PMT17-00893 City of Menifee Permit No.: PMT17-00893
29714 HAUN RD.
S�CCEL/1 MENIFEE, CA 92586 Type: Pool/Spa-Residential
MENIFEE Date Issued: 0 312 312 01 7
PERMIT
Site Address: 25230 STEPPING STONE CIR, MENIFEE, Parcel Number: 339-403-024
CA 92584 Construction Cost: $20,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL ONLY,520 SF,WITH 56'U/G GAS LINE FOR FIRE FEATURE, FIRE PIT,AND BBQ
Work:
Owner Contractor
JOHNNY RODRIGUEZ ALOHA POOL&DESIGN INC
25230 STEPPING STONE CIRCLE 41083 SANDALWOOD CIRCLE STE I
MENIFEE,CA 92584 MURRIETA, CA 92562
Applicant Phone:9514539728
MARK KLINGSPOON License Number.965927
ALOHA POOL&DESIGN INC
41083 SANDALWOOD CIRCLE STE I
MURRIETA, CA 92562
Fee Description Oft Amount t$1
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
Inspections not specified 116 116.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 3.00
General Plan Maintenance Fee-Electrical 1 23.35
$637.35
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_Pennil_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
1 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 9ivision 3 of the Business and 0I am exempt from Ocensure under the Contractor's State License Law for
Professions Code and my license is in full fore and effect. the following reason:
License Class &�—3 'ce e No._-f 6 S'SZ 7 By my signature below I acknowledge that,except for my personal residence
Expires LI Signature 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 DECLARATIq6 have built as an owner-builder if it has not been constructed in its entirety by
O l hereby affirm under penalty of perjuv one of the following declarations:l 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 wwwleRinfo.ca.gov/caflaw.htmf.permit is issued.
Policy# Date
❑I 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 -Py 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.)have read this
number are: application anif the information I have provided is correct.I agree to comply
Carrier with all appli ble city and county ordinances and state laws relating to
building cons ruction.I authorize representatives of this city or county to
Policy# Expires enter the cab ve identified property for inspection purposes.
(This section need notto be completed is the permit is forone-hundred ! ----
dollars($100)or less Date
PROPER 'WNER OR AUTHORIZED AGENT
�7 certify that in the performance of the work for which this permit is issued,
I shall not employ an persons in any manner so as to become subject to the CITY BUSW S LICENSE#
workers compensa on laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the7wor rs compensation provisions of Section 3700 of the Labor
Code,I shall forth Ith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date Z , mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAIL RE TO SECURE WORKER'S COMPENSATION COVERAGE IS 0 Yes "o
UNLAWFUL,J`JgD 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 hecoDistrict(SCtionor See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Toes
CONSTRUCTION LENDING AGENCY 0 Yes �o
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) ❑Yes "o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjurythat I am exempt from the permitting checklisf.I understand my requirements underthe State of
Contractors License Law for the reason(s)indicated below by the California Health&1SafetV Code,Section 25505 and 25534 concerning
checkmark(s)I have placed nextto the applicable Item(s)(Section 7031.5 hazard us in terfJl reporting.
Business and Professions Code).Any city or county that requires a permit to OYesrTVo -_. /
construct,after,improve,demolish or repair any structure,prior to its
Date-17L
issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractors State EPA R /N,REPAIR AND PAINTING fRRP)
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 Cade)or that he or she is exempt from Ilcensure 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 properly owners and property
than($S00). managers who do the paint-disturbing work themselves orthrough 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.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 Contractors State License Law does not apply to an owner of a 0 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 R was
not built or improved forthe purpose of sale. 0 No EPA Lead-Safe Certified Firm is required forthis project because:
0I,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 : SAFETY PERMIT/PLAN CHECK APPLICATION
.,. .
Menifee
DATE 1123 PERMIT/PLAN CHECK NUMBERan n nain,5
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 w v .s 1019.tip 4 DOG
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME L)-x
ADDRESS
PHONE
/ j 7iC; —�`,U EMAIL J
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER. O YES 0
BUSINESS NAME Ot9 L-
ADDRESS 1,953 JAB'✓,�,A-t --12Oz c4/ G//Z, S1-2,= - ulLL¢, -A 9z11'
PHONE 9S� 7'Z400� EMAIL
CONTRACTOR'S STATE LIC NUMBER �C7�7 Z� LICENSE CLASSIFICATION G
VALUATION$ 9 a' SO,FT L SQ FT
APPLICANT'S SIGNATURE DATE 7
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE PAID AMOUNT AMOUNT -1' � n OCASH 0CHECK# CREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586951-572-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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