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PMT17-00493 City of Menifee Permit No.: PMT17-00493 29714 HAUN RD, Type: Pool/Spa-Residential rnCCEL/17. MENIFEE,CA92586 MENIFEE Date Issued: 02/17/2017 PERMIT Site Address: 33491 PENCIN RD, MENIFEE, CA 92584 Parcel Number: 362-110-069 Construction Cost: $20,000.00 Existing Use: Proposed Use: Description of INGROUND GUNITE POOL 392 SO FT Work: Owner Contractor ADAM&MINDIE PADILLA QUALITY CUSTOM POOLS INC 33491 PENCIN RD 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 Qty Amount($1 Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 3.00 General Plan Maintenance Fee-Electrical 1 23.35 $521.35 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_Pennit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and D 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 Class t:S ' 6' 6 License No.rtC119 gd_LQ By my signature below I acknowledge that,except for my personal residence Expires 11 •3D •j 7 Signature i�z 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 ❑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,for the performance of work for which www le=info ca.zov/calaw.html. this permit is issued. Date Policy# PROPERTY OWNER OR AUTHORIZED AGENT C--�I have and will maintain workers compensation insurance,as required by O 8 m signature below 1 certify to each of the following:I am the property �- section 3700 of the Labor Code,for the performance of the work for which Y Y g ty owner or authorized to act on the property owners behalf.I have read this this permit is issued.My workers compensation insurance Carrier and policy application and the information I have provided is correct.I agree to comply number are: _ with all applicable city and county ordinances and state laws relating to Carriers L2e.'r 54 ✓\)Ck 0'ruck building construction.I authorize representatives of this city or county to Policy# C..•6,10002i 01-1 Expires '7 a rtheabove rdentill dprope�rty for inspectionpurposes. ('this section need not to be completed is the permR is fo one-hundred lil T'�l ., Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT artily that in the performance of the work for which this permit isissued, CITY BUSINESS LICENSE# �O�eS-7' shall not emoloy any persons in any manner so as to become subject to the workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Will the applicant or future building occupant handle hazardous material or a Code,I shall forthwith comply with those provisions. mixture containing a hazardous material equal to or greater that the Applicant Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS D Yes AO 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($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(SCAQM D)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY D Yes darNo 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 Cade) ❑Yes C_yNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD 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 Contractors 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 es• D No dd 2 Business and Professions Code).Any city or county that requires a permit to ✓/�.�/I� Vir -Date •f 2 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 EPA RENOVATION REPAIR AND PAINTING(RRPI that he or she is licensed pursuant to the provisions of the Contractors State 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)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)6 managers who do the paint-disturbing work themselves or through their 01,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: www eoa.Rov/lead or contact the National Lead Information Center at compensation,will do( )all of or( )portion of the work,and the structure is 1-800-024-LEAD(5323). not intended or offered for sale.(Section 7044,Business and Professions Code;The Contractors State License Law does not apply to an owner of a D An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees or personal effort,builds or improves the Certified Firm Name: property provided that the improvements are not intended or offered for 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 D No EPA Lead-Safe Certified Firm is required for this project because: not built or improved for the purpose of sale. QI,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. iiA=L SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE t I PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME �' POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK a + PROJECTADDRESS 3Agt ASSESSOR'S PARCEL NUMBER �f/� - '`0 �+�� LOT p` TRACT OWNERNAME �ta2a ,lto ADDRESS ay`7,HOI I PHONE OCS 1 .31�5,U L52 EMAIL APPLICANT NAME ADDRESS col cu u Udn PHONE 0,5 b-1 q S-1 32 EMAIL CONTRACTOR'S NAME.), OWNER BUILDER? O YES_'NO BUSINESS NAME kc,-tt c eywl ADDRESS 'SOl V\Q,,- z PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER •Zg5w20 LICENSE CLASSIFICATION GS3 Ci VALUATION$ 10,uo0 SOFT 3alZ. SF LSQFT APPLICANT'S SIGNATURE DATE *I' I-7• 1"� DEPARTMENT DISTRIBUTION 'p CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP AMOUNT INVOICE I 'JAI• : 5' PAID AMOUNT �� J CASH CHECKt! OCREDI7 CARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECKR O CREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES C' NO DL NUMBER NOTARIZED LETTER O YES O NO City of I'✓lenifee Building St Scifety Deportment 29714 NDun Rd. Menifee, (A 92586 951-1572-6777 www.cityofinenifee.us inspection Request Line 951-246-6213 El-;y CIF IIPIENIFEE EN'T E,t;ttDING AND SnCFj`t DEPAR�M Padilla House Menif OJ&S94Y G 951-313-6252 *ppproyal of these plans shall m' y censtrued:o be a permit f ,or an I of,any be 4 pt on the violation of ao'?u« isions o!the federal,state r aty regulations an jobsite until compfetfo . o ' 1 Garage 3614 light 3925f PM Dnveway • P Is 376' 14' u9M S6" PL L IN t aaem 68-<- PmI Equipment 1 i Scale: 0.08 in. Der ft.