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
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Cr and Ti May
27841 Ridge Drive
Menifee CA 92585
Taylor • l ` Pools,
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