PMT17-00474 City of Menifee Permit No.: PMT17-00474
29714 HAUN RD. Type: Residential Plumbing
e
�XCCELh? MENIFEE, CA 92586
MENIFEE Date Issued: 0 2/1 612 01 7
PERMIT
site Address: 24049 CIRCLE DR, MENIFEE, CA 92587 Parcel Number: 35D-082-020
Construction Cost: $7,900.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING LEACH LINES
Work:
Owner Contractor
ALEX AYALA LANIK ENTERPRISES INC
24049 CIRCLE DRIVE P O BOX 891416
MENIFEE, CA 92587 TEMECULA, CA 92589
Applicant Phone:9516767114
CARLY ROZZO License Number:458947
LANIK ENTERPRISES INC
PO BOX891416
TEMECULA, CA 92589
Fee Description OQl t Amount f$1
Sewer 1 150.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Plumbing 1 7.50
$186.50
The issuance of this permit shall not prevent the building official from thereafter requidng 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_Bldy_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 Contractors State License Law for
Professions Code and my license is in full force and effect, the following reason:
License Clas License No. l/. "l ! By my signature below I acknowledge that,except for my personal residence
ExpiresU \Signature J in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that I
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 ,,v,,y,,y.le¢info.ca.zov/calaw.html.
this permit is issued.
Policy If Date
cyrnave and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
/section 3700 of the Labor Cade,forthe 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 workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
number are: l �q,� �n application and the information I have provided is correct.I agree to comply
Carrier (.✓V` IdlyQ-g ��1 l,l f`�`-'L� with all applicable city and county ordinances and state laws relating to
n f building construction.I authorize representatives of this city or county to
Policy# Kl!J 4 (-I Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
a 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#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to th workers compensation provisions of Section 370D offthe Labor
Code,I shal fa h/witi comply i those provisions. i I _ Will the applicant or future building occupant handle hazardous material or a
Applicant G�' Date . l�rpm _''I mixture containing a hazardous material equal to or greater that the
tt amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SEi RE WORK R'S M ENSATION COVERAGE IS ❑Yes ❑No
UNLAWFUL,AND SHALL SUBJECT AN EMP OYER 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($100,000),IN r o ion occupant require a permit for the construction modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SC ion or See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY D Yes ❑No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility he 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 underthe 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(s)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that ❑No that requires a permit to Date
construct,alter,improve,demolish or repair any structure,priorto 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 ofthe Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)orthat 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.epa.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
property who,through employees'or personal effort,builds or improves the o An EPA Lead-Safe Certified Renovator will be responsible for this project
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:
❑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
PERMIT/PLAN CHECK APPLICATION
rMenifee
1 M
DATE 'L- I — ` PERMIT/PLAN CHECK NUMBE
TYPE: ❑COMMERCIAL QRESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION []ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL
❑NEW QPLUMBING ❑RE-(rROOF-NUMBER OF SQUARES
LJ DESCRIPTION OF WORK CckcA, l GAY (�
PROJECT ADDRESS L4 ` C- C +'LL<- `) Y
c,lty o
ASSESSOR'S PARCEL NUMBER a- LOT1� TRALtng & Safety Dept.
