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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 n � � r ✓' ell 4 LO a ✓ P � O9y x o � as N �x a � s a o ✓ p 'a o c. \% c U