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PMT18-01605 City of Menifee Permit No.: PMT18-01605 29714 HAUN RD. Type: Residential Electrical <A—CCEL/F%> MENIFEE, CA 92586 MENIFEE Date Issued: 04/06/2018 PERMIT Site Address: 26215 CHERRY HILLS BLVD, MENIFEE, Parcel Number: 337-090-021 CA 92586 Construction Cost: $7,500.00 Existing Use: Proposed Use: Description of REMOVE EXISTING TUB, INSTALL NEW WALK-IN TUB, INSTALL NEW 20 AMP CIRCUIT FOR Work: OUTLET, DRYWALL PATCH Owner Contractor IRENE TUPPER SAFE STEP WALK-IN TUB COMPANY INC 26215 CHERRY HILLS BLVD 15262 PIPELINE LANE MENIFEE,CA 92586 HUNTINGTON BEACH, CA 92649 Applicant Phone:7143738545 SAFE STEP WALK-IN TUB COMPANY INC License Number: 983603 15262 PIPELINE LANE HUNTINGTON BEACH, CA 92649 Phone:7143738545 Fee Description O_yt Amount I$1 Receptacle,Switch,Outlet&Fixture 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Electrical 1 5.80 $149.80 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_Perrnit_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 1 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 o I am exempt from Iicensure under the Contractors State Ucense Law for Professions Cade pryi my license is In full force and effect. the following reason: License ..Class ''�� tense lVe� 11s�a- By my signature below l acknowledge that,except for my personal residence Expire{lap� signature c71- L� in which I must have resided for at least one year prior to completion of improvements covered by this permit.1 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 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.leeinfo.ca.gov/ca law.html. this permit is issued. Policy 4 Date PROPERTY OWNER OR AUTHORIZED AGENT o I have and will maintain workers compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which ❑By my signature below I certify to each of the following:I am the property this permit is issued.My workersAmpensati Insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this number are: 1�j ( application and the information I have provided is correct.I agree to comply V\ Iv—� N with all applicable city and county ordinances and state laws relating to Carrier � �r building construction.I authorize representatives of this city or county to Policy K C't`0�—n Expires — (— 4 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 o I certify that in the performance of the work for which this permit Is issued, I shall not empinv any persons in any manner so as to become subject to the CITY BUSINESS LICENSE 8 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,1 sf�t\�fo\rthw"r_D�)comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant \\, .7' 1 / Date .�, mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes ❑No UNLAWFUL,AND SHALL SUBJECT 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($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 District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCr1ON LENDING AGENCY ❑Yes ❑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) ❑Yes ❑No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that am exempt from the permitting checklist.I understand my requirements under the State of California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reasons)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes o No Business and Professions Code).Any city or county that requires a permit to 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(RRPI License Law(Chapter 9(commencing with Section 7DODI 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 Iicensure 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 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($500). managers who do the paint-disturbing work themselves or through their o I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at not Intended or offered for sale.(Section 7044,Business and Professions 1-BOD-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the Improvements are not intended or offered for Certified Finn Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because: o I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7D44,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RAP rule please fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: PERMIT/PLAN CHECK NUMBER I(?- I lP PLANNING CASE NUMBER TYPE: O COMMERCIAL RESIDENTIAL C MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: C ADDITION ALTERATION :;DEMOLITION GtJ'ELECTRICAL C MECHANICAL O NEW LUMBII1NG C//RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK /?-P7iv�VE o7�(� (h.$k/) ,v LtTs //Jc."bb'Nc-ln 11' ZO �"'r CAYzwni t- /V� om"V+ Wr l % PROJECTADDRESS 969I1; Li,ecqf 11FI/S "Vvd ZIP ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME lreAe- K 8r ADDRESS '76 /5 eAeCy Ni1)S Blvd Spin 6, cA qZSZ if V PHONE 141 Z33 i4864 EMAIL Building Dept. APPLICANT NAME Al,� IwiS uer" APR 0 6 2018 ADDRESS /526ZReceived �' 2if.n �y�vrl n �B /LI dla0 �cI PHONE 7)L/ 373 ;'ry! EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES 0 BUSINESS NAME ADDRESS /S2fjL ,Ili LPI , %NYI�I /ti �'I. Ca -/ L( 9 PHONE 714 373 j$''1S EMAIL CONTRACTOR'S STATE LIC NUMBER yn3 e3 LICENSE CLASSIFICATION VALUATION $. 7561-0 SQ FT L SQ FT APPLICANT'S SIGNATURE 17a� � DATE LI b 1 CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION '�`f{ ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENG EERING ' I E - C74e INVOICE TOTAL - LAOI,S{o GREEN ov SMIP OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER C YES O NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityofinenifee.us `= 7 ENIF 'y�:- ter; cn � c � \ � k 'D C4 Cl)CO) CO n_ m \ \ / » < M � ® ow m k . _ . / ƒ - q CD / � � � © 0� 4;k > z \ \ 0c 22m CO ' CO) -0 e � � 0 \ O r O m m :E / > I e 2 CDRc r � � z > z m $ - -_ ± \ ? � 2to \ � � k \ƒ } k {k kA CO) -0I -L / wlc � D ■a krn o - 2 -n 2 � z "a@ IL i 2 / -4 � � m 0 Ror � , ) ( } 46 CUM > it p ® ; © (ri m r, � _ / , k \ � \ w # i m j ) \ x m z ; S \ \ ' } \ /CD C) CD D 0- 0 > 0 O gr « # to �� ' O % tP Dr? 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