PMT17-02573 City of Menifee Permit No.: PMT17-02673
29714 HAUN RD. Type: Pool/Spa-Residential
�A_Ccl_=O� MENIFEE,CA 92586
MENIFEE Date Issued: 0 712 512 01 7
PERMIT
Site Address: 28690 MAHOGANY TRAIL WAY, Parcel Number: 333-690-030
MENIFEE,CA 92584 Construction Cost: $39,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA, 370 SF,WITH ROCK GROTTO&SLIDE
Work:
Owner Contractor
SUSANNE VOHS QUALITY CUSTOM POOLS INC
28690 MAHOGANY TRAIL WAY 30138 MARNE WAY
MENIFEE,CA 92584 MENIFEE,CA 92584
Applicant Phone: 9516799732
HANNAH BARRETT License Number..795820
QUALITY CUSTOM POOLS INC
30138 MARNE WAY
MENIFEE,CA 92584
Fee Description ON Amount ISI
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 2.00
SMIP RESIDENTIAL 1 6.00
General Plan Maintenance Fee-Electrical 1 23.35
$525.35
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_Permit_Template.rpl 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 perjurythat 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 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 CS3 p Licensee No. _ 9 S$2.0 By my signature below I acknowledge that,except for my personal residence
le—
Expires 2sa 1-1 —E Signature Z b-t- :K� in which I must have resided for at least one year pdorto completion of
improvements covered by this permit.I cannot legallysell 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 ofthe following declarations:I licensed contractors.I understand that a copy ofthe applicable law,Section
have and will maintain a certificate of consent ofself-insure for worker's 7044 ofthe 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.leginfii.ca.gov/caIaw.htmI.permit is issued.
Policy# Date
,a'lhave and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 ofthe 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.1 have read this
number are: application and the information I have provided is correct.I agree to comply
Carrier Eu ergs{ N>tf oy%o A with all applicable city and county ordinances and state laws relating to
1 building construction.I authorize representatives ofthis city or county to
Policy# CA i 0 n o Zi A 1 7 Expires /1 111 enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for ane-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that in the performance ofthe work for which this permit is issued,
I shall not employ 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 compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comp[ with those provisions. Will the applicant or future building occupant handle hazardous material or
Applicant_7 r Date a�_ mixture containing a hazardous material equal to or that the
—c amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS dA Yes Q No
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($100,001)),IN occupant require a permit for the wnstrection 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 37060FTHEIABOR CODE,INTEREST,AND ATTORNEYS FEES forgufdelm
CONSTRUCTION LENDING AGENCY Yes
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 ofthe work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) o Yes(2�1f0
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guldeand the SCAQMD
I hereby affirm under penalty of perjury that 1 am exempt from 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.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 //
Business and Professions Code).Any city or county that requires a permit to � 0 Date 3/6//7
construct,alter,improve,demolish or repair any structure,prior to its 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRPJ
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.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
or',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 ofthe work,and the structure is www.epa.gov/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 o 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:
❑I,as owner of the property am exclusively contracting with licensed
contmCors 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.
J�UILDING & SAFETY PERMIT/PLAN CH ECK APPLICATION
Menifee
DATE 7 2,9 1-1 PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL ❑RESIDENTIAL 0 MULTI-FAMILY ❑MOBILE HOME POOL/SPA ❑SIGN
SUBTYPE: []ADDITION []ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL
❑NEW [-]PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 64nife e1 orjj Aq K)41, aN r0CI n ide
PROJECTADDRESS X6 23t,90 Hqh a 01
Building & Safety Dept.
ASSESSOR'S PARCEL NUMBER
333— LAD •o?Q LOT TRACT
PROPERTY OWNER'S NAME UD a JUL 2 5 201?
ADDRESS 2.136 O Makog oieoTr iReeeived
PHONE 9S1 337 1-1 /1 EMAIL
APPLICANT NAME
ADDRESS 30138 M Aij
PHONE QSI b72 9-132- EMAIL
CONTRACTOR'SNAME der OWNERBUILDER? [_-]YESWX0
BUSINESS NAME OuiL CA4s4d Pool, irnc
ADDRESS Ablay, a mot
PHONE qrl b-)5 A +32 EMAIL
CONTRACTOR'S STATE LIC NUMBER -7ggg20 LICENSE CLASSIFICATION CS3 - g
VALUATION$ 39 . 000 SO FT 570 L SQ FT
APPLICANT'S SIGNATURE DATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAIDAMOUNT
AMOUNT -.+frf'J•V-� C„ty✓• O CASH O CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES O NO DL NUMBER NOTARIZED LETTER O YES NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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28690 Mahoganey Trail
Menifee, Ca 92585
951-337-1711
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WILDING AND ETY DEP RTMENT
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REVIEWED BY
proval of these plans stall,of be construed tobeapermitbr, an
violation previsions oft a federal,state or
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jobsite until mpletion.
Scale: 3/32" = 1 ft.