PMT17-00746 City of Menifee Permit No.: PMT17-00746
_ /-> 29714 HAUN RD. Type: Pool/Spa-Residential
'( ICCEL MENIFEE, CA 92586
MENIFEE Date Issued: 03/13/2017
PERMIT
Site Address: 33500 DAILY RD, MENIFEE, CA 92584 Parcel Number: 384-040-001
Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA 600 SQ FT,20 L FT GAS LINE FOR FIREPIT-VERIFY FENCING-
Work:
Owner Contractor
DAVID WEIS A CUT ABOVE CONSTRUCTION POOLS&
33500 DAILY RD LANDSCAPE INC
MENIFEE,CA 92584 26025 NEWPORT ROAD#A533
Applicant Phone:8007007754
CHRIS YOUNG License Number:672202
A CUT ABOVE CONSTRUCTION POOLS& LANDSCAPE INC
26025 NEWPORT ROAD#A533
MENIFEE,CA 92584
Fee Description ,Qtv Amount 1$1
Swimming Pool/In-Ground Spa 1 467.00
Plumbing Fixtures and Vents,fixtures 1 116.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Plumbing 1 5.80
General Plan Maintenance Fee-Electrical 1 23.35
$644.15
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 l am under provisions of with a licensed contractor(s)pursuant to the Contractors state License Law).
Chopter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from Rcensure under the Contractor's State License Law for
Professions Code and my license is in full forces effect. the following reason:
License Clas C-S is p eNo. By my signature below l acknowledge that,except for my personal residence
Expires 1� 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 I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder If It has not been constructed in its entirety by
O 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 avallable upon request when
compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following websfte:
by Section 3700 of the Labor Code,for the performance of work for which ,xww,leeinfo.ca.eov/ralaw.html.
this permit is issued.
Policy If Date
D l have 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 D By my signature below l 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.l have read this
numberare: application and the information I have provided is correct.I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy B Expires J 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
D 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 p ,O�S.l ll 10I
worker's co MU)RnE�
f California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to hensa provisions ol'Section 3700 of the Labor
Code,Is all fpse provisions. Will the applicant or future building occupant handle hazardous material or
ApplicaDate /" I mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARM •FAE WORKE 9 COMPENSATION COVERAGE IS o YeshNoUNLAWFUL,AECT ANE LOYER TO CRIMINAL PENALTIES Will their(t/ended use ofthe building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($10D,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 forguidelines
CONSTRUCTION LENDING AGENCY a Yes
I hereby affirm that under the penalty ofperjury 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 ofa school?
(Section 3097 Civil Code) Dyes �No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.l understand my requirements under the State of
hereby affirm under penalty of perjury that lam exempt from theContractor's License Law for the reason(s)indicted below by the Califior 's in It & Te ode,Section 25505 and 25534 concerning
haz dc6 ma'yre�r51 reparti g.
chsiness and
I have placed next to the applicable that r(Section permit oY d No/ Z �/�
Business and Professions Code).Any city of county that requiresa permit to /// Date J IIIJJJ
construct,alter,improve,demolish or repair any structure,prior to its PR RTYO R Ulm EDAGENT
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 R AIRAND AINTING RRP
License Law(Chapter9(commencingwith Section 7000)of Division 3 ofthe The EPA Renovation,R it and ainfing(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 acivil 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
D 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 ofthe work,and the structure is www.epa.goy/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 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. D No EPA Lead Safe Certified Firm is required for this project bemuse:
D 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.
J
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 3`I�—�� PERMIT/PLAN CHECK NUMBER P ' -DV
TYPE: O COMMERCIAL PRESIDENTIAL O MULTI-FAMILY O MOBILE HOME POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION 'V ELECTRICAL O MECHANICAL
O NEW ZC PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK t9a_ .S WA-r Uklr
PROJECTADDRESS
ASSESSOR'S PARCEL NUM,,BE^^R'' '00I LOT TRACT
OWNER NAME V V W
ADDRESS
PHONE (`j' �v�(�_ �'�5 Tinn EMAIL
APPLICANT NAME
ADDRESS I
PHONE EMAIL
f� '
CONTRACTOR'S NAME —��1�� e,'I'�' OWNER BUILDER? YES C NO
BUSINESS NAME
ADDRESS Z PULS
PHONE 9S( EMAIL
CONTRACTOR'S STATE LIC NUMBER LC IZ LAB LICENSE CLASSIFICATION
VALUATION$ 2S - Q FT U0 1D L SQ FT
APPLICANT'S SIGNATURE DATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP
INVOICE 5 PAID AMOUNT O
AMOUNT (o ' O CASH CHECKl1 :CREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES 0 NO
City of IVMemfee Building & Safet9 DeparTment 29714 HOLIi' Rd. Menifee, CA 92536 951-572-6777
wvn-v. Rycimenifee.us lnsoectin-n Retitlest Line 951-246-6213
i
LIC.#C42_998op APN#384040001-0
Dave Weis 33500 Daily Rd Menifee,CA 92584
® A A City of Me ifee
& Building & ate y Dept.
