PMT16-03550 City of Menifee Permit No.: PMT16-03650
29714 HAUN RD.
-(;Kccr=LA--'> MENIFEE,CA 92586 Type: Pool/Spa-Residential
MENIFEE Date Issued: 11/02/2016
P E R M I T
SiteAddress: 30371 DAWNRIDGE CIR, MENIFEE, CA Parcel Number: 364-270-015
92584 Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of INSTALL IN GROUND SPA AND GAS&ELECTRIC FOR BBQ AND FIRE PLACE
Work:
Owner Contractor
JOHN WHANN ALOHA POOL&DESIGN
30371 DAWNRIDGE CIR 41083 SANDALWOOD CIRCLE STE I
M ENIFEE, CA 92584 MURRIETA, CA 92562
Applicant Phone: 9514539728
MARK KILINGSPOON License Number.965927
ALOHA POOL&DESIGN
41083 SANDALWOOD CIRCLE STE I
MURRI ETA, CA 92562
Fee Description PA Amount 1$)
Swimming Pool/In-Ground Spa 1 467.00
Plumbing Fixtures and Vents,fixtures 1 116.00
Building Permit Issuance 1 27.DO
Inspections not specified 116 116.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Electrical 1 23,35
$754.36
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
forlefted-
AkB1dg_PennR_Tennp1ate.rpt Page I of I
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 contractor(s)pursuant to the Contractors State License Law).
Chapterg(commencing with section 700D)of Division 3 of the Business and a I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full for"11 and effect. the following reason:
License Class— C_a�3 Lit e No. ir my signature below I acknowledge that,except for my persona I residence
Expires ap Signature in which I must have resided foratleast.ne year priorto completion of
WORKE R&C N improvements covered bythis permit.I cannot legallysell a structurethat I
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 law,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 webs[te:
by Section 3700 of the Labor Code,for the performance of work for which
this permit is Issued. www.Ieginfo.ca.gov1calaw.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,for the performance of the work for which u By my signature below I certify to each of the follomdrig:I am the property
this permit is Issued.My worker's compensation insurance carrier and policy owner or alorized to act on the property owner's behalf.I have read this
number are: application hd the Information I have provided is correct.I agree to comply
Carrier with all alp ell Cable city and county ordinances and state laws relating to
building 1� !on.I horize representatives of this city or county to
enterth ,`ru� tir
Policy III Expires veiden 12diproperty for Inspection purposes.
(This section need not to be completed is the permit is for one-hundred
dollars($100)or less Date
1 IcertiNthatinth performance of the work for whkh this permit is issued PROPJJ OWN AGENT
, I,
I shall not employ y persons in any manner so as to become subject t; 4SINESS LICENSE If
_0 in
workeescompe a ion laws of California,and agree that if I should become
r
subject to thew rk r' visions of Section 3700 of the Labor HAZARDOUS MATERIAL DECLARATION
s compensa
Code,I shall rop y with those provisions. te Will the applicant or future building occupant handle hazardous material or a
Applicant Da mixture containing a hazardous material equal to or greater that the
i. amounts spNfied on the Hazardous Materials Information Guide?
. LU
WARNING:F LURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 o Yes
UNLAWFUL,AND SHALL SUBJECr AN EMPLOYER TO CRIMINAL PENALTIES OW
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the Intended use of the building by the applicant or future building
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FO occupant require a permit for the construction or modilication from South
R Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGEN 0 Yes "o
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) a Yes No
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 ftern(s)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to ciYes 0
construct,alter,Improve,demolish or repair any structure,prior to its ? Date
issuance,also requires the applicant for the permit to file a signed statement PROPERfY OWNER OR AUTHORIZED AGENT
that he or she Is licensed pursuant to the provisions of the Contractoes State EPA RENOVATION,REPAIR AND PAINTING(RRPI
License Law(Chapter 9(commencing with Section 7000)of Dwision 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
a nd 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 permit subjects the applicant to a civil penalty of not more residence or childca re facility to be RRP-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
n 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( )allofor( )portion of the work,and the structure is www'.epa.govIlead 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
property who,through employees'or personal effort,builds or improves the n An EPA Lead-Safe Certified Renovator will be responsible for this project
property provided that the improvements a re not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of
completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.:
not built or improved for the purpose of sale. a No EPA Lead-Safe Certified Firm is required for this project because:
ci 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business a nd Professions
Code;The Contractoes 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 ie
—Dept.
NOV 0 2 2016
411."Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: OCOMMERCIAL CRESIDENTIAL CMULTI-FAMILY OMOBILEHOME %OPOOL/SPA OSIGN
SUBTYPE: OADDITION OALTERATION ODEMOLMON 0ELEC`rRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK + (ay"FS
PROJECTADDRESS 3 F_ c4— C1-2 ISZL(
ASSESSOR'S PARCEL NUMBER SQ4-110 0 k5_ LOT ICIS1 TRACT .'so t4-ZOL
OWNER NAME cu V�A 'J'J
ADDRESS -3i-,>3--? i 19ASwrj
PHONE f�/- ffd—T,5'� y EMAIL
APPLICANTNAME 1v)AyZ11c__
ADDRESS /
PHON v EMAIL
CONTRACTOR'S NAME jql-V OWNER BUILDER? 0 YES 00
BUSINESS NAME
ADDRESS V/492-3
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBE LICENSE CLASSIFICATION
VALUATION SO FT LSQFT
APPLICANT'S SIGNATURE DATE
CITY OF MENIFEE BUSINESS LICENSE NUMBER
DEPARTMENT DISTRIBUTION SL
MfBUILDING PLANNING ENGINEERING FIRE GRIEN P
INVOICE IDAMOUNT
AMOUNT � IVA* PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT
7 OCASH C)CHECK# 0 CREDIT CARD VISA/MC
LOWNER BUILDER VERIFIED 0 YES 0 No DLNUMBER NOTARIZED LETTER 0 YES 0 40L
City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
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