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PMT17-00928 City of Menifee Permit No.: PMT17-00928 29714 HAUN RD. �/-�CCELA— MENIFEE, CA 92586 Type: Residential Plumbing MENIFEE Date Issued: 03/29/2017 PERMIT Site Address: 32560 BRADLEY RD, MENIFEE, CA Parcel Number: 360-360-005 92584 Construction Cost: $6,000.00 Existing Use: Proposed Use: Description of ADDITION OF LEACH LINE TO EXISTING SEPTIC SYSTEM Work: Owner Contractor JOHN FARQUHARSON LANIK ENTERPRISES INC 32560 BRADLEY RD P 0 BOX 891416 MENIFEE,CA 925a4 TEMECULA, CA 92589 Applicant Phone:9516767114 MARIA JAUREGUI License Number.458947 LANIK ENTERPRISES INC P0 BOX 891416 TEMECULA, CA 92589 Fee Description ON Amount 1$1 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 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 he forfeited. AA eldg_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 o I am exempt from licensure under the Contractors State License Law for Professions Cod nd y licen a fs in full force and effect. the following reason: License Class 'cens No. By my signature below I acknowledge that,except for my personal residence Expires 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 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 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 'this permittississu d. www.leginfo.ca.gov/calaw.html. Policy# �PV1174T�f �-I VU 1i'..t' Date PROPERTY OWNER OR AUTHORIZED AGENT ❑I have and will aintam worker's 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:1 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 re: ;-. p /\� >�� !� application and the information I have provided is correct.I agree to comply Carrier i(�lt A,f'Q-L ..Sd v L l.C- �,Lp-� with all applicable city and county ordinances and state laws relating to 11 building construction.I authorize representatives ofthfs city or countyto Policy# l6q r Ixpires_l„, enter the above identified propertyfor inspection purposes. (This section need not to be completed is the permit is for one-hundred N Date dollars($100)or less PROPERTY OWNER OR AUTHORIZ AGENT ❑I certify that in the performance of the work for which this permit is issued, 1 shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# �J workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compens t. n provisions of Section 370D of the Labor Code,I shall hwitF�CQr�.ply wi those provisions. I �G � f^ Will the applicant or future building occupant handle hazardous material or a 1 mixture containing a hazardous material equal to orgreater that the Date AppllcaM amounts s ecified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE RKER'S COMPENSATION COVERAGE 15 o Yes amounts 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 forguideli es CONSTRUCTION LENDING AGENCY ❑Yes rliha 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) D Yes d 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 Contractors License Law for the reason(s)indicted below by the California Health&Safety Cod Section 25505 and 25534 concerning hazardous m terial reAortfng checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 � p P-1 ^ 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 PROPERTY76VWER OR AU 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(RRP) 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 Iicensure 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-certffied 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.eoa.