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PMT18-01126 City of Menifee Permit No.: PMT18-01126 29714 HAUN RD. AACt ELL�4 MENIFEE, CA 92586 Type: Pool/Spa-Residential MENIFEE Date Issued: 03/13/2018 PERMIT Site Address: 28715 ACANTHUS CT, MENIFEE, CA Parcel Number: 333-500-017 92584 Construction Cost: $32,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA, 394 SF,WITH U/G GAS LINE FOR FIRE PIT Work: Owner Contractor CLIFFORD MARTIN QUALITY CUSTOM POOLS INC 28715 ACANTHUS COURT 30138 MARNE WAY MENIFEE,CA 92584 MENIFEE,CA 92584 Applicant Phone: 9516799732 HANNAH BARRETT License Number.795820 QUALITY CUSTOM POOLS INC 30138 MARNE WAY MENIFEE, CA 92584 Fee Description Qy Amount 1$) Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 Inspections not specified 116 116.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 5.00 General Plan Maintenance Fee-Building 1 5.80 General Plan Maintenance Fee-Electrical 1 23.35 $646.15 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 properly 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 D 1 am exempt from licensure underthe Contractor's State License Law for Professions Code and my license Is in full force and effect. the following reason: License Class CS3 - License No. - 7-0 gY m nature below l acknowledge that,except form Y signature g p ypersonal residence Expires 2oI Signature in which l must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION Improvements covered by this permit.I cannot legallysell a structure that I have built as an owner-builder if it has not been constructed in its entirety by D I hereby affirm under penalty of perjury one of the following declarations:) licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure forwurkers 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 this permit is issued. www.leeinfo.ca.eov/calaw.latml. Policy It Date 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 D By my signature below I certify to each of the following:)am the property this permit is issued.My workers compensation insurance carrier and polity, 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 Carrier Cucres} N- ona.A with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# CA i 0 n c ?-I 1`I Expires 77/I IJ 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 OWNER OR AUTHORIZED AGENT D 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# workers 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 comppiLiyy�i with those provisions. Will the applicant or future building occupant handle hazardous material or Applicant' Date _ mixture containing 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 db Yes (gyVo UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES '"''++Wiill 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 car modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District cons(SCtionor modification checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo astAlrlin CONSTRUCTION LENDING AGENCY Wes ax hereby affirm that underthe penalty ofperjurythere is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency forthe performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) o Yes Q�vo 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 checklist.I understand my requirements underthe State of Contractors 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 �eDV��'a'J Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED 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,REPAIR 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 contactors Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a p and the basis for the alleged exempti re-1978 on.Any violation of Section 7031.5 by residence or childcare facility to he RRP-certified firms and comply with than Applicant fora permitsubjectsthe applicant toacivil penalty of not more required practices.This includes rental property ownersand 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.gov/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 Contactprs State License Law does not apply to an owner of a 0An 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 I,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 MENIFEE DATE: `6 I PERMIT/PLAN CHECK NUMBER Wff 1 11SX-0 PLANNING CASE NUMBER TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME---<POOL/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 G(,t,YXI fps. Cjl el -Pint PROIECTADDRE55 ,14'71 C,1 . ZIP C ASSESSOR'S PARCEL NUMBER ' j?j -�j(',y' ��'� LOT TRACT Building Dept. OWNER NAME p„r-�%,., MAR 13 2018 ADDRESS ZOOI N C Received PHONE �f.S'1.—1'Z S ' 91 D EMAIL APPLICANT NAME ccrrC—,v} ADDRESS I Q (31.Y-Y12 PHONE 9 S` EMAIL CONTRACTOR'S NAME , Ct,Yr-C OWNER BUILDER? 0 YES�QNO BUSINESS NAME S)00'L- ADDRESS 30134 vY%L V,-D - PHONE EMAIL p CONTRACTOR'S STATE LIC NUMBER _?G 9 q)_0 LICENSE CLASSIFICATION c-S 3 g VALUATION $ SQ FT 39 Li L SQ FT APPLICANT'S SIGNATU lll� DATE V13�I� 07-Y STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: _ '^ CIN OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE 1`�_Nlz? INVOICETOTAL 1 1 ;J GREEN a SMIP OWNER BUILDER VERIFIED 0 YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityofmenifee.us NIF Existing 5'6"CMU Wall ED 13"PlanterWall 9' r Spa fte•Step 6'Gas Flre Pit p 0' 26'S" lan— Comnite Area P Concreta Area pdOl 3q�1 SFPl. 7 lT Existing CMU Wail Concrete Area W Existing Patio Cover 'xT M Existing Patio Cover T � ' City of m n I j Martin Residence Bullding DE 000 28715 Acanthus Cf. Pool 0 Menifee, Ca 92584 /MAR 13 F-I�t 951-775-1970 �q p j ReCe ed ts 1 112"Poly Gas 1"Sch 40 UL CITY OF MENIFI BUILDING AND PLAN APPROVI REVIEWED B� -Approval of these plans s tpproval of,any violation regulations and ordinance jobsite until completion.