PMT17-03442 City of Menifee Permit No.: PMT17-03442
29714 HAUN RD.
�^-CCEL/> MENIFEE,CA 92586 Type: Pool/Spa -Residential
MENIFEE Date Issued: 09/29/2017
PERMIT
Site Address: 27847 LUCERNCE DR, MENIFEE, CA Parcel Number: 333-731-010
92585 Construction Cost: $35,000.00
Existing Use: Proposed Use:
Description of POOL AND SPA.360 SQ FT WITH ELECTRICAL(2 LIGHTS)
Work:
Owner Contractor
QUINCY SCOTT S C POOLS&LANDSCAPES INC
27847 LUCERNCE DR 33975 SIDNEY CIRCLE
MENIFEE,CA 92585 WINCHESTER, CA 92596
Applicant Phone: 9517572644
STEVE CURRIE License Number: 758701
S C POOLS&LANDSCAPES INC
33975 SIDNEY CIRCLE
WINCHESTER,CA 92596
Fee Description O0t Amount($1
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 2.00
SMIP RESIDENTIAL 1 5.00
General Plan Maintenance Fee-Building 1 0.00
General Plan Maintenance Fee-Electrical 1 23.35
$524.35
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.ryt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improvesthereon,and who contracts for the projects
I 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 Contractor's State License Law for
Professions Code and my license Is in full force and effect. the following reason:
License Class C -S 3 cense No. S
By my signature below I acknowledge that,except for my personal residence
Expires 3ro 51 nature 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 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 website:
by Section 3700 of the Labor Code,for the performance of work for which tytyw.leeinfa.ca cov/calaw html.
this permit is Issued.
Policy If Date
I have and will maintain workers compensatbn Insurance,as required by PROPERTY OWNER OR AUTHORIZED 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
p Carrier `L with all applicable city and county ordinances and state laws relating to
VaT' 1--" +y ..a building construction.I authorize representatives of this city or county to
Policy# i 4h4j 3C2Expires 71 ^Z'L- -1 C 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 Dale
PROPERTY OWNER OR AUTHORIZED AGENT
❑I certify that In the performance of the work for which this permit is issued, O J f � l I
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 111
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker ompensation provisions of Section 3700 of the Labor
Code, al rthwith Iva those provisions. WIII the applicant or future building occupant handle hazardous material or a
App \ Date-7-��i^� 7 Macau containing a hazardous material equal to or greater that the
amoun specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes 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 gullelines
CONSTRUCTION LENDING AGENCY ❑Yes ❑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?
(Section 3097 Civil Code) ❑Yes 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 Calffo Ith&Safety Code,Section 25505 and 25534 concerning
azardous t e r
checkmark(s)I have placed next to the applicable items)(Section 7031.5 0 (� p Business and Professions Code).Any city or county that requires a permit to Date 1 \ � l— 11
construct,alter,improve,demolish or repair any structure,priorto Its PROPER AUTHORIZED ENT
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 flit
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
❑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.eoa.eovAead 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
completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.:
not built or Improved for the purpose of sale. o 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 ; SAFETYPERMIT/PLAN APPLICATION
- �C_ !enifee
DATE: `5 - PERMIT/PLAN CHECK NUMBER \
TYPE: <�COMMERCIAL O RESIDENTIAL U MULTI-FAMILY C MOBILE HOME ! POOL/SPA SIGN
SUBTYPE: O ADDITION O ALTERATION 0 DEMOLITION J ELECTRICAL O MECHANICAL
n.NEW 0 PLUMBING 0 RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK �o C.2L'T E �0 OL -A- S
PROJECTADDRESS �� Q�j�-� �1}�,V Cr RtQ C 1J 2, ZIP g
ASSESSOR'S PARCEL NUMBER ✓ • , I LOT TRACT
OWNER NAME V I N G.
ADDRESS ezi yv-)
PHONE V�,\C\ 13 EMAIL
APPLICANT NAME S ,2R
ADDRESS S'y.�
ONE EMAIL
CONTRACTOR'S NAME 1 OWNER BUILDER? 0 YES G NO
BUSINESS NAME S L FPO L.5\AD
DRESS S 35
PHONE 15 1) "75-7 - ZL9`A EMAIL
CONTRACTOR'S STATE LIC NUMBER `795,')d , LICENSE CLASSIFICATION 3.
VALUATION$ 3 �7 , 6 On SQ FT 3 0 L SO FT
APPLICANT'S SIGNATURE DATE " �q - ► 7
,CITY STAFFUSEONLY
DEPARTMENT DISTRIBUTION ACCEPTEDY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE CD 119
PERMIT FEE v)aQ, V SMIP GREEN
PLAN CHECK FEE I INVOICE TOTAL
OWNER BUILDER VERIFIED OYES C) NO DRIVERS LICENSE# NOTARIZED LETTER () YES G NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityo1menijFee.us
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