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
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