PMT17-02347 City of Menifee Permit No.: PMT17-02347
29714 HAUN RD.
�!-ICCEL/-> MENIFEE, CA 92586 Type: Pool/Spa -Residential
MENIFEE Date Issued:
07/07/2017
PERMIT
Site Address: 27067 NORTH BAY LN, MENIFEE, CA Parcel Number: 333-440-027
92585 Construction cost $44,030.00
Existing Use: Proposed Use:
Description of INSTALL POOL AND SPA WITH GAS AND ELEC LINES FOR POOL EQUIPMENT
Work:
Owner Contractor
EDWARD SALAS MAJESTIC POOL CONSTRUCTION
27067 NORTH BAY 31566 RAILROAD CANYON ROAD
MENIFEE,CA 92585 STE 2#106
Applicant Phone:9514456384
JEREMIE DYE License Number:889638
MAJESTIC POOL CONSTRUCTION
31566 RAILROAD CANYON ROAD
STE 2#106
CANYON LAKE, CA 92587
Fee Description gty Amount f$)
Swimming Pool/in-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 2.00
SMIP RESIDENTIAL 1 6.00
'General Plan Maintenance Fee-Electrical 1 23.35
$525.35
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 Pagel 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 ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code and mylicense Is in full force and effect. the following reason:
License Class C6-✓ UG License No.Myo 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.l 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 wehsite:
by Section 3700 of the Labor Cade,for the performance of work for which
this permit is issued.
www.leftinfo.ca.i!ov/calaw.htm].
Policy# /��CJ� ( � f/(Y Date
❑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 workers compensation insurance carrier and policy owner or authorized to act on the property owners 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
�y ,n building construction.I authorize representatives of this city or county to
Policyp�l3T�® / 1 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
❑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 g
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 fort with com i those provisions. Tim y �Z�I/7 Will the applicant or future building occupant handle hazardous material or a
Applicant GC Date Yam! ! 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 Yes ❑No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES Will the Intended use of the building bythe applicantor 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
ADDITIONTOTHECOSTOF COMPENSATION,DAMAGESAS PROVIDED FOR Coast Air Quality Management District(SCtionor modification
permitting checklist
IN SECTION 3796 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY Yes ❑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) ❑Yes NNO
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
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&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 .hazardous material re%yam/(ing. 777
Business and Professions Code).Any city repair
that requires a permit toconstrucl n�G/ Date
issuance,also alter,improve, applicshorrepairanysttofile ,signeor d
to its PR RTYOWNER ORA HORIZED 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(RRPI
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 Cade)or that he or she is exempt from licensure of not receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the allegedexemption.Anyviolation of Section residence or childcare facility to be RRP-tertified firms and comply with
than
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
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
property who,through employees'or personal effort,builds or improves the O An EPA Lead-Safe Certified Renovator will be responsible for this project
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
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.
,IkMenifee
DATE Uv! C ZOl7 PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL []RESIDENTIAL MULTI-FAMILY ❑MOBILEHOME [aPOOL/SPA []SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL
❑NEW [-]PLUMBING El RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK IW6 fi
11
y�11 /f))
PR01ECTADDRESS 270tel OoR H Gft/(
ASSESSOR'S PARCEL NUMBER �>33 -+40 - dad LOT TRACT G{�
PROPERTY OWNER'S NAME
'ADDRESS -70 w UA L41 iX-e ,den Ise c ,
PHONE ��S�P �7� 01 q ( EMAIL
APPLICANT NAME Ci
ADDRESS
PHONE EM/AI`L,
CONTRACTOR'S NAME JO 6&Z OWNERBUILDER7 ❑YES❑NO
BUSINESS NAME
ADDRESS
PHONE `7`��� ,�p� (� / EMAIL
CONTRACTOR'S STATE LIC NUMBER g 8'((,0 J(z�% LICENSE CLASSIFICATION C s�
VALUATION$ Wow o SO FT L SQ FT y y
APPLICANT'S SIGNATURE DATE N(-,y
DEPARTMENT DISTRIBUTION �/J CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP T i ' o
INVOICE 525.AMOUNT (� 7� PAID AMOUNT 0CASH 0CHECK# OCREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH OCHECK# 1)CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 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
�z
1
�4*OkAAJIESTIC
Pool Construction
(951)445-6384
To Whom it may concern,
This letter confirms that Jeremie Dye is an employee/agent of Majestic Pool
Construction. He is completely authorized to request and/or receive construction permits
and business licenses as part of his normal duties.He is also authorized to provide
payment for such items either by company check or credit card.
If you have any questions please feel free to call me or my office at any time.
Respectfully,
President Date
C53-889638
Obie Rodriguez
Majestic Pool Construction
(951)445-6384
majesticpoolconstruction@outlook.com
C
N
E
_ n
m 3
� w
n
0
o
m
� N
3
�Q� v m
c
a um
3 w
zc c�0
O O t G N
C � �
U
N � O N J Cq Yl u1
6 C
O J N
N to
C 0] ti NO]N�
O ti O
=a o m
fV
O O
O Q O
C U
J C
vs
nt
0
ae
I