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PMT17-02348 City of Menifee Permit No.: PMT17-02348 _ 29714 HAUN RD.{ Type: Residential Addition 7•CCEL/� MENIFEE,CA 92586 MENIFEE Date Issued: 07/07/2017 PERMIT Site Address: 27841 LAKE RIDGE DR, MENIFEE, CA Parcel Number: 333-352-013 92585 Construction Cost: $36,000.00 Existing Use: 1 &2 Family Residence Proposed use: Description of NEW INGROUND POOL&SPA 420 SO FT WITH 2 LIGHTS Work: Owner Contractor JAMES&TERESITA MAY TAYLOR MADE POOLS INC 27841 LAKE RIDGE DRIVE 18795 OAK VIEW WAY MENIFEE, CA 92585 LAKE ELSINORE,CA 92530 Applicant Phone:9518166444 GEORGE BOUILLON License Number:795053 TAYLOR MADE POOLS INC 18795 OAK VIEW WAY LAKE ELSINORE, CA 92530 Fee Description OQt Amount t$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_Penni[_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). Chapter!](commencing with section 7000)of Division 3 of the Business and Lam exempt from llcensurglunder the CCoent cto/ls State License Law for Professions Cade and my 2license is In fuLicoen and ffe the following reason: L� License Class /��� �sG�S By my signature below l acknowledge that,except for my personal residence Expires !,Signature In which l must have resided for at east one year prior to camPletionof WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a'structure that I have built as an owner-builder if it has not been constructed in its entirety by D 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 ofselFinsure 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 ,Mv,N leeinfa.ca.¢av/calaw.html. this permit is issued. Policy if 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 forwhich ,_By my signature below I certify to each of the following:I am the property this permit is issued.My workers compensation insurance carder and policy owner or authorized to act an 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 cis struction.l authorize sentatives of this city or county to Policy Expires enter e identified pro for inspection purposes. (This section need not to be completed is the permit is for one-hundred !-� Date d /L� dollars($100)or less rROPERTY OWNER OR AUTHORIZED AGENT XI certify that in the performance of the work for which this permit is issued, O�/ I 1 shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE N . 9 workers compensation ws f California,and ag e t if I should become HAZARDOUS MATERIAL DECLARATION subject to the warkgd pensation provisi Section 3700 ofth bar Cade,I shall forth t omply has tsions. Will the applicant or future building occupant handle hazardous material or Applicant a Date 3er�G 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 Dyes Po UNLAWFUL,AND SHALL SUBIECTAN 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 3THE COSTLAB OF OR CODE,INTEREST, ADATTOGES AS REYSFEOVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,IN7EREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY OYes mWo 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 Cade) D Yes pb.No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD hereby affirm under penalty of perjury that l am exempt fromthe permitting checklist.I understand my requi errs under the State of Contractors License Law for the reason(s)indicated below by the California Heait &:11rpfery tje,Se 505 and 25534 cancer rag checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous ao Business and Professions Code).Any city or county that requires a permit to PCes o J construct,alter,improve,demolish or repair any structure,prior to its Date/� / 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 IRRP) 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.Anyvfolatfon 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 a 1,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 ofor( )portion of the work,and the structure is www.eoa.euv/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 D 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. D No EPA Lead Safe Certified Firm is required for this project because: D 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 s Menifee DATE b D1 'LD PERMIT/PLAN CHECK NUMBER OT M—D 4J4 TYPE: [-]COMMERCIAL []RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION [—]ALTERATION ❑DEMOLRION ❑ELECTRICAL ❑MECHANICAL ❑NEW, /❑` 'PLLUUMMBING ❑/RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK VV i h � pp h y / PROJECT ADDRESS ASSESSOR'S PARCEL NUMBERS ,�`2T'O�3 LO TRACT PROPERTY OWNER'S NAME G�.Arr�� /�/ Sj O / ADDRESS d� ��y�Gf PHONE 9S/-1� 13 -���� EMAIL APPLICANT APPLICANT NAME ADDRESS PHONE / y AIL CONTRACTOR'S NAME / / / OWNER BUILDER? 0YESaIO BUSINESSNAMEQ7 ADDRESS O ! /�/it/ �� /s✓O�,� C PHONE �S� s������ EMAIL CONTRACTOR'S STATE LIC NUMBER LICE dSE CLASSIFICATION C S� VALUATION$ ---76�,49V llt� SO FT L SO FT �D Z-- APPLICANT'S SIGNATURE DATE / RON DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE ��r 1 PAIDAMOUNT AMOUNT �'f' OCASH 0 CHECK# 0CREDIT CARD VISA/MC ij PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# OCREDIT CARD VISA/MC OWNER BUILDERVERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO Building & a ty ept. City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586951-672-6777 www.cityofinenifee.us Inspection Request Line 140-I22011 Received l Illlllf:l l411Hl_ _�iilg�illIEI11E,_ � 1 , flllil�l!1{IIIII _lfifllaflijjlll_ \� ��;�I' 1011 Equipment lam I I ■ • e<a. Cr and Ti May 27841 Ridge Drive Menifee CA 92585 Taylor • l ` Pools, r..