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PMT17-02360
City of Menifee Permit No.: PMT17-02360 29714 HAUN RD. �AICCEL/? MENIFEE,CA 92586 Type: Residential Plumbing MENIFEE Date Issued: 07/10/2017 PERMIT Site Address: 30425 CURZULLA RD, MENIFEE, CA Parcel Number: 472-040-029 92596 Construction Cost: $5,000.00 Existing Use: Proposed Use: Description of LEACH LINE ADDITION,3-66'CHAMBERS Work: Owner Contractor MR&MRS MCMAHON LANK ENTERPRISES•INC 30425 CURZ0LLA RD P 0 BOX 891416 MENIFEE,CA 92596 TEMECULA, CA 92589 Applicant Phone:9516767114 ASHLEY TAYLOR License Number:458947 LANIK ENTERPRISES INC P O BOX 891416 TEMECULA, CA 92589 Fee Description OQt Amount($1 Sewer 1 150.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 7.50 $185.50 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 Pennit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of 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: License Class T7 Q C M — License o.U By my signature below 1 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.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 o 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.leginfo.ca.gov/calaw.htmi. this permit is issued. Policy# RWCC3693t PROPERTY OWNER OR AUTHORIZED AGENT Date ❑I have and will maintain worker's compensation 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 worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this numbera4re: cc-- � application and the information I have provided is correct.I agree to comply Carrier [ « YLJL t_Q Ci�< 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 l!1- 1 Ila% enter the above" ed property for inspection purposes. �7 (This section need not to be completed is the permit is for one-hundred Date 7 t1 1 dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is issued, �2 I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE Ifr7 ' worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall for i[I m with those provisions. Will the applicant or future building occupant handle hazardous material or a A licant Date mixture containing a hazardous material equal to or greater that the PP amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURN6 SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes ,efjo 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($300,000),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 ❑Yes 940 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 W qo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that 1 am exemptfrom the permitting checklist.I understand my requirements under the State of Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning hazardous material reporting. a checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 pyes ❑No 1 'r• Business and Professions Code).Any city or county that requires a permit to Date 1 ED a 1 �,. construct,alter,improve,demolish or repair any structure,priorto its PROPERTY OWNER OR AL AGENT r. issuance,also requiresthe applicantforthe pennitto file a signedstatement 4 that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI 11.. License Law(Chapter 9(commencing with Section 7000)of Division 3 of the y^ The EPA Renovation,Repair and Painting(RRP)Rule requires contractors g' 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 F 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 ❑I,as ownerof the property,or my employee with wages as theirsole 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 Contractor's State License Law does not apply to an owner of a P O An EPA Lead-Safe Certified Renovator will be responsible forthis 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 because: ❑1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code: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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ienifee DATE PERMIT/PLAN CHECK NUMBER I -O;t5w TYPE: ❑COMMERCIAL []RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL ]NEW ❑✓ PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Leach line addition,3-66'chambers PROJECT ADDRESS 30425 Curzulla Rd. Winchester CA ASSESSOR'S PARCEL NUMBER 472-040-029 LOT �_ TRACT PROPERTY OWNER'S NAME Mr.