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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.