PMT18-01160 City of Menifee Permit No.: PMT18-01160
29714 HAUN RD. Type: PoollSpa-Residential
�!- CCIl MENIFEE, CA 92586
MENIFEE Date Issued: 03/1612018
PERMIT
Site Address: 29801 FAR SHORE DR, MENIFEE, CA Parcel Number: 333-700-006
92585 Construction Cost: $58,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA WITH GROTTO WATERFALL
Work:
Owner Contractor
CARLOS BRAVO MAJESTIC POOL CONSTRUCTION
29801 FAR SHORE DRIVE 31566 RAILROAD CANYON ROAD
MENIFEE, CA 92585 STE 2#106
Applicant Phone: 9514456384
OBIE RODRIGUEZ License Number: 889638
MAJESTIC POOL CONSTRUCTION
31566 RAILROAD CANYON ROAD
STE 2#106
CANYON LAKE, CA 92587
Fee Description gty Amount fSl
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 3.00
SMIP RESIDENTIAL 1 8.00
General Plan Maintenance Fee-Electrical 1 23.35
$628.35
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 contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 70DD)of Division 3 of the Business and o I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class G S3 License No. S 6 /O(/o
By my signature below I acknowledge that,except for my personal residence
Expires Z — ZO(!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 legally sell a structure that I
0lherehy affirm under penalty ofperjuryone of the following declarations:) have built as an owner-builder if it has not been constructed in its entirety by
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
compensation,issued by the Director of Industrial Relations as provided for 7044 of the Business and Professions Code,is available upon request when
by Section 3700 of the Labor Code,for the performance of work for which this application is submitted or at the following website:
this permit is issued. www.leeinfo ca eavycalaw hurl.
Policy It —
Date
have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
/sdliItion 3700 of the Labor Code,for the performance of the work for which 0 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 owners behalf.i have read this
number are: application and the information I have provided is correct.1 agree to comply
Carrier_ SI -(7usJ L-D with all applicable city and county ordinances and state laws relating to
Polity#o1 � Y£�O�f� building construction.I authorize representatives ofthis city or county to
( Expires_ 4 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
_01 certify that in the performance of the work for which this permit is issued, PROPERTY OWNER OR AUTHORIZED AGENT
I 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
subject to the workers comSs of Section 3700 of Lobar HAZARDOUS MATERIAL DECLARATION
Code,I shall f ncco rions. Will the applicant or future building occupant handle hazardous material ora
Applicant Date ( mixture containing a hazardous material equal to or greater that the
amounts�'sp&ecifred on the Hazardous Materials Information Guide?
WARNING:FAILURETO SECMPENSATION COVERAGEIIs 0Yesd(NoUNLAWFUL,AND SHALL SUR TO CRIMINAL PENALTIES /\4
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the int nded use of the building by the applicant or future building
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist
lines
CONSTRUCTION LENDING AGENCY OYes forguld�,No
I hereby affirm that under the penalty of perjury there 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) 0 Yes a(No
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 Rem(s)(Section 70315 h ardous material reporting.
Business and Professions Code).Any city or countythat requires a permit to
construct,alter,Improve,demolish or repair any structure,prior to its / Date-3-2
issuance,also requires the applicant for the permit to file a signed statement PR N ORAUTH IZE GENT
that he orshe is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AN AINTING(RRP)
Ucense Law(Chapter9(commencing with Section 7000)of Division 3 ofthe
Business and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-1978
an Applicant for a perm it subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified firms and comply with
than($500). required practices.This includes rental property owners and property
managers who do the paint-disturbing work themselves or through their
01,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.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 Contractors State License Law does not apply to an owner of a
property who,through employees'or personal effort,builds or improves the 0 An EPA Lead-Safe Certified Renovator will be responsible for this project
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
completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.: '
not built or improved for the purpose of sale. 0 No EPA Lead Safe Certified Firm is required for this project because:
0 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.
MENIFEE
.,
t
DATE: `� _ 1 / PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: 0 COMMERCIAL 0 RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME POOL/SPA O SIGN
SUBTYPE: 0 ADDITION C ALTERATION O DEMOLITION O ELECTRICAL 0 MECHANICAL
O NEW O PLUMBING 0 RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK O OIL S S 6L A - � vo nJ4'-P,1
ice+
PROJECTADDRESS 2—iV-01 / � ZIP 92_5`0 r
ASSESSOR'S PARCEL NUMBER 333- '7C.b-(fXjLO LOT TRACT City of en ee
OWNER NAME C4 v ' Building Dept.
ADDRESS S'4
PHONE /611 S 716 5v EMAIL Received
APPLICANT NAME 015ldc- O/,'�/�iV� Z ecei V
ADDRESS 1 f70
PHONE l�,j kOO O// Z__ EMAIL Q % e. C " CJoIS• COS-,
v
CONTRACTOR'S NAME rr /OWNER BUILDER? O YES ^ 0
BUSINESS NAME ^c5^Tl L 0 c'(.._ a 1Y 4' --C�-+
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE
��LIJJCNUMBER "?Lf LICENSE CLASSIFICATION 4f
VALUATION$ tij d CI 6 SO FT `f �p 3 L SO FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL I 5a g GREEN 3- SMIP
OWNER BUILDER VERIFIED C 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
n
ENIFE