&Mrs.McMahon ADDRESS 1162 San Vicente Rd. Ramona CA PHONE (760)7895752 EMAIL APPLICANT NAME Ashley Taylor ADDRESS 28822 Old Town Front St. Temecula CA PHONE (951)676-7114 EMAIL Carly@lanikseptic.com CONTRACTOR'S NAME Gordon Lank OWNERBUILDER7 ❑YES©NO BUSINESS NAME Lanik Enterprises, Inc ADDRESS P.O.Box 891416 Temecula CA PHONE (951)676-7114 EMAIL Carly@lanikseptic.com CONTRACTOR'S STATE LIC NUMBER IISM4-1 1 LICENSE CLASSIFICATION A,B&C42 VALUATION$ $5.000.00 SO FT L SQ FT APPLICANT'S SIGNATURE DATE 07/07/2017 DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN I SMIP 0&0 R 51 / INVOICE IaL` �yO PAIDAMOUNT AMOUNT O.7 O CASH OCHECKp O[REDn'CARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH 0 CHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92586 951-672-5777 www.cityofinenifee.us Inspection Request Line951-246-6213 County of Riverside Leac1l,'L - _ DEPARTMENT OF ENVIRONMENTAL HEALTH www.rivcoeh.org OWTS INSPECTION CARD APN: 106L— 040 — O'OLC1 Permit No.: ON ( 72—) Site Address: 3O4aS C.urztlllo, City: Mylc,�nQJ+Qx- Zip: OQ,�y To schedule an inspection please call ARiverside 951-955-8980 or ❑ Indio 760-863-7570 All cancellations/reschedules must be received prior to gam on the day of inspection or additional fees will apply. OWTS Components Date Re-Inspection Inspector of Inspection Date Initials p icT IA.Op a each In /Bed3 (,(,� Seepage Pits tm OLY adat Septic Tank Abandonment d. 06tw Sewer Lateral "iS 'F uivl D- o ht.�1A isers 9, yNit4*1OA U VK ffluent Filters Final Inspection TOSEPOSTEDATJOSSITEINPLAIAI VIEW EPO-55(REV 4/16) City of Menifee Building 8 Safety Dept. JUL 10 2017 Received n 0 r r County.of Riverside DEPARTMENT OF ENVIRONMENTAL HEALTH www.rivcoeh.org ~ LAND USE APPLI�ATRJ of Menffee UI ding 8 Safety Dept. OFFICE USE ONLY 3880 Lemon Street•Suite 200•Riverside•CA•92501-(951)955-8980 PE CODE: FEE: ❑47-950 Arabia Street•Suite A•Indio•CA 92201-(760)863-7570 JUL 19 2017 _D i li z 4 EHS# 1-7C)5 ON# �7n LMS# APN: TRIPM PM -71-7.7 LOT# O�• USEOFPERMIT: SECTION A vkC Name Qt OWNER: Address 3b Z LJL%%@1 Ci M n� ee Zip `Phone '760 - -1 Z Email ` Company Name A ent/Contractor AGENT/ CONTRACTOR: Mailing Address 1611 city t(, a- CONTRACTOR: r Phone - I Email PROPERTY INFO: SlteAdtlress b ? u t,1t1� City W►hC Y Zi 8 Waler Agency/Well Lot Size 0q APPLICANTS SIGNATURE: DATE: ?IS SECTION.:. Below-For Office Use Only CC c / CHECK is checked,lths application shall be considered denied until the Information Is provided. �.]i-7 0 S c5.� PCAfr �❑o!Holding Tank Agreements Required ❑Floor Plan and/or Plumbing LayoUT Required ACertilicate of Existing OWTS Required(C42) ❑Special Feasibility Boring Report Required ❑WQCB Clearance Required ❑Detailed Contour Plot Plan Required 0 to 5 foot intervals) ❑Solis Percolation Report Required SI E EVALUATION INSPECTI R MARKS: OLI c k% EHS INITIALSIDATE: SECTION C. ❑NEW REPAIR I REPLACEMENT ❑EXISTING ❑PUMP ❑ATU ❑CONNECT TO SEWER I FIXTURE UNITS# BDRMS# Soils Percolation/Boring Report By: Date: Project# C42 Certification By: Date: License# '1 T O�aYt Lavin t �.�l�- 4 a o1i{'7 Septic tank cap.: Soil Rate: Tested Depth: Max. trench depth: trio dtlo,.� 'Xi y CPr)rfs�1 Sq.FL Bollrom Area: Total Linear FL: Line(s): /' &ALf IQIS LF Len the �VV10 feet - Each3feetwide Sidewall Allowance: Ft.Rock) Sq.ft.Running foot Rock below drain line: _in. or *Iastic Chambers r Leach Lines/bed special design for slope: ❑N/A ❑Overburden Factor: Pit Diameter: No.pits: Depth below Inlet(bi): Pit Total Depth: Max..allowabled epth: CONSTRUCTIO /IN TALLAT ON REMARKS, I' w1 Ids N t l OL U, . 1� W I �/XlS E1 u SECTION D This Application is 6'�Approved O Denied regarding the design of the OWTS as indicated on the accompanied.plot plan using the requirements set forth in Section C above.No constructloy is permitted in the required reserved 100%Expansion area. EHS Signature: Dale: Qs I7 khw FPO-921REV 7116) DisUroultm:WHITE-Me Fria:YELLOW-81,1 .O.pt.PINK-Apacanl