PMT18-02366 City of Menifee Permit No.: PMT18-02366
29714 HAUN RD. Type: Pool/Spa-Residential
<A -L/> MENIFEE,CA 92586
MENIFEE Date Issued: 05/15/2018
PERMIT
Site Address: 29248 LAKE HILLS DR,MENIFEE,CA Parcel Number: 333-380-009
92585 Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of INGROUND GUNITE POOL&SPA,485 SF,WITH WATERFALL
Work:
Owner Contractor
BRADLEY EATON ALOHA POOL&DESIGN INC
29248 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
MURRIETA,CA 92562
Fee Description Oy Amount(5)
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Electrical 1 23.35
$522.35
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 Permil_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 I am under provisions of with a licensed contractor(s)pursuant to the Contmdors State License Law).
Chapter9(commencing with section 7000)of ivisfon 3 ofthe Business and O I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license Is in full fort 9
ffand effect. the following reason:
License Class_ 57 'ce eNo. le-S'SZ7 By my signature below l acknowledge that,except for my personal residence
L�Expires Signature in which I must have resided for at least one year prior to completion of
I improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATI have built as an owner-builder If it has not been constructed in its entirety by
a I hereby affirm under penalty of perjuv 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 37CO of the Labor Code,for the performance of work for which vnvw.leeinfc.a.eov/calasv.lstml.
this permit is issued.
Policy R Date
o I 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 y my signature below l certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carrier and policy weer or authorized to act on the property owner's behalf.I have read this
number are: application anil the information 1 have provided is correct.1 agree to comply
Carrier with all appl ble city and county ordinances and state laws relating to
building con ruction.I authorize representatives of this city orcounty 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 I ---
dollars($300)or less Date
PROPER OWNER OR AUTHORIZED AGENT
\91 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�SS LICENSE#
workers compensa on laws of California,and agree that if I should become HAZARD tOVVVVVIUS MATERIAL DECLARATION
subject to the lwor is compensation provisions of Section 3700 of the Labor
Code,I shall fdrth ith comply with those provisions. Will the applicant or future building occupant handle hazardous material or
Applitan[ Date Z , mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAIL RE TO SECURE WORKER'S COMPENSATION COVERAGE IS 0 Yes cWo
UNLAWFUL,MD 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 Duality Management hecoDistrict(SCtionor modee ification
Soutist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidst Air Qua
CONSTRUCTION LENDING AGENCY 0Yes GS'No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility he 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 "a
OWNER BUILDER DECLARATIONS 1 have read the Hazardous Material Information Guideand the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklis.I understand my requirements underthe State of
Contractor's License Lawfor the reason(s)indicated below by the California Health Safety Cade,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazard us in teri'I reporting.
Business and Professions Code).Any city or county that requires a permit to Dyes to .. //
construct,alter,improve,demolish or repair any structure,priorto its Date
issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWPIER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVA�LON,REPAIR AND PAINTING(RRPI
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 Cade)or that he or she is exempt from licensure 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 1-800-424-LEAD(5323).
Code,The Contractor's State License Law does not apply to an ownerof a D An EPA Lead-Safe Certified Renovator will be responsible for this project
propertywho,through employees'or personal effort,builds or Improvesthe
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. D 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 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.
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BUILDING & SAFETY PERM IT/PLAN CHECK APPLICATION
MENIFEE
New.Better. Best.
DATE \d 1<3 PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME OOL/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 �aOpc Sp
PROJECTADDRESS Z /-f/LvS O/Z- _
ASSESSOR'S PARCEL NUMBER 3. !a- LOT TRACT
OWNER NAME 5,4 O•.j
ADDRESS Z Z c- dL GvvL . G/y�J'8
PHONE `ji,�--ZZ7� EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME �' ¢J ,y�a,_ OWNER BUILDER. O YES O
BUSINESS NAME
ADDRESS `�/D�3y�gry�.� e�mp c�/�. s 6Z
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER S—GI L� LICENSE CLASSIFICATION LS
VALUATION$ 2. S`-pcQct� SO FT LSQ FT
APPLICANT'S SIGNATURE DATE
FIRM","
DEPARTMENT DISTRIBUTION CITY OFMENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
141
INVOICE PAID AMOUNT
AMOUNT • 9CASH O CHECK# OCREDR CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 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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