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PMT17-02054 City of Menifee Permit No.: PMT17-02054 29714 HAUN RD. Type: Pool/Spa -Residential '(XC ' LR> MENIFEE,CA92586 MENIFEE Date Issued: 06/22/2017 PERMIT Site Address: 26289 ADELINA DR, MENIFEE,CA 92584 Parcel Number: 360-600-012 Construction Cost: $30,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA,458 SF,WITH U/G GAS AND ELECTRIC LINES FOR BBQ ISLAND Work: Owner Contractor CURTIS&HEIKE DYDELL INFINIUM CONSTRUCTION 26289 ADELINA DRIVE 42801 LARRY LEE LANE MENIFEE, CA 92584 TEMECULA,CA 92592 Applicant Phone:9517979476 RICK MCROBERTS License Number: 976676 INFINIUM CONSTRUCTION 42801 LARRY LEE LANE TEMECULA, CA 92592 Fee Description Qtv Amount tS) Receptacle, Switch, Outlet&Fixture 1 116.00 Swimming Pool/In-Ground Spa 1 467.00 Plumbing Fixtures and Vents,fixtures 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Electrical 1 29.15 $761.15 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_Perrnit 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 Contractor's State License Law for Professions Code and my license is in full force and effect the following reason: t — 91&(, � License�Ctla�ss,L�3 License No. By mysignature below l acknowledge that,except for my personal residence Expires'/3 t11 I 1 Signab+ in which I must have resided for at least one year odor to completion of T'� improvements'covered by this permit.l cannot legally sell a structure that I WORKER'S COMPENSATION DEC RATION have built as an owner-builder if it has not been constructed in its entirety by ci 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 www.Ieainfc.ca.Roy/caIaw.htmI.permit Is Issued. Policy# Date ,4I have and will maintain workers compensa0on 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 owners behalf.I have read this number ar • / ' application and the information I have provided is correct.I agree to comply Can--- IS CW t`-c g r f-A- C �Woc,4 ti with all applicable city and county ordinances and state laws relating to }) d�36 building construction.I authorize representatives of this city or county to Policy# �L Expires 'Z Z / k enter the above identified property for inspection purposes. (This section need not to he completed Is the permit is for one-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 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 3700 of the Labor Code,I shall forthwit Iywith-tho rowsions. // Will the applicant or future building occupant handle hazardous material or Appli tnt i Date (O'm-0 mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FA ECURE WORKER'S COMPENSATION COVERAGE IS o Yes o No 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 for guidelines CONSTRUCTION LENDING AGENCY u Yes o No 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 ❑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 Contractors License Law for the reason(s)indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Oyes ❑No 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 AUTHORIZED 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-certified firms and comply with an Applicant fora permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their o I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit.- compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a ciAn EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the Improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or Improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. O No EPA Lead-Safe Certified Firm is required for this project bemuse: ❑1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. APPLICATION& SAFETY PERMIT/PLAN CHECK 4 • Yr 5 Menifee DATE k'22-17 PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF//SQUARES p DESCRIPTION OF WORK pd lv A?0- + - BS4J PROJECTADDRESS o 6O US4, /I/)(//" /5)" ASSESSOR'S PARCEL NUMBER -3L00-l0C0-0%a LOT TRACT BUIId ntY & =t I')6 t OWNERNAME `��y?I,$' /.4 14010 ADDRESS Zp 1y7'I�F.�IY� �✓ PHONE -7I10J39 Ia T' I- �S EMAIL Receive APPLICANT NAME n� t 64 ADDRESS .} - PHONE EMAIL IG,C�Tt1�POvL�L Gi{jeo• (fin.•.• CONTRACTOR'S NAME 1iV,-1M 11 A•l �pn •S'�-rvlG�°j- OWNER BUILDER? OYES SRO BUSINESS NAME ADDRESS 327St9 Jlg/lel p /,,J/✓JGfi/� PHONE 951 2il(o -'j'IS 'I EMAIL CONTRACTOR'S STATE LIC NUMBER 176,1g7-2 LICENSE CLASSIFICATION VALUATION$ U)WL) SOFT 4Sa LSQFT �7 APPLICANT'S SIGNATURE "� DATE 6-22 1 / DEPARTMENT DISTRIBUTION ICITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN 0 SMIP INVOICE '' AA PAIDAMOUNT O O AMOUNT -7L0 • �Jb • '� CASH 0CHECKq CREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# 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 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 ------------------------------------------ JTER WALL WITH 'OOL COPING, °' ENEER � + 12" POOL WALL V W A P/A P/A P/A 6„ ------------------------------------------------------ i P/A 12" "3/4" POLY GAS LINE FOR BBQ AND 1" ELECTRICAL CONDUIT BAJA SHELF WITH UMBRELLA SLEEV POOL EQUIPMENT n' NEW GREY CONCRETE WITH BROOM FINISH 9' 3 CITY 0 BUILDI EXISTING 6' BLOCKp L�N A WALL REVIRA © ACCESS: INFINIUM TO REBUILD �APP�walofl SECTION OF WALL AND approval of, REINSTALL GATE TO CODE regulations an jobsite until cc