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PMT16-03736 City of Menifee Permit No.: PMT16-03736 29714 HAUN RD. Type: Pool/Spa-Residential <A—CCELA? MENIFEE, CA 92586 MENIFEE Date Issued 11121/2016 P E R M I T Site Address: 25965 CARAVAN CT, MENIFEE,CA Parcel Number: 358-512-016 92584 construction Cost: $35,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 220 SQ FT Work: Owner Contnictor HARRIS/GARZA RESIDENCE PARADISE POOLS AND DESIGNS INC 25965 CARAVAN CT 43064 BLACKDEER LOOP#E MENIFEE,CA 92584 TEMECULA, CA 92590 Applicant Phone:9512961961 MIKE STEPHENSON License Number. 943481 PARADISE POOLS AND DESIGNS INC 43064 BLACKDEER LOOP#E TEMECULA, CA 92590 Fee Description city Amount IS) Swimming Poollin-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 official from thereafter requiring the correction of errors in the plans and specifications or from preventing builiding operations being carried on thereunder when in vilolation 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.Bldg_Pemii1—TeMplate.rpt Page 1 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). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for Professions Code and my license Is in full force and effect the following reason: License Class License No. By my signature below I acknowledge that,except for my personal residence Expires 4�5jgnatuee=�— 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 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 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 workees 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 www.leginfo.ca.govLcaIaw.htmI. this permit is issued. Policy# PROPERTY OWNER OR AUTHORIZED AGENT Date a I have and will maintain worker's compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which ci By my signature below I certify to each ofthe 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 -ICA- With all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this cltVorcountyto Policy# !705eocl r, E'xplres P. I�7 enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for on�hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ci I certify that In the performance of the work forwhich this permit is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# oaojtgl worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall forthwith compl�An those provisions. Will the applicant or future building occupant handle hazardous material or a Applgant'�, Date 11-2( 49 mixture containing a hazardous material equal to or greater that the I amounts specified on the Hazardous Materials Information Guide? WARNING:FAH.0 RE T,"SEC)IRE WORKER'S COMPENSATION COVERAGE IS 0 Yes efwl� EU UNLAWFUL,ANDSHA BJECT 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 Management District(SCAQM D)?See permitting checklist IN SECrION 3706 OF THE LABOR CODE,INTEREST,AN D ATTORNEYS FEES forguidelines CONSTRUICTION LENDING AGENCY a Yes Lk6 I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 10GO 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 Q.N6 OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law forthe reason(s)indicated below by the hazardous @ter rting. checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 oYes no, Business and Professions Code).Any city or county that requires a permit to C.^, Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWN OR THORIZED AGENT 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 RENO it, 'A' 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 cam pensation for most work that distu rbs paint in a p re-1978 and the basis for the a leged exem ption.Any violation of Section 7031.5 by residence or ch ildca re facility to be RRP-certifiled firms a nd cam ply with an Applica nt for a perm it su bjects the applica nt to a civil pena ItV of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing 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( )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 704,Business and Professions 1-800-424-LEAD(5323). Code;The Contractor's State License Law does not applyto 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 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 forthis project because: ci 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 mmmmll= enifee DATE PERMIT/PLAN CHECK NUMBER Of mwo.- o,;5j5(,0 TYPE: �' COIVIMERCIAL ORESIDENTIAL 0MULTI-FAMILY OMOBILEHOME P-P'COL/SPA OSIGN SUBTYPE: OADDITION '0ALTERATION ODEMOLITION OELECTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK -q j le— PROJECTADDRESS ASSESSOR'S PARCEL NUMBER aKoltp LOT TRACT OWNER NAME 's ADDRESS �25--163- PHONE u;- g-§5 , 3 y 2 EMAIL APPLICANT NAME /44 1 V- ADDRESS 413'�'6 4/ Z' -7-�--� C�Lj PHONE 16 EMAIL CONTRAC`rOR'S NAME P��J- ijOaS,,�FJS OWNERBUILDER? OYESOIN� BUSINESSNAME �14J ADDRESS V3c,6-/ I PHONE q,�I, EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ SO FT L SO FT APPLICANTS SIGNATL—nlr--,QL- DATE CITY STAFF USE ONLY E)EPAKTMENT DISTRIBUTION go SM,P 145o I L1IYUbmkA1Vtv I�LICENSENUNIBER BUILDING PLANNING ENGINEERING FIRE GREEN '�55191 INVOICE T AMOUNT PAID AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT CASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED C)YES 0 No DL NUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building& Safety Department 29714 Haun Rd. Menifee, CA 92586 951-572-6777 www.cityofmenifee.us Inspection Request Line 951-246-6213 Lr) = El Su ..........