PMT17-03888 City of Menifee Permit No.: PMT17-03888
_ 29714 HAUN RD.
'�CCEL/? MENIFEE,CA 92586 Type: Pool/Spa -Residential
MENIFEE Date Issued:
10/31/2017
PERMIT
Site Address: 25950 BETH DR,MENIFEE, CA 92584 Parcel Number: 358-233-001
Construction Cost $25,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA 828 SO FT
Work:
Owner Contractor
STEVE&CAROL MANIGLIA ALOHA POOL&DESIGN INC
25950 BETH DR 41083 SANDALWOOD CIRCLE STE I
MENIFEE, CA 92584 MURRIETA, CA 92562
Applicant Phone:9514539728
MARK KLINGSPORN License Number:965927
ALOHA POOL&DESIGN INC
41083 SANDALWOOD CIRCLE STE I
MURRIETA,CA 92562
Fee Description QtV Amount t$1
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 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
I 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 ivision 3 ofthe Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full fort and effect. the following reason:
License Class LDS Lice a No. -765 5Z 7 By my signature below I acknowledge that,except for my personal residence
Expires Signature in which l 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 DECLARATI have built as an owner-builder if it has not been constructed in its entirety by
o I hereby affirm under penalty of perjuWone 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 following website:
by Section 3700 of the Labor Code,for the performance of work for which w,nw,leeinfo.ra.eov/calaw.html.
this permit is issued.
Policy If Date
o 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 y 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 caner or authorized to act on the property owners behalf.I have read this
number are: application anif the information I have provided is correct.I agree to comply
With all appli ble city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy q Expires enter the ah�ve identified property for inspection purposes. -
(This section need not to be completed is the permit is for one-hundred j• --
dollars($10D)or less Date
PROPER WNER OR AUTHORIZED AGENT
\rsj q certify that in the performance of the work for which this permit is issued,
4shallnotemolovan persons in any manner so as to become subject tot he CITY BUS IsS LICENSE If
workers compensa on laws of California,and agree that if I should become - HAZARDOUS MATERIAL DECLARATION
subject to the wor es compensation provisions of Section 3700 of the tabor
Code,I shall fr]rths ith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date Z mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAIL RE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes r;:No
UNLAWFUL,AOD 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(SC construction
or See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguld astA fines
CONSTRUCTION LENDING AGENCY oYes to
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) Dyes "a
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 usm tterl'i reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes "o Il ,�/j �7
/
Business and Professions Code).Any city or county that requires a permit to �( Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OW�IR ORAUTHORIZEDAGENT
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.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
receiving wmpensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of5ection 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($500). managers who do the paint-disturbing work themselves or through their
D I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.aov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800.424-LEAD(5323). ,
Code;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.IF,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because:
D 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING _ . ►
DATE: to s / PERMIT/PLAN CHECK NUMBER ���✓abt�
TYPE: O COMMERCIAL C RESIDENTIAL O MULTI-FAMILY O MOBILE HOMEWOOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBBIINGG O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK
PROJECTADDRESS 2'S SGy6 Agy� �z _ ZIP
ASSESSOR'S PARCEL NUMBER 3_�A .265-00I LOT TRACT 1�0
OWNER NAME Aq// GJr4-
ADDRESS ZJS-Z) -
PHONE EMAIL /
APPLICANT NAME
ADDRESS
PHONE EMAIL
I
CONTRACTOR'S NAME OWNER BUILDER? O YES Jd'NO
BUSINESS NAME �r7�
ADDRESS l _y-r`✓�-'� vGBo/J Gr•2. �ZS��
PHONE �$ /�7�� /EMAIL
CONTRACTOR'S STATE LIC NUMBER 9lv �! Ti 7 LICENSE CLASSIFICATION
VALUATION $ Zs��a -- SO FT /'' L SQ FT
APPLICANT'S SIGNATURE I DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY:
PERMITFEE SMIP —t GREEN
PLAN CHECK FEE INVOICE TOTAL
OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE#i NOTARIZED LETTER O YES O NO