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PMT17-03159 City of Menifee Permit No.: PMT17-03159 29714 HAUN RD. 4fICCELA> MENIFEE, CA 92586 Type: Pool/Spa-Residential MENIFEE Date Issued: 09/08/2017 PERMIT Site Address: 30662 WILLOW VILLAGE DR,MENIFEE, Parcel Number: 364-145-016 CA 92584 Construction Cost: $30,000.00 Existing Use: Proposed Use: Description of INSTALL INGROUND FIBERGLASS POOL 397 SQ FT Work: Owner Contractor JEFF SPAULDING QUALITY FIBERGLASS POOLS 30662 WILLOW VILLAGE DR 32497 HWY 74 MENIFEE,CA 92584 HEMET, CA 92545 Applicant Phone: 9519266060 RYAN MONTUORO License Number: 361530 QUALITY FIBERGLASS POOLS 32497 HWY 74 HEMET, CA 92545 Fee Description 01rt Amount ISI Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Electrical 1 23.35 $523.36 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_Pernit Template.rpt Page 1 of 1 j 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). C hat er9(commcing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractors State License Law for Professions Code cling my license is in full force and effect. the following reason: JS License ClassC_`' 5 is o -;0 By my signature below I acknowledge that,except for my personal residence Expires p 1 —3O—a0Iq Signatur in which I must have resided for at least one year prior to completion of ORKER'S COMPENSATION DEC TION 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 ❑1 hereby affirm under penalty of pen 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 worker's 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 webslte: by Section 3700 of the Labor Code,for the performance of work for which this permit is Issued. www.leginfo.ca.eov/calaw.html. Policy# Date Is/ PROPERTY OWNER OR AUTHORIZED AGENT I have and will maintain workers compensation insurance,as required by 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 owneror 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 w tO with all applicable city and county ordinances and state laws relating to /r��n, p //__ building construction.I authorize representatives of this city or county to Policy#oo©o 1,349 Expires_(Q " I1 ` Ip 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 ❑I cer(ffy that In the performance of the work for which this permit is issued, I shall not emolov any persons In any manner so as to become subject to the (hTrdous ITY BUSINESS LICENSE# D C* workers compensation laws of California,and agree that if 1 should becomeAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Clode,I shall forthwith complywith those prov io s. III the applicant or future building occupant handle hazardous material or a pplicantQiA CL IT G P0+?�SDate 9 -8 I-7ixture containing a hazardous material equal to or greater that the mounts sfgocified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE W RKER'S COMPENSATION COVERAGE IS Yes efNo UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIESill the intended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),INoccupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FORoast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEESr guide[' CONSTRUCTION LENDING AGENCY Yes JNo I hereby affirm that under the penalty of perjury there is a construction III the proposed building or modified facility be within 1000 feet of the [ending agency for the performance of the work which this permit is issueduter boundary of a school? (Section 3097 Civil Code) Yes No OWNER BUILDER DECLARATIONS ave read the Hazardous Material Information Guide and the SCAQMD rmitting checklist.[understand my requirements under the State of I hereby affirm under penalty of perjury that am exempt from the lifornia Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the ma ar' porting. checkmark(s)I haveplaced next to the applicable item(s)(Section7031.5 es No Businessand Professions Code).Any city or county that requires a permitto Dale construct,alter,improve,demolish or repair any structure,pr[orto its PROPER OWNER 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 RENOV EPAIR AND PAINTING RRP 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)orthat he or she is exempt from[[censure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Anyvlo[ation of Section 7031.5 by residence or childcare facility to be RRP-certified fans and comply with than 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 ❑1,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.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 ❑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 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 outthe RRP Acknowledgement. BUILDING & SAFETYPERMIT/PLAN CHEAPPLICATION . City of MenIie0 Menifee uIIdin 8 Safety Dept. � DATE SFP 0 a 2011 PERMIT/PLAN CHECK NUMBER PH Ti Q,�5t 69 TYPE: ❑ppC,,..OMMMERCIAL RESIDENTIAL MULTI-FAMILY El MOBILE HOME POOL/SPA []SIGNS114"(MDB N []ALTERATION []DEMOLITION []ELECTRICAL []MECHANICAL []NEW []PLUMBING FIRE jp--ROOF-NUMBEROFSQUARES DESCRIPTION OF WORK PROJECTADDRESS 3064 .2 (A), NOW WVi'flaqe, p IV ASSESSOR'S PARCEL NUMBER 3`A-j%Q 1 1OLOT4�5 TRACT PROPERTY OWNER'S NAME (J 1 ADDRESS low v( r , MentG PHONE q51 __7(CLt- EMAIL APPLICANT NAME U 0L L Tools — h-h, ADDRESS 32 A- rA TZ6'ql— PHONE �SI- q26 - 0040 EMAIL CONTRACTOR'S NAME Ova ( P ',SOWNERBUILDER? ❑YES NO BUSINE Eu IJ Is ADDRESS Z 1 CA 92_5_41s— PHONE �S/- q� 6 -606Q EMAIL /' 537 CONTRACTOR'S STATE LIC NUMBER 3 6153 o LICENSE CLASSIFICATION (f — VALUATION$ C D SO FT L SO FT 8 '6 APPLICANT'S SIGN UR DATE 1 CITY STAFF USE WILY DEPARTMENT DISTRIB ON CFfYOF MENIFEE BUSINESS LICENSE NUMBER I BUILDING PLANNING EN IN G IRE GREEN SMIP O INVOICE PAID AMOUNT AMOUNT {J CASH OCHECK# OCREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT OCASH OCHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES C NO DL NUMBER NOTARIZED LETTER O YES (D NO City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 PA / PA PA /L i p� \� uh O`pp PA \ 11 �WP / PA PA q PA TURF PA PA A" W TURF ❑ n��t� 5 �o e ` n