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PMT17-01740 City of Menifee Permit No.: PMT17-01740 29714 HAUN RD. �A-CCELA7-. MENIFEE,CA 92586 Type: Pool/Spa-Residential MENIFEE Date Issued: 0 6/0 212 01 7 PERMIT Site Address: 25895 FARMINGTON RD, MENIFEE,CA Parcel Number: 358-100-054 92584 Construction Cost: $34,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 436 SO FT Work: Owner Contractor CHRIS&TAMMY FIELD TAYLOR MADE POOLS INC 25895 FARMINGTON RD 18795 OAK VIEW WAY MENIFEE, CA 92584 LAKE ELSINORE, CA 92530 Applicant Phone:9518166444 GEORGE BOULLON License Number.795053 TAYLOR MADE POOLS INC 18795 OAK VIEW WAY LAKE ELSINORE, CA 92530 Fee Description Oty Amount i$1 Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 5.00 General Plan Maintenance Fee-Electrical 1 23.35 $524.35 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 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 .41 am exempt from licensure under the Contr ctor's State License Law for Professions Code and my license is in full farce and effect. +-fig the following reason: /Y6 �`�i✓�i CQS License Class License l !/�� By my signature below I acknowledge that,except for my personal residence Expires Signature i 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 forworker'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.leeinfo ca aov/calaw.html. this permit is issued. Policy# Date PROPERTY OWNER OR AUTHORIZED AGENT ❑I have and will maintain worker's compensa ton 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: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 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 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 tPLI-certify that in the performance of the work for which this permit is issued, O�r L r' 1 shall not emolov any persons in any manner sous to me subject to the CITY BUSINESS LICENSE# • v worker's compenVC1, f California,an at if I should become HAZARDOUS MATERIAL DECLARATION subject to the wonsa ' n pr of Section 3700 of the Labor Code,I shall fo ovisions. Will the applicant or future building occupant handle hazardous material or a Applican � Date mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURETO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes iNo UNLAWFUL,AND SHALLSUBIECT 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 ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit t construction or modification from South IN SECTION 3706 OF THE LABOR CODE;INTEREST,AND ATTORNEYS FEES - Coast Air Duality Management District(SCAQMD).See permitting checklist fogguidelines - —-- - _ --` - ---'-- - --- CONSTRUCTION LENDING AGENCY ❑Yes Xwo 1 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 ^o OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I unders and my requirements under the State of California Health&S e ode,Section 255 an 34 Concerning Contractor's License Law for the reason(s)indicated below by the hazardous matey' rting. �e checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 . es ❑No Business and Professions Code).Any city or county that requires a permit to to construct,alter,improve,demolish or repair any structure,prior to its PROP TY OWNER OR THORIZED 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 Contractor's 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 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($500). managers who do the paint-disturbing work themselves or through their o I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Lode:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. APPLICATIONBUILDING & SAFETY PERM IT/PLAN CHECK ,Menifee DATE PERMIT/PLAN CHECK NUMBER I TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME WPOOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL *NEW OPLUMBING ORE-ROOF-NUMBEROFSQUAR DESCRIPTION OF WORK /ILEGd 4C� S C�GIS /U ra PROJECTADDRESS 2 G ,/ 1 ASSESSOR'S PARCEL NUMBER 3S0 �Ob—( +� LOT TRACT OWNER NAME ADDRESS PHONE EMAIL APPLICANTNAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME ��j�/y/{�� f(C OWNER BUILDER? O YESA(�ZLO BUSINESS NAME ADDRESS PHONE 9S/ � �a�y EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ 3'f,4D0 SSQQ FT L SQ FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF MENIFJ�D WSLI I SE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE ?jS PAID AMOUNT C O AMOUNT CASH CHECK# 0CREDIT CARD VISAIMC PLAN CHECK FEES PAID AMOUNT OCASH 0 CHECK# •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 Access FIFLD RFS , �5895 FftRMlNg7a,� �c�- Ieech fieM low 7A.a k ///propane eiecOk fan panel O,y a- ;F1.1cRas1denca ayaeating deck - garages di v y � I �10g' POe � r gale 9 El�tcTMA�N City R Safety Dept. Building JUN 0 2 2017 Fenced animal area Fenced animal area Receive CITY OF MENII EE BUILDING AND SAFETY EPARTMENT PLAN APPROVAL >- V Y-VIEWED '�Y _-- DATE (� gae US :.„••,.lal esr7lan.,F..iloort ,f)^:tr:xd be a permit for,or an V i-h: ` decal stat=or rite �- pml.ed pf @¢C t:t4St bl kegt 011 regula,ions and ordilia res. � % "�' pr•^� �. to Lj ccmplet o .. ExWdre gem