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PMT17-03778 City of Menifee Permit No.: PMT17-03778 29714 HAUN RD. �ljCCEt./�k. MENIFEE,CA 92586 Type: Pool/Spa-Residential `"'�'°'" " MENIFEE Date Issued: 10/23/2017 PERMIT Site Address: 25301 ROBINSON CREEK,MENIFEE,CA Parcel Number: 339-383-008 92584 Construction Cost: $40,000.00 Existing Use: Proposed Use: Description of IN GROUND POOUSPA. 2 LIGHTS AND 2"POLY GAS LINE. Work: Owner Contractor EMMANUEL CHAVEZ MAJESTIC POOL CONSTRUCTION 25301 ROBINSON CREEK 31566 RAILROAD CANYON ROAD MENIFEE,CA 92584 STE 2#106 Applicant Phone:9514456384 OBIE RODRIGUEZ License Number:889638 MAJESTIC POOL CONSTRUCTION 31566 RAILROAD CANYON ROAD STE 2#106 CANYON LAKE, CA 92587 Fee Description ON Amount f$) Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 6.00 General Plan Maintenance Fee-Building 1 0.00 General Plan Maintenance Fee-Electrical 1 23.35 $525.35 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 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 contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and 0I am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and effect p the following reason: S License Class 6 .3 License No. 5- G 6 3 a By my signature below i acknowledge that,except for my personal residence Expires — 7-0/C7 Signature in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a stmcture that I 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 workers 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 fallowing website: by Section 3700 of the Labor Code,for the performance of work for which www.IeRinfo.u.gav/caIaw.htmI.permit is issued. Policy g Date I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT se 'on 3700 of the Labor Code,for the performance of the work for which 0 By my signature below I certify to each of the following:I am the property this permit is issued.My workers compensation insurance order 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 with all applicable city and county ordinances and state laws relating to Carrier .S rTf_ building construction.I authorize representatives of this city or county to Policy p Expires `T - 2 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 Dale PROPERTY OWNER OR AUTHORIZED AGENT ❑I 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 laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers camp ation ro9 isions of Section 3700 of the Labor Code,I sh t co p Ith provisions. Will the applicant or future building occupant handle hazardous material or a Applican ate / mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORT 'S COri SATION COVERAGE Is o Yes r l0 UNLAWFUL,AND SHALL SUBIECr AN PLOYRIMINAL 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 Coas[Air Quality Management District(SCAQMD)?See permitting Checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guide[i s CONSTRUCTION LENDING AGENCY o Yes No 1 hereby affirm that under the penalty of perjury there is a construction Will th 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 bou�"dary of a school? (Section 3097 Civil Code) ❑Yes of No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD I hereby affirm under penalty of perjury that I am exempt from the Permitting checklist I understand my requirements under the State of California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous an I reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es 0 Business and Professions Code).Any city or county that requires a permit to Date 3� construct,alter,improve,demolish or repair any structure,prior to its pR NER OR ORI 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 Contractors state EPA RENOVATION.R PAIR AINTING(RRP) License Law(Chapter 9(commencing with Section 7000)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 0I,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.eav/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-80OA24-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 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 Certffimtlan 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: 01,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 & SAFETY PERMIT/PLAN CHECK APPLICATION DATE: PERMIT/PLAN CHECK NUMBERPWI 03-1 16 TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME OL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK CO C- .s'P/F ry 6::o tTT 1-44U- PROJECTADDRESS ZS"3 o �2/eOB r/✓�y^) / £�>� Q' ZIP Z.r&51 ASSESSOR'S PARCEL NUMBER J� � 7Jg�'C)CfoLOT y TRACT ea b OWNER NAME .41VV% G- G> ✓L ADDRESS 7' s'3 a / / S coocxEl- PHONE I '74 O 2? 7 g3,L EMAIL APPLICANT NAME �'.,��v�' r6 ADDRESS 3/ ! / �� p 0"4 �'� r.I PHONE 9rI V Cl5' 6 308 EMAIL CONTRACTOR'S NAME OWNER BUILDER? OYES Q NO BUSINESS NAME J. LSt s1)G 00 L ,./S'Pvv✓G`V ADDRESS PHONE G EMAIL CONTRACTOR'S STATE LIC NUMBER 6 "4.:e LIICENSE CLASSIFICATION 657 � VALUATION $ 4 v d SQ FT Olt L SQ FT APPLICANT'S SIGNATURE DATE �0 r 1 7 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF,MENIFEE BUSINESS LICENSE NUMBER V BUILDING PLANNING ENG ERING FIRE ACCEPTED B PERMIT FEE _J� J• 3s SMI GREEN PLAN CHECK FEE INVOICE TOTAL OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO t _of Menitee r.�of!?deri`3e Br!;!ding SGfor;-Oei; 97 crrrie�,. .' 1�i ri r,:Un ,R,'. A;ier I',Fee, �A S__..�3-::-;Building & Basely Dept. -ex, t�1 OCT6 V 1;