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PMT16-04707 City of Menifee Permit No.: PMT16-04707 29714 HAUN RD. Type: PoollSpa -Residential �l-�CCEL/�> MENIFEE,CA 92586 MENIFEE Datelssued: 12/30/2016 PERMIT Site Address: 29872 TWIN LAKES RD, MENIFEE,CA Parcel Number: 333-590-007 92585 Construction Cost: $48,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 500 SQ FT Work: Owner Contractor ERIC&HALEY ZAHORECZ TAYLOR MADE POOLS INC 29872 TWIN LAKES RD 18795 OAK VIEW WAY MENIFEE,CA 92585 LAKE ELSINORE, CA 92530 Applicant Phone: 9518166444 GEORGE BOUILLON License Number.795053 TAYLOR MADE POOLS INC 18795 OAK VIEW WAY LAKE ELSINORE, CA 92530 Fee Description Oft Amount i51 Swimming Pool/in-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 7,00 General Plan Maintenance Fee-Electrical 1 23.35 $626.35 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. AA_Bkg_Permit_Template.rpt Page 1 of 1 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 f Ium exempt from licensur under the Conte cto sState License Law for Professions Code and my license is in full forceeande,� the following reason; /oo - ��License Class LLcen !S�-� By my signature below I acknowledge that,except for my personal residence Expires 17 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 workers 7044 of the Business and Professions Cade,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.leeinfo.w.eov/celaw.html. this permit is issued. Policy q Date o I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which ,6LBy my signature below I certify to each of the following:I am the property this permit Is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners 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 building co struction.I authorize r sentatives of this city or county to Policy q Expires enter t e identified pro for inspection purposes. (This section need not to be completed is the permit is for one-hundred dollars($100)or less Date ROPERTY OWNER OR AUTHORIZED AGENT XI certify that in the performance of the work for which this permit Is issued, O� 1 ' I shall not ern ploy any persons in any manner so as to become subject to the CITY BUSINESS LICENSE q workers compensation l ws fCalifornia,and ag e t if l should become HAZARDOUS MATERIAL DECLARATION subject to the work pensation provisi Section 3700 of th bar Code,I shall forth 't amply . thos islans, Will the applicant or future building occupant handle hazardous material or Applicant Date 3U 71v mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS aYes Omo 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($500,000),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(SC construction or See permitting checklist IN SECr10N 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for Coast Ai.r ines Qua CONSTRUCTION LENDING AGENCY a Yes ptblo 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) o Yes Pd.No 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 requir ents underthe State of Contractors License Law for the reasons)indicated below by the California Heal] & fety e,Se 505 and 25534 cancer .ng yl checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous al repo Business and Professions Code).Any city or county that requires a permit to sees o / -/ construct,alter,improve,demolish or repair any structure,prior to its Date/ PROPERTY OWNER 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRP) 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 ❑I,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.eoa.eov/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 Contractors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovatorwill be responsible fortha 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. o No EPA Lead-Safe Certified Firm is required for this project because: a I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors 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 Menifee DATE PERMIT/PLAN CHECK NUMBER ko� 0410 TYPE: O COMMERCIAL k RESIDENTIAL O MULTI-FAMILY O MOBILE HOME POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL fR'NEW O PLUMBING ORE-ROOF --N��U��MBER FSQUAJ lS / DESCRIPTION OF WORK PROJECTADDRESS G�p7}�2�/. y� /� }�I,7l�� ASSESSOR'S PARCEL NUMBER Jam/ �O 00 LOT I�H TRACT -� DD OWNER NAME ��y �G�/yoG'Z ADDRESS PHONE �1'B�-��zQ� ,7 EMAIL APPLICANTNAME ADDRESS PHONE ,> EMAIL J CONTRACTOR'S NAME � �� /.'�j 6flG�-s OWNER BUILDER? O YES kNO BUSINESS NAME ADDRESS PHONE EMAIL q CONTRACTOR'S STATE LIC NUMBER 7J" �.3 LICENSE CLASSIFICATION VALUATION$ Q SO FT S� L SO.FT// / APPLICANT'S SIGNATURE CffY STAFF USE ONLY DEPARTMENT DISTRIBUTION .L1 CITY OF ME FEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN #Q SMIP INVOICE PAIDAMOUNT O O :> AMOUNT CASH CHECK# CREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LEITER O YES O 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