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PMT17-02683 City of Menifee Permit No.: PMT17-02683 29714 HAUN RD. <A-CCEL/? MENIFEE,CA 92586 Type: Residential Plumbing MENIFEE Date Issued: 0 8101/2 01 7 PERMIT Site Address: 28311 MOUNTAIN VIEW PL,MENIFEE, Parcel Number: 350-122-007 CA 92587 Construction Cost: $2,500.00 Existing Use: Proposed Use: Description of INSTALL NEW 1200 GAL SEPTIC TANK WITH NEW LEACH LINES,ABANDON EXISTING TANK AND Work: LEACH LINE Owner Contractor DAVID DAVIDSON - 28311 MOUNTAIN VIEW PLACE MENIFEE,CA 92587 Applicant License Number: DAVID DAVIDSON 28311 MOUNTAIN VIEW PLACE MENIFEE,CA 92587 Phone:3233362348 Fee Description Qtv 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 $186.50 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 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_Pennit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects hereby affirm under penalty of perjury that 1 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 ❑I am exempt from Iicensure under the Contractors State License Law for Professions Code and my license is in full force and effect. the following reason: License Class License No. By my signature below I acknowledge that,except for my personal residence Expires Signature in which l must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that 1 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 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 sub ' e rat the follow, website: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. d m o. . ov calaw. Policy# _. Date R D I have and will maintain workers compensation insurance,as required by OPEi Wf4E R RIZED 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 workers compensation insurance carrier and policy owner or authorized to act on the property owners 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 construc' . onzerep entatives of this city or county to Policy# Expires enter ti o veidemfie operty fo nspection purposes. (This section need not to be completed Is the permit Is for one-hundred Date dollars($100)or less NEftO DTHORIZEb AGENT o I certify that In the performance of the work for which this permit is issued, 1 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 I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date 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 o Yes o 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($100,000),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 o Yes D No I hereby affirm that under the penalty of perjury there is a construction WIII 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? tiWction ❑Yes o No NER URDRATIONS 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 al Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes o 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 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 IRRPI 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 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 as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: ompensation,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 Contractors 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: o 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. PERMIT/PLANBUILDING & SAFETY APPLICATION Menifee DATE of (? ( PERMIT/PLAN CHECK NUMBER TYPE: ❑COMMERCIAL RESIDENTIAL [—]MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION []ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL Clty of S M nifee El NEW PLUMBING [I RE-ROOF-NUMBER OF SQUARES Boding $ tyDept. DESCRIPTION OF WORK 2017 PROJECTADDRESS )I L[,�J`'Q[. yl / G>`/ `L ASSESSOR'SPARCELNUMBER �S, !g2_=1 &7LOT TRACT PROPERTY OWNER'S NAME ADDRESS PHONE _- j��g EMAIL - T� APPLICANT NAME ADDRESS PHONE ? ��� 2J EMAIL , CONTRACTOR'S NAME OWNERBUILDER? S❑NO p BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION O � VALUATION$ O v L SQ FT A PPLICANT'SSIGNA;r R DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP k INVOICE I PAIDAMOUNT �f—�/1 O n AMOUNT :���// OCASH CHECKri .CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 County of Riverside DEPARTMENT OF ENVIRONMENTAL HEALTH. ,/ / www.rlvcoah.org 4 I t_.v d// LAND USE APPLICATION p� / /ji d70 / OFRCE USE ONLY J 7- PE eoDE -,FEE, 3880 Lemon Street•Suite 200•Riverside•CA•92501—(951)955-8980 ❑47-950 Arabia Street• uite A•Indio•CA 92201—(760)868-7570 CI e q- "A 1424 _ � _ �e ;9'EHS# + . 06'Z ON# O� LMS# Al 1 APN:sSU TR/PM O S' LOT 6Y 3 USE OF PERMIT: Cj��s rk[(s t-&1 njnrU �X��fr ",(C Si ECSCO�71i Name I• OWNER: Address LQ Vi • t CI f zip qa59T -7 Jam-_ -/ Phone Email /Ci JAY �• aw AGENT/ Company Name A entfContractor CON/TRACTOR: MailingAddress Boy city -e CA Z /v/ Phone Email PROPERTY INFO: Site Address 2 .I•' •n �e cityf• ze i, WaterA enc/well W Lot Size C00 i APPLICANT'S SIGNATURE: DATE: .�^�" ••._ u. e�low For_. ce IAA r :,.- ::;41 ,... CHECK BOX IF REQUIRED If arh box is checked this application shall be considered denied until the information is provided. e r❑ olding Tank Agreements Required ❑Floor Plan and/or Plumbing Layout Required BuildSafet Dept.: C ing & Certificate of Existing OWTS Required(C-42) ❑Special Feasibility Boring Report Required ❑WQCB Clearance Required ❑Detailed Contour Plot Plan Required(1 to 5 foot intervals) ❑Soils Percolation Report Required 11 SITE EVALUATION INSPECTION REMARKS: an EHS INITIALSIDATE: d ❑NEW REPAIR/REPLACEMENT I XEXISTING 1 ❑PUMP 1 ❑ATU I ❑CONNECTTOSEWER I FIXTURE UNITS# - BDRMS#J4 - Soils PercolatronlBodng Report By: Date: Project# CA2 Cpzp Y By. 5ee p 6vs luL Date:�I J ) License#Ll n R rY S ) Septic tank cap.: Soil Rate; Tested Depth: / U Max. trench depth: I2L / x,_j � Sq.Ft Bottom Area: ,5e Total Linear FLI 5.U Line(s): r' Len the feet- Each 3feet wide Sidewall Allowance: Ft.Rockf Sq.It.Running foot Rock below drain line: +T in. or lactic Chambers Leach Lines/bed special design for slope: O WA ❑Overburden Factor. Pit Diameter. No.pits: Depth below Inlet(bi): Pit Total Depth: Max.allowable depth: CONSTRUCTIONBNSTALLATION REMARKS: �� u v �yyLJ 7uh- G L Cf LAt OL" a. La� ILgua1 — lL q.41-'t k U UwTS dYI IGZ�^'�u'YI C(� / C7Y�t TIY This Application Is.EV Approved ❑ nled raga ing the design of the OWTS as indicated on the accompanied plot plan using the requirements setforth in Section C above.No constructlopels permitted I the required reserved 100%Expansion area. EHS Signature: Date: f1 epo.92 may vlsl DlsOibutlore WHIiE—Oxfice FJC YELLOW—&day DePL NNX—apolmnt I i APPROXIMATELY 9,000 S.F. BACK LOT AREA ADJACENT LOT �(E) G.L. FENCE EXISTING WASTE LINE POINT OF CONNECTION EXISTING LEACH LINE --------------_"_._._._._--.-.-._._. _._._._._._._._ ............. ............. -- -- ........ — — — — — — — — —. 4r�o���i• . sT�Nc r — — - - 1 1 EACH FIELD EX15TING ��� � NEW � CONNECT - - - - - - - - - - --)- - - - - I200GAL q ' SEPTIC TANK' EXISTIN i 1 1 PATIO L EXISTING UNDERGF -.- - - - - - - - SEPTIC :NEW LEACH FIELD AND SEPTIC TANK ?- "f/ e- ACCORDING TO SOILS ENGINEER l r" ''J >: ! DE51GN AND COUNTY OF RIVERSIDE ENVIRONMENTAL DEPARTMENT APPROVAL r i / r F TIC TANK AND LEACH LINE TO CTED ONLY UPON INSTALLATION C SYSTEM IMPROVEMENT. EXISTING ND TANK TO BE FILLED WITH SLURRY