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PMT17-00912 City of Menifee Permit No.: PMT17-00912 29714 HAUN RD. Type: Residential Plumbing <A-CCELA-' MENIFEE, CA92586 MENIFEE Date Issued: 0 312 812 01 7 PERMIT Site Address: 31111 GEARY ST, MENIFEE, CA 92584 Parcel Number: 358-150-019 Construction Cost: $5.000.00 Existing Use: Proposed Use: Description of REPLACE LEACH LINES Work: Owner Contractor JAMES&CATHERINE DUNN DIAMOND W EXCAVATING 31111 GEARY STREET 21285 SHOEMAKER DRIVE MENIFEE,CA 92584 WILDOMAR,CA 92595 Applicant Phone: 9516745476 WALLY WILLETTE License Number:554199 DIAMOND W EXCAVATING 21285 SHOEMAKER DRIVE WILDOMAR, CA 92595 Fee Description Oft Amount f51 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 slated,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_Perrnit_Templale.rpl 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 o I am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and effect p the following reason: License Class C y Z License No.S!5r-♦7/9/ g signature below I acknowledge that,except for m y m y nature g p y personal residence Expires t-3/-/8 Signature in which 1 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 ❑I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.)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 ' www.leainfp.ca.eov/ca law.htm I. this permit is issued. Policy# Date 161 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 o 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 owner's behalf.I have read this number are: application and the information I have provided is correct.)agree to comply Carrier S'TGTC FG ha with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# Expires 19P Z-5 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 ❑I certify that in the performance of the work for which this permit Is issued, shall not employ any persons In any manner so as to became subject to the CITY BUSINESS LICENSE# 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 co ply with those provisions. o Will the applicant or future building occupant handle hazardous material or a Applicant W r.CY W Date `3-Z 6 -/-2 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 ❑Yes ❑No 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(SCAQM D)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes ❑No I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility he 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 ❑No 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 Contractors License Law for the reason(s)Indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes ❑No 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 OWNER OR AUTHORIZED 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(ARP) License Law(Chapter9(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 D 1,as owner of the property,or my employee with wages as theirsole 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 property who,through employees'or personal effort,builds or improves the D An EPA Lead-Safe Certified Renovator will be responsible for this project 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: ❑1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Cade: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 03/27/2017 PERMIT/PLAN CHECK NUMBER % '�� `joa TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION [-]ELECTRICAL []MECHANICAL ❑NEW []PLUMBING [-IRE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Replacement of leach lines n^p� ullding & Safet PROJECTADDRESS 31111 Geary Street v�vVLA! Y De I. ASSESSOR'S PARCEL NUMBER ;e V- 1F�- OT' TRACT MAR 2 8 2011 PROPERTY OWNER'S NAME Received ADDRESS 31111 Geary Street PHONE (951)956-6663 EMAIL rennym20l6@icloud.com APPLICANT NAME Wally Willette ADDRESS 21285 Shoemaker Lane PHONE (951)318-5772 EMAIL wldomar@aol.com CONTRACTOR'S NAME Wally Willette OWNER BUILDER? ❑YES❑✓NO BUSINESS NAME Diamond W Excavating Inc. ADDRESS 21285 Shoemaker Lane,Wildomar,CA 92595 PHONE (951)318-5772 EMAIL widomar@aol.com CONTRACTOR'S STATE LIC NUMBER 554199 LICENSE CLASSIFICATION C-42 VALUATION$ $5,000.D0 SO FT L SO FT APPLICANT'S SIGNATURE DATE 03/27/2017 FIN-STAFF USE ONLY DEPARTMENT DISTRIBUTION �[ CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN ' SMIP INVOICE 1Q�+ PAID AMOUNT AMOUNT l�T',„,JJ OCASH OCHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECKN 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 County of Riverside DEPARTMENT OF ENVIRONMENTAL HEALTH f, www.rivcoeh.org OWTS INSPECTION CARD APN: ���J r)' s0_p I q Permit No.: ON ( L ' Site Address: I I ` � ('', Q n-CIATs� City: l�Q rL i'l ..k Zip: �J 15�1 , To schedule an inspection please call ❑ Riverside 951-955-8980 or ❑ Indio 760-863-7570 All cancellations/reschedules must be received prior to 8am on the day of inspection or additional fees will apply. OWTS Components Date Re-Inspection Inspector of Inspection Date Initials Septic Tank e ` Leach Lines/Bed _ g Seepage Pits Septic Tank Abandonment Sewer Lateral D-Box Risers Effluent Filters V/ Final Inspection TO BE POSTED ATJOB SITEIN PLAIN VIEW ED -55(RW4/36) oNwrK; County of Riverside DEPARTMENT OF ENVIRONMENTAL HEALTH www.rivcoeh.org LAND USE APPLICATION OFFICE USE ONLY )d13880 Lemon Street•Suite 200•Riverside•CA•92501—(951)95wm PE CODE: FEE: ❑47-950 Arabia Street•Suite A•Indio•CA 92201—(760)863-757p`3—]y�,EHS# ON# LMqPTR/PM p Cos, LOT# _ iUS :SECTION ANameOWNER: Address r'p/ y �/ eQ � lcit `'✓f �i!