PMT18-01683 City of Menifee Permit No.: PMT18-01683
29714 HAUN RD. Type: Pool/Spa-Residential
r�A'? MENIFEE,CA 92586
arum,ASML—x MENIFEE Date Issued: 04/12/2018
PERMIT
Site Address: 26822 ELK CREEK CT, MENIFEE, CA Parcel Number: 338-342-028
92586 Construction Cost: $46.000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA,350 SF
Work:
Owner Contractor
JOE&COURTNEY CHEBAT CAL/PACIFIC POOLS&SPAS INC
26822 ELK CREEK COURT 17024 VAN BUREN BLVD STE C
MENIFEE,CA 92586 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 (j,yt Amount(bl
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 2.00
SMIP RESIDENTIAL 1 6.00
General Plan Maintenance Fee-Electrical 1 23.35
$525.35
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 buiiiding 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_Pennit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds orimproves 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 o 1 am exempt from Iicensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
a
License Class 0C 0 --licenSIFN . By my signature below l acknowledge that except for my personal residence
Expires T4 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 DECLAR ION 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 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 worker's 7U44 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.leeinfa.ca.¢ov/calaw.html.
this permit is Issued.
Policy g Date
CI have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which 2
my signature below I certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
numberare: �/ � application and the information I have provided is correct.I agree to comply
Carrier_ Jc�C d2/`!!n /V./Li[/V with all applicable city and county ordinances and state laws relating to
build' g-c-0nstru l authorize representatives of this city or county to
Policy iL odc /!S q} "j Expires y- J-3 �/a nter the above iden[ifietl pfo rty for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date �^ Z—�O
dollars($100)or less y
PROPE'R'FY--OWNER JAR AUTHORIZED AGENT ae
O I certify that in the performance of the work for which this permit is issued,
I shall not empt-van"ersmssir anY'�n.,n so as to become subject to the CITY BUSINESS LICENSE 11
worker's cord� so aws of Califoml ,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subJecyt�he ararker's compensation pr Zisions of Section 3700 of the labor
Co �I shall forth0i h comply wit Ilse provisions. Will the applicant or future building occupant handle hazardous material or a
ApliaaB Date ` 1- 0 mixture containing a hazardous material equal to or greater that the
amounts s506ed an the Hazardous Materials Information Guide?
WARNING•.SA7 RE TO SE[CORE WORKER'S COMPENSATION COVERAGE IS o Yes No
UNLAWF ,AND3HAtt5UB1ECT 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 econt(SCtionor See permitting fro checklist
IN SECTION 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES for Coast
Air i
CONSTRUCTION LENDING AGENCY oYes pNo
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) o Yes
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
hereby affirm under penalty of perjury that I am exempt from the California Health - o e, e n 25505 and 25530 concerning
Contractor's License Law for the reasons)indicated below by the hazardo ateria repo t`ing.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 / 0
Business and Professions Code).Any city or county that requires a permit to oY No �� Date ( I 1' �f1
construct,alter,improve,demolish or repair permit
structure,prior to its PROPERTY OWNE 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 Contractor's 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 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
a1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Programvisit:
compensation,will do I )all of or I )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 Contractor's State License Law does not apply to an owner of a O An EPA Lead-Safe Certified Renovator will be responsible for this project
propertywho,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. ❑No EPA Lead-Safe Certified Firm is required for this Project because:
❑I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractoes 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 RAP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: 4/(/IL /Q PERMIT/PLAN CHECK NUMBER 8
PLANNING CASE NUMBER
TYPE: C COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME k POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHOW f Menifee
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES Building Dept
DESCRIPTION OF WORK 3T0 6 �_^ 1�Q 4
PROIECTADDRESS �63 >-2 (°-'�,/2 Crf�c'`c{L (!�, I/n, p ZIP `1 —cei S e
ASSESSOR'S PARCEL NUMBER LOT TRACT 36 b YD-3
OWNER NAME C TdE /I �GvQr�C/'+�12
ADDRESS u '32Z
PHONE 45_t - S8`3 �2 EMAIL
APPLICANT NAME / C Qp5L
ADDRESS 12 rj+{i .Qt//LCL IdW • f7'F- /!i!/cn r. C4
PHONE Tr( - 776 _ _266 2_ EMAIL
CONTRACTOR'S NAME /[ A c-t ; leI'_T/O t OWNER BUILDER? 0 YES
BUSINESS NAME Ac "elcp2 5-�
ADDRESS / 701-Y t4s-/
PHONE X7/ -'27G.- ')nb 2 EMAIL �•
CONTRACTOR'S STATE LIC NUMBER G!rZ ig 76 LICENSE CLASSIFICATION
VALUATION$ Y6/ Q FT X S~a L SO FT
APPLICANT'S SIGNATURE DATE y_/•L g
0TYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCE CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE WS
INVOICE TOTAL GREEN SMIP
OWNER BUILDER VERIFIED O 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.cityofinenifee.us .; ..
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