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PMT17-02993 City of Menifee Permit No.: PMT17-02993 29714 HAUN RD. "7ACCELJk? MENIFEE, CA92586 Type: Pool/Spa-Residential MENIFEE Date Issued: 0 812 312 01 7 PERMIT Site Address: 31124 MILLBURY DR, MENIFEE, CA Parcel Number: 372-480-018 92584 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 382 SQ FT Work: Owner Contractor CASIMIRO&SARA VALERA PACIFIC COAST POOLS INCORPORATED 31124 MILLBURY DR 26499 JEFFERSON AVE UNIT E MENIFEE, CA 92584 MURRIETA, CA 92562 Appllcant Phone: 9512960199 BRANDY CORAL License Number:852237 PACIFIC COAST POOLS INCORPORATED 26499 JEFFERSON AVE UNIT E MURRIETA, CA 92562 Fee Description Oft Amount f5l Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Electrical 1 23.35 $622.35 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_Pennit_Template.rpt 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 perjury that I am under provisions of with a licensed contractors)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from Iicensure under the Contractor's State License taw for Professions Code and my license is in full force and ecffe�ct-.-� the following reason: License Class ( ) Ucense No. By mysignature below l acknowledge that,except formy personal residence Expires 2-1 1 V Signature a54- 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 D 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 submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. www.leeinfo.ta.aov/calaw.html. Policy# Date ❑I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which D 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:,/I� ��.,� y� application and the information I have provided is correct.I agree to comply Carrier 1 wKkK t711/�i1�- with all applicable city and county ordinances and state laws relating to //�1 -'I��r732 % building construction.I authorize representatives of this city or county to Policy#U"1 W� t tr 17D I Expires O enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred dollars($100)or less Date PROPERTY OWNER OR AUTHORIZED AGENT D I certify that in the performance of the 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# workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to t orkers wmpensation provisions of Section 3700 of the labor Code,I shal f rthwl[I comply with those provisions. Will the applicant or future building occupant handle hazardous material or a mixture containing a hazardous material equal to or greater that the Applicant Date_ amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes arao— 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 IN SECTION 3706 OFF THE L ADDITION TO THE HE LABOR CODE,INTEREST,AND ATTORNEYS FEES COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist forguideliness CONSTRUCTION LENDING AGENCY °Yes ;Y 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 hound I school? (Section 3097 Civil Code) °Yes o No 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 Contractors License Law for the reason(s)indicated below by the California) . r Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardou to al reporting. Business and Professions Code).Any city or county that requires a permit to °Yes °No ,T !'—l�l Date ll� I 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 IRRP) 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 awork RRP-cat disturbs paint in a ply w76 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 properly owners and property than($SOD). 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: wmpensation,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 1-800424-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 thatthe 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. a No EPA Lead-Safe Certified Firm is required for this project because: a 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 Ucanse 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 • APPLICATION ,ik DATE O 2,3 I PERMIT/PLAN CHECK NUMBER ��ri-oazms TYPE: O.COMMERCIAL O RESIDENTIAL C MULTI-FAMILY 0 MOBILE HOME t3.Y00L/SPA C SIGN SUBTYPE: O ADDITION C ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING 0 RE-ROOF--NUMBER OF SQUARES DESCRIPTION OF WORK D) U S J PROJECTADDRESS 1 L/ Lf ASSESSOR'S PARCEL NUMBER la;z 4fo 'pis /LO�T �61 TRACT "5' OWNER NAME /rD J- tjvfk--) ' ADDRESS PHONE EMAIL APPLICANT NAME ADDRESS PHONE EMAIL y CONTRACTOR'S NAME OWNER BUILDER? OYES O NO BUSINESS NAME ADDRESS PHONE b' • '-� ��7� EMAIL CONTRACTOR'S STATE LIC NUMBER 2,2 LICENSE CLASSIFICATION Cr S-3 VALUATION$ W LJO SOFT - Q L SO FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUS';E SENUMBER BUILDING PLANNING ENGINEERING FIFE GREEN SMIP 05 INVOICE 1^^ PAID AMOUNT AMOUNT O.OF•�S 0CASH G CHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH G CHECK# 0CREDIT CARD VISA/MC OWNER BUILDER VERIFIED `)YES <% NO DL NUMBER NOTARIZED LETTER C YES C NO UP SLOPE UP SLOPE UP SLOI GRASS AREA -20" 2 ............. lol............... 3'6"DEPTH 30i 6'6"DEPTH- ........ .............................................. ---------37--. ............. ............ GRASS AREA WHITE SAFETY?;RIP C PING EXISTING CONCRETE VALERA RESIDENCE Cl-riv OF IVITNIFEE BUILDING AND SAFETY DEPARTMENT