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PMT16-04232 City of Menifee Permit No.: PMT16-04232 29714 HAUN RD. Type: Pool/Spa-Residential <A—CC*iLA-"3' MENIFEE, CA 92586 MENIFEE Date Issued: 12/1912016 P E R M I T Site Address: 28757 PARK TRAIL WAY. MENIFEE, CA Parcel Number: 333-680-001 92584 Construction Cost: $38,000.00 Existing Use: Proposed Use: Description of INGROUNG POOL&SPA 430 SQ FT Work: Owner Contractor PAULHENDRICKS MAJESTIC POOL CONSTRUCTION 28757 PARK TRAIL WAY 31566 RAILROAD CANYON ROAD MENIFEE, CA 92584 STE 2#106 Applicant Phone:9514456384 ORBELIO RODRIGUF7 License Number: 889638 MAJESTIC POOL CONSTRUCTION 31566 RAILROAD CANYON ROAD STE 2#106 CANYON LAKE, CA 92587 Fee Description Qtv Amount Swimming PooVin-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 building 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__B1dg_Perrnit Template.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 0 1 am exempt from licensure under the Contractor's State License Law for Professions Code a nd my limnse is in full force and effecL the following reason: License Class_(:�.5-,2;, LicenseNo. By my signature below I acknowledge that,except for my personal residence Expires /-/7-Z 7 Signature In which I m ust have resided for at least one yea r prior to com pletion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I have built as an owner-builder if It has not been constructed in its entirety by o I hereby affirm under Pena Ity 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-Insu re for worker's 7044 of the Business and Professions Code,is ava ilable upon request when compensation,issued by the Director of Inclustria I 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.gay/calaw.htmi. Policy# Date u 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 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 are: application and the information I have provided is correct.I agree to comply Carrier with all applicable city and county ordinances and state laws relatingto building construction.I authorize representatives of this city or counlyto Policy# Expires enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date 0do ars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT -Al certify that in the performance of the work for which this permit Is issued, I 9itall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE It worker's compensation laws of California,and agree that if I should become subject to the worker's compensation provisions of Section 3700 of the Labor HAZARDOUS MATERIAL DECLARATION Code,I sha th-kose promy:1sions. Will the applicant or future building occupant handlehazarclous material ora Applicant Date mixture containing a hazardous material equal to or greater that the amounts 590 ified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE NSATION COVERAGE IS a Yes KNo UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Wilithe intended use of the building bythe 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 FOR occupant require a permit for the construction or modification from South IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist forguid lines CONSTRUCTION LENDING AGENCY a Yes To I hereby.affirm that under the pene Ity 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 b d ry of a school? (Section 3097 Civil Code) ci Yes �Nla 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 by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Prarclous me en.@I repo .n . Business and Professions Code).Any city or county that requires a permit to Py�_Vy__Q' Date construct,alter,improve,demolish or repair any structure,prior to its Issuance,also requires the applicantforthe permit to file a signed statement PROPERTY OWNER OR AUTAGR4i!tD AGENT that he or she is licensed pursua nt to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(FIRM 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 FIRP-certified 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($500). managers who do the paint-disturbing work themselves or through their o 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA!s Renovation Program visit: compensation,will do( )all of or I )portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800424-LEAD(5323). Code,The Contractopes state License Law does not apply to an owner of a n An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees!or personal effort,builds or im proves the property provided that the improvements are not intended or offered for Certifiedlirm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. ci No EPA Lead-Safe Certified Firm is required for this pmject bemuse: a 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement.. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION A$ ..�k','--'Menifee DATE PERMIT/PLAN CHECK NUMBER I TYPE: () COMMERCIAL ORESIDENTIAL 0MULTI-FAMILY 0MOBILEHOME ^OOL/SPA "SIGN SUBTYPE: CIADDITION OALTERATION ODEMOLITION "" ELECTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 0 PROJECTADDRESS Z-8757 Rwqc -7�nt-rc- ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME Poo-ve, ADDRESS 15-1+er PHONE !Prl 7,3 /--33Z3 EMAIL APPLICANTNAME C— ADDRESS ell, C-t ITZJ77 PHONE EMAIL CONTRACTOR'S NAME OWNERBUILDER? ��)YES�%� BUSINESSNAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER ee!F(a X-� LICENSE CLASSIFICATION 4�, VALUATION $ FT L SO FT _QNT`S SIGNATURE ��ATE —12— ZZ4=====j _2CITYS UkE 01VUY DEPARTMENT DISTRIBUTIUN Avg LI1Y UF MtNii-tE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE � r ,�)a PAID AMOUNT AMOUNT CASH CHECK# CREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT CASH CHECK# CREDITCARD VISA/MC OWNER BUILDER VERIFIED 0 YES 0 NO DLNUMBER NOTARIZED LETTER YES 0 NO Citv of Menifee Building& Sofety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofmenifee.us Inspection Request Line 951-246-6213 vO 5F: 4s