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PMT17-03118 City of Menifee Permit No.: PMT17-03118 29714 HAUN RD. Type: Pool/Spa -Residential �A-CCEL/� MENIFEE, CA 92586 MENIFEE Date Issued: 09/01/2017 PERMIT Site Address: 26065 BYERS RD, MENIFEE,CA 92585 Parcel Number: 330-190-013 Construction Cost: $1,200.00 Existing Use: Proposed Use: Description of ELECTRICAL GROUND FAULT FOR ABOVE GROUND SWIMMING POOL-600 SO FT, 30FT X 20FT Work: PER CC ELECTRICAL ONLY-NO FENCE/ALARM NEEDED DUE TO LADDER BEING ABLE TO BE REMOVED. CODE CASE 17-1000 Owner Contractor MICHAELRUTLEDGE 26065 BYERS RD Applicant License Number MICHAEL RUTLEDGE 26065 BYERS RD MENIFEE,CA Phone:8582325694 Pee Description gyt Amount($ Services,Switchboards,Control Centers&Panels 1 116.00 Services, Switchboards, Control Centers&Panels 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 1.00 General Plan Maintenance Fee-Electrical 1 11.60 $272.60 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 Mantles,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 with a licensed contractors)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am Under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and ❑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: License Class License No. 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 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 ❑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 Cade,for the performance of work for which www leei A o tml. this permit is issued. Policy# Date ❑I have and will maintain workers compensation insurance,as required by PPERTYWNER OR h6THORIZED 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 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 Carrier with all applicable city and county ordinances and state laws relating to 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 ❑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 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 mixturecontai ing a hazardous material equal to or greater that the amounts sp Ified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes Xlo 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 permitfor the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quali anagement District(SCAQMD)?See permitting checklist IN SECTION 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES' -- - --for --- - _ - - - - - - _ -- - -- -- guidelin CONSTRUCTION LENDING AGENCY ❑Yes 0 1 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 bound of a school? (Section 3097 Civil Code) ❑Yes t5'No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting the list.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the reason(s)indicated below by the California H th&Safety Code,Section 25505 and 25534 concerning hazard u motet' r porting. oheckmark(s)I have placed next to the applicable item(s)(Section 7031.5 ( es N Business and Professions Code).Any city or county that requires a permit to ✓ Date construct,alter,Improve,demolish or repair any structure,priorto Its NER AUTHORIZEDAGENT 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 fRRPf 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 icensure 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($500). managers who do the paint-disturbing work themselves or through their ❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible forthis project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions \\ Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. - _.. BUILDING &SAFETY PERMIT/PLAN CHECK APPLICATION 7 91)1 IT DATE PERMIT/PLAN CHECK NUMBE MT' — TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES �L DESCRIPTION OF WORK PROJECTADDRESS (`J ASSESSOR'S PARCEL NUMBER /-3 19 'b13 LOT TRACT OWNER NAME !�'JG/ 1 ,( ( led ADDRESS /+7 , , PHONE Yv I"/ Z�2 4f V EMAIL j APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES O NO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ 2 d 0 SO FT Q Q L SO FT APPLICANT'S SIGNATURE Lad DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING CLANNING ENGINEERING FIRE GREEN SMIP INVOICE n-1 1 In� PAIDAMOUNT n AMOUNT �r L K CASH OCHECKH OCREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0 CASH 0 CHECK$1 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menlfee City of Menifee Building&Safety Department 29714 Houn Rd. Allenifee, CA 92536 951-6727 djn9 3 Safety Dept. www.cityofinenifee.us Inspection Request Line 951-246-6213 SEP 0 1 2011 Reee1ved