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PMT17-00519 City of Menifee Permit No.: PMT17-00519 29714 HAUN RD. Type: Residential Plumbing <A-CCF-UA MENIFEE, CA 92586 MENIFEE Date Issued: 02/22/2017 PERMIT Site Address: 29060 AVENIDA DE LAS FLORES, Parcel Number: 341-142-016 MENIFEE,CA 92587 Construction Cost: $4,500.00 Existing Use: Proposed Use: Description of 1200 GAL SEPTIC TANK REPLACEMENT Work: Owner Contractor LINDA KOELLING LANIK ENTERPRISES INC 29060 AVENIDA DE LAS FLORES P O BOX 891416 MENIFEE,CA 92587 TEMECULA;CA 92589 Applicant Phone:9516767114 ASHLEY TAYLOR License Number:458947 LANIK ENTERPRISES INC P0 BOX 891416 TEMECULA, CA 92589 Fee Description City Amount lE7 Sewer 1 150.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 7.50 $185.50 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_61dg2ernit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe projects I hereby affirm under penalty of perjury that I am under provisions of with a licensed cantractor(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 l Cttodd� L'S e and ma �i y license is in full force and e`ff'ect.p.�1, the following reason: License Class Yzs -. Licens No. By my signature below I acknowledge that,except for my personal residence Expires C111-7 Signature in which l must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that 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 this permit is issued, www.lezinfo.ca.eov/calaw.html. Policy# Date l-Ahave and will maintain worker's 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 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 Carrier Y with all applicable city and county ordinances and state laws relating to `,,,, building construction.I authorize representatives of this city or county to Policy# JnM `3` Expires 1� enter the above identified property `roperty for inspection purposes.. (This section need not to be completed is the permit is for one-hundred �� l d)c t 4CW Date 2l 22 1 6-1 dollars($100)or less PROPERTY OWNS O�THd ORIZED AG ENT ❑I certify that in the performance of the work for which this permit is issued, I shall not ern olov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 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 w' V_ with those provisions. Will the applicant or future building occupant handle hazardous material or a t1'Applicant �r 1 �'� 1 ht C w oat. -Z-1 22 Q 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 a Yes NNo 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(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for gui elines CONSTRUCTION LENDING AGENCY ❑Yes NNo 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 �Wo 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 Contractor's License Law for the reason(s)indicated below by the hazardous material re ort' checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 NYes ❑No �T 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 OWN UTHORIZED 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 IRRPI License Law(Chapter 9(commencing with Section 7D00)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 1,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 Contractor's State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible forthis 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: 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. BUILDING & SAFETY PERMIT/PLAN CHECK A• • • Menifee DATE 2122 h 1 PERMIT/PLAN CHECK NUMBER M 1 J TYPE: ❑COMMERCIAL []RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME POOL/SPA []SIGN SUBTYPE: []ADDITION []ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL ❑NEW ®PLUMBING El RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK _!(' ,•*'�,�� '( ,11 j 1' PROJECTADDRESS V ► S \ i1,i�ref ASSESSOR'S PARCEL NUMBER 3y�—11-12'�,�p LOT 140 TRACT PROPERTY OWNER'S NAME ADDRESS p� PHONE EMAIL //.. APPLICANT NAME ' \ K ADDRESS T PHONE (n ILA EMAIL CONTRACTOWSNAME \ OWNERBUILDER? ❑YES NO BUSINESS NAME ADDRESS 2 22. L1.1L7� Y PHONE 11 � A EMAIL f- \k- j\C-COM CONTRACTOR'S STATE LIC NUMBER �`J84RRy-1 LICENSE CLASSIFICATION r C Z VALUATION$ sj SO FT L SQ FT APPLICANT'S SIGNATURE DATE -Z122iCITYSTAFFUSEONL DEPARTMENT DISTRIBUTION CITY OF NI EE BUSINESS ENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT r, AMOUNT O CASH O CHECK# O CREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH 0 CHECK# O CREDITCARD VISAIMC OWNER BUILDER VERIFIED OYES G NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-572-6777 www.cityofinenifee.us inspection Request Line 951-246-6213 City of Menifee i Building & Safety Dept. FEB 222017 Received Mc ye s pp ry i CITY OF MENIFEE BUILDING AND SAFETY DEPARTMENT "moo+ PLAN APPROVAL wj IZ"' C'a^c.ck I f REVIEWED BY M ILF � e ATE 'Approval of these plans shdr rn, lmtrutd:u be a permit for,or an 1 ! approval of,any violation of at:, o:k mans of the federal,state or city regulations and ordinances. This set of approved plans k nn��e jobsite until completion. I't COUNTY OF RIVERSIDE a. f-t'r—• DEPARTMENT OF FNVIRONMENTAL HEALTH ONSITE WASTEWAI ER TREATMENT SYSTEM rt.ls DweIGn9 12vo Gal.Septic Tank klU� ® Commercal (6�96_; Sq.Ft.of Leach Line 66 XLSfi ® Seepage Pits _ No.Dia_BI_TD_MDR ® Conned to Sewer Concrete Pump Chamber r ® Contract to Existing • Installation of leach lines are not to exosed N i*�* ft.in depth VT chamber.• Install risers to grade,leaving lids accessible for cleaning. Nate: Larger tanks (2000 gallons or greater) require 2 fisers to access primary SO• Approved cleanable effluent filters must be installed to faa7tate servilift • No on-site water softening devices shall be discharged into the 5:WSystem without clearance from the California Regional Wah • :unlity Control Boarrdd • Installation shall conform to the current ur • Any grading in the area of proposed drip .,. '•,n require new approval bythS Department, Date: EHS County of Riverside 'v= DEPARTMENT OF ENVIRONMENTAL HEALTH ,@ www.rivcoeh.org OWTS INSPECTION CARD APN: Permit No.: ON Site Address: 2-ctc( /'tiV&At- Pi Lws f=Cofruity: _Gut \/Kt Zip: GR To schedule an inspection please call ❑ Riverside 951-955-8980 or ❑ Indio 760-863-7570 All cancellations/reschedules must be received prior to Sam on the day of inspection or additional fees will apply. OWTS Components Date Re-Inspection Inspector of Inspection Date Initials Septic Tank 1:9-"00 -seepage Pits Septic Tank AbandonmentZtS gSWertaterar l3-Bex rc , ffluent Filters TO BE POSTED A TJOB SITE IN PLAIN VIEW EPO-55(REV 4/16) City at Menitee Building & Satety Dept. FEB 2 2 toll, Received