PMT18-01162 City of Menifee Permit No.: PMT18-01162
29714 HAUN RD. Type: Pool/Spa-Residential
4�k-GCC A> MENIFEE, CA 92586
`"""-1'k syk— MENIFEE Date Issued: 03115/2018
PERMIT
Site Address: 25235 STEPPING STONE CIR, MENIFEE, Parcel Number: 339-403-022
CA 92584 Construction Cost: $36,500.00
Existing Use: Proposed Use:
Description of INGROUND POOL ONLY,410 SF WITH HEATER
Work:
Owner Contractor
MATT&SHANNON BARNETT CAL/PACIFIC POOLS&SPAS INC
25235 STEPPING STONE CIRCLE 17024 VAN BUREN BLVD STE C
MENIFEE, CA 92584 RIVERSIDE, CA 92504
Applicant Phone: 9517762002
GARY SOPER License Number:652876
CAL/PACIFIC POOLS&SPAS INC
17024 VAN BUREN BLVD STE C
RIVERSIDE, CA 92504
Fee Description Q�t 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 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_Sldg_Pennit_Terrplate.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION propertywho builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjurythat I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License taw).
Chapter-9(commencing with section 7000)of Division 3 of the Business and o I am exempt from]!censure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class �� --ticense�t . A
By my signature below I acknowledge that,except for mVpersonal residence
Expires_ Signa 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 DECLA ION
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 workers 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.leginfo.ca.gov/�law.html.permit is issued.
Policy# Date
' I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
ssection 3700 of the Labor Code,for the performance of the work for which y my signature below I certify to each of the folloWng: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.]agree to comply
Carrier. JCY d/L/[G� /�//t with all applicable city and county ordinances and state laws relating to
^ 0 builnsttaU` authorize representatives of this city or county to
Policy fL�G)C_ //S 9'27 Expires y" �3 /a nter the above identified-pro rty for inspection purposes. p
(This section need not to be completed is the permit is for one-hundred Date 2-
dollars($100)or less PROP&W-OWN R AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit is issued,
I shall no[em to anypenvnsin-ar yY mpnner so as to become subject to the CITY BUSINESS LICENSE#
workerso ns3tion-laws of California\and agree that if I should become HAZARDOUS MATERIAL DECLARATION
c
subjecyt the corkers compensation pp4isions of Section 3700 of the Labor
Co Ishall forth�wi hcomply will t use provisions. Will the applicant or future building occupant handle hazardous material or
/ 0 mixture containing a hazardous material equal to or greater that the
plican Date +� amounts spelfied on the Hazardous Materials Information Guide?
WARNING:SA RE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes No
UN— LA�rANDTSHALtSLr9JECT 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 DDUARS($10D,000),IN occupant requires permit for the construction or modification from South
IN SECTIODITION N
3 THE COST OF COMPENSATION,CODE,INTER DAMADATTOGES AS REYSFEOVIDED FOR Coast Air Quality Management District(SCAQM D)?See permitting checklist
IN SECTION 37060FTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguideli
lum-
CONSTRUCTION LENDING AGENCY ❑Yes r6 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
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 under the State of
Contractors License Law for the reason(s)indicated below by the California Health o e, e . 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardo ateria po qng.
Business and Professions Code).Any city or county that requires a permit to oY No \ Date
construct,alter,improve,demolish or repair any structure,prior to its pROPERTyO NE OR AAA EDAGENT
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(RRPI
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 licersure receiving compensation for most work that disturbs paint in apre-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
D 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.ena.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:
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.
MENIFEE
DATE: �' tlS /a PERMIT/PLAN CHECK NUMBER a
PLANNING CASE NUMBER
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME ?TOOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
' W O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK L dot//V HJ/1 �J
PROIECTADDRESS ZT 1 2 s gLLC-`� ZIP
ASSESSOR'S PARCEL NUMBER '3?r- `/b 3 ^ DX2_ -6 LOT / TRACT �StY Menif
OWNER NAME ,6y✓z,,�/F-r7 77 /�/vD '�/9/l/�YO/[/
ADDRESS x S�� s �' �°p/�/6 .freT/� Qi 12--- �c^ MAR 15 201
11
PHONE cl�'1 - 7 `f�3 93 7S EMAIL ,O Receh
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APPLICANT NAME f CUL-C �,5
ADDRESS 17161 �£.5/J 2 /t'1 ��C�C �l�C✓IJ/�F" S'2 in 7
PHONE 9rr --??�_ 16) EMAIL
CONTRACTOR'S NAME 14t
Q OWNER BUILDER? O YES O
BUSINESS NAME �/�/�/ c- �L c- o l 1�7/0J
ADDRESS 0 O 1- / r/W /( //
PHONE �Sf 7 �(� ZItII31 a--d EMAIL
CONTRACTOR'S STATE LICNUMBER F S)-V76 LICENSE CLASSIFICATION CS"7
VALUATION$ 6 j Q FT / L SQ 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 SaL , GREEN SMIP
OWNER BUILDER VERIFIED 0 YES 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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