PMT17-00836 City of Menifee Permit No.: PMT17-00836
29714 HAUN RD.
'ACCEU/ MENIFEE,CA 92586 Type: Pool/Spa -Residential
MENIFEE Date Issued: 0 311 7/2 01 7
PERMIT
Site Address: 30651 SADDLEHORN WAY, MENIFEE, Parcel Number: 358480-016
CA 92584 Construction Cost: $51,400.00
Existing Use: Proposed Use:
Description of INGROUND GUNITE POOL&SPA 469 SO FT
Work: 'INSPECTOR TO VERIFY FREESTANDING PATIO COVER SIZE/PERMIT'
Owner Contractor
MARIA FLORES CAL/PACIFIC POOLS&SPAS INC
30651 SADDLEHORN WAY 17024 VAN BUREN BLVD STE C
MENIFEE,CA 92584 RIVERSIDE, CA 92504
Applicant Phone:9517762002
GARY SOPER License Number:652876
CAL/PACIFIC POOLS&SPAS INC
17024 VAN BUREN BLVD STE C
RIVERSIDE,CA 92504
Fee Description City Amount(El
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 3.00
SMIP RESIDENTIAL 1 7.00
General Plan Maintenance Fee-Electrical 1 23.35
$527.35
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 violafion 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 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 Class (5:3 Uc a 1sF`7( By my signature below I acknowledge that,except for my personal residence
Expires Q 3/ ) Signature inwhichl 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 DECLARATI 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 �y,,v,,,leRinfo.ca.eov/calaw.html.
this permit is issued. _
Policy# Date
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 policy owner or authorized to act on the property owners behalf.I have read this
number are: t1 application and the information I have provided is correct.I agree to comply
Carder vC L��/?L/ /Ur7 7G with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy N .rL!/G/f�a �-O 1 Expires y 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
o I certify that in the performance of the work for which this permit is issued, `1Z�I5
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE ri ��sJ
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
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts sp don the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes o
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 gold I"
CONSTRUCTION LENDING AGENCY o Yes �b No
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 boun of a school?
(Section 3097 Civil Code) ❑Yes No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checkf . my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California H h&5Vely Code,Se n 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazard mate' ports
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes -7
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 O THORIZE AGENT
issuance,also requires the applicant for the permitto file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors State EPA REN NATION REPAIR AN AINTING RRP
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Re epair 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 subjectsthe 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
❑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.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800424-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
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. ❑No EPA Lead-Safe Certified Firm is required for this project because:
o I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 70",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.
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
Menifee
DATE 3 7 PERMIT/PLAN CHECK NUMBER 00650
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME OOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
[DESCRIPTION OF WORK Y49 6,6? /4L
PROJECT ADDRESS f7t6
41V
ASSESSOR'S PARCEL NUMBER 3Se' Y LOT TRACT �1�?l Y
OWNER NAME 44,v2/,* pel wt S-
ADDRESS G� 3�6�1/ -i901aV7GEmfQ
q I�J PHONE ! sl' /C� L d 3</ EMAIL
APPLICANT NAME lklelc /J c.S Fj7✓/�
ADDRESS l 7DZ i°/
PHONE `/f/-77U - LOCS L- EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES *�qO
BUSINESS NAME ,^
ADDRESS /701 Y V iCh//wa---
PHONE S'� ^?-76 ^10r-�L EMAIL
CONTRACTOR'S STATE LIC NUMBER 79 LICENSE CLASSIFICATION CS-3
D
VALUATION $ �l `71D(�D T 4/09 LSQFT
APPLICANT'S SIGNATURE DATE 3-/7'/7
CITYSTAFF USE ONLY
MW
DEPARTMENT DISTRIBUTION CITY/�Olrf�1N7�JIFtBVINE$SyICENSE NUMBER
BUILDING PLANNING ENGINE£ FIRE GREEN SMIP V 3��5
INVOICE ^ 35 PAID AMOUNT
AMOUNT pL�. OCASH OCHECK# <)CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
Pacific Pools and Patios
61,2r.
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400,000 BTU HEATER
2HP VARIABLE SPEED PUMP
525 SO FT CART FILTER
30 AMP PANEL
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