PMT18-02426 City of Menifee Permit No.: PMT18-02426
29714 HAUN RD.
�CCEL/-> MENIFEE, CA 92586 Type: Pool/Spa-Residential
MENIFEE Date Issued:
05/1712018
PERMIT
Site Address: 29183 ABELIA GLEN ST,MENIFEE, CA Parcel Number: 333-640-020
92584 Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of 409 SQ FT UNDERGROUND POOL&SPA. UG.GAS FIRE PIT
Work:
Owner Contractor
BRETT&CATLIN GRIFFITTS PACIFIC COAST POOLS INCORPORATED
29183 ABELIA GLEN STREET 26499 JEFFERSON AVE UNIT E
MENIFEE, CA 92584