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PMT16-03227 City of Menifee Permit No.: PMT16-03227 29714 HAUN RD. Type: Pool/Spa-Residential <A-CCr=LA—> MENIFEE, CA 92586 MENIFEE Date Issued: 09/30/2016 P E R M I T Site Address: 29140 GOOSENECK TR, MENIFEE, CA Parcel Number: 364-240-013 92584 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INGROUND POOL 350 SO FT Work: Owner Contractor SCOTTBRUNSON A CUT ABOVE CONSTRUCTION POOLS& 29140 GOOSENECK TR LANDSCAPEINC MENIFEE, CA 92584 26025 NEVVPORT ROAD#A533 Applicant Phone: 8007007754 CHRIS YOUNG License Number:672202 A CUT ABOVE CONSTRUCTION POOLS&LANDSCAPE INC 26025 NEVVPORT ROAD#A533 MENIFEE, CA 92584 Fee Description QtV Amount Swimming Pool/in-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Electrical 1 23.35 $522.35 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 BidgPemit Template.rpt Page 1 of I CITY OF MENIFEE LICENSED DECLARA71ON 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 contratitor(s)pursuant to the Contractors State License Law). Chapterf)(commencing With section 7000)of Division 3 of the Business and a I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is In full force antLeffect. the following reason: n—C:, Licens Clasj Ic No. By my signature below I acknowledge that,except for my personal residence Expire:l�� I 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 V DECLARATION 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 ofthe following declarations:I licensed contractors.I understand that a copy ofthe 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 subm tried or at the following website: by Section 3700 of the Labor Code,for the performance of work for which this permit Is issued. www.IeRInfo.ca.aov/calaw.htmI. Policy# Date a I have and Will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 ofthe Labor Code,for the performance ofthe work for which a By my signature below I certify to each of the following:I am the property this permit is issued.My workees 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 with all applicable city and county ordinances and state laws relating to Carrier 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 permiths fo;one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ct I certify that in the performance ofthe work for which this permit is issued, Ishallnotermil any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# n to worker's ccurl-Rnsation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subje.tto hew rk scom ensa_Un provisions of Section 3700 of the Labor Code,I s all to ith comp provisions. Will the applicant or future building occupant handle hazardous material or a A ic mixture containing a hazardous material equal to or greater that the pp11I a 1`7 Date amounts specified on the Hazardous Materials Information Guide? WARN[r�-FAIL SE UREWORKE S COMPENSATION COVERAGE 15 0yes JEC EM S LS JECTANE LOYER TO CRIMINAL PENALTIES UNLAWFUL,AND HAL TAN Ii Will the 71 ,,ded use ofthe building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Qua lity Ma nagement District(SCAQM D)?See Perm itting checklist IN SECrION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCrION LENDING AGENCY 0 Yes �A`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 ofthe lending agency for the performance ofthe work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) a Yes �No 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 C I f I h.5ple cle,Section 25505 and 25534 concerning Contractor's Ucense Law for the reason(s)indicated below by the h:zi a=us m tel repo_09 checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 -F F(� :�W (�-- -/6 Business and Professions Code).Any city of county that requires a permit to construct,alter,improve,demolish or repair any structure,prior to its PRbZERTYOWfiIEX6F U R EDAGENT 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 Contractoes State i �IIRAND AINTINGIRRP) License Law(Chapter 9(commencing With Section 7000)of Division 3 of the The EPA Renovation,RIO&at dainting(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 a 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 an Applicant for a permit subjects the a pplica nt to a cWil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves orthrough their o 1,as owner afthe propertV0 or my employee with wages as theirsole employees.For more information about EPA!s Renovation Program visit: compensation,will do( )allofor( )portion ofthe 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 ofa 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 yea r 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: 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 a pply to an owner of a If your project does not comply with EPA RAP rule please fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ....-Menifee DATE -�,O-Ao PERM IT/PLAN CHECK NUMBER FkmtoeO4159�0 TYPE: OCOMMERCIAL PESIDENTIAL CMULTI-FAMILY COMOBILEHOME )—CPOOL/SPA OSIGN SUBTYPE: OADDITION C)ALTERATION ODEMOUTION XELEcrRICAL 'OMECHANICAL ONEW gPLUMBING 0 RE-ROOF-NUMBER OF SQUARES_ DESCRIPTION OF WORK' PROJECTADDRESS ASSESSOR'S PARCEL NUMBER 5�4-,-;240 -013 LOT E57 TRACT '304,;L;,- I OWNER NAME 75��/V�1)tj I f)cmi— ADDRESS 6xwswd&-� Y7�1,kz�, P H 0 N E EMAIL APPLICANT NAME cgaf-� ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNERBUILDER? QYES 9)qo BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER -Z,-ZfJ e�— LICENSE CLASSIFICATION VALUATION$ SC)t FT SSD LSQFT APPLICANTS SIGNATURE L (2Zt3 DATE C�-� CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION LI1YUkMtN11 BUNNEbS UCLN5E NUMBER BUILDING PLANNING ENGINEERING FIRE I GRE'EN SMIP INVOICE I t,5n.;3 931 PAID AMOUNT AMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0 CASH ()CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES 0 No DL NUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building&Safety Department 29714 Haun Rd Menifee, CA 92586 951-672-6777 www.cityofmenifee.us Inspection Request Line 951-246-6213