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PMT18-02404 City of Menifee Permit No.: PMT18-02404 29714 HAUN RD. <A>CCELA? MENIFEE, CA 92586 Type: Pool/Spa-Residential MENIFEE Date Issued: 0 611 612 01 8 PERMIT Site Address: 25962 FIREWEED,MENIFEE,CA 92584 Parcel Number: 339-490-002 Construction Cost: $32,000.00 Existing Use: Proposed Use: Description of NEW 384 SO FT POOL&SPA WITH 2 LIGHTS Work: Owner Contractor DANIEL M. PLASCENCIA TAYLOR MADE POOLS INC 25962 FIREWOOD ST 18795 OAK VIEW WAY MENIFEE,CA 92584 LAKE ELSINORE,CA 92530 Applicant Phone:9515151039 TAYLOR MADE POOLS INC License Number.795053 18795 OAK VIEW WAY LAKE ELSINORE,CA 92530 Phone:9515151039 Fee Description QQtr Amount!$) 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-Building 1 0.00 General Plan Maintenance Fee-Electrical 1 23.35 $524.35 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 contacts for the projects 1 hereby afRrm 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 PfUin exempt from licensurgqunde��c;��t�Ucense Law for Professions Code and m license Is in full force and ffe the following reason: License Class fl,<p Ucen By mysignature below l acknowledge that,except fornypemonal residence Expires 117 Signature /�� in which l most have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed in its entirety by ❑I hereby affirm under penalty of perjury one of the following declarations:) 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 providedfor this application is submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which u�,nyleelnfo.ca.eav/calaw.lstml. this permit is issued. Policy N Date - a 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 Kay 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 number are: application and the information I have provided is correct.I agree to comply Carrier with all applicable city and county ordinances and state laws relating to building co struction.l authorizer esentatives of this city or county to Policy11 Expires en[ert d$re identified pro for inspection purposes. (This section need not to be completed is the permit is for one-hundred -�� Date G/ 10 dollars($100)or less ROPERTY Ou%yNER OR AUTHORIZED AGENT Xi certify that in the performance of the work for which this permit Is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE N worker's compensation ws ygf Califomia,and ag e t If I should became HAZARDOUS MATERIAL DECLARATION subject to the work c fpensation provisi Section 3700 of bar Code,I shall forth t omply thou isi is. Will the applicant or future building occupant handle hazardous material ora Applicant L Date 3U�r'o mixture containing a hazardous material equal to orgreater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 aYes PNo UNLAWFUL,AND SHALLSUBIECTAN 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($100,00(1),IN occupant require a permit for the construction or modlilcation from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldelines CONSTRUCTION LENDING AGENCY crYes pmlp I hereby affirm that under the penally of perjury there is a construction Will the proposed building or modified facility be within 1000feet of the lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) a Yes p6.No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm underpenaltyof perjury tha[lam exempt from the permitting checklist l understand my requir ents under the State of Contractors m under penaltaw for y reason(s)Indicated belowrom by the California Healt S, fety >jis,Se 'sits and 25534 cancer/In,hazardous al repocheckmark(s)I have placed next to the applicable item(s)(Section 7031.5Ma �lBusiness and Professions Code).Any city or county that requires a permit to � c pa 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(RRP) License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRPj Rule requires contractors Business and Professions Code)orthat he or she is exempt from licentiate receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of Section 703L5 by residence or childcare facility to be RRP-certified firths 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($5011). managers who do the paint-disturbing work themselves or through their al,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.eua.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 DAn 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 yearof 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 1,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 : �" r�r...;p;Ia.:.a.:;� DATE: 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 O ELECTRICAL O MECHANICAL EW O PLUMBING 0! RE-ROOF NUMBER OF S�QUUARES / DESCRIPTION OF WORK PROJECTADDRESS Z5�/leZ.fj�G�� S ZIP ASSESSOR'S PARCEL NUMBER LOT LOT TRACT OWNER NAME /�/✓/�L /'�� / s' ADDRESS -1�39�-2— PHONE �f5/-��or,�—� �� EMAIL APPLICANT NAME ADDRESS �d �1��'� !/I��Gr��/ //� L� i/r �� /. X�/ PHONE ��-��-�Q�j� EMAILL�Gt,,O CONTRACTOR'S NAME OWNER BUILDER? O YES NO BUSINESS NAMEp�jf�Y��Z ®"/"sue/✓]L ,,/�.iV� ADDRESS PHONE��'�� d�p EMAIL rr CONTRACTOR'S STATE LICNUMBER �950�� LICENSE CLASSIFICATION -.J3 VALUATION$ ,J�UU!/. SQ FT L SQ FT APPLICANT'S SIGNATURE DATE 4 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: `�' ` CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE c5e— INVOICETOTAL `j24, 3 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.Cityofm vapVenifee Building Dept. NlF MAY1 � 2018 Received y C � O_ O �� _. 7 �J 0CD �a r-0 W o o -O co N El CD w � W v n - (DtE - n fli / w m sr 5 rn CJl 0000.4 03 PlAin, � � n � � N N p �MTI g - b� � A _