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PMT16-03282 City of Menifee Permit No.: PMT16-03282 29714 HAUN RD. <ACCELA—> MENIFEE, CA 92586 Type: Pool/Spa-Residential ...... MENIFEE Date Issued: 10/06/2016 P E R M I T Site Address: 26433 VELIA CT, MENIFEE, CA 92584 Parcel Number: 360-611-016 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA, 177 SF Work: Omer Contractor KETIH&LINDA KRUTNAUP PREMIER POOLS&SPAS 26433 VELIA COURT 26499 JEFFERSON AVE MENIFEE,CA 92584 MURRIETA,CA 92591 Applicant Phone:9512960199 BRANDY CORAL License Number.852237 PREMIER POOLS&SPAS 26499 JEFFERSON AVE MURRIETA, CA 92591 Phone: 9512960199 Fee Description -ty Amount($ Swimming Pool/in-Ground Spa 467.00 Building Permit Issuance 27.00 GREEN FEE 1.00 SMIP RESIDENTIAL 4.00 General Plan Maintenance Fee-Electrical 23.35 $522.35 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of emors 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 Bldg_Pemit—Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed cantractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effie t�. the following reason: License Class License No. By my signature below I acknowledge that,except for my personal residence in which I m ust have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that I Expires 2 Signature I WORKER'S COMPENSATION 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 of the following declarations:I licensed contractors.I understand that a copy of the applicable low,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 www.IeazIrTfQ.ca.gov/caIaw.htmI. this permit Is Issued. Date to ((79 Policy# A PROPER&OWNER OR AUTHORIZED AG ENT o 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 corn pensation insura nce 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.[agree to comply with all applicable city and county ordinances and state laws relating to Carrier ft' &ZRkg building&wisquction.I authorize representatives of this city or county to Policy# K2,(�M9�Z_ Expires enter th�abqye identified property for inspection puripas as. (This section need not to be completed Is the permit is for one-hundred Date cp- dollars($100)or less PROPERTYOWNER OR AUTHORIZED�GENT o I certify that in the performance of the work for which this permit is issued, Ishallnotermil 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 workees compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply wilth 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 Dyes 0 wo— 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 Dyes 04W_� I hereby affirm that under the penalty of perjury them 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 ci 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 California Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)indicated below by the hazard ( —6—((A O'TZ:�Q Date checkmark(s)I have placed next to the applicable itern(s)(Section 7031.5 Dyes a No Business and Professions Code).Any city or county that requires a permit to construct,alter,improve,demolish or repair any structure,priorto its PROPERTY OWNERIOR AUTHORIZED AGENT issuance,also requires the applicant for the permit tofille a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINT] GIRRPI 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 licensum 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 childcare facility to 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($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.er)a.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 Contractoes 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: 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. o No EPA Lead-Safe Certified Firm is required for this project bemuse: n 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. "'Menifee DATE PERMIT/PLAN CHECK NUMBER TYPE: 0 COMMERCIAL 0 RESIDENTIAL � MULTI-FAMILY 0 MOBILE HOME 41106OL/SPA 0 SIGN SUBTYPE: OADDITION 0ALTERATION ODEMOLITION OELECTRICAL OME�,HANlf ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES C ty 0 �[Bnifee _--aWIding & Safety Dept. DESCRIPTION OF WORK J51)j 52A 1-7:7 t47- rT n R gnig PROJECTADDRESS �Lw�> vsouk tt %2koa4 Received ASSESSOR'S PARCEL NUMBER �0- toj%- jolle LOT TRACT &DIS64 OWNER NAME Y—&hA i-hAffV1 KVU4V%(A4V2_ ADDRESS 3 3 Ue,[(-rA CA M.P ki 4cL PHONE EMAIL APPLICANT NAME Zia KAU, ADDRESS SA,mi M PHONE EMAIL CONTRAcroWS NAME f�6,p M�.e OWNERBUILDER? OYESONe BUSINESS NAME ADDRESS VU- mumeA PHONE EMAIL 69ALe ��;94z � CONTRACTOR'S STATE LIC NUMBER "K!?--2-37� LICENSE CLASSIFICATION o�_3 VALUATION $ SQ FT L SO FT APPLICANT'S SIGNATURE MIE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN smip Ll INVOICE PAIDAMOUNT AMOUNT epQ -Y� �� -,is 1 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES I PAIDAMOUNT I 1 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED 0 YES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 11" LLI M z 0 io Lu 0: + X 0: x W < w > < 1= = IL LU LU 3: 1— U) z 0 In LU 0 i—L LU LLI co U) ui ca U) 0 0: �e w (L U u z 0 z U) Lu 0 I= 0 E —j M 0 LL LU U) U)