PMT18-01127 City of Menifee Permit No.: PMT18-01127
29714 Type: Pool/Spa-Residential
. C�CCEL/�1 MENIFEE,
CA 92586 MENIFEE Date Issued: 03/13/2018
PERMIT
Site Address: 30911 LAJOE ST, MENIFEE, CA 92584 Parcel Number: 360-465-015
Construction Cost: $34.000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA, 579 SF
Work:
Owner Contractor
TIMOTHY KAUFMAN QUALITY CUSTOM POOLS INC
30911 LAJOE STREET 30138 MARNE WAY
MENIFEE, CA 92584 MENIFEE,CA 92584
Applicant Phone:9516799732
HANNAH BARRETT License Number: 795820
QUALITY CUSTOM POOLS INC
30138 MARNE WAY
MENIFEE,CA 92584
Fee Description Qtv Amount!$)
Swimming Pool/In-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 Menffee.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_aldg_Permil_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)pursuanttothe Contractors State License Law).
Chapter!)(commencing with section 7000)of Division 3 of the Business and O I am exemptfrom licensure underthe Contractols5tate License Lawfor
Professions Code and my license is in full force and effect. the following reason:
License Class CS3 " Q License No. 7cl9$2-0 By my signature below l acknowledge that,except for my personal residence
Expires 201¢. Signature /icy.— in which l must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit 1 cannot legallysell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
o I hereby affirm under penalty of perjury one of the following declaration: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
this permit is issued. www.leeinfo.ca.eov/calaw.html.
Policy# Date
,_-A4 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 o 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 conect.I agree to comply
Carrier CutrtS} N VinoA with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Polity# CA z 0 n o 'L15"t Expires 7/I /I S 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 Date
PROPERTY OWNER OR AUTHORIZED AGENT
D I certify that in the performance of the work for which this permit is issued,
shall not emolov 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,l shall forthwith compI with those provisions. Will the applicant or future building occupant handle hazardous material or
Applicant O/t�o, Date /" mixture containing a hazardous material equal to orgreater that the
—r- amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS CbgYes (3�tlo
UNLAWFUL,AND SHALLSUBIECTAN EMPLOYERTO CRIMINAL PENALTIES Will the intended use of the building bythe 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 hecoDistrict(SCtionor See permitting from
checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES foist Ai.rQ s
CONSTRUCTION LENDING AGENCY �j'es 2
I hereby affirm that underthe penalty of perjurythere is a construction Will 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) o Yes 000
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that l 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 California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 r.rshazardous material reporting. /
Business and Professions Code).Any city or county that requires a permit to 3/ L
Date\>1D /)7
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(Chapter9(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 orchildcarefacilitytobeork tatditurb painIcomre-197ply h
th Applicant for a permit subjects the applicant toacivil penalty of not more required practices.This includes rental property owners and property
than($500).
managers who do the paint-disturbing work themselves orthrough their
❑1,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 D An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the P p 1
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:
o 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: PERMIT/PLAN CHECK NUMBER a,
PLANNING CASE NUMBER
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOM 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 QolAvj4-P_ al cc_vi e)
PROJECTADDRESS 60cl ( t o , Y-j ZIP
ASSESSOR'S PARCEL NUMBER 3100-14 rogS ' 01,S LOT TRACT
OWNER NAME
ADDRESS 1309 1 ► Ob Building Dept.
PHONE OL L-\9 . S'514 . 5S1 Zy EMAIL MAR @ J 2018
APPLICANT NAME W LA 0, " %C)Ly-rq;-� Received
ADDRESS yy\.e W
PHONE C` S \ (j" Q-1 62 EMAIL
CONTRACTOR'S NAME J a M Y-V- OWNER BUILDER? OYES O
BUSINESS NAME \,C, k` t-O,,-, ' ,
ADDRESS p\3Q, r-Aay
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER "79 S 9 20 LICENSE CLASSIFICATION ( 3
VALUATION$ b SQ FT vj—1 cj L SQ FT
APPLICANT'S SIGNATURE DATE 3 3
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTEDBY: � CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL I 43P GREEN - SMIP
OWNER BUILDER VERIFIED OYES O 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
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Kaufman Residence
30911 LaJoe St.
Menifee, Ca 92584 .to
949-554-5824
aITY OF MENIFEE
UILDING AND$AFE'y
N APPROVAL
I \
VIEWED BY
'Approval of these plans shall not be cons,
ap rovalof,,anyviolationofanyprovisiona
re ulations and ordinances. A4 set ofappi
site until completlon.