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PMT16-04270 City of Menifee Permit No.: PMT1 6-04270 29714 HAUN RD. Type: Pool/Spa-Residential <A-CCFL:A-> MENIFEE, CA 92586 MENIFEE Date Issued: 1212112016 P E R M I T Site Address: 26336 NOVA LN, MENIFEE, CA 92585 Parcel Number: 331-491-021 Construction Cost: $44,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 396 SQ FT Work: Owner Contractor VERA GOLUBVIC MANNY'S POOL PLASTER REMODELING INC 26336 NOVA LN 24384 SUNNYMEAD BLV STE 101 MENIFEE, CA 92585 MORENO VALLEY, CA 92553 Applicant Phone:9513512466 MANUEL RUIZ License Number.,975104 MANNY'S POOL PLASTER REMODELING INC 24384 SUNNYMEAD BLV STE 101 MORENO VALLEY, CA 92553 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 6.00 General Plan Maintenance Fee-Electrical 1 23.35 $625.35 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of en-ors 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. AkBldg_Perrnll-TeMplate.rpt Page 1 of 1 OTY OF MENIFEE Propertywh builds or improves thereon,and who contracts for the projects _RAATn1QN with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of penury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and 0 1 am exempt from licensure underthe Contmctoes State License Law for Professions Code and my license is in full force and effect. the following reason: UcenseClass— C '5_� Lice e No By my signature below I acknowledge that,except for my personal residence Expires I I ?,I I I�( Signature 1� 11Z in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION 6) 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 ,1'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 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 forwhich this permit is issued. www.leginfo.ca.gov/ulaw.html. Policy# vo 4J C X1_0 2� 0-1-4 Date si,rhave and will ma intain worker's compensation insura nce,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the La bar 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 with all applicable city and county ordinances and state laws relating to Carrier ,,j Z 5 C building construction.I authorize representatives of this city or county to Policy#L,.�LJ C-3 U 2=J_Expires S� I enterthe above identified property for Inspection purposes. (This section need not to be comple ted is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT wr'certify that in the performance of the work for which this permit is issued, Ishallnotemplo any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# worker's compensation laws of California,and agree that if I should became HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant inin-57-t-0 Date 21-L-) mixture containing a hazardous material equal to or greater that the amountssp ffied on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 a Yes 2. UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will th e intended use of th e building by the applicant or future building AND CIVIL FINES UP TO ON E HU NDRED 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 Qua lity Management District(SCAQM D)?See permitting checklist IN SECnON 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guide]' CONSTRUCIrION LENDING AGENCY u Yes ZZ 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) 0 Yes M44a OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQIYID 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 R4 N — Business and Professions Code).Any city or county that requires a permit to constnuct,alter,improve,demolish or repair any structure,prior to its M52� &U/ Date PROPERTY OWNERWAUTHAIZED 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 IRRPI 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-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 sale 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 7044,Business and Professions 1-800-424-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 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 sa le. 0 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 Contractor's State License Law does not apply to an owner of a If your project cloo not comply with EPA FIRP rule please fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION .."'Menifee DATE 12-1 -Lt( I J- PERMIT/PLAN CHECK NUMBER TYPE:I OCOMMERCIAL ORESIDENTIAL OMULTI-FAMILY OMOBILEHOME 1�4001-/SPA OSIGN SUBTYPE: OADDITION OALTERATION ODEMOLITION OELECTRICAL OMECHANICAL (Y/NEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK tjQ.&) :;,00L 4 e- fn PROJECTADDRESS Uc� (-,?,J AA-e il I P-e (4 ASSESSOR'S PARCEL NUMBER 0.2021 - LOT '3< TRACT o1563FO OWNERNAME Qe '(C� C---?L, � I ADDRESS -�-(�3) &) oUc-A 1�10 Mt V1 i pt t ct PHONE tLL-p) EMAIL APPLICANITNAME vooL ADDRESS VA �)�q (�b\,LW INA-Cj5j �! lid 10 o Y-Z/v 0 0 c, oq PHONE EMAIL CONTRAcToWS NAME OWNERBUILDER? OYES "o BUSINESS NAME yv� I ADDRESS -z- 4 N(4, uk,&/�4 m',,p PHONE zsl� - EMAIL CONTRACTOR'S STATE LIC NUMBER c!)4 LICENSE CLASSIFICATION c- VALUATION$ cn,)0 sQ FT , -bj L � L SO FT DATE / L/ 2,/ CITY STAFF USE ONLY CITY OF MENIFEE BUSINESS UCENSL NUMBEF DEPARTMENT DISTRIBUTION BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE PAID AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC AMOUNT PLAN CHECK FEES PAID AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building&Safety Depaitment 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofmenifee.Lis Inspection Request Line 951-246-6213 J, (241 ON/ ?NY 3L' N—� CITY OF ME] vc, BUILDING A V� - 0 PLAN APPR( -V-6, L D REVIEWED E 'Approval of th�e pi approval of,any vwa, regulatim and, jobsk uid..