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PMT16-03540 City of Menifee Permit No.: PMT16-03540 29714 HAUN RD. Type: Pool/Spa -Residential <A—CCIELA-? MENIFEE, CA 92586 MENIFEE Date Issued: 11/0112016 P E R M I T Site Address: 28595 PLANTAIN ST, MENIFEE, CA Parcel Number: 333491-002 92584 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INSTALL POOL AND SPA Work: Owner Contractor NICK&DEBBIE DIETZ PACIFIC COAST POOLS INCORPORATED 28595 PLANTAIN ST 26499 JEFFERSON AVE UNIT E MURRIETA, CA 92562 Applicant Phone: 9512960199 BRANDY CORAL License Number:852237 PACIFIC COAST POOLS INCORPORATED 26499 JEFFERSON AVE UNIT E MURRIETA, CA 92562 Fee Description 9tt Amount($ Swimming Pool/ln-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Electrical 1 23.35 $622.35 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 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_BIdg_Permi1—TernpIate.rpt 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 contraCtOT(S)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and a I am exempt from licensu re under the Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: License Ciao__ (�_72 License No. xqz-2 --31 By my signature below I acknowledge that,except for my personal residence .C— Expires Signature in which I must have resided for at least one year priorto completion of improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by a I hereby affirm under penalty of perjury one of the following decla rations: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 availa ble upon request when compensation,issued by the Director of Industrial Relations as provided for t is a * tion is submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. ww le 'iIo.ca.eov/caIaw.htmI. Policy# Date a I have and will me intain worker's com pensation insura nce,as required by PKOP FRTY OWN ER OR AUTHORIZED AGE NT section 3700 of the La bor Code,for the 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 an the property owner's behalf.I have read this numberare: application a nd the information I have provided is correct.I agree to com ply Carrier 11(111ftl,� with all applicable city and county ordinances and state laws relating to b "Id' onstruction.I authorilze representatives of this city or county to Policy# _Xn�V) Expires 1?_'0 - �r -V--q 1AX ente nitified property for inspection purposes. -hundred (This section need not to be completed is the permit is for one Dad dollars($100)or less PVPERTY OWNER OR AUTHORIZED AGENT a I certify that in the performance of the work for which this permit is issued, Ishallnotemplo any persons in any manner so as to become subject to the CITY BUSINESS LICENSE 9 worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worferl3kimpensation provisions of Section 3700 of the Labor Code,I shall fb h those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant_7t Date C/ mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAIURE TO SECURE WORXER'S COMPENSATION COVERAGE IS o 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 Ma nagement District(SCAQM D)?See permitting checklist IN SECTION 3705 OF THE LABOR CODE,I NTEREST,AND ATTORNEYS FEES forguldeline§.— CONSTRUCTION LENDING AGEN oYes; -d-No 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 n of a school? lending agency for the performance of the work which this permit is issued outer bou!�Ow (Section 3097 Civil Code) o Yes n No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQUID I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of California Health&-Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)indicated below by the hazardousn"E"leporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes o No Business and Professions Code).Any city or county that requires a permit to construct,alter,improve,demolish or repair any structure,Prior to its Date Issuance,also req uIres the applica nt for the perm it to file a signed statement PRCIPERTY,6WNER OR AUTHORIZED AGENT that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION.REPAIR AND PAINTING IFIRP) 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 most work that disturbs paint in a pre-1978 and the basis for the a Raged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RAP-certified firms and comply with an Applica nt for a permit su bjects the applicant to a civil pena Ity of not more than($500). required practices.This includes rental property owners and property 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.goyllead or contact the National Lead Information Center at not intended or offered for sa le.(Section 7044,Business a nd 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,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: a 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contnctoes 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 RAP Acknowledgement. city at menifee NOV o "Menifee DATE PERMIT/PLAN CHECK NLIMI�EER�(4- TYPE: 0 COMMERCIAL C) RESIDENTIAL C) MULTI-FAMILY 0 MOBILE HOME �;;O�OL/SPA 0-SIGN SUBTYPE: 0 ADDITION 0 ALTERATION 0 DEMOLITION 0 ELECTRICAL 0 MECHANICAL CNEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Y4 ; %(A . PROJECTADDRESS 9,� 505- vo ASSESSOR'S PARCEL NUMBER 5S.3 LOT —0(j) TRACT OWNERNAME ADDRESS PHONE EMAIL APPLICANT NAME f ,I)LA "� j ADDRESS 5;j w M (A*�� PHONE �20 02--91- EMAIL CONTRACTOR'S NAME OWNERBUILPER? OYESQWO�' BUSINESS NAME ADDRESS (lyxt PHONE J-�j EMAIL j bDj-e,0` P CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ SQ FT LSQFT 9 Pp izzm I - APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITYOFMENIFEE USINESS LICENSE NUM8ER BUILDING PLANNING ENGINEERING FIRE GIEEN S IP INVOICE UN AMOUNT PAIDAMO NT OCASH OCHECK# 0 CREDIT CARD VISA/MC rPUN CHECK FEES PAIDAMOUNT 0 CASH C)CHECK# 0 CREDIT CARD VISA/MC --R .IINI' BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building &Safety Depot-tment 29714 HOUn Rd. Menifee, CA 92586 951-672-6777 www.cityofmenifee.tiS Inspection Request Line 951-246-6213 Fke( Love Seat Plante Baja Shelf 2 Sheer DE New Deck 7' Spa +1f Seating V 9 Deck StackStor Deck Red Salm New Deck Equipt L,