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PMT17-04572 City of Menifee Permit No.: PMT17-04572 c 29714 HAUN RD. Type: Pool/Spa -Residential ;NCCEL/-> MENIFEE, CA 92586 MENIFEE Date Issued: 12/29/2017 PERMIT Site Address: 28585 VELA DR, MENIFEE,CA 92586 Parcel Number: 339-481-011 Construction Cost: $25,000.00 Existing Use: Proposed Use:. Description of INSTALL 414 SQ FT POOL AND 50 SQ FT SPA WITH HEATER GAS AND ELECTRIC. FUTURE Work: ELECTRIC AND GAS STUB OUT AT FIRE PIT. Owner Contractor KIMBERLY NEUGART MR CARLOS POOLS AND CONSTRUCTION INC 28586 VELA DR 978 NORTH AMEILA AVE SAN DIMAS, CA 91773 Applicant Phone:6263328731 DIANE JOHNSON License Number:385622 MR CARLOS POOLS AND CONSTRUCTION INC 978 NORTH AMEILA AVE SAN DIMAS, CA 91773 Fee Description QtV Amount ISI Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 4.00 $499.00 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specificafions or from preventing builiding operations being carded 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 with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from Ilcensure underthe Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: License Class Ci 53 License No. 'J`d 5 oZ ) By my signature below I acknowledge that,except for my personal residence Expires 5 51! ( Signature in which I 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 DECLARATION 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 worker's 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 www.le info.ca. ov talaw.html. this permit is issued. /_ � Policy# Date .44/^ /"have and will maintain workers compensation insurance,as required by YYY PROPERTY OWNER 0 AUifFIORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which f I;By my signature below 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 sll\Alixf \ tt 5 U v,6LAA e_,P with all applicable city and county ordinances and state laws relating to �+ building construction.Iauthorize representatives of this city or county to Policy# M 6 111.U-e Expires lo�/�l Sri enter the above identified property for Inspection purposes.(This section need not to be completed Is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNE OR UTHORRED AGENT o I 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# worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith con with t se provisions. a/ N fy Will the applicant or future building occupant handle hazardous material or a Applicant ate /Al L I I mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SEC R ORKER'S COMPENSATION COVERAGE IS 0 Yes rNo UNLAWFUL,AND SHALL SULUECT'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($300,000),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(SCtionor modee ification checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY oyes PNo I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 100D 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 �y No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjurythat I am exempt from the permitting checklist I understand my requirements under the State of Contractor's License Law for the reason(s)Indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting. Business and Professions Code).Any city or county that requires a permit to )Xes�(�❑�No ) construct,alter,improve,demolish or repair any structure,prior to its � r Date /A/�I j `'7 issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNER R A ORIZED AGENT that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION.RiAIR AND PAINTING fRRP) License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RAP)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 casts or a e alleged exemption.Any violation of Section of not by residence or childcare facility to be RRP-certified firms and comply with thanApplicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). P P m' 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.eoa.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 ❑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. 0 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 70",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 RAP rule please fill out the RAP Acknowledgement. SAFETYBUILDING PERMIT/PLAN CHECK APPLICATION - y IP.fl- iee DATE:12/29/17 PERMIT/PLAN CHECK NUMBER '— TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME 6 POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL $NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK Build new gunite pool and spa (pool is 414 sq. ft., and spa is 50 sq. ft.). Gas and electrical stub and 600 sq. ft. of concrete. PROJECT ADDRESS 28586 Vela Drive, Menifee ZIP 92586 ASSESSOR'S PARCEL NUMBER 339-481-011 LOT 39 TRACT28859-1 OWNERNAME KimberlyiNeugart ADORE,,sS 28586 Vela Drive, Menifee, CA 92586 PHONE 951-491-1609 EMAIL Diane.mrcarlospools@gmaiI com eool�renlT•uenec Diane Johnson ADDRESS 978 N. Amelia Ave., San Dimas, CA 91773 PHONE 909-227-1874 EMAIL Diane.mrcadospools@gmail.com CONTRACTOR'S NAME Mr. Carlos Pools & Construction © OWNER BUILDER? OYES ONO BUSINESS NAME Same as Contractor ADDRESS 978 N. Amelia Ave., San Dimas, CA 91773 PHONE 626-332-8731 EMAIL mrcarlos@verizon.net CONTRACTOR'S STATE LIC NUMBER OO:JOLL LICENSE CLASSIFICATION •'-''� C153 VALUATION$ 25,000 SQ FT 464 (pool &spa) L SQ FT APPLICANT'S SIGNATURE DATE 12/29/17 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF ME NIFEE BUSINESS LICENSE NUMBER ACCEPTED BY: BUILDING PLANNING ENGINEERING FIRE rEnlwll FCC JIVIIP VRLCIV PLAN CHECK FEE INVOICE TOTAL OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO City of Menifee Building &Sofety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.Cityofinenifee.uS Dlayw- Job Site Address: d,gL"' S6 U$.IQ�Y`. CITY OF MEN]FEE Contact/Phone#: aloR—a��_IS7� POOL SUBCONTRACTOR FORM CONTRACTOR CONTRACTOR CITY BUSINESS CATEGORY LICENSE#/CLASS LICENSE# POOLCONTRACTORaS56aYa- 33 ALARM SYSTEM CONCRETE(DECK) {� J 1 n V1 o eLE ELECTRICAL EXCAVATION FENCE GUNITE MECHANICAL PLASTER PLUMBING STEEL TEMPERED GLASS TILE OTHER c, NO (n oC Z O PC O 4C O HOUp 3U 1L ' Q CO ¢ p0[ = O OWp Zm � � � N to Cf W i W U N W W < - --- -Lnj Mb LU w ---------------- ca 0 uj o m � s aVd t�3 53NI mN � QQ o w cN Y Q Q K � c0 N J + � OZ Q � O w aZ wQ < w = Q U LU W w U C� zz � wF w ^ CNN J z N X Z Lu m N F W p Z O Lo N QQ x WU Qv Q b 11 4 Q J Z U W U PC j W F � Um D Z w J 9 w m W U W Z Z W o >- .........................NATURAL LOT ORAINAGE.................... � Ui -z QZ