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PMT17-03638 City of Menifee Permit No.: PMT17-03638 29714 HAUN RD. Type: Residential Plumbing '�CCELI? MENIFEE, CA 92586 MENIFEE Date Issued: 10/12/2017 PERMIT Site Address: 31048 BYERS RD, MENIFEE, CA 92584 Parcel Number: 358-140-005 Construction Cost: $7,900.00 Existing Use: Proposed Use: Description of EXISTING TANK IS DAMAGED, REPLACING WITH NEW 750 GAL TANK Work: Owner Contractor JEFFREY DYKE LE PEW INDUSTRIAL INC 31048 BYERS RD 41735 ELM STREET#303 MENIFEE, CA 92584 MURRIETA, CA 92562 Applicant Phone:8889615971 TIM HUMPHREY License Number:988020 LE PEW INDUSTRIAL INC 41735 ELM STREET#303 MURRIETA, CA 92562 Fee Description QQt r Amount($) Sewer 1 150.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 7.50 $186.50 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_Permit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects 1 hereby affirm under penalty of perjury that I am under provisions of with a licensed contractors)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for Professions Code uaand my license is in full force and effect. O, the following reason: License Class C l Z K Ucen No. e U 6 By my signature below I acknowledge that,except for my personal residence Expires 10 Signature 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 I ompensation,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 www.leginfo.ca.gov/caIaw.html.permit is Issued. Policy# Date e ave and will maintain worker's compensation Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT s ction 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 worker's compensation Insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number am: -/ 1 r application and the Information I have provided Is correct.I agree to comply Carrier K)& lE)a'd 1 �Ly S V[�(/1$k,Y (ry with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy#"W U1Z Q 6 3 Expires t1l 19 u� /-1 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 certify 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 CITY BUSINESS LICENSE# worker's compens tlon laws l of California,a ree that if I should become HAZARDOUS MATERIAL DECLARATION subject toitheaer's dmpensation pro sio of Section 3700 of the Labor Code,I shith am 1 r lit q„rav ions. WIII the applicant or future building occupant handle hazardous material or a Applicant Datenil 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 IS ❑Yes WNo 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 r o ion occupant require a permit for the construction modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SC ion or See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes rNo 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) ❑Yes 7?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 re uirements under the State of California Health&Safety Code,Se on 5505 and 25534 concerning Contractors License Law far the reason(s)indicated below by the hazardous materi orting. /I1 checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 iWes o N [V 1 Business and Professions Code).Any city or county that requires a permit to Date V I construct,alter,improve,demolish or repair any structure,priorto its PROPERTY OWNER OR AUTHORIZED A ENT issuance,also requires the applicant forthe permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI License Law(Chapter 9(commencing with Section 70Do)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-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 sale 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.gov/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 Contractor's State License Law does not apply to an owner of a o 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 bulk or improved for the purpose of sale. - ❑No EPA Lead-Safe Certified Firm is required forthis project because: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Cade:The Contractor's 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 & SAFETY PERMIT/PLAN CHECK APPLICATION ✓i DATE: PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL ty-MIDENTIAL O MULTI-FAMILY Q MOBILE HOME O POOL/SPA "SIGN SUBTYPE: ^ADDITION O ALTERATION 0 DEMOLITION O ELECTRICAL O MECHANICAL O NEW VLALUMBING 0 RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK VXe ` z;, PROJECTADDRESS (3y Gv'c2 U1c/1 yv�L✓t...