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PMT17-03941 City of Menifee Permit No.: PMT17-03941 29714 HAUN RD. �CCEL/b1 MENIFEE,CA 92586 Type: Pool/Spa-Residential MENIFEE Date Issued: 11/01/2017 PERMIT Site Address: 28820 RICHFIELD CIR, MENIFEE, CA Parcel Number: 372-440-020 92584 Construction Cost: $32.000.00 Existing Use: Proposed Use: Description of UNDERGROUND POOUSPA-440 SQ FT WITH 1 POOL AND 1 SPA LIGHT. Work: - - Owner Contractor AARON&HILDA NERING CERTIFIED POOL TECH 28820 RICHFIELD CIRCLE P 0 BOX 890905 MENIFEE, CA 92584 TEMECULA, CA 92589 Applicant Phone:6194543062 KEVIN MURPHY License Number:394246 CERTIFIED POOL TECH P O BOX 890905 TEMECULA, CA 92589 Fee Description City Amount 151 Swimming Pool/ln-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 5.00 General Plan Maintenance Fee-Electrical 1 23.35 $524.35 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_Pennit 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 contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from Iicensure under the Contractor's State License Law for Professions Co a annddjny IicSnse is in full force and effect * _ /_ the following reason: """��� License Class v J / rff� Lic S No. `� By my signature below I acknowledge that,apt for my personal residence i `, ch I must have etion of Expires 7/ C Signature In imp olvem nts coveredsided by hIs pe 1 r``�+n gaIly5 111 ao t ulcture that I WORKER'S COMPENSATION DECIARA ON have built as an owner-builder '5 been�cof�1 led in its entirety by o I hereby affirm under penalty of pep ry one of the'following declarations:I licensed contractors.I understan at a c`o`ptf the appllcable Section have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions COB�tis available up when compensation,issued by the Director of Industrial Relations as provided for Mowing c by Section 3700 of the Labor Code,for the performance of work for which this application Is submitted or at the f owing webs�� this permit is issued. www.leelnfo.ca.eov/calaw.html. Policy R to o I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AG dT section 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 workers 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 applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy R Expires enter the above identified property for inspection purposes. (This section eed not to be completed is the permit is for one-hundred Date dollars 0-1 or less PROPERTY OWNER OR AUTHORIZED AGENT 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 If workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the orkers compensation provisions of Section 3700 the labor Co, e,I shall ith on, ¢with those provisions. / Will the applicant or future building occupant handle hazardous material or a Applicant � Da mixture containing a hazardous material equal to or greater that the amounts spe on the Hazardous Materials Information Guide? WARNI G:FAILURE SECURE WORKER'S COMPENSATION COVERAGE IS o Yes VIKO UNLAWFUL,AND ALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the Intended use of the building by the applicant or future building AND CIVIL FINES O 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 M agement District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guideline CONSTRUCTION LENDING AGENCY ❑Yes o I hereby affirm that under the penalty of perjury there is a construction WIII the propos!eouilding or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer bou of a school? (Section 3097 Civil Code) o Yes UNO OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the 5CAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of Contractors License Law for the reason(s)indicated below by the Callf0imp Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ha ousha ous mat��eporting. Business and Professions Code).Any city or county that requires a permit to es ❑N r / construct,alter,Improve,demolish or repair any structure,prior to its Date Issuance,also requires the applicant for the permit to file a signed statement PROPER OWNER ORA ORIZEDAGENT i that he or she Is licensed pursuant to the provisions of the Contractors State EPA RENOVATION RE IR AND PAINTING 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 liceuure 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 o 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.eo(a.eov/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 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 built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because: in 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 & SAFETY PERMIT/PLAN CHECK APPLICATION "Alk� Menifee DATE: ('� 7 PERMIT/PLAN CHECK NUMBER � TYPE: O C MMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME VP_oOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMMBB`I_NG O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK PROJECTADDRESS �j (iD / (if�( 1fLG� ��� ZIP ASSESSOR'S PARCEL NUMBER A- 40 bati LOT 3 eDI'- TRACT OWNERNAME /f'1�'0/V lLh� IV irG21 d� ADDRESS PHONE EMAIL APPLICANTNAME IV UP- ADDRESS , . / p PHONE '7 1//— `T U (l LJ�! EMAIL ,/"l U A 1/" . ON CONTRACTOR'S NAME E BUILDER? OYES tZTJO BUSINESS NAME ADDRESSy`, �J //�j PHONE �' ( o` Gy[��(// EMAIL ' -`� CONTRACTOR'S STATE LIC NUMBER -/ / � �� LICENSE CLASS FICA ON C 4" VALUATION$ �v- 00Z) SO.FT / b L SO FT APPLICANT'S SIGNATURE '�- DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE ACCEPTED B ' � I I f I D I 2-Dl PERMIT FEE .,1 L�. rj• 1 SMIP GREEN PLAN CHECK FEE 1A INVOICE TOTAL OWNER BUILDER VERIFIED O YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES O NO (:ily Nf110 Ot Mern(ee BGQ tlnnt. City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 9258f bV-fi-6ff www.cityofinenifee.us IYUY Ct,!. Received t _ El j t � ® u t� z M f?