PMT16-03428 City of Menifee Permit No.: PMT16-03428
29714 HAUN RD.
<A-CCF-LA—> MENIFEE,CA 92586 Type: Pool/Spa-Residential
MENIFEE Date Issued: 10/1912016
P E R M I T
Site Address: 27555 RENAISSANCE CIR, MENIFEE,CA Parcel Number: 336-530-002
92584 Construction Cost: $40,000.00
Existing Use: Proposed Use:
Description of INGROUND GUNITE POOL&SPA 450 SO FT
Work:
Owner Contractor
SHAUN&JESSICA HALL CABO POOLS
27555 RENAISSANCE CIR 37636 YNEZ ROAD L7#178
MENIFEE,CA 92584 TEMECULA, CA 92591
Applicant Phone:95145307911
ANDY SCHMADER License Number: 796B13
CABO POOLS
37636 YN EZ ROAD L7#178
TEMECULA, CA 92591
Fee Description 9bt Amount
Swimming PooVin-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
$526.35
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 bulliding 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 Bidg_Pemlt Template.ript Page 1 of 1
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 contmctor(s)pursuant to the Contractors State License Law).
Cbapter9(commencing with section 7000)of Division 3 of the Business and a I am exempt from ficensure under the Contriicton's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class C- �2.�
7V.L_1�le�6 k 3 By my signature below I acknowledge that,except for my personal residence
Expires I Si ..tun. Y�
_:au\ — in which I must have resided for at least one yea r prior to 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
ci I hereby affirm under pena Ity of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have a nd will maintain a certificate of consent of self-Insure for worker's 7D44 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 La bor Code,for the performance of work for which
this permit is Issued. www.leginfo.ca.gov/caIaw.htmI.
Policy# Date
cr I have and will maintain worker's compensation Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,forthe performance of the work for which ci 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
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy If Expires enter the above identified property for inspection purposes.
(This section need not to be completed Is the permit is for one-hundred
dollars($100)or less Date
V'certify that in the performance of the work for which this permit is issued, PROPERTY OWNER OR AUTHORIZED AGENT
Ishallnotemplo any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#_ 0:�Y51q I
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker' o pensation provisions of Section 3700 of the Labor
Code,lshall rt ith ly with those provi.sions. Will the applicant or future building occupant handle hazardous material or a
Applicant IERT�_Date 1-�k,�3kzo mixture containing a hazardous material equal to orgreater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS oYes ciNo
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applica nt or futu ne building
AND CIVIL FIN ES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN
ADDITION TO TH E COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist
for guidelines
CONSTRUCTION LENDING AGENCY ci Yes a 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) aYes oNc,
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractoes License Law for the reason(s)Indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to uYes ci No
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT .Date
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 fRRPj
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
and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-1978
an Applicant for a Perm it subjects the applicant to a civil Pena Ity of not mom residence or childiuire facility to be FIRP-certified firms and comply with
than($500). required practices.This includes rental property ownersand property
managers who do the paint-disturbing work themselves or through 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( )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 a An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,th rough employees'or persona I effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sa le.If,however,the building or improvement is sold within one yea r of Firm Certification No.:
com pletion,the Owner-Builder will have the burden of proving that it was
not built or Improved for the purpose of sa le. a No EPA Lead-Safe Certified Firm Is required for this project because;
o 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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
IN I
r
.,"Menl'Tee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: OCOMMERCIAL ORESIDENTIAL 0MULTI-FAMILY OMOBILEHOME 9-POOL/SPA OSIGN
SUBTYPE: OADDITION OALTERATION ODEMOUTION OELECTRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES—
DESCRIPTION OF WORK 6-11A�<-C qA-
PROJECTADDRESS 2--75-5-5— Qj�kj),A 5 5 ftAX4
ASSESSOR'S PARCEL NUMBER 1
15?Mj0CP_LOT TRACT
OWNER NAME
ADDRESS 4f_\L
PHONE EMAIL
APPLICANT NAME VtArL..:,�
ADDRESS �-A 0 6L(,o 0 -4-3<r
PHONE CV�-k - �1 k I - ad-0 EMAIL
CONTRACTOR'S NAME C�"C) 9LXO!=4 OWNERBUILDER? OYES G5NO
BUSINESS NAME C/30,70
ADDRESS LA t A,(,0 \LA-L- &5�,"
PHONE qN-k- -1\2,- I.I.Cru EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ �401 k-"yo SO FT --V�b LSQFT c� (.0
APPLICANT'S SIGNATURE --DATE
DEPARTMENT DISTRIBUTION USIN LICEN ETIBER
BUILDING PLANNING ENGINEERING FIRE � GREEN SMIP
INVOICE
AMOUNT PAIDAMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# 11 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building& Safety Deportment 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213