�t� ZIP ct ASSESSOR'S PARCEL NUMBER LOT TRACT OWNERNAME —• wKc- / ADDRESS 3 D ci, o." PHONE EMAIL APPLICANT NAME #-rlu.S I1,yc ADDRESS Lln 3L .1- sc-c 2 O PHONE EMAIL EMAIL �//(- tic,��lc��L(•., CONTRACTOR'S NAME (..l .lf/64 OWNER BUILDER? <>YES -)NO BUSINESS NAME Le IgCA. N ADDRESS 1rI ( (�,f Q PHONE �� J-S`�- O G �� EMAIL �] CONTRACTOR'S STATE LICC NUMBER V LICENSE CLASSIFICATION -cc� VALUATION$ �L -(, U b SQ FT L SQ FT APPLICANT'S SIGNATURE DATE CITY STAFF US£ONI.Y DEPARTMEM DISTRIBUTION ACCEPTED BY CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE 3"1 PERMIT FEE I - SMIP GREEN FOWNER CHECK FEE INVOICE TOTAL BUILDER VERIFIED C YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO Lic.#C42-988020 5ry �� 13 CL U ® LL Q U_ O "Q 855 - (KO -00s ! 42,,, e'H s t7o885 O � boo S 'OJrL_.( 0r '•;; ; "? JDE �� O+MO( DErHT14iE1�.l`" Ci:" Ei iV! ZGJf�1 iTAL -;EALT� Dwelling �Aa-)7�cal. Sep' Tank —� Commercial i8 <' Sq. Ff.of each fine — Seepage Pits — No. r BI Connect to Sewer � Concrete ump Cha er Connect to Existing • Installation of leach lines are not to exceed Y ft.in depl • Install risers to grade,leaving lids accessible for Lintothese lean Note: Larger tanks (2000 gallons or greaterrisers o ac s primary chamber. • Approved cleanable effluent filters must be insttate se ici� • No on-site water softening devices shall be disthese tic ystem without clearance from the California Regional Water Ql Board. • Installation shall conform to the current UPC: • Any grading in the area of proposed drip linire new a oval by this Department. Date: !o /� 5fp/� ENS: �- � v a aor,;� County of Riverside PC C+ 5 • DEPARTMENT OF ENVIRONMENTAL HEALTFfi C � -S www.rivcoeh.org tO/t212ot7 : 'QcA -"r LAND USE APPLICATION t� OFFICE USE ONLY 1G73880 Lemon Street•Suite 200•Riverside•CA•92601—(951)955-8980 (� PE CODE: /� FEE: yr-1 q ❑47-950 Arabia Street•Suite A•Indio•CA 92201—(760)863-7570 �j p M�jY�t�`Y$� r� t �t d� ` ` 7,2 EHS# I�C7 885 ON# —loos LMS I TR/PM LOT# u SECTION A Name Jeffrey Dyke OWNER: Address 31048 Byers Rd City Menifee Zip 92584 Phone Email AGENT/ Company Name Le Pew Industrial, Inc. Agent/Contractor Timothy Humphrey CONTRACTOR: Mailin Address 41735 Elm Street, Suite 303 cjtv Murrieta zip 9256 Phone 888/961-5971 Email tim le ewindustrial.com LL. LL PROPERTY INFO: Site Address Same as above city Zip Water Agenc Lot Size APPLICANT'S SIGNATURE: DATE: SECTION B low—For Office Use Only CHECK BOX IF REQUIRED If any box is checked,this application shall be considered denied until the information is provided. ❑ Holding Tank Agreements Required ❑Floor Plan and/or Plumbing Layout Required IS Certificate of Existing OWTS Required(C-42) ❑Special Feasibility Boring Report Required ❑WQCB Clearance Required ❑Detailed Contour Plot Plan Required(1 to 5 foot Intervals) ❑Soils Percolation Report Required S ENION INSPECTION REMAt2I�� f ;m Srat��strtTto� GYa Ct/�7 /rz a.,.1 /yvsf c� /f'fP.ui�� i� EHS INITIALS/DATE: SECTION C ❑NEW EPAIR REPLACEMEN ❑EXISTING ❑PUMP ❑ATU ❑CONNECT TO SEWER I FIXTURE UNITS# BDRMS# Soils Percolation/Boring RelpZrtfl, Date: Project# C-42 Certification B : Date: 1� Lice nse# rm uw1 g08oat'j Septic tank p.: Soil Rate: Tested Depth: Max. trench depth: —7 O Sq.Ft.Bot1QM Area: Total Total Linear Ft.: Line(s): S`•T 1 t6v Len th:_Iz feet - Each 3feeC�M Sidewall Allowance: Ft.Rock/ Sq.ft.Running foot Rock below drain line: to in. or ❑Plastic Chambers Leach Lines/bed special design for slope: ❑N/A ❑Overburden Factor: Pit Diameter. No. pits: Depth below Inlet(bi): Pit Total Depth: Max.allowable depth: 10l C ST UCTION/JgTALLATIQNR gF2 a JOt7 : 'nb'M i1T�M IAI($�K' VU �'TLtLtS I dl , t ba tnd rrvl t }�Yt z L ;v� MaL to V . owl ✓v, ob_ fia Ff . s t I ri c�c 1i (� e;:C- SECT N D This Application is Approved O Denied regarding the design of the OWTS as indicated on the accompanied plot plan using the requirements set forth in Section C above.No construction is prittegh the required reserved 100%Expansion area. EHS Signature: I Date: rD l2�aol� County of Riverside 3 DEPARTMENT OF ENVIRONMENTAL HEALTH www.rivcoeh.org w CERTIFICATION OF EXISTING SUBSURFACE DISPOSAL SYSTEM ❑3880 Lemon Street•Suite 200•Riverside•CA•92501—(951)955-8980 ❑47-950 Arabia Street•Suite A•Indio•CA 92201—(760)863-7570 Property Information: APN: 358140005-2 Date of Inspection: 09/26/2017 1. Owner: Jeffrey Dyke Address: 34048 Byers Rd City: Menifee FAILURE TO PROVIDE ALL REQUIRED INFORMATION SHALL PREVENT OWNER FROM OBTAINING ENVIRONMENTAL HEALTH APPROVAL 2. Show design and location on a scale of 1:20 or 1:40 of the sewage disposal system and 100%expansion area in relation to dwellings, structures,wells, rock outcroppings,drainage,watercourses,etc. 3. a. I examined existing subsurface sewage disposal system at the above location on 912 612 01 7 and determined that the tank capacity is 750 gallons and that there is sq.ft.of leach line bottom area. There are bedrooms in the dwelling and there are fixture units. t2/i Nc�.a S b. There are )-- leach line(s), each ft.long Depth ft. E Rock ❑ Plastic Chamber c. There are Seepage pit(s),each ft. in diameter, and ft.TD. ft. BI. d. The leach bed is ft. by ft.,total sq.ft.of leached area. Depth is ft. 4. a. Construction of septic tank(Please check one of the following): ❑ concrete ® Fiberglass ❑ Steel ❑ Other: b. Internal dimensions of septic: Length ft. Width ft. Depth ft. c. Condition of tank(please check yes or no for each question): Inlet Tee present? ®Yes ❑ No Tank Structure deteriorated? ®Yes ❑ No Outlet Tee present? Yes ❑ No Effluent Filter Present? /'❑ Yes ® No Two compartments? ®Yes El No d. Condition of D-Box: Level? id Yes ❑ No Replaced? ❑Yes 121�No 5. a. While pumping the tank,did effluent flow back into tank from absorption system? ❑ Yes ® No b. Prior to pumping,was the liquid level in the tank above the outlet tee? ❑Yes ®No c. Was the area around the lids oxidized? ❑Yes ® No d. Is design of system gravity feed? M Yes ❑ No e. Were well(s)observed on this or adjacent property? ❑Yes ® No If yes, indicate distance of well from: Septic tank _ ft. Leach lines _ Seepage Pits ft. f. Distance from springs, lakes,and natural water courses(check all that apply): N/A ❑ Septic Tank _ ft. ❑ Leach lines ft. ElSeepage Pits ft. g. Is sewer within 200 ft.of structure and abuts property line? ❑ Yes ® No Additional Comments: h. How long has dwelling been vacant? if applicable) months weeks ® N/A 6. a. ❑ It is my opinion that the system appears to be in good working order and can be expected to function properly with proper maintenance. No repairs are necessary at this time. b. ® It is my opinion that the system is not in good working order and will not function properly without the following repairs: A NEW TANK IS NEEDED I certify under penal of perjury that oregoing is true and correct ature: i Sign t Name: Timothy Humphrey Contractor License No.: aaan2n Expiration Date: nrtnhpr 2017 Pumper Co.: Le Pew Industrial Inc. Phone Number: 888-961-5971 Address: 41Z36 Elm Rtrppt, Ridtp 3n3 City: Murrieta Zip: 92562 County of Riverside —FA-KAL kLT P(/9"6—e7/ A EN 1 _ DEPARTMENT OF ENVIRONMENTAL HEALTH www.rivcoeh.org OWTS INSPECTION CARD APN: Permit No.: ON 2905 Site Address; ?,10�(8�1�Vefs City: liAevII'ee- Zip: oloRssq To schedule an inspection please call.Riverside 951-955-8980 or ❑ Indio 760-863-7570 All cancellations/reschedules must be received prior to Sam on the day of inspection or additional fees will apply. OWTS Components FDate Re-Inspection Inspector of Inspection Date Initials ie See Septic Tank Abandon LL Sewer tateraI LL 'B-Box— luent Filters Final Inspection TOBEPO TEDAT BSRM NPLAI VIE Y` ore ( 1� � I�� I f oflw� `fIl