PMT18-02365 City of Menifee Permit No.: PMT18-02365
29714 HAUN RD. Type: Pool/Spa-Residential
�CCEL/� MENIFEE,CA 92586
MENIFEE Date Issued: 05/15/2018
PERMIT
Site Address: 29380 LAKE HILLS DR, MENIFEE,CA Parcel Number: 333-390-008
92585 Construction Cost: $20,000.00
Existing Use: Proposed Use:
Description of INSTALL GUNITE POOL ONLY (NO HEATER)480 SF.
Work:
Owner Contractor
SANCHEZ RESIDDENCE ALOHA POOL&DESIGN INC
29380 LAKE HILLS DRIVE 41083 SANDALWOOD CIRCLE STE I
MENIFEE,CA 92585 MURRIETA,CA 92562
Applicant Phone:9514539728
MARK KLINGSPOON License Number:965927
ALOHA POOL&DESIGN INC
41083 SANDALWOOD CIRCLE STE I
MURRI ETA,CA 92562
Fee Description QQt Amount(S)
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 3.00
General Plan Maintenance Fee-Electrical 1 23.35
$521.35
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
1 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 9hrision 3 of the Business and 01 am exempt from Iicensure under the Contractors State License Law for
Professions Code and my license is in full forchiand effect. the following reason:
License Class df5—3 — 'te a No. `I G-S r7Z 7 By my signature below I acknowledge that,except for my personal residence
Expires /4 Signature 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
WORKERS COMPENSATION DECIARATI have built as an owner-builder if it has not been constructed in its entirety by
01 hereby affirm under penalty of peduv 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.leeinfa.ca.eov/alaw.lstml.
this permit is issued.
Policy# Date
0 I 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 _Py my signature below 1 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 anjjIll�the information I have provided is correct.I agree to comply
Carrier with all appl'r54ble city and county ordinances and state laws relating to
building con ruction.I authorize representatives of this city or county to
Policy# Expires enter the cab ve identified property for inspection purposes. .
(This section need not to be completed is the permit is for one-hundred ---
dollars certify
that
or less Date
PROPER OWNER OR AUTHORIZED AGENT
certify that in the performance of the work for which this permit is issued,
I shall not emolov an persons in any manner so as to become subject to the CITY BUS S LICENSE#
workers compensa on laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the coot es compensation provisions of Section 370D of the Labor
Code,I shall firth ith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date Z mixture containing a hazardous material equal to or greater that the
amounts specified an the Hazardous Materials Information Guide?
WARNING:FAIL RETO SECURE WORKER'S COMPENSATION COVERAGE IS 0 Yes p:No
INLAWFUL,; VD 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($100,001)),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant Quality Management hecoDistrict(SCtionor modee ification
checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo astA noes
CONSTRUCTION LENDING AGENCY o Yes �o
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 "0
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 checklis.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
uso
checkmark(s)I have placed next to the applicable Item(s)(Section 70315 m ter!']reporting.
�rTl
Business and ProfessionsOyes hazard Cade).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OW0tR OR AUTHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement 1
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVAVON.REPAIR AND PAINTING(RRPI
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the v
Business and Professions Code)or that he or she Is exempt from Iicensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
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 he 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($S00). managers who do the paint-disturbing work themselves or through their
❑1,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.eoaxov/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 0 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. 0 No EPA Lead-Safe Certified Firm is required for this project because:
01,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 70",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.
BUILDING A PERMIT/PLAN CHECK
• A APPLICAir, .......e
M_E_NIF_EE
11A New. Better. Best. 'OZS
DATE PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME 1+ rOOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
PROJECTADDRESS ^1-,�/��SGJ �✓[., .
ASSESSOR'S PARCEL NUMBER �7zJ il� ®—>Jvp•LOT 2k�- TRACT
OWNER NAME r
ADDRESS Z 4 3�D G(i= Gc'•--S 7 z S��
PHONE yl 5�—�''� EMAIL
APPLICANT NAME MaL Lr,..vG3�a
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME pc, OWNER BUILDER? O YES O
BUSINESS NAME/
ADDRESS [
PHONE ��j ` y 7 EMAIL
CONTRACTOR'S STATE LIC NUMBER a/G S�5 Z 7 LICENSE CLASSIFICATION G S3
VALUATION$ Z d Odpd— SQ FT yko L SQ FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT OCASH 0CHECK0 OQCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT O.CASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Dept
29714 Haun Road I Menifee,CA 92586
951-672-6777
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