADDITION CALTERATION ODEMOLITION OELECTRICAL O- MECHANICAL
VNEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 3 7 z-- P6 Z,, 7
PROJECIFADDRESS
ASSESSOR'S PARCEL NUMBER 36 L/- 161 - 012 - LOT TRACT
OWNER NAME
ADDRESS 9
PHONE Lb 6 - 6 - 4'? EMAIL
APPLICANT NAME C�e- -'-
ADDRESS /-?6.LV 6v,,,'�
PHONE '7'ri- EMAIL
CONTRACTOR'S NAME Aoe-,r ,r OWNERBUILDER? OYESOVO
BUSINESS NAME ZAvfZ :$
ADDRESS //60,-V
PHONE L EMAIL
CONTRACTOR'S STATE LIC NUMBER 6�r),J'?," LICENSE CLASSIFICATION
VALUATION$ I(q, SO FT L SO FT
APPLICANT'S SIGNATURE- DATE
DEPARTMENT DISTRIBUTION SMIP CITYOFME E NUMBER
BUILDING PLANNING ENGINEERING FIRE�GREEN 0
INVOICE PAID AMOUNT I
AMOUNT :3"�- i � --CASH 0 CHECK# 0 CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
LOWNEIR BUILDER VERIFIED 0 YES 0 NO DLN' UMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
wwwxityofirnenifee.us Inspection Request Line 951-246-6213