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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