PMT17-03132 City of Menifee Permit No.: PMT17-03132
29714 HAUN RD.
'ACCELA— MENIFEE, CA 92586 Type: Pool/Spa-Residential
"'. """"" MENIFEE Date Issued: 09/05/2017
PERMIT
Site Address: 28138 SPRING CREEK WAY,MENIFEE, Parcel Number: 333-600-008
CA 92585 Construction cost: $40,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA,424 SF, 1 SPA LIGHT, 1 POOL LIGHT
Work:
Owner Contractor
NIGHAT BEG&LAGABRIEL REDIC TAYLOR MADE POOLS INC
28138 SPRING CREEK WAY 18795 OAK VIEW WAY
MENIFEE,CA 92585 LAKE ELSINORE,CA 92530
Applicant Phone:9515151039
GEORGE BOULLON License Number:795053
TAYLOR MADE POOLS INC
18795 OAK VIEW WAY
LAKE ELSINORE, CA 92530
Fee Description q_yt Amount I$)
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_aldg_Pernit_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 contractor(s)pursuant to the Contractors State License Law),
Chapter9(commencing with section 71100)of Division 3 of the Business and PILam exempt from licens''urfq under the Conti State License Law for
Professions Code/and my license is in full farceaa the following reason:
License Class C—'3� Ucen �S�S By my signature below l acknowledge that,except formy personal residence
Expires ,711 Signature �� in which l must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
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 sell-Insure for worker's 7044 of the Business and Professions Code,is ava0able 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 s.,,v,N_leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy# Date
o I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 370D of the La bar Code,for the performance of the work for which XBy my signature below l 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 an the property owners behall.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 co slruction.I authorize r� senlatives of this city or county to
Policy If Expires enter rye identified pro q rorinspectionpurposes.
(This section need not to be completed is the permit is for one-hundred < 7 Date
dollars($100)or less - KROPERTY OWNER OR AUTHORIZED AGENT
)C1 certify that in the performance of the work for which this permit is issued,
Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE
workers compensation ws fCalifornia,and aomspalif l should became HAZARDOUS MATERIAL DECLARATION
subject to the work e}'c pensation pravisi Section 3700 ofth hoc
Code,]shall forths' omply f rhos isi�ons. Will the applicant or future building occupant handle hazardous material or
Applicant L Date 3U�ly 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 15 Oyu PNo
UNLAWFUL,AND SHALL SUBIECTAN 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)7 See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldelines
CONSTRUCTION LENDING AGENCY oyes pCblp
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) o Yes P"o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that l am exempt from the permitting checklist.I understand my requir ents under the State of
Contractors License Law for the reason(s)tndicated below by the California Heart & fety aa,Se i 505 and 25534 tooter ng
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous al repo
Business and Professions Cade).Any city or county that requires a permit to Jae o
construct,alter,improve,demolish'or repair any structure,prior to its Date a /
issuance,also requires the applicant for the permit to file a signed statement PROPERNOWNER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter9(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-978
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 orthrough their
a1,as ownerofthe property,or myemployeewith wages as thetrsole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all ofor( )portion of the work,and the structure is www.eoa.eov/lead or contactthe 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 aAn 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. o No EPA Lead-Safe Certified Firm is required for this project hecause:
o I,as owner ofthe 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 it your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
r
i�. - : i•I I ... r � ...,.t �r r'Fri �� 5 'r`{ca,�.r.
& SAFETY PERMIT/PLAN CHECK A. • •
r;:
Menifee
DATE qJ� , PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME WPOOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
NEW O PL,UM/BING O RE-ROOF-NUMBER OF SQUARE w /
DESCRIPTION OF WORK �W OD� ( /YS �l/�/i��'✓ �}-
PROJECTADDRESS Q s' /�//✓(j�C'��yL j,/jd�� v1� ,d,i°i
ASSESSOR'S PARCEL NUMBER
�L LOT TRW,
ity of Menifee
OWNER NAME / e-glacrp
ADDRESS 017
PHONE ASS'—�/� ��1'Z`� /EMA/IL
APPLICANT NAME G'6 6t�G�C�iL�
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME
eOY OWNER BUILDER? O YES NO
BUSINESSNAMEE
ADDRESS
PHONE 1-!V ^ ��j D�� a EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ �'4w j4U SQ FT L SO FT
APPLICANT'S SIGNATURE -� ' DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP (,Q
INVOICE PAID AMOUNT
AMOUNT OCASH OCHECKA OCREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH O CHECK N 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Oepartment29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213