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PMT17-00140 City of Menifee Permit No.: PMT17-00140 29714 HAUN RD. Type: Pool/Spa-Residential '�!-�CCELA-1' MENIFEE,CA 92586 MENIFEE Date Issued: 01/23/2017 PERMIT Site Address: 27936 RIVERSHORE CT, MENIFEE,CA Parcel Number: 333-370-022 92584 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 565 SO FT Work: Owner Contractor MARK&KARN LOVELL ALOHA POOL&DESIGN INC 27936 RIVERSHORE CT 41083 SANDALWOOD CIRCLE STE I MENIFEE,CA 92585 MURRIETA, CA 92562 Applicant Phone:9514539728 MARK KLINGSPORN License Number.965927 ALOHA POOL&DESIGN INC 41083 SANDALWOOD CIRCLE STE 1 MURRIETA,CA 92562 Fee Description city Amount IE) Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Electrical 1 23.35 $522.35 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_Perrrd Templale.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)pursuantto the Contractors State License Law). Chapter9(commencing with section 7000)of D' sion 3 of the Business and ❑I am exempt from licensure underthe Contractors State License Law for Professions Code and my license is In full fort d effect. , '7 the following reason: License Class G�7 Lire No. J7(0,—/ 0% By my signature below I acknowledge that,except for my personal residence 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 DECIARATI have built as an owner-builder if it has not been constructed in its entirety by ❑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 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 for which this permit is issued. www.leginfo.ca.gov/calaw.html. Policy# 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 ❑By my signature below I certify to each of the following:I am the property this permit is issued.My workers compensation insurance carrier and polity owner or out rued to act on the property owners behalf.I have read this number are: application d the information I have provided is correct.I agree to comply with all app i ble city and county ordinances and state laws relating to Carrier building co ruction.I authorize representatives of this city or county to Policy# Expires entert a identified property for inspection purposes. (This section need not to he completed is the permit is for one-hundred dollars($100)or less I Date PROPER • NER OR AUTHORIZED AGENT rtify that in the performance of the work for which this permit is issued, 1 s all not employ a persons in any manner so as to become subject to the CITY BUS ESS LICENSE# V�S3 workers compens 1 n laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the w s compensation provisions of Section 3700 of the Labor Code,I shall fin h it Tc�mply with those provisions., Will the applicant or future building occupant handle hazardous material or a Applicant Data mixture containing a hazardous material equal to orgreater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAI TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes UNLAWFUL,A HALLSUBIECTAN EMPLOYER TO CRIMINAL PENALTIES Will the tended use of the building by the applicant or future building AND CIVIL PINES 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)7 See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airlines Qua CONSTRUCTION LENDING AGENCY o Yes( ovlfo 1 hereby affirm that underthe 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 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 requirements under the State of Contractors 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 hazardous material reporting. $)(Section 7031.5 � oYes�o 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 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 o 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 gov/lead/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 Renovator will be responsible for this project prmperty 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: o 1,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 TYPE: []COMMERCIAL ❑RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME OOL/SPA [_]SIGN SUBTYPE: ❑ADDITION []ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL ❑NEW ❑PLUMBING El RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK �Q• PROJECTADDRESS Z�g.3� u1;2 t57 ka�.� ASSESSOR'S PARCEL NUMBER 7J'�'Jj �,Q 'O LOT TRACT 05— PROPERTY OWNER'S NAME I/ ADDRESS q PHONE �7'ZS 3Zy—/Z�l� EMAIL APPLICANT NAME Om ADDRESS PHONE EMAIL f CONTRACTOR'S NAMEt 6- Ij OWNER BUILDER? OYES BUSINESS NAME ADDRESS 1 W.3 5,^J4;,y+L_ G! PHONE'/�'�r.�—`f 7 ZI?' EMAIL CONTRACTOR'S STATE LIC NUMBER 9(1a !!�_'J U) LICENSE CLASSIFICATION VALUATION$ Zs_a SQ FT �_j b�� L SQ FT 1 APPLICANT'S SIGNATURE DA / ?� e = _ DEPARTMENT DISTRIBUTION CITY OF�Q§NI �l{�NjorTLICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREENfW77SMIP INVOICE pgID AMOUNT O —AMOUNT • CASH C)CHECK# CREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 r ja �y U Jt X ` 1 � � 3 � I e � �1 I �9 A � 's I Q