A MAR 3 017
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COUNTY OF RIVERSIDE
A.09 DEPARTMENT OF ENVIRONMENTAL HEALTH
CERTIFICATION OF EXISTING SUBSURFACE DISPOSAL SYSTEM
,/ City of Menifee
Ltl 3880 Lemon Street•Suite 200•Riverside•CA•92501-(951)955-8980 Building & Safety Dept.
❑47-950 Arabia Street•Suite A•India•CA M01—(760)863-7570
MAR 13 2017
Property Information: APN: 384040001-0 Date of Inspection: 3rV2017
1. Owner.. Dave Weis Address: M500 Daily Rd City:, Men'
(ece t'
FAILURE TO PROVIDE ALL REQUIRED INFORMATION SHALL PREVENT OWNER FROM OBTAINING
ENVIRONMENTAL HEALTH APPROVAL
2. Show design and location on a scale of 1:20 ojMf the sewage disposal system and 100%expansion area in relation to
dwellings,structures,wells,rock outcroppings,drainage,watercourses,etc.
3. a. I examined existing subsurface sewage disposal system at the above location on 3/3/2017 and determined that
the tank capacity is 1200 gallons and that there is _ sq.ft.of leach line bottom area. There are
bedrooms in the dwelling and there are _ fixture units.
b. There are 2 leach line(s),each 80 ft.long Depth 480 ft. ❑Rock Gf Plastic Chamber
c. There are Seepage pit(s),each fL in diameter,and _ ft.TD. ft BL
d. The leach bed is _ ft. _ ft,total sq.ft.of leached area. Depth is _ fL
4. a. Construction of septic tank(Please check one of the following):
❑ Concrete @@Fiberglass ❑Steel ❑Other:
b. Internal dimensions of septic: Length 9 1/2 ft. Width 6 R Depth a 1/2 ft-c. Condition of tank(please check yes or no for each question): Inlet Tee present? GL Yes ❑ No
Tank Structure deteriorated? ❑Yes Ed No Outlet Tee present? Ed Yes ❑No
Effluent Filter Present? QrYes ❑No Two compartments? 5d Yes ❑ No
d. Condition of D-Box: Level? @f Yes ❑No Replaced? ❑Yes ❑No
5. a. While pumping the tank,did effluent flow back into tank from absorption system? ❑Yes 9 No
b. Prior to pumping,was the liquid level in the tank above the outlet tee? ❑Yes ff No
c. Was the area around the lids oxidized? ❑Yes Nf No
d. Is design of system gravity feed? 59 Yes ❑No
e. Were well(s)observed on this or adjacent properly? ❑Yes 5d No
If yes,indicate distance of well from: Septic tank ft. Leach lines _ Seepage Pits _ ft.
f. Distance from springs,lakes,and natural water courses(check an that apply): WA
❑ Septic Tank _ ft ❑ Leach lines _ ft. ❑Seepage Pits _ fL
g. Is sewer within 200 ft.of structure and abuts property line? ❑Yes ONO
Additional Comments:
h. How long has dwelling been vacant?(if applicable) months weeks Ur NIA
6. a. Ld It is my opinion that the system appears to be in good working order and can be expected to function properly with
proper mainte �n\re. No repairs are necessary at this time.
b. ❑ It is my apini n ththe system is not in good working order and will not function properly without the following
r
' repairs
I certify under en of e ry foregoing is true and correct
Signature: Print Name: Daniel E. Murphy
Contractor License No.: 988020 Expiration Date: October 2017 _
Pumper Co.: LePew Industrial Inc. Phone Number: 888-961-5971
Address: 41735 Elm Street,Suite 303 City: Murieta Zip: 92562
DFL-SAY-IM(REV 11/14)