�l/ F C e ziPhone ,J 7 r1 G— O� 7 "�Compan Name �I QIV 0_' (d Wf�Q T'I h q enUCont2ctor W Q// l (/� / (/e-7re— AGENT/ ` ' l _/CONTRACTOR: Mailin Address z^�//z�7/,J`1� e� Cit _/W //(/6�1C(Y ZiqZ.��Phone qT1 �/`7' �7�� W /61OGYlaY b C( c/, Cerro/PROPERTY INFO: SiteAddess36�` 1y�e�1-� Cit /•/ P{�//`ree Zip G,/v� Water Age�ncy7/Well �/11 y��-D Lot Size l �7 APPLICANT'S SIGNATURE: W (jlJ(C�(!� r101 CTION B Below—For Office Use Only ECK BOX IF REQUIRED �Ullding & Sdfe box is checked.this a Iication shall be considered denied until the information is mvided. ty Dept. olding Tank Agreements Required ❑Floor Plan and/or Plumbing Layout Required MAR 7 ertificate of Existing OWTS Required(C-42) ❑Special Feasibility Bodng Report Required 2:6 20�/ QCB Clearance Required ❑Detailed Contour Plot Plan Required(1 to 5 foot intervals) oils Percolation Report Required SIT EYAL ATION INSPECTION REM KS:op aclru2c i E)i.eeBH (4 V EHS INITIALS/DATE: SECTION C 0 NEW I .REPAIR/REPLACEMENT 1 ❑ EXISTING' ❑PUMP ❑ATU ❑ CONNECT TO SEWER FIXTURE UNITS# BDRMS# Soils Perdolation/Bodng Report By: Date: Project# - C-42 Certification By: Date: License# Septic tank cap.: Soil Rate: Tested Depth: Max. trench depth: Sq.Ft.Bottom Area: otal Linear Ft.: Line(s): Length: feel - Each 3 feet wide Sidewall Allowance: Ft.Rock/ _Sq.ft.Running foot Rock below drain line: . _in. or Okplastic Chambers .Leach Linesibed special design for slope: 0 N/A ❑Overburden Factor. Pit Diameter. - No.pits: Depth below Inlet'(bi): Pit Total Depth: Max.allowable depth: CONSTR CTI N/INST TION K SECTION D This Application's Approved 0 Denied regarding the design of the OWTS as indicated on the accompanied plot plan using the requirements set forth in Section C abov No construction is permitted in the required reserved 100%Expansion area. EHS Signature: ` Date EPO-92(REV 711 ) Oisbibulion:WHRE—Office File;YELLOW—Bldg.Dept PINK—I o�ni COUNTY OF RIVERSIDE DEPARTMENT OF ENVIRONMENTAL HEALTH CERTIFICATION OF EXISTING SUBSURFACE DISPOSAL SYSTEM ❑3880 Lemon Street•Suite 200•Riverside•CA•92501-(951)955-8980 ❑47-950 Arabia Street•Suite A•Indio•CA 92201-(760)803-7570 Property Information: APN: 3$8- 13-0- U 19 -6 Date of Inspection: 1. Owner: Address: 3/111- G eufY ST City: ?*2 eh/fee FAILURE TOPROVIDE ALL REQUIRED INFORMATION SHALL PREVENT OWNER FROM OBTAINING ENVIRONMENTAL HEALTH APPROVAL 2. Show design and location on a scale of 1:20 or 1:40 of 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 a�t�th-e^ above location on _zz�/� and determined that the tank capacity is OOo gallons and that there is 1 i sq.ft.of leach line bottom area. There are 3 bedrooms in the dwelling and there are fixture units. b. There are 3 leach line(s),each 9S ft. long Depth 3 ft. ❑ Rock 0 Plastic Chamber c. There are Seepage pit(s),each _ ft.in diameter,and ft.TD. ft. BI. d. The leach bed is _ ft. by _ ft.,total sq.ft.of leached area. Depth is it. 4. a. Construction of septic tank(Please check one of the following): - 0 Concrete ❑ Fiberglass ❑ Steel ❑ Other: b. Internal dimensions of septic: Length 7 y9 ft. Width 'f•7 - ft. Depth q-25' ft. c. Condition of tank(please check yes or no for each question): Inlet Tee present? 29 Yes ❑ No Tank Structure deteriorated? ei Yes ❑ No Outlet Tee present? ® Ye ptoy of Menefee sB & Sfe D _ Effluentent Filter Present? ❑ Yes � � U N No Two compartments? Yes No g a ty ept. d. Condition of D-Box: Level? 0 Yes ❑ No Replaced? ❑ Yes M No MAR 212017 5. a. While pumping the tank,did effluent flow back into tank from absorption system? 0 Yes I7 No b. Prior to pumping,was the liquid level in the tank above the outlet tee? AYes ❑ No Received c. Was the area around the lids oxidized? ❑Yes JO No d. Is design of system gravity feed? Yes ❑ No e. Were well(s)observed on this or adjacent property? ❑Yes SI No If yes,indicate distance of well from: Septic tank _ ft. Leach lines _ Seepage Pits ff. f. Distance from springs, lakes,and natural water courses(check all that apply): ❑ Septic Tank _ ft. ❑ Leach lines _ ft. ❑ Seepage Pits _ ft.g. Is sewer within 200 ft.of structure and abuts property line? ❑ Yes )N No Additional Comments: h. How long has dwelling been vacant?(if applicable) months weeks ® N/A 6. a. ❑ It is my opinion that the system appears to be in good working order and can be expected to function properly with proper maintenance. *No repairs are necessary at this time. b. 0 It is my opinion that the system is not in good working order and will not unction properly without the following repairs: Lead 7-4`lC5 . CZLc Ica //ei C09/6Ce I certify under penalty of perjury that the foregoing Is true and correct. � Signature: W r--7Z&t/. [ Print Name:- W qt/y _ /iv / 11 eT 2 e Contractor License No.: Expiration Date: / -33/- /8 PumperCo.: 9fQ14?O/7d e✓ Phone Nu ber: ?S-( 674 - Address: city. Gt�J�e�D�r�p Zip: DEHSANd 84 fREV 11/14)