PROPERTY OWNER'S NAME V�-( if x 0.l0. FLU 16 2017
ADDRESS 15 `-t 14 C ( YG( e ✓
ved
PHONE EMAIL �C.�.I
APPLICANT NAME 0A ✓ l "'RG�nZ`7�� c [,
ADDRESS �c7 � I q ( `kt I (,.,
PHONE �� I �� ( ( � EMAIL INr' G(YkL C . Co.I'`
CONTRACTOR'S NAME a V\ 1 � - ` N C' OWNER BUILDER? [_-]YES ONO'
BUSINESS NAME
� �J I I
ADDRESS Q1\- U g b /c 6 I -! I,
PHONE ( lr� 1 to �llJLr q/EMAIL grt/-1
CONTRACTOR'S STATE LIC NUMBER `�[Sb / `7 / LICENSE CLASSIFICATION
VALUATION$ 2 1 Q FT L SQ FT
APPLICANT'S SIGNATURE ^ 'O DATE 2
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ItoENGINEERING FIRE GREEN SMIP
INVOICE PAIDAMOUNT n
AMOUNTjF
OCASH OCHECKB CREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT I OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZEDLETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92596 951-6 72-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
C't
t f Buildin y of Menifee9
S 8 Safety Dept
FEB 16 201)
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Received
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CITY OF ME IF E n 3
BUILDING AND SAFETY DEPART � -
PLAN APPROVAL
y S 0o
REVIEWED BY ( L-C 0
DATE
'Approval of these plans shall not be construed to be a permit for,or an t !
approval of,any violation of any provisions of the federal,state or city
regulations and ordinances, This set of approved plans must be kept on the
iobsite until comoletion.
COUNTY OF RIVERSIDE
PARTMENT OF ENVIRONMENTAL HEALTH
LAND USE APPLICATION
OFFICE USE ONLY
,9{� PE CODE FEE:
3880 Lemon Street•Suite 200•Riverside•CA•92501_(9.51)955-8980
❑47-950 Arabia Street•Suite A•Indio•CA M01—(760)86'3-7570 al 1 7/ •""
EHS 4 ONE LMS# APN.
TR/PM LOT# USE F PERhIIT: p L�0,� J e Y.
SECTION A my p V1 d L
Name I / QIlOC J'D T17 a I /r
04VNER: Address `fl I y-C e Vcitve / e Received
/
Phone S lQ Email ,J
Company Name enUContrador lit
AGENT/
CONTRACTOR: Mailtn Addreesssf
-Phone J ` (olk—D I Email
SI nature /� Date
PROPERTY INFO: Site Address J 1J' "lcAq Cf i rcl e— DV city en
r N/e �rll ✓' ' `�wD Lot Size
SECTION B Below—For Offlce Use Only _
CHECK BOX IF REQUIRED
If any box is Checked•this application shall be considered denied until the information is provided.
Cl Holding Tank Agreements Required u Floor Plan and/or Plumbing Layout Required
G Certificate of Odsting OWTS Required(C-42) ❑Special Feasibility Boring Report Required
❑WOCS Clearance Required Q Detailed Contour Plot Plan Required(1 to 5 foot intervals)
❑Soils Percolation Re rt Required
SITE EVALUATION INSPECTION REMARKS.:
EHS INITIALS/DATE:
SECTION ,—
❑NEW REPAIR REPLACEMENT ❑ EXISTING ❑PUMP ❑ATU 0 CONNECT TO SEWER ''FIXTURE UNITS# IBDRMS
Soils Percolation/Boring Report By: Date: Prpj¢yCf " _
C42 ertification By: Date: LiEe( I� ns�` jq, Qq,`j
r�
tN\ vU V -- -
Septic tank cap: Soil Rate: Tasted Depth: Max. trench depth:
Sq.Ft Bottom :�, 1 Iotal Linear Ft: ne a)�
L-�' Li � ' feet - Each 3 feet wide
Sidewall Allovrance: Ft Rock/ Sq-tL Running foot Rock below drain fine: _n in. or "❑Plastic Chambers
Leach Lines/bed special desigrf for slope: ❑NIA O Overburden Factor.
Pit Diameter. No"pfts: Depth below Inlet(bi): Pit Total Depth: Max allowable depth:
CONSTRUCTION/INSTALLATION REMARKS:
s+oll 2� x38 "Ch b4 . 7::r-;4S+al j e luvo - ar,d r6;trt -b
rad t?
SECTION D
This Application is Approved 0 Dented regarding the design of the OWTS as indicated on the accompanied plot plan using the requirements set forth in
Section C above. o const tion Is permitted in the required reserved 100%Expansion area.
EHS Signature: Date: cq '
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