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PMT17-02520 City of Menifee Permit No.: PMT17-02520 29714 HAUN RD. Type: Pool/Spa-Residential �A-CCEL/-> MENIFEE,CA 92586 MENIFEE Date Issued: 07/19/2017 PERMIT Site Address: 28759 ERIDANUS DR, MENIFEE, CA Parcel Number: 339-353-009 92586 Construction Cost: $30,000.00 Existing Use: Proposed Use: Description of IN GROUND POOL WITH 1 LIGHT 299 SO FT Work: Owner Contractor ZEFERINO&SHAWNNA CASTANON JOHN M GREGORIO 28759 ERIDANUS DRIVE 32063 CAMINO SENECO MENIFEE,CA 92586 TEMECULA,CA 92592 Applicant Phone: 9515063738 MIKE GREGORIO License Number:492386 32063 CAMINO SENECO TEMECULA, CA 92592 Phone:9513171756 Fee Description Oft Amount f$1 Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Electrical 1 23.35 $523.35 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_Permk_Template.rpt Page 1 of 1 wi X 3 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 o i am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and effect. the following reason: rrr� L_Wsetlass 1144 . 7i��ey License No. By my signature below 1 acknowledge that,except for my personal residence ExpiresS-3 1- I �A- 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 DECLA ON have built as an owner-builder if it has not been constructed in Its entirety by ❑I hereby affirm under penalty of pe ury one of th owing 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 website: by Section 3700 of the Labor Code,for the performance of work for which www.leginfo.m.gov/calaw.html. this permit is issued. Policy# Date ❑1 have and will maintain worker's compensaton insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which o 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 I have provided is correct.I agree to comply with all applicable city and county ordinances and state laws relating to Carrier building construction.I authorize representatives of this city or county to Policy# 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 certlfy that in the performance of the work for which this permit Is issued, shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# workers compensation laws of California,and agree that if 1 should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code, s a forthw'Fijyc Tj ith th s tovisions. Will the applicant or future building occupant handle hazardous material or a Applica I Oate 7'/`7-/' mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARN] FAILURETOS U E WORKER'S COMPENSATION COVERAGE IS ❑Yes �,No UNLA F L,AND SHALL UB CT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND C V FINES UP TO E UNDRED THOUSAND DOLLARS($500,000),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 forguidelines CONSTRUCTION LENDING AGENCY ❑Yes r b " - 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 "Po OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD / permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjurythat I am exempt from the Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning hazardous material re 'ng. checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 1W7T.0 No Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,prior to its PR RTY owr&O THORIZED AGEfW 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 OVATION REP Is State E A ENR AND PAINTING RRP License Law(Chapter 9(commencing with Section 7000)of Division 3 of the EPA Renovatio pair 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.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 I )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 ❑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: o 1,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. �\/ILni ,ee DATE V ` Lot `ZQl PERMIT/PLAN CHECK NUMBERPWF 1-1 "b2L5: 2_ 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 PROJECTADDRESS JL 7 _� E n da V\ t_ Jc,,1', 21594, ASSESSOR'S PARCEL NUMBER '�5_-5 C-5 3 -b0C) LOT TRACT PROPERTY OWNER'S NAME ,S 1G lnl 1'\ n C, n ADDRESS S C E r- c0.V \ LA ( S Lt ✓\ C I C �1 CI zS G PHONE �� -� JJ �QC'f ,� EMAIL APPLICANT NAME J Arm G C c - `% I G V� ADDRESS 151 p v&-, ',,A-Ao 1- I o -e- C K- PHONE q�-) 1 -7- 1 S (e EMAIL CONTRACTOR'S NAME I O� 1 OWNER BUILDER? [:]YES `[9NO l BUSINESS NAME ADDRESS yv� 1 Vl p PHONE EMAIL `'` C G 2 CONTRACTOR'S STATE LIC NUMBER 4CQ-3 '3L LICENSE CLASSIFICATION VALUATION$ D t7D SQ FT L SQ FT APPLICANT'S SIGNATUR DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PNNING EN ERING LA FIRE G EN SMIP INVOICE Er- 4jCj PAID AMOUNT AMOUNT VJ 2 ✓CASH OCHECK# OCREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT "CASH 'OCHECK# CCREDITCARD VISA/MC [OWNER BUILDER VERIFIED 4 YES 0 NO DL NUMBER NOTARIZED LETTER C YES 0 NO --- �- - City ot PA0111100 fety Dell. City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 9$1iN1 �$ 7 www.cityofinenifee.us Inspection Request Line 951-246-6213 JUL 19 2017 Deceived Tuscany Pool and Spa 32063 Camino Seneco, Temecula, CA 92592 Office 951- 255-0436 Lie. # 492386 To whom it may concern: 'V I, John Michael Gregorio, owner of Tuscana Pool and Spa hereby authorize Jane Tickey-Williams to pull permits from the city for ' Toscana Pool and Spa and also authorize Jane Tickey-Williams to apply v for a city business license and/or renew my license. 0 John IO�ichael Gregorio, ® er Tuscana Pool and Spa Sllfil� OF (� Fri IlPt 1 vnc //cl�,s, lx �z ;tee /Uo �h I� �ws�,c�il� azavcc� 6b�1/7 c ��Iw u vta vKx s gv�s�n i�cr¢ 2�t tvi7l rv�s�Vv/[e,,T u LINDA 1. 'n COMNi Nil " NOTARY PUBLIC-CALIFORNIA N RIVERSIDE COUNTY MY Comm.EXP.APR.5,207B' City of Menifee Building &Safety Dopt. JUL 19 2017 Received � CI 2 I . rM-L r? di e 7 I� „j7 a