PMT16-03609 City of Menifee Permit No.: PMT16-03609
29714 HALIN RD. Type: Pool/Spa-Residential
<A-CCF-LA-> MENIFEE, CA 92586
MENIFEE Date Issued: 11/03/2016
P E R M I T
Site Address: 25605 DRIFTVIIEWCIR,MENIFEE, CA Parcel Number: 339-450-012
92584 Construction Cost: $35,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA,420 SF
Work:
Owner Contractor
MILO VILLEGAS VACATION POOLS INC
25605 DRIFTVIEW CIRCLE P 0 BOX 10940
MENIFEE,CA 92584 INDIO, CA 92202
Applicant Phone:7607750468
JOHN PALMIERI License Number: 856835
VACATION POOLS INC
P 0 BOX 10940
INDIO, CA 92202
Fee Description Qtv Amount($
Swimming Pool/in-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 2.00
SMIP RESIDENTIAL 1 5.00
General Plan Maintenance Fee-Electrical 1 23.35
$524.35
The issuance of this permit shall not prevent the building offidial from thereafter requiring the correction of emers in the plans and
specifications or from preventing bulliding operations being carded 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_Permit Ternplate.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe 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).
Chapter9(commencing with section 7000)of Division 3 of the Business and ci I am exempt from licensure under the Contractor's State License Law for
Professions Code and m,4 license i.s in full force and effe the following reason:
License Class r, -3—y Una. a ky-j— By my signature below I acknowledge that,except for my personal residence
se
Expires 1A47 Signatu in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DEC6 2ATION have built as an owner-builder if it has not been constructed In its entirety by
o I hereby affirm under penalty of perju ry 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-insum 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
this permit is issued www.leginfo.ca.goy/calaw.litmi.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
o I have and will maintain worker's compensation insurance,as required by
section 3700 of the Labor Code,forthe 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 compensation insurance carrier and policy owner or authorized to act an the property owner's behalf.I have read this
numberare application and the information I have provided is correct.I agree to comply
,,�4 etT—
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
enter the above identified property for Inspection purposes.
Policy# O-L 2�LZ kO Expires?:f I?—/7
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
a I certify that in the performance of the work for which this permit Is issued,
I shall not employ any persons In any manner so as to become subject to the CITY BUSINESS LICENSE#
worker's comAsation laws of California,and agree that If I should become HAZARDOUS MATERIAL DECLARATION
W LVC Wyl MCI�UWJ I IyCICdLIUI I PIUVJWUIIb UI�CLLIUI I�I VV UJ U IV WVUF
Code Will the applicant or future building occupant handle hazardous material or a
A ppr, mixture containing a hazardous material equal to or greater that the
ca Date amounts specified on the Hazardous Materials Information Guide?
IMAR I FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ci Yes ci No
I
L UN�
IN FUL,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
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FO occupant require a permit for the construction or modification from South
R Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY ri Yes ci 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) ciYes nNo
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
Contractor's License Law for the reason(s)indicated below bythe California Health&Safety Code,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 riYes o No
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its
issuance,also requires the applicant for the permitto file a signed statement PROPERTY OWNER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractoes State EPA RENOVATION,REPAIR AND PAINTING IRRP)
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 alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-cerlifled firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more
then($500). required practices.This includes rental property owners and property
managers who do the paint-clIsturbing work themselves or through their
o 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( I all of or( )portion of the work,and the structure Is www.epagov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions I-BOG-424-LEAD(5323).
Code;The Contractor's 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 am not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year 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 sale. o 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 Continictor'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
-Wenifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: CCOMMERCIAL ORESIDENTIAL CIMULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN
SUBTYPE: OADDITION CALTERATION ODEMOLITION CELECTRICAL OMECHANICAL
ONEW CIPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK loor-t giva
v City at Menifee
--Pt.
Cr C(Q ,uwing & �IdMLY
PROJECTADDRESS OE"
ASSESSOR'S PARCEL NUMBER LOT TRACT NOV u 3
OWNER NAME C�� hflo Recelvied
ADDRESS 'M625� C k) C
PHONE XG EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME 1A6q71C& IM�S OWNERBUILDER? CYESANC)
BUSINESS NAME col)c
A ESS (3
DDR ��n EC C14
PHONE 26'0- 7 -71,0 VCf EMAIL
CONTRACTOR'S STATE LIC NUMBER IrLICENSE CLASSIFICATION C
3 ARl�
10
T
VALUATION$ SQ Fr ";"u L SQ FT
4/�
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE
PAID AMOUNT OCASH OCHECK# 0 CREDIT CARD VISAIMC
AMOUNT egu-251 �Mpm-a!�
PLAN CHECK FEES I PAIDAMOUNT I I OCASH OCHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 No DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-5777
www.CityOfmemfee.us Inspection Request Line 951-246-6213