PMT17-01516 City of Menifee Permit No.: PMT17-01516
29714 HAUN RD.
<-1CCEL/� MENIFEE, CA 92586 Type: Pool/Spa-Residential
MENIFEE Date Issued: 05/16/2017
PERMIT
Site Address: 25752 BUFFALO CIR, MENIFEE, CA Parcel Number: 358-502-019
92584 Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of INGROUND SPA, 120 SF,WITH U/G GAS LINE FOR FIREPIT
Work:
Owner Contractor
KEVIN GUTHRIE A CUT ABOVE CONSTRUCTION POOLS&
25752 BUFFALO CIRCLE LANDSCAPE INC
MENIFEE, CA 92584 26025 NEWPORT ROAD#A533
Applicant Phone:8007007754
CHRIS YOUNG License Number.672202
A CUT ABOVE CONSTRUCTION POOLS&LANDSCAPE INC
26025 NEWPORT ROAD#A533
MENIFEE, CA 92584
Fee Description OQt Amount 1E1
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
Inspections not specified 116 116.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Electrical 1 23.35
$638.35
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 carded 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_Bidg_Pennit Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION propertywho builds or improves thereon,and who contracts forthe projects
with a licensed contractors)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter!)(commencing with section 7000)of Division 3 of the Business and ❑I am exemptfrom licensure underthe Contractors5tate License Law for
Professions Code a d my license is in full force and epffe,,t c�J�.�y/ the following reason:
License Class 'ce o. l(v I L-L"`"
By my signature below I acknowledge that,except for my personal residence
Expires n Signatur 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
a 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 permit is issued. www.leeinfo.ca.eav/calaw.html.
Policy# Date
D 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 D 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 an the property owners behalf.I have read this
number are:
application and the information I have provided is correct.I agree to comply
Carrier 7 r r� l� ^'``ql with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# (3 7 Expires 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
a I certify that in the performance of the work for which this permit is issued,
I shall not emolov any persons to any manner so as to become subject to the CITY BUSINESS LICENSE It
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject tot w rker cot
visions of Section 3700 of the Labor
Code,I sh fortliwi coprovisions. �1 Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TOS 'S COMPENSATION COVERAGE IS o YesUNLAWFUL,AND SHALLSPLOYER TO CRIMINAL PENALTIES Will the int nded use of the building by the applicantorfuture building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the building
constructionbyeapplicant
li modification from South
ADDITION 3706 OF THE
LABOR CODE,COMPENSATION,DAMADATTOGES AS REYSFEOVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 370fi OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldelines
CONSTRUCTION LENDING AGENCY ❑Yes
I hereby affirm that under the penalty of perjury there is a construction Will the roposed 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
OWNER BUILDER DECLARATIONS I have re d the Hazardous Material Information Guideand the SCAQMD
permitting checklist I understand my requirements under the State of
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors License Law for the reason(s)indicated below 6y the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous at I rep ng.ayes
Business and Professions Code).Any city or county that requires a permit to ((( - Date I I
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY WNER O ORIZED AGE T
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 REPAI NO PAINT! G 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 licensure receiving compensation for most work that disturbs paint in a preracto
and the casts for the alleged exemption.Any violation it penalty of not o residence or childcare facility to be RRP-certified firms and comply with
th -1978
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 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.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-SOD-424-LFAD(5323).
Cade;The Contractors State License Law dam not apply to an owner of a D An EPA Lead-Safe Certified Renovator will he 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 Firma required for this project because:
a 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 APPLICATION
Menifee
DATE S' 77 PERMIT/PLAN CHECK NUMBER �y
TYPE: O COMMERCIAL SIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION '"ELECTRICAL O MECHANICAL
O NEW {MBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Q �- /].�' l�1 City of Menifee
PROJECTADDRESS - �11 'C� ,,..pp
ASSESSOR'S PARCEL NUMBER � GW
— �+ - OtCT LOT TRACT Received
OWNER NAME 2
ADDRESS 2_ S Z j/ &,1�IO CAL
PHONE — /Z,,z,"�—(p qZ EMAIL
APPLICANT NAME C!T"�u� YOWAlb
r
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME `� t_ PtftJ9T (� OWNER BUILDER? O YES )ONO
BUSINESS NAMME� `�,�- 1� /� ,p 7
ADDRESSq ZL¢02� U�v{ k / F C3
PHONE /5- ZLfq`-7? !�_ EMAIL
CONTRACTOR'S STATE LIC NUMBER 01 77ZU 2_ LICENSE CLASSIFICATION C
VALUATION$ `L J' ()`)D F / L SQ FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN - SMIP
INVOICE AMOUNT PAID AMOUNT 300- ,
O CASH O CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH 0 CHECK# 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 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213