PMT17-01061 City of Menifee Permit No.: PMT17-01061
29714 HAUN RD.
�AACCELX— MENIFEE,CA 92586 Type: Pool/Spa-Residential
MENIFEE Date Issued: 04/11/2017
PERMIT
Site Address: 30580 BUCKBOARD LN, MENIFEE, CA Parcel Number: 358A50-010
92584 Construction Cost: $20,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA,425 SF
Work:
Owner Contractor
SALVADOR BUSTOS QUALITY CUSTOM POOLS INC
30580 BUCKBOARD LANE 30138 MARNE WAY
MENIFEE,CA 92584 MENIFEE,CA 92584
Applicant Phone:9516799732
HANNAH BARRETT License Number:795820
QUALITY CUSTOM POOLS INC
30138 MARNE WAY
MENIFEE,CA 92584
Fee Description Qtv Amount(Sl
Swimming Pool in-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 3.00
General Plan Maintenance Fee-Electrical 1 23.35
$521.35
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 thereunderwhen in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise staled,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_Pemrit_Template.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 Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class Cd'3 — Q Ucense No. —19 P37-0 By my signature below l acknowledge that,except for my personal residence
Expires 2017 Signature xA 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 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 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 www.leginfo.m.goy/miaw.h1ml.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 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.I agree to comply
Carrier Cucrtsi NV tfoy%aA with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# CA z 6 o a 7-19'1 Expires —I 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,
I shall not emolov any persons in any manner so as to become 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 370D of the Labor
Code,I shall forthwith comppfk�yiwith those�proqvi,sions. Will the applicant or future building occupant handle hazardous material or a
Applicant` (!' Date��f _ 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 d' yes(�40
UNLAWFUL,AND SHALL SUB1ECfAN EMPLOYERTO CRIMINAL PENALTIES ""Wiill the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,00D),IN occupant require a permit for the construction or modification from South
IN SECTIODITION N
3 THE FTHELBCOST OF OR CODE,INTERTION,DAMADATTOGES AS REYSFEOVIDED FOR Coast Air Quality Management District(SCAQM D)?See permitting checklist
IN SECTION 37060FTHEIABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelin
CONSTRUCTION LENDING AGENCY '(:W.
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) o Yes C�pfo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist I understand my requirements underthe State of
Contractors License Law for the reason(s)Indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable ftem(s)(Section 7031.5 ,ter hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to � D Date all-//7
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 fife a signed statement
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRPI
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
o 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.eoa.¢ov/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 aAn 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. o 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 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.:.
APPLICATION& SAFETY PERM IT/PLAN CHECK
Menifee
DATE / / PERMIT/PLAN CHECK NUMBER 'O10t4I
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
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
Of Menifeeriv fFbI t
PROIECTADDRE55 3US U
Building
ASSESSOR'S PARCEL NUMBER LOT TRACT AP
R 11
�. _ �
OWNER NAME ta5 �Vp+
ADDRESS 30 O o
PHONE CAL-1 L) EMAIL
APPLICANT NAME
ADDRESS
PHONE pti,�) to-10O, GL-j � L EMAIL
CONTRACTOR'S NAME Oy,r OWNER BUILDER? O Y . O
BUSINESS NAME a LA CA I PJA h
ADDRESS
PHONE(2k,q� + )O'\ q q-1 7j Z EMAIL
CONTRACTOR'S STATE LIC NUMBER -7Q C,q)_(>) LICENSE CLASSIFICATION ('.--`
VALUATION$ (92 SO FT "11'�J L SO FT l
APPLICANT'S SIGNATUR ✓ -t:_-"'� DATE y.. /
� n
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT I I O CASH O CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT I O CASH O CHECK# O 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 Houn Rd. Menifee, CA 92586 951-672-6777
www.Cityofinenifee.us Inspection Request Line 95.1-246-6213
City of Menifee
Building & Safety Dept,
I APR 11 2017
ncr0ught Iron
Fence Received
F
Sun Derk �
Existing PWn[er
Plants
l
+12"
Spa
S
4'0"Deep 8'6'
O Spa
1'1• 46"pip
a ez,9
O N 3'6"Deep
r
+32"
Reef Step
G2ss Area ch
e
Concrete area
FuNn:80Q Island
ExISGrg COncrte
Existing Pado Cow East,I Ouse ]"
6'
mi E uignent
Bustos Residence '6"Vinyl Fence
5'6"Vinyl Ee 30580 Buckboard Lane CNow
Menifee, Ca 92584
951-285-0411 1112'Poly Ga
1"Sch 40 UL
`( OF MENIFEE
LDING AND SAFETY DEPA FNT
PLAN APPROVAL
6 6'
.',HEWED BY 'I
DATE
000roval of th ans shall not be construed to be a p it for,or an
.'P,� oval o violation of any provisions of the federal,s r city
/� / ordinances. This set of approved plans must be k on the
if completion.
Scale: 0.09 in.oer ft,