PMT16-04074 City of Menifee Permit No.: PMT16-04074
29714 HAUN RD. Type: Residential Electrical
<A-CCE1:A—> MENIFEE,CA 92586
MENIFEE Date Issued: 12/13/2016
P E R M I T
Site Address: 28760 AVENIDA MARBELLA, MENIFEE, Parcel Number: 364-111-021
CA 92584 Construction Cost: $6,000.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING TUB WITH WALK-IN JACUZZI TUB USING EXISTING PLUMBING FIXTURES,
Work: INSTALL 2 20A DEDICATED CIRCUITS
Owner Contractor
TRACY MCCALLI&THELMA ANDERS DI-LAR INDUSTRIAL SUPPLY INC
28760 AVENIDA MARBELLA 1541 PARKWAY LOOP STE E
MENIFEE,CA 92584 TUSTIN, CA 92780
Applicant Phone:7145443100
GRANT HOFFMAN License Number:326317
DI-LAR INDUSTRIAL SUPPLY INC DBA LJ HAUSNER CONS'
1541 PARKWAY LOOP STE E
TUSTIN,CA 92780
Fee Descirliption Piz Amount($1
Receptacle, Switch,Outlet&Fixture 2 121.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Electrical 1 6.05
$155.05
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 buillding 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�Bldg_Permit-Templatespt 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 pedury 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 underthe Contractor's State License Law for
Professions Code and my license is In full force and effect. the following reason:
License Class License Uo. By my signature below I acknowledge that,except for my personal residence
-",X
Expires Signature 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
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 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 websfte;
by Section 3700 of the Labor Code,for the performance of work for which
this permit is issued. www.leginfo.ca.gov/calaw.html.
Policy# Date
)(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 c 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 arq;— application and the information I have provided is correct.I agree to comply
Carrier 7,`7 ve pe�
L with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy#-i6lr-�Ot 33757W.Expires 2-s enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundreil Date
dollars($100)or less PROPERTY OWNER ORAUTHORIZED AGENT
o 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 subjectto the CITY BUSINESS LICENSE#
worker's compensation laws of Califomia,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 fort ' omply with tb �ovlsions. Will the applicant or future building occupant handle hazardous material or a
Applic rZ, �p Date mixture containing a hazardous material equal to or greater that the
—4 Kt&— — amounts specified on the Hazardous Materials Information Guide?
WARNINGi FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes a 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 Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ayes oNci
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) ci Yes ci No
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 ciYes ci 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 PROPERTY OWN ER OR AUTHORIZED AGENT
Isisuance,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 JRRPI
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-cerfified 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 workthemselves or through their
o 1,as owner of the property,or my employee with wages as their sole employees.For mom information about EPA!s Renovation Program visit:
compensation,will do( )all of or( )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 ci An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,th rough em ployeee or personal effort,builds or!in proves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building orimprovement is sold within one yearof Firm Certification No.:
completion,the Owner-Builder will havethe burden of provingthat itwas
not builtorimproved forthe purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because:
n 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.
,&Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: OCOMMERCIAL #RESIDENTIAL OMULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN
SUBTYPE: OADDITION i6ALTERATION ODEMOLITION (WELECTRICAL OMECHANICAL
ONEW (OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 01�e-J)LAc-f W1,jACta?,,1w4LJ4
?(AA(wt�� + Q�v,�,viE 2,,>,4m#06ET
PROJECTADDRESS A0,C_ V14Aiz-)ac4t+ Oae6A
ASSESSOR'S PARCEL NUMBER 2X_qLA-jkj-(n\ LOT TRACT
14f�lbeL�M A,14,&p S ClIal 0.1 MenIfee
'T BU,IdIn
OWNER NAME r&AI M r �L,�
CAJ A SAM410!
ADDRESS q_AC-7 6 c> Ave- Yk,412-104141+ DEC 13 2016
PHONE bt?-I393- 30!iL8 EMAIL
APPLICANTINAME ( TZ
::�j -Ayjt- 14,XVIVIAW ROceived
ADDRESS POW41- C6,�2ja Atcc,4_ 644-ot
PHONE c:;-f(cf- 3(01) EMAIL
CONTRACTOR'S NAME OWNER BUILDER? YES WNO
BUSINESS NAME
ADDRESS JS_�( j too� 4C T"tj ^ CI�A
PHONE :71q -_5VV--_3j6C> EMAIL
CONTRACTOR'S STATE LIC NUMBER 2 LICENSE CLASSIFICATION
VALUATION$ Q FT LSQFT
APPLICANT'S SIGNATURE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION LI r77F_M_E_N=5INE55 ULENSE NUNIBLK
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVCHICE
I E55 .C�6 PAIDAMOUNT
AMOU I v55-c5 0 CASH 0 CHn ECKA#ff OCREDITCARD ViSA/MC
PLAN CHECK FEES PAID AMOUNT 1 0 CASH 0 CHECK# OCREDITCARD VISA/MC
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.cityofinenifee.us Inspection Request Line 951-246-6213
City Ot Menifee
Building & Safety Dept.
