PMT18-02321 City of Menifee Permit No.: PMT18-02321
29714 HAUN RD.
'q�CCEU/ MENIFEE, CA 92586 Type: Pool/Spa-Residential
MENIFEE Date Issued: 05/1112018
PERMIT
Site Address: 29063 VERMILLION, MENIFEE,CA 92587 Parcel Number: 351-261-004
Construction Cost: $31,000.00
Existing Use: Proposed Use:
Description of POOL AND SPA 454 SQ FT WITH 3 LIGHTS
Work:
Owner Contractor
ERNESTO GOMEZ QUALITY CUSTOM POOLS INC
29D63 VERMILLION 30138 MARNE WAY
MENIFEE, CA 92587 MENIFEE, CA925B4
Applicant Phone:9516799732
QUALITY CUSTOM POOLS INC License Number:795820
30138 MARNE WAY
MENIFEE,CA 92584
Fee Description f3,yt Amount 1$1
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
$624.35
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_Pemit_Template.rpt Page 1 of 1
Hannah Barrett-Quality Custom
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractors State License Law for
Professions Cade and my license Is in full force and effect the following reason:
License Class ex - Q License No. -I CIS,$20
By my signature below l acknowledge that,except formy personal residence
Expires 2,oI Signature in which l 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 DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
a 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 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 Cade,for the performance of work for which www.leelnfo.ca.aov/calaw.latmi.
this permit is issued.
Policy 0 Date
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 a 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.l have read this
number are: application and the information I have provided is correct.I agree to comply
Carrier Eutrs.Sl, N/ ti orta.A with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy N CA z 0 n o 215'i Expires `7I J I71� enter the above identified property for inspection purposes.
(This section need not to he completed Is the permit is for one-hundred Date
dollars($100)or less
PROPERTY OWNER OR AUTHORIZED AGENT
o 1 certify that in the performance of the work for which this permit is Issued,
I shall not emolov any persons in any manner so as to become subject to the CRY BUSINESS LICENSE If
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comp) with those provisions. Will the applicant or future building occupant handle hazardous material or
Applicant V� -L/ Date 3 J&Jim mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS AD Yes(]�100
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES WWillill the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($SOO,OOD),IN accupant require a permit for the construction or modiriation from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Air A Coast Coa Quality Management District(SCAQMD)7See permitting checklist
IN SECTION 37OG OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast irltn s
CONSTRUCTION LENDING AGENCY �lves e Jo
1 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) Oyu(i�pfo
OWNER BUILDER DECLARATIONS 1 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 reasons)indicated below by the
California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable items)(Section 70315 hazardous material reporting.
� �//
Business and Professions Code).Any city or county that requires a permit to cVWa� g�j Date 3/L//-,
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 IRRPI
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 licensure receiving compensation for most work that disturbs paint in apre-197B
and the basis forthe permit
s alleged exemption.subjects
thapplicant
nt to a civil
it penaltyction of not m y residence or childcare facility to he RAP-certified firms and comply with
than
Applicant fora permit subJects the applicant too civil penalty of not more required practices.This Includes rental property owners and property
than($SOD). managers who do the paint-disturbing work themselves or through their
ol,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.eaa.Fav/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-024-LEAD(5323).
Code,The Contractor's State License Law does not apply to an owner of a 0An 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. a No EPA Lead Safe Certified Firm is required for this project bemuse:
a I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's 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: Fj 1L t 8 PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION 0 ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK ,,
PROJECTADDRESS 2olf)Li3 �Crw,i�\�eiY` ZIP cj'1s% -I
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME 0 22
ADDRESS -.;i_o ' b92 Wkkv NkzAJc'_¢
PHONE `31.3- aLcq-L • 1.22"L EMAIL
APPLICANT NAME Y
ADDRESS ga a p.Lq,,m�y
PHONE �L EMAIL
CONTRACTOR'S NAME i.fn rvni OWNER BUILDER? OYES, 0
BUSINESS NAME
ADDRESS 2201300
PHONED qXt br7A 0l -1Z`b'5- EMAIL
CONTRACTOR'S STATE LIC NUMBER -7cjSa'2_JD LICENSE CLASSIFICATION Q66 -
VALUATION$ ? p -p ^//9SO FT L{�� L SQ FT
APPLICANT'S SIGNATURE-L�� _ �' 't- DATE
DEPARTMENT DISTRIBUTION ACCEPTED BY: CRY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
`
INVOICETOTAL .?9C7 EEN SMIP S ��
OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES O NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee,CA 92586 (951)672-6777
www.cityofmenifee.us
City Of Menifee NIF
Building Dept.
MAY 1 12018
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Planter Area
32'6"
Grass Area Reef 7'Sp
Pavers Step +12" J
'
TV Deep
o s
1 1/2"Poly Gas Line � 32'6"
r---- ------7°Sch 40 UL--------— m- ---------- 5'Oeep
Pavers
Sq
- s
uare re- as o m Bench 8'3"
Existing Patio Cover
o Angelus Castle Cobble
Distresss 1&2 Pavers
Gomez R 'dence
29k63 Verml ' n alccondensers;
�40ifee, Ca 92 7 0
3-997-1
O< K
1 a � Pool Equipment
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0 13.3�.
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C1, of Menifee
3 I Ming Dept.
OP
MAY 1 1 2018
Received