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PMT17-02468 City of Menifee Permit No.: PMT17-02468 29714 HAUN RD. Type: Pool/Spa -Residential {ACCELA? MENIFEE,CA 92586 MENIFEE Date Issued: 07/14/2017 PERMIT Site Address: 26310 ADELINA DR, MENIFEE, CA 92584 Parcel Number: 360-600-005 Construction Cost: $16,000.00 Existing Use: Proposed Use: Description of NEW 14 X 281N GROUND VINYL LINER SWIMMING POOL. NO GAS, ELECTRICAL ONLY. ONE LOW Work: VOLTAGE LIGHT. Owner Contractor ANDRE CUTHBERTSON SECARD POOLS 26310 ADELINA DRIVE 9292 NINTH ST MENIFEE,CA 92584 RANCHO CUCAMONGA, CA 91730 Applicant Phone:9099804407 RICARDO JOYA License Number:233403 9292 NINTH ST RANCHO CUCAMONGA, CA 91730 Phone:9094770373 Fee Description O_yt Amount ISI Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 3.00 General Plan Maintenance Fee-Electrical 1 23.35 $521.35 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 carded 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 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). hereby affrm under penalty of perjury that I am under provisions of apter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from Iicensure under the Contractor's State License Law for rofessions Code and my license is in full force and effect. the following reason: License Class �.S License o. Z. 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 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 ❑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 vvwwleeinfo.ca.zmv/calaw.html. this permit is issued. Policy# Date ❑I have and will maintain worker's compensaLlon 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 worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number are: application and the information 1 have provided is correct.1 agree to comply Carrier LIZFi with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# SQ5C1 15W 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# worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's comp ions of Section 3700 o ytheabor Code, orthwit with[ oovisions. y Will the applicant or future building occupant handle hazardous material or Code,I sh orthwit vvitht 0� Appllca t Date ! mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide. WARNING:FAILURE TOSEC� WORKER'S COMPENSATI COVERAGE IS ❑Yes An UNLAWFUL,AND SHALI.5CIBIECT 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)7 See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guideli ,es CONSTRUCTION LENDING AGENCY 0Yes ono 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 bouryfery of a school? (Section 3097 Civil Code) ❑Yes o 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 California Health&Safety Code,Section 255 d 25534 conce ing Contractor's License Law for the reason(s)indicated below by the hazardous in repo checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es o Business and Professions Code).Any city or county that requires a permit to - Date lTpr construct,alter,Improve,demolish or repair any structure,prior to its PROP R OR ALIT D A T 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 Contractor's State EPA RENOVATION REPAIR AND P NTING IRRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repai nd 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 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 Contractor's 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. ❑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 kMenifee DATE 7 / 1:7 PERMIT/PLAN CHECK NUMBER PV/ I P —Q14ILQ9' TYPE: O COMMERCIAL `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 DESCRIPTION OF WORK M 2 N V l_Ilu tital 00 L4. � PROJECTADDRESS 3(D /,J 172., 92�D% ASSESSOR'S PARCEL NUMBER 3(ob(o- Qlhm -0,cS LOT (yQ TRACT OWNER NAME - a ADDRESS - PHONE ((,10) 452 ' 1511 EMAIL APPLICANT NAME A ADDRESS 9ZR2- M,yrg S1• PHONE EMAIL Y' C 6cd,'L.f) LS.COM CONTRACTOR'S NAME SocAQb Ls OWNER BUILDER? O YES O NO BUSINESS NAME Lc L5 ADDRESS 'Z NWTt.L Sr. PHONE f Tg) 1750-(p74.1 EMAIL CONTRACTOR'S STATE LIC NUMBER �33q-p3 LICENSE CLASSIFICATION C- 5 .3 VALUATION SQ FT 3y2 L SQ FT APPLICANT'S SIGNATURE DATE OTYSTAFFUSEONLY DEPARTMENT DISTRIBUTION CITY OF CM-EENNIIF--E-EE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP ` �L/ ✓ INVOICE PAID AMOUNT �, L ��• O CASH O CHECKk CREDIT CARD VISA/MC N CHECK FEES PAID AMOUNT OCASH OCHECK# 0CREDITCARD VISA/MC UILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO 0 City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 925�"0972 67 Gaiety www.cityofinenifee.us Inspection Request Line 951-246-6213 �UL 14 2011 Received Ca Pools, Inc. 9292 NINTH STREET,STE.B e 4RANCHO CUCAMONGA,CALIFORNIA 91730 (909)980-4407 August 9,2016 LETTER OF AUTHORIZATION To whom it may concern, Secard Pools, a Corporation, hereby authorizes Ricardo Joya (R.J.), Permit Tech, to act as a representative on behalf of our company. He is authorized to get business licenses, pull permits, appear in a court of law and act as any necessary agent required by entities he may incur. This will include, but is not limited to, the counties of Los Angeles, Orange, San Bernardino, Riverside, Ventura and San Diego. This authorization is imposed as valid today on August 9, 2016 and will remain J valid until August 8, 2017. Thank you. ,� I City of Menifee ( �1 Building &Safety Dept. JUL 14 2017 I ReceWd x oe Secard President x Robert Cannon, Notary (� x ` 7 ROBERT CANNON Jodi Secard Kidder ��—' ,' COMM. #2002481 m Notary Public-CalAomla N CFO/Secrets BANBERN MN0000NIY M Comm.F .DEC.X"2 16 OFFICES AND SHOWROOMS IN 14' LL CEO Q �Ho11.pW DEEP W a� U U. WDEa O CE) C DVE2 Cwe2 tbou PHT Uoo� VECIPACAL �q•9 a(a310 ADEl.iu4 "D2. i �a (E) C'jAQI��E. W A- :Y N t