PMT17-00127 City of Menifee Permit No.: PMT17-00127
29714 HAUN RD.
�CCEL/> MENIFEE, CA 92586 Type: Pool/Spa -Residential
MENIFEE Date Issued: 0111 912 01 7
PERMIT
Site Address: 30423 COWBOY UN, MENIFEE, CA 92584 Parcel Number: 358-521-012
Construction Cost: $60,000.00
Existing Use: Proposed Use:
Description of INGROUND GUNITE POOL&SPA 200 SO FT WITH ART WATERFALL
Work:
Owner Contractor
STEVE& KATHLEEN PETROFF QUALITY CUSTOM POOLS INC
30423 COWBOY LN 30138 MARNE WAY
MENIFEE,CA 92584 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 ISI
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 3.00
SMIP RESIDENTIAL 1 8.00
General Plan Maintenance Fee-Electrical 1 23.35
$528.35
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_Bldg_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 ❑I am exempt from 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 LLi_ceenseLNo. l�1SCJ I—Q) By my signature below I acknowledge that,except for my personal residence
Expires Signature 7 f^ 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 1
WORKER'S 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-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,forthe performance of work for which www.leeinfo.ca.Rov/calaw.htm 1.
this permit is issued.
Policy# Date
(,oyhave and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
�VJ section 3700 of the Labor Code,for the performance of the work for which �By my signature below 1 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 relatingto
Carrier building construction.I authorize representatives of this city or county to
Polity# CA,1 00G 1 L 9'1 Expires -1 1, (1-7 aennterrtthe above ideat[fied property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred !'— J(�'--- Date 141 q (1
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
❑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 LICENSE# Oa 46 ; 8
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 comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts sp cified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yesa
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($1G0,000),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)7 See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ❑Yes Qiw
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) ❑Yes (100
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 al Safety Cade,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable items)(Section 7031.5 we ❑No
Business and Professions Code).Any city or county that requires a permit to �� Date Q /7
construct,alter,improve,demolish or repair any structure,priorto its PROPERTY OWNER OR AUTHORcD 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 LRRPI
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( I all of or( )portion of the work,and the structure is www.epa.aov/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 ciAn 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 sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
o I,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.
SAFETYBUILDING & PERMIT/PLAN APPLICATION
_q
Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL ❑RESIDENTIAL ❑MULTI-FAMILY [:]MOBILE HOME POOL/SPA [-]SIGN
SUBTYPE: []ADDITION []ALTERATION ❑DEMOLITION ❑ELECTRICAL [-]MECHANICAL
[-]NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK (� „',.k s a R�iu. c-ov^--Y -
�x Fa v
PROJECTADDRESS oN13 Co an
ASSESSOR'S PARCEL NUMBER ,� 5'�,� LOT TRACT
PROPERTY OWNER'S NAME
ADDRESS 3D„1'Lzi r_a,..,v�o Lo_rvy,
PHONE 015 L U3o 1311 EMAIL
APPLICANT NAME a w,�b, 13amo.-FF
ADDRESS L,13C6 Mary 1Na
PHONE c�S t ' L1Bc1'Ln EMAIL
CONTRACTOR'S NAME OWNERBUILDER? ❑YES®NO
BUSINESS NAME t Poe
ADDRESS —6o IjA M -
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION C �J —
VALUATION$ 4O1L'i / SOFT Z.00sT LSO FT
APPLICANT'S SIGNATUR 1�,,wZ� DATE 1 1`t 1 1 -1
DEPARTMENT DISTRIBUTION p- CITY OF MENIFEE BUSINNE�ESSS�S[[LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN (/ SMIP r o
INVOICE yr Rs , PAID AMOUNT
AMOUNT "�/(/ V• OCASH OCHECKB OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH OCHECKN OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES ONO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
- Existing 2:1 Upslape
Existing 2:1 Upslope pla
pa
! p/a Pta
Bench
Ad Rock + •5'
8h Country Manor Wall Waterfall
OSar Stools 5' +18.
zs s 0 TV �V 5
Concrete Area Is pia p/a Concrete Area
as
Hand Rail
IBM At 8 Cowl,
10'x 19 Existing Cal Room 10'x 11'
and Concrete Area City of Menifee
Existing AlCUnit Building & Safety Depi
✓ JAN 19 2017
Received
Pool Equipment
ncrela /,�
Concrete
N Petroff Residence
30423
VI/ 30423 Cowboy Lane
Menifee, Ca 92584
v �� ....
Y OF MENIFEE
�• I BUILDING AND SAFE PARTMENT
i PLAN APPROVAL �►
`Appro:alofifles z s � ' .:I'•rIIF!`?bP 1C.+.:;d .• 01 i
�nroval of,any
,,:nm and or anrpq- This set of a pro d plans must be KePt on the
oncrote v.i tian Existing Walkway
Existing Criveway
Concrete