DEC 13 2016
ROceived
Qy
C-
CP ITY OF MENIFEE
'3UILDING AND SAFETY DEPARTMENT
PLAN APPROVAL
REVIEWED BY\^
DATE
*Approval of these plans shall not be construed to be a permit for,or an
approval of,any violation of any provisions of the federal,state or city
regulations and ordinances. This set of approved plans must be kept on the
jobsite until completion.
<EiD 5229 Walk-in Tub Combination, Whirlpool And Pure Air Bath Models
TECHNICAL SPECIFIC
COMBINATION WHIRLPOOL PUREAIR
Electrical Specifications Device Power Requiremy"Ifs Device Power Requirements Device Power Requirements
\,420V,5A, W Motor, 12OV,SA,6OHz,500'W Motor,
Blower _qgd;4�60C NIA
----60OW Heater 60OW Heater
PumplMotor(Ozone) 12OV,7A,6OHz 1(1 20V,0.25A,6OHz) 12OV,7A,6OHz 1(120V,0.25A60HZ) N/A
Heater 12OV,12.5A,6OHz,I.RW 12OV,12.5A.,60Hz,1.510 NIA
Ught 120V,1.6A.60K:::� N/A WA
GFCI-Protected Circuits Two Dedicated 12OV,20A,BOHZ One Dedicated 12OV,20A,60Hz One Dedicated 120V,20A,6OHz
Dimensions
Bath Weight(empty) 220 fles(I DID kg) 203 lbs 1(92 kg) 182 fils(83 kg)
overall Dimensions(L)x(W)X H) 52*L x 29.63"W x 3r H(1 3211min Lx 753mm W x:940mm H)
Drain Location Left Hand/Pight Hand
Total Weight(Floor Loading) 780 lbs/75 lbs/ft- Mendap
Operating Gallonage(Min-Max) 55(Min)/63(Miric)US Gallons(208 L(Min)/368 L(MaquilRIg aflallety Dept,
A.Overflow Height $1.50'(800mm)
B.Drain Rough-in(From Side Wall) 10.75 (273mm) DEC 13 2016
C.Drain Rough-in(From Back Wall) 13.38"(340mm)
D.Drain Shoe Lenp 8.0"(203mm)
E.Rim Height 2'(61 mm)
F.Deck Wdth* 4'(1 02mm) Note:Deck width reflects indicated area only.
G.Service Access Dimensions See Illustration Beim
H.Overall Height 37'(940mm)
Water Heater Capacity 50 US Gallons(182 L)
(Minimit Recommended)
KEY DIMENSIONS
Top Combination Left-Hand Model Illustrated DrainlOverflow
10. 5.(B) Heater Overflow
4'(F)t.�� Blower
131313" ---- Pump/
(C) Hand Motor 31.510-(A)
Held 'D "- -. i
Spout--0 qbo CC--, : I
20.27'
Drain Bottom
(D)
Servtc!Access SG), 2 .63' Sellice A as(G), Drain 8.0
5.�5'X 13.5 (C nter) 22.0'x 13.5" 10.75'(B)
52.W(L) 45.5" 2.0'(E)
22.0'----1 1 1'—2725"—', L
Door 37" 42.75" 16.62" F
12.8
36.51
0 1) [U 31A2' 033,84'
28.0" 0
1--28..63
14.0" L 5.38' E 1.14 Cross Section
Front ind
0 2015 Jacuzzi Luxury Bath - For additional Information call Customer service 800-2884002 IsWIM.1acuml.com
Relerto Installation Instructions Included with fixture before beginning installation. Please confirm Product mailability and specifications before commencing with any Installation work,
PRODUCT SPECIFICATIONS AND AVAILABILITY ARE SUBJECTTO CHANGE wITHOUT NOTICE. LX65000E