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PMT17-01115 City of Menifee Permit No.: PMT17-01115 29714 HAUN RD. Type: Pool/Spa-Residential <A-CCELA> MENIFEE, CA 92586 MENIFEE Date Issued: 0411412017 PERMIT Site Address: 25860 WHITMAN DR,MENIFEE, CA Parcel Number: 339-051-032 92586 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INSTALL POOL AND SPA Work: Owner Contractor JAY STEWART A CUT ABOVE CONSTRUCTION POOLS& 25860 WHITMAN RD LANDSCAPE INC MENIFEE, CA 92586 26025 NEWPORT ROAD#A533 Applicant Phone:8007007754 CHRIS YOUNG License Number:672202 26025 NEWPORT ROAD#A533 MENIFEE,CA 92584 Fee Description Qtv Amount#SI Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Electrical 1 23.35 $522.35 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_Permt_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 contractors)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and in I am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and effect. the following reason: License Class C_S� Ucen ENo.�P�Z-`7�'l- 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 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.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.ca.gcv/calaw.htmI.permit is issued. Policy# Date in 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 ❑By my signature below I certify to each of the following:I am the property this permit is issued.My worker's 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 yy vU with all applicable city and county ordinances and state laws relating to ` Carrier�I I building construction.I authorize representatives of this city or county to Policy# \ S1 c b�l. Expires I ( / enter the above identified property for inspection purposes. (This section need not to he completed is the permit is for one-hundred e-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, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to tF�rthfi er' I co pensation provisions of Section 3700 of the Labor Code,I shalco ply wftUhose provisions. Will the applicant or future building occupant handle hazardous material Ora Applicant Date mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO 5 UR OR R'S COMPENSATION COVERAGE 15 ❑Yes o UNLAWFUL,AND SHALL SU PLOYER 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 ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction D modification from South IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)7 See permitting checklist for guidelines CONSTRUCTION LENDING AGENCY ❑Yes 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 ) 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 Contractor's License Law for the reason(s)Indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning h srdoygmoate Ire mg. checkmark(s)I have placed nett to the applicable item(s)(Section 7031.5 vC6ve- `� 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 AU RIZEDA T issuance,also also requires the applicant for the permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION REPAIR A D PAIN G IRRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Pa g(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 than($500). required practices.This includes rental property owners and property 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 of 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 Contractor's State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible forthis 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 provingthat it was not built or Improved for the purpose of sale, o No EPA Lead-Safe Certified Firm is required forthis 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 Contractor's 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. 6ullning 8 sefe'gCot,l,,. Menifee Receovec DATE PERMIT/PLAN CHECK NUMBER WIT 11 - O «�� TYPE: O COMMERCIAL '.MESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O(ELEcTRICAL O MECHANICAL O NEW (PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK � V PROJECTADDRESS Zsld1017 WI'fI�MtUf kt-- 61�� ASSESSOR'S PARCEL NUMBERLOT 4� TRACT OWNER NAME SIT 5�11, 11,� ADDRESS GJ /W-- PR E MktAJ fob PHONE S�- - lY EMAIL vnn��Lnn y APPLICANT NAME WLSu ADDRESS PHONE EMAIL CONTRACTOR'S NAME C ' lL OWNER BUILDER? O YES . 0 BUSINESS NAME ADDRESS �ZtDc�-Z� CJ'A PHONE q Z�(��7SY EMAIL /_ 7 CONTRACTOR'S STATE LIC�NcU[MMBER � G-ZZ3-Z— LICENSE CLASSIFICATION cgs 3 VALUATION$ ��1/� SO FT L SQ F(T,/�^ -7 APPLICANT'S SIGNATURE ( DATE e DEPARTMENT DISTRIBUTION 1 CITY OF�I Q`E/NIF�E'E,BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN S P INVOICE 54ge %- PAIDAMOUNT AMOUNT J 6 LL 0 CASH <,CHECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92596 951-672-6777 www.cityofntenifee.LIS Inspection Request Line 951-246-6213