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PMT17-00907 City of Menifee Permit No.: PMT17-00907 29714 HAUN RD. Type: Pool/Spa -Residential S4CCEL/-> MENIFEE, CA 92586 MENIFEE Date Issued: 03/2712017 PERMIT Site Address: 28886 CEDAR BROOK LN, MENIFEE,CA Parcel Number: 372-461-007 92584 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 421 SO FT Work: Owner Contractor ANGELA ALAYVILLA PACIFIC COAST POOLS INCORPORATED 28886 CEDAR BROOK LN 26499 JEFFERSON AVE UNIT E MENIFEE,CA 92584 MURRI ETA,CA 92562 Applicant Phone:9512960199 BRANDY CORAL License Number.852237 PACIFIC COAST POOLS INCORPORATED 26499 JEFFERSON AVE UNIT E MURRI ETA, CA 92562 Fee Description ON Amount isl Swimming Pool/In-Ground Spa 1 46T00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee.-Electrical 1 23.35 $622.36 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_Pernit_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 ❑I am exempt from liconsure under the Contractors State License Law for Professions Cade and my license is in full force and effect..,L the following reason: License Class G� License No. !lJ J By my signature below I acknowledge that,except for my personal residence Expires Ly 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 1 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 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 ,,yww lei a.ca. ov calaw.htm1. this permit is Issued. Z7(� Policy# Date 1 PROPER OWNER OR AUTHORIZED AGENT o I have and will maintain workers compensation Insurance,as required by 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: application and the information 1 have provided is correct.I agree to comply with all applicable city and county ordinances and state laws relating to Carrier building construction.I authorize representatives of this city or county to Policy# Qwya_11149 L Expires fjflLy ente 7;;�7 fied property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROP RTY OWNER OR AUTHORIZED AGENT o 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# workers compensation laws of California,and agree that if 1 should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall fo Twit comply with those provisions. Will the applicant or future building occupant handle hazardous material or / mixture containing a hazardous material equal to or greaterthat the Applicant Date 27 l G amounts speelikil on the Hazardous Materials Information Guide? WARNING:FAI URE TO SECURE WORKER'S COMPENSATION COVERAGE IS D Yes ❑No UNIAWFUL,A DSHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use ofthe building by the applicantor 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 guidelin CONSTRUCTION LENDING AGENCY D Yes dNo 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 No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of California Health&Sa ty Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous in reporting. ^� checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 DYes o �1 Z /1 J 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 ORA RIZED 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRPI 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)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 ❑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 1-800-424-LEAD(5323). 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 ar 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 ❑No EPA Lead-Safe Certified Firm Is required for this project because: not built or improved for the purpose of sale. -; �- o 1,as owner of the property am exclusively contracting with licensed ;I: * 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 Jhe. Acknowledgement. - BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE PERMIT/PLAN CHECK NUMBER PMTI — 0-7 TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME Ot-PO&OL/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 1 . PROJECTADDRESS Ctd4" 6rCT�6__ a/K-IL ASSESSOR'S PARCEL NUMBER ,,y, - Q1 -M'7 LOT 115 TRACT 3 g3 OWNER NAME rl i 0-�� vt ll ak. ADDRESS 2,GW4 I6YaD-,C— PHONE EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES O N6� BUSINESS NAME �v5 ADDRESS ,��, PHONE �j 0�Y / ��// '' EMAIL / CONTRACTOR'S STATE LIC NUMBER �5(/ � LICENSE CLASSIFICATION VALUATION$ �� SOFT G�,�-/ L SQ FT APPLICANT'S SIGNATURE DATE - DEPARTMENT DISTRIBUTION CITY OFFMMENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN I CIO SMIP INVOICE ^^��]] 2 PAID AMOUNT AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER O YES NO City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-572-6777 www.cityofinenifee.Lis Inspection Request Line 951-246-6213 STACK STONE 1 ' LONG, 3 I� RE A , 3CM RAV E CP ST O ;ET. ACE 'ERTINE :--FACE 6' e oEP� DEVf 2' 11 CA 00 CA N p� o ap 'ALL AYVILLA RESIDENCE XREAR SCALE: 1/8"=1 FT NEW Ei rY MENIFEE EPARTMENT O NG AND SAFETY D NORTH Ei711 _.,..nv Al 2 _4001