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 ❑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: ❑I,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 APPLICATIONI _tMenifee DATE -OL c1 - PERMIT/PLAN CHECK NUMBER r , l 11� A TYPE: ❑COMMERCIAL EXESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: []ADDITION ALTERATION ❑DEMOLITION ❑ELECTRICAL []MECHANICAL ❑gNEW� LUfMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK L_c-�G1/1 i a-c QA� I+-�oy> PROJECTADDRESS Q Y l ASSESSOR'S PARCEL NUMBER 3(p 0 - 3 (po ^ LLSJeS TRACT PROPERTY OWNER'S NAME J hn ADDRESS - �bY_ I ", � PHONE ,S - MAIL APPLICANT NAME MO,V 1 G rGt.�/�-Y 'PDADDRESS 1� L�p T' S PHONE l�l l,[1lQ I �� EMAIL to rjC, 0 [6L111 � C . Cdr� CONTRACTOR'S NAME \ V YIDS OWNERBILIZER? ❑YESRNO BUSINESS NAME I �t. (�11�11JYl S ADDRESS TO I,, -7 �b � ( `P/ 1 1 PHONE lso VI (o ' I EMAIL (A,V La-hi L fic CONTRACTOR'S STATE LIC NUMBER 4 LICENSE CLASSIFICATION VALUATION$ 0 ,-- SQ L SQ FT APPLICANT'S SIGNATURE l DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP 1;Da+31 INVOICE PAID AMOUNT AMOUNT � OCASH CCHECK# CCREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZEDLETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92556 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 a�arn`,a County of Riverside 'ems` r�= DEPARTMENT OF ENVIRONME(RTAW�piQ H ►"" Y1 n ,'.. �P1A www.rivcoeh.org BUITdRiL rP / %KR6 LAND USE APPLICATION MAR 2 9 201! .OFFICE USE ONLY 0 3880 Lemon Street-Suite 200-Riverside-CA-92501+-(951)955-8980 - p PE CODE: FEE: ✓� c1 ❑47-950 Arabia Street-Suite A•Indio-CA 92201-(760)863-7570 C ('I V-T k�A21'Y 2- EHS# ON# LMS# APN G-,3 1--0o t+ TR/PM LOT# USE OF PERMIT: Zn c- SECTION A i �Y lX` Y. «. Name I a r-,qr L(-P V�QI-�pJl�, f� OWNER: Address s .11 Y Q� `�' city �+ l ^ Zi Phone 1 Email AGENT/ Com 'an Name �S: ��! EfAA-( .,r jNVV, X. A enUCcnlmcla N(ArM _ IL �T Zi CONTRACTOR: Nlailing Addres�. -11 (� I Cil r �, , Phone to - I Email it - PROPERTY INFO: Site Address Cit Z LLO1' er AgencvlWell CZ`-y� u'� Lot Size APPLICANT'S SIGNATURE: �. / %�J� ti DATE: �^'J SECTION B Below—RvIMWUse Only CHECK BOX IF REQUIRED - If any box is checked.this application shall be considered denied until the information is provided. ❑Holding Tank Agreements Required ❑Floor Plan and/or Plumbing Layout Required ❑Certificate of Existing OWTS Required(C42) ❑Special Feasibility Boring Report RequNed ❑WQCB Clearance Required ❑Detailed Contour Plot Plan Required(1 to 5 fool intervals) ❑Soils Percolation Report Required SITE EVALUATION INSPECTION REMARKS: EHS INITIALS/DATE: .. SECTION C ❑NEW I OIREPAIR 1 REPLACEMENT ❑EXISTING ❑PUMP ❑ATU ❑CONNECT TO SEWER IXTURE UNITS# 1BDRMS# Soils Percolation/Boring Report By. Date: Projeel0 - C-42 Ceniricalion By: Date: UcenseK - Lek.,i/; 3 -13 - I.' . y�'2 'i Y � Septic lank cap.: - Soil Rate: Tested Depth: Max. Trench depth: Sq.FL Bottom Area: Total Linear FL: I-me(s): V I I Lengl feel - Each 3 feet wide Sidewall Allowance: Ft.Rock/ Sq.A.Running fool Rock below drain line: in.. or Izslic Chambers Leach Lines/bed special design for slope: ❑N/A ❑Overburden Factor Pit Diameter: No.pits: Depth below Intel(bi): Fit Total Depth: Max.allowable depth: �._ CONSTRUCTION/INSTALLATION REMARKS: + SECTION D _ This Application is iTApproved O Dented regarding the design of the OWTS as indicated on the accompanied plot Plan using the requirements set forth in Section C above.No construction is permitted in the required reserved 100%Expansion area. EHS Signature: //� _ '- Date: EPO-e[IHEV 7lIGi [xstribulion WHITE 0IGce Fdn:YELLOW- Jg Drys. INF-AW+linnl City of Menife Building & Safety Dept. MAR 2 9 2017 Received County of Riverside DEPARTMENT OF ENVIRONMENTAL HEALTH www.rivcoeh.org OF OWTS INSPECTION CARD APN: //__Permit No.: ON Site Address: 3 -2 60 hr<cl/,� K, ��r3� c'City: 1��/e�al r_ Zip: 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 c Line / Bed Seepage Pits Septic Tank Abandonment Sewer Lateral B- isers Ffl.[emm- .7{"rs a Inspection TO BE POSTED ATJOBSITEINPLAIN VIEW EPO-55(REV 4/16)