PMT17-03529 City of Menifee Permit No.: PMT17-03629
29714 HAUN RD.
<A—CCEL/> MENIFEE, CA 92586 Type: Pool/Spa-Residential
MENIFEE Date Issued: 1 0/0412 0 1 7
PERMIT
Site Address: 31923 SEWALT CT, MENIFEE, CA 92584 Parcel Number: 360-581-029
Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA 565 SQ FT
Work:
Owner Contractor
CHRIS LAMBROS ALOHA POOL&DESIGN INC
31923 SEWALT CT 41083 SANDALWOOD CIRCLE STE I
MENIFEE, CA 92584 MURRI ETA, CA 92562
Applicant Phone: 9514539728
MARK KLINGSPORN License Number.965927
ALOHA POOL&DESIGN INC
41083 SANDALWOOD CIRCLE STE I
MURRIETA, CA 92562
Fee Description O_yt Amount 151
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Electrical 1 23.35
$522.35
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 tamed 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_Permit_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 perjurythat I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of 91vision 3 of the Business and D I am exempt from licensure under the Contractor's State License taw for
Professions Code and my license is in full fort and effect. the following reason:
License Class le No. `765-17— 7 By my signature below l acknowledge that,except for my personal residence
Expires //2�1 Signature in which I must have resided for at least one year priorto completion of
Improvements covered by this permit.I cannot legallysell a structure that I
WORKER'S COMPENSATION DECLARATIq4 have built as an owner-builder if it has not been constructed in its entirety by
o I hereby affirm under penalty of perjuv 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 wmiw.Ieginfci.ca.gov/mIaw.htmI.permit is issued. w
Policy# Date
D 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 for which oBy 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 annil the information I have provided is correct.I agree to comply
Carrier with all appligbble city and county ordinances and state laws relating to
building con ruction.I authorize representatives of this city or county to
Policy# Expires enter the a ve identified property for inspection purposes.
-
(This section need not to be completed is the permit is for one-hundred ---
dollars($100)or less Date
PROPERY WNER OR AUTHORIZED AGENT
\,17 certify that in the erformance of the work for which this permit is issued,
Ishallnotemolov an persons in any manner so as to become subject to the CIN BU5�55 LICENSE#
workers compensa on laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to thewor rs compensation provisions of Section 3700 of the Labor
Code,1 shall M h ith comply with those provisions. Will the applicant or future building occupant handle hazardous material ora
Applicant Date , mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAIL RETO SECURE WORKER'S COMPENSATION COVERAGE 15 o Yes rJ:No
UNLAWFUL, D 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 cons(SCtionor modee ification
checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguld Coast
fines
CONSTRUCTION LENDING AGENCY o Yes to
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) D Yes C.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 checklis.I understand my requirements under the State of
Contractors License Law for the reason(s)indicated below by the California Health Safety Code,Section 25505 and 25534 concerning
hazard DYes l us
__m teri 1 reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ' �J
Business and Professions Code).Any city or county that requires a permit to �j Date
construct,alter,Improve,demolish or repair any structure,prior to its PROPERTY OWIR OR AUTHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement 11
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVXIO/N.REPAIR AND PAINTING(RRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the v
Business and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint In a pre-1978
an Applicant for a permit subjects the applicant too civil penalty of not more residence or childcare facility to he RRP-certified firms and comply with
than($Scan. required practices.This includes rental property owners and property
managers who do the paint-disturbing work themselves or through their
cr 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 wh'o,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 because:
D 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
'Ienifee
501
DATE: PERMIT/PLAN CHECK NUMBER �r7 D3
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME OOL/SPA O SIGN
SUBTYPE: .7 ADDITION O ALTERATION O DEMOLITION O ELECTRICAL s MECHANICAL
O NEW " PLUMBING ::7 RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK PROJECTADDRESS 3117,3 �fJ'�L'�e/7' ZIP z
ASSESSOR'S PARCEL NUMBER ""NI 1 LOT SW TRACT 1 l
OWNER NAME
ADDRESS
PHONE i9LfXi-3�6 "3/L/� EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
' '^ n r
CONTRACTOR'S NAME >')6 // / &nj OWNER BUILDER? t%YES
BUSINESS NAME
ADDRESS Q SI�}�0,� I.*-®o ,rt., .1, % z-
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBE g�JJ �f L� LICENSE CLASSIFICATION
VALUATION$ 2 SO FT ,`�`S� L SQ FT
APPLICANT'S SI SNATUR DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY SIC/may/ CITYOF MENIIF_7✓)'G✓FE€BUSINES/vyTS LICENSE NUMBER
/.Y./
BUILDING MANNING ENGINEERING FIRE
PERMIT FEE 5 a� SMIP — GREEN
PLAN CHECK FEE INVOICE TOTAL 5 a a.3!;-
OWNERBUILDERVERIFIED r%YES NO DRIVERS LICENSE# NOTARIZED LETTER YES O NO
Civy of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us
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