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PMT17-03489 City of Menifee Permit No.: PMT17-03489 29714 HAUN RD. rACCJEL/� MENIFEE,CA 92586 Type: . Pool/Spa-Residential MENIFEE Date Issued: 1 010 212 01 7 PERMIT Site Address: 29301 FENWICK CIR, MENIFEE, CA Parcel Number: 364-320-019 92584 Construction Cost: $36,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 385 SQ FT Work: Owner Contractor NICOLAS RAMIRF7 TAYLOR MADE POOLS INC 29301 FENWICK CIR 18795 OAK VIEW WAY MENIFEE, CA 92584 LAKE ELSINORE, CA 92530 Applicant Phone: 9515151039 GEORGE BOULLON License Number 795053 TAYLOR MADE POOLS INC 18795 OAK VIEW WAY LAKE ELSINORE, CA 92530 Fee Description O_yt Amount I$) Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 5.00 General Plan Maintenance Fee-Electrical 1 2135 $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 carded 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 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractors)pursuant to the Contactou5tate 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 Lam exempt from licens���rff under the Contr ctors State License Law for Professions Code and my license is in full force and Hest. the following reason: ND License Class (f— j3 Users By my signature below I acknowledge that,except for my personal residence Expires�7//1 Signature in which I must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sal a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder ifit has not been constructed in its entirety by ❑I hereby affirm under penalty of perjury one of the fallowing 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 Cade,is available upon request when compensation,Issued by the Director of Industrial Relations as provided for this application is submitted or at the following avebsite: by Section 3700 of the Labor Code,for the performance of work for which svwvcleeinro.ca.gpv/calaw.html. this permit is Issued. Policy It Date a I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work forwhich X'By my signature below I certify to each of the following:I am the propeny 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 co struction.l authorizer sentatives of this city or county to Policy Is Expires enter t t identified pro for inspection purposes. (This section need not to be completed Is the permit is for one-hundred a� Date dollars($100)or less ROPERTY OWNER OR AUTHORIZED AGENT )(1 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 R workers compensation) cos (California,and agrfe t if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker pensation provisi af5ection 3700 of th abor Code,1 shall Fonh�s((tl omply hos lions. Will the applicant or future building occupant handle hazardous material or Applicant /� a Date 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 a Yes P 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 guidelines CONSTRUCTION LENDING AGENCY O Yes ji 1 hereby affirm that under the penally of perjury there is a construction Will the proposed building or modified Facility be within 100D 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) Oyu pd-No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requi!.9wents under the State of I hereby affirm under penalty of perjury that I am exempt From the California Healt 2191ye,Se : 505 and 25534 tooter nilContractors License Law for the reasons)Indicated below by the hazardous acheckmark(s)I have placed next to the applicable Item(s)(Section 7031.S dyes O �Business and Professions Code).Any city or county that requires a permit to .y�ri�� construct,alter,improve,demolish or repair any structure,priorto 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 Contactors State EPA RENOVATION,REPAIR AND PAINTING IRRP) License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors receiving compensation fformostworkthatdfedfir firms in comply with and the basis For the alleged exemption.Any violation of Section 7033.5 by residence or childcare facility to be RRP-certified firms and complywilh 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 O 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.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 0 An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal eRprt,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. D No EPA Lead-Safe Certified Firm Is required for this project because: D I,as owner of the property am exclusively contacting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contactors 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. i APPLICATION Menifee DATE: /O PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL (" RESIDENTIAL O MULTI-FAMILY 0 MOBILE HOME OOL/SPA G SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NE.W/ O PLUMBING O RE-ROOF NUMBER OF QUARES DESCRIPTION OF WORK 5'P0.. cy PROJECTADDRESS Z��D/��ei✓cUj Cir� ZIP 1��8 ASSESSOR'S PARCEL NU``,M,rBE��R,�,, „j(O4 -019 LOT TRACT OWNER NAME NAME IV16 Zan ' ADDRESS -79 3el z�&1L!// �- PHONE EMAIL " APPLICANT NAME ADDRESS �7 5 PHONE EMAIL CONTRACTOR'S NAME Gze-OWNER BUILDER? CI YES 0 BUSINESS NAME ADDRESS.PHONE EMAIL EMAIL /? a CONTRACTOR'S STATE�LI.CC NUMBER ;; __Y LICENSE CLASSIFICATION VALUATION$ --�1�� SOFT L SQ FT APPLICANT'S SIGNATURE l DATE �m �/ CITY STAFF USE ONLY_ DEPARTMENT DISTRIBUTION CITY OF ME�EUS_INESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY: �f(//1f('/ "/'71 S PERMIT FEE 3� SMIP .., GREEN a— PLAN CHECK FEE INVOICETOTAL OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE tf NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92586 951-672-6777 www.cityo finenifee.Us