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PMT16-03265 City of Menifee Permit No.: PMT1 6-03265 29714 HAUN RD. Type: Pool/Spa-Residential <A-CCEILA—> MENIFEE, CA 92586 SMI- MENIFEE Date Issued: 10/0512016 P E R M I T Site Address: 31616 NORTHFIELD, MENIFEE, CA Parcel Number: 358-234-022 92584 Construction Cost: $30,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 800 SQ FT,290 L FT GAS LINE FOR FUTURE USE Work: Owner Contractor KELLY WHITTEMORE 31616 NORTHFIELD LN MENIFEE,CA 92584 Applicant License Number. KELLY WHITTEMORE 31616 NORTHFIELD LN MENIFEE, CA 925B4 Phone:9513173382 Fee Description 9tX Amount($ Swimming Poollin-Ground Spa 1 467.00 Plumbing Fixtures and Vents,fixtures 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Plumbing 1 5.80 General Plan Maintenance Fee-Electrical 1 23.35 $645.15 The issuance ofthis permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing buillding 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. SidgPentLTemplate.rpt Page I of 1 f-r1the prj. U .c c. .os. .Law'. CITY OF MENIFEE e L JL property who builds or improves thereon,and wh 3 contracts LICENSED DECLARATION with a licensed contractor(s)pursuant to the ConZcton stat ns wf.� I rl hereby affirm under penalty of perjury that I am under provisions of ti. Chapter9(commencing with section 7GOO)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!s in full force and effect. the following reason: License Class Ulcense No. By my signature below I acknowledge that,except for my personal residence Expires-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 WORKER'S QgMPENSATION DECLARATION have built as an owner-builder if It has not been constructed in its entirety by ,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 requestwhen 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 www.leginfoA. ov w.htmI. this permit is issued. Policy# VJ4 Date /0 PRdl`ERTYbWNER OR AUTHORIZED AGENT u I have and will maintain worker's compensation insurance,as required by 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: 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 buildingpn km.I authorize representatives of this city or county to r Hred prope Policy If Expires e er e or spection purposes. (This section need not to be completed is the permit is for one-hundred r Date 0 1 dollars($100)or less P k6FE-RrivowN ER OR�AUHORQEDArGENT a I certify that in the performance of the work for which this permit is issued, Ishalinotemplo any persons in any manner so as to become subject to the CITI BUSINESS LICENSE# workees 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 with those provisions. Will the applicant or future building occupant handle hazardous material or a mixture containing a hazardous material equal to or greater that the Applicant Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ri Yes o No 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 occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST;AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY u 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 boundary of a school? (Section 3097 Civil Code) uYes allo 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 California Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)Indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes ci No Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNE R OR AUTHORIZED AGENT 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI 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 mostwork that disturbs paint in a pre-1978 and the basis for the alleged exemption.Anyviolation of Section 7031.5 by residence or childcare facilityto be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than J$500). managers who do the paint-disturbing work themselves or through their a 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a ci An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. a No EPA Lead-Safe Certified Firm is required for this project because: 0 1,as owner of the property am exclusively contracting With licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. ,�Menlfee DATE PERM IT/PLAN CHECK NUMBER TYPE: OCOMMERCIAL ORESIDENTIAL 0MULTI-FAMILY OMOBILEHOME jVfOOL/SPA OSIGN SUBTYPE: OADDITION OALTERATION C)DEMOUTION OELECTRICAL OMECHANICAL �PNEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK _ wBnt 4 1 2? PROJECT ADDRESS ASSESSOR'S PARCEL NUMBER LOT TRACT If, OWNER NAME 60(1!1 k)k%4, 4-^O�r ADDRESS ? I � /(a -A)w j1kt6,aJ PHONE 9V-317-3-3 02- — EMAIL J::�cif an7 APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? )�ES 0 NO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ 31�avd> z) L SQ FT APPIL TE ZV JMF�FFUSEONLY DEPARTMENT DISTRIBUTION q7— SMIP IV I CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEr Q I — W — NVOI,CE PAID AMOUNT NT PL AMOUNT K115 I I 1 0 CASH 0 CHECK 0 0 CREDIT CARD VISA/MC PLAN CHECK FEES I PAID AMOUNT I 1 0 CASH 0 CHECK# 0 CREDIT CARO VISA/MC OWNER BUILDER VERIFIED 0 YES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building&Safety Deportment 29714 Houn Rd. Allenfee, CA 92586 951-672-6777 www,cityofmenifee.Lis Inspection Request Line 951-246-5213 Mllr'r wr M1,N 'I R M ON MUM NO IS I AMMOM RIM— W M -MMOr'IIII IV,M,N RIP zw, M L-W W�IVA MWWWWOMMAO-VA INA �'k S We" .q WQIII QVAWV% -0-W-0-4 Nl -4, 04015MM.,WRIONN M 4 ;go"marn M mgm, 0 11 Orl III&,r#,PC", ,4 P4 0 ONNI I WNt qb- a Vol M,.V,�W49�9, "_ ,40 '4 -141 N MqM'. W.' 2&'W#N 1 4 111M. — m I , N, MAW.0-M F,;4 .Mr .05IIII FFF�40