PMT17-03709 City of Menifee Permit No.: PMT17-03709
29714 HAUN RD.
t Type: Pool/Spa-Residential
ACCELA? MENIFEE, CA 92586
MENIFEE Date Issued: 10/13/2017
PERMIT
Site Address: 29267 MOON HILL CT, MENIFEE, CA Parcel Number: 340-332-006
92584 Construction Cost: $54,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA W/GROTTO&SLIDE,.17 L FT GAS LINE FOR FIRE PIT&FUTURE BBQ
Work: ISLAND, 1 GFCI RECEPTACLE FOWFUTURE BBQ
Owner Contractor
JOSH&WINNIE LABAN ,
29267 MOON HILL CT
MENIFEE, CA 92584
Applicant License Number:
JOSH &WINNIE LABAN
29267 MOON HILL CT
MENIFEE, CA 92584
Phone: 9513767992
Fee Description QtV Amount f5l
Receptacle, Switch, Outlet& Fixture 1 116.00
Swimming Pool/In-Ground Spa 1 467.00
Piping/Repiping Single Family Residential 1 163.00
Building Permit Issuance 1 27.00
GREEN FEE 1 3.00
SMIP RESIDENTIAL 1 &00
General Plan Maintenance Fee-Plumbing 1 8.15
General Plan Maintenance Fee-Electrical 1 29.15
$821.30
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_Bidg_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe 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).
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's St_at\e License Law for
Professions Cade and my license is in full force and effect. the following reason: 3a5*VA,
License Class License No. By my signature below I acknowledge that,except for my personal residence
Expires Signature in which I must have resided for at least one year prior to completlon of
WORKER'S COMPENSATION DECLARATION 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 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 ofessions Code,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this applica ' s or at the following website:
by Section 3700 of the Labor Code,for the performance of work for which
.
this permit is issued. le , a.c 0 html.
1
Policy# I,11 Date Io 11-11 J 7
❑I have and will maintain worker's compensation insurance,as required by PR PERTY N R O A THORIZED AGENT / ,
section 3700 of the Labor Code,for the performance of the work for which El B igna[ure low 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 are: application and the information I have provided is correct.I agree to comply
Carrier with all applicebl ci d county ordinances and state laws relating to
gbuildingu io I uthorize representatives of this city or county to
Polity# Expires de ' d property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date IO/13 1-7
dollars($100)or less R R AUTHORIZED AGENT
❑I certify that in the performance of the work for which this permit is issued,
IshallnotemoloV any persons In any manner so as to become subject to the ICENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant 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 IS ❑Yes Wflo
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 ❑Yes oft
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 2'l(0
OWNER BUILDER DECLARATIONS I have read the Hazarclou5 MabirriRl Information Guide and the SCAQMD
permitting checklist.I u d rst n y requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California Healt ty o e, ction 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the haza 'al in
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es /
Business and Professions Code).Any city or county that requires a permit to Date O s/12
construct,alter,improve,demolish or repair any structure,prior to Its pit O N R O AU O ZED 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 Contractor's State EP RENOV ON REPAIR ND PAINTING RRP
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The Renovation,Rep r and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she 1s 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 RRPcertified 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.epa.goy/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 ❑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:
❑1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code: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.
SAFETYBUILDING & PERMIT/PLAN CHECK APPLICATION
a
Menifee
DATE: 10/03/2017 PERMIT/PLAN CHECK NUMBER (• 1 — !71�
TYPE: COMMERCIAL D RESIDENTIAL r-4 MULTI-FAMILY O MOBILE HOME • POOL/SPA SIGN
SUBTYPE: ADDITION _- ALTERATION c DEMOLITION O ELECTRICAL MECHANICAL
NEW PLUMBING RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF W01W Vx31 in ground Pool. 8' raised Spa. Man Made Grotto/Slide
Gas For Fire Pit & Future BBQ Island. 120V 15AMP GFI Receptacle for Future BBQ Island
PROJECTADDRESS 29267��M��o��o{{--n�� Hill Court, Menifee ZIP 92584/��-
ASSESSOR'S PARCEL NUMBER ...T[<J ✓3 p�•C�� LOT TRACT
OWNER NAME Josh & Winnie Laban
ADDRESS 29267 Moon Hill Court, Menifee, CA , 92584
PHONE 951-376-7992 EMAIL Wlam90501@yahoo.com
APPLICANT NAME Josh Laban
ADDRESS 29267 Moon Hill Court, Menifee, CA , 92584
PHONE 951-376-7992 EMAIL Wlam90501@yahoo.com
CONTRACTOR'S NAME N/A OWNER BUILDER? ' YES D NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER N/A LICENSE CLASSIFICATION
VALUATION$ 54,000.00 FT 49& �� �( i 3�1 L SQ FT 140
APPLICANT'S SIGNATURE DATE 10/0g2017
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PANNING ENGINEERING FIRE
PERMIT FEE SMIP Lt
GREEN
PLAN CHECK FEE INVOICE TOTAL
OWNER BUILDER VERIFIED G YES NO DRIVERS LICENSE R NOTARIZED LEFFER ! YES i_� NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee,CA 92526 9.551-,�6#)Menitee
w w w.ri t yofm en i f ee.us
E4ullding & safety Dept.