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PMT16-03961 City of Menifee Permit No.: PMT16-03961 29714 HAUN RD. Type: Pool/Spa-Residential <A—CCIELA-�' MENIFEE, CA 92586 0,9 Wt.— MENIFEE Date Issued: 1210512016 P E R M I T SiteAddress: 23350 BADGER CREEK LN, MENIFEE, Parcel Number: 351-241-021 CA 92587 Construction Cost- $30,000.00 Existing Use: Proposed Use: Description of INGROUND GUNITE POOL&SPA 400 SQ FT Work: Owner Contractor CHRISTOPHER SMITH QUALITY CUSTOM POOLS INC 23350 BADGER CREEK LN 30138 MARNE WAY MENIFEE,CA 92587 MENIFEE, CA 92584 Applicant Phone:9516799732 HANNAH BARRETT License Number.795820 QUALITY CUSTOM POOLS INC 30138 MARNE WAY MENIFEE, CA 92584 Fee Description ON Amount Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Electrical 1 23.35 $523.35 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. AkBidg_Permit-Templatexpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapterg(commencing with section 7000)of Division 3 of the Business and a I am exemptfrom 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 C S*a- License No. —)Cl g C6'1,0 By my signature below I acknowledge that,except for my personal residence Expires %k 1:h0 1 1-1 Signatu'- in which I must have resided for at least one year prior to completion of improvements covered bythis permit.I cannot legallysell a structure that I WORKEWS COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in Its entirety by ci 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-insum 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 37GO of the Labor Code,for the performance of work for which www.Ieainfo.ca.gov/caIaw.htmI. this permit is issued. Policy# Date �_,W have and will maintain workees compensation Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the 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 on the property owner's behalf.I have read this number am: application and the information I have provided is correct.I agree to comply with all applicable city and county ordinances and state laws relating to Carrier �'Lrc�f Nq:'�l OL� 't building construction.I authorize representatives of this city or county to Pc,licy#/-dAI00V-LI-L-1 —Expires 'I 1-7 enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date I-LIS/1 dollars($100)or less tt;;� 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 ILICENSE# 0 Qq-7'_K6 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 c0M2_1Y with those provisions. Will the applicant or future building occupant handle hazardous material or a mixture containing a hazardous material equal to or greater that the Applicalt_lDbN� Date 12-1 S71 I(, amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ci Yes C;19 No UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applimnt or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,0GO),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(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY 0 Yes (4 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) a Yes VNo 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 for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 (AYN a No Business and Professions Code).Any city or county that requires a permit to Date I Z LS-11 L construct,alter,improve,demolish or repair any structure,priorto its PROPERTY OMER OR AUTHORIZED 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 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-certifled firms and comply with an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves orthrough 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 I )all of or I )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 1-80D-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a a An EPA Lead-Safe Certified Renovatorwill be responsible for this project property who,through employeee 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 willl have the burden of proving that it was not built or improved for the purpose of sale. 0 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 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 j& ' "'Menifee DATE I'L.S- . tu PERMIT/PLAN CHECK NUMBER FW((O.-0 mo TYPE: 0 COMMERCIAL 0 RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME CSAOL/SRA 0 SIGN SUBTYPE: OADDITION 0ALTERATION ODEMOLITION OELECTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK PROJECTADDRESS 23360 ASSESSOR'S PARCEL NUMBER V51 -.?141,ID21 LOT oze TRACT OWNER NAME ADDRESS PHONE EMAIL APPLICANT NAME I ADDRESS 3oi�,% �-WrLA v,)��A PHONE -1LALo- EMAIL CONTRACTOR'S NAME OWNERBUILDER? OYES'�>ft BUSINESSNAME ADDRESS 1)O06q T-11L&Y�o V�)­d v\A-v,�-feL PHONE R91 Vjri R-13?, EMAIL CONTRACTOR'S STATE LIC NUMBER -1 0 LICENSE CLASSIFICATION C66 VALUATION $ 3b.,()00 SQ FT L40D LSQFT APPLICANT'S SIGNATURE DATE It Q DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE � GREEN SMIP 0 0 Q 7'.6 56 INVOICE I OUNT 0 CASH 0 CH AMOU�T I $59;;5.5�!`A�DAM ECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES PA D AMOUNT -ASH OCHECK# 0 CREDIT CARD VISA/MC I Or OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityof,menifee.us Inspection Request Line 951-246-6213 zo +6" Spa +6" 3'6" Deep Light 24' 7' Deep Light Reef Step Grass Area Concrete Area Smith Residence 0 -12-6"- 23350 Badger Creek Lane Menifee, Ca 92587 a 951-233-6903 Pool Equipment Inty f Mbinifee BOlding afety Dept. C 05 6 Received 0i MENIF '�,'01'!' GA SAFETY DEPAR ENT DA' 09 �0"t P dits shd,no;be,,onstrt to be a Perm for,or a Jf,ony voiation of an�provisions c e federal,stat or ci ft�,uoauons and ordinances. This set of appri w! plans must b pt on e jub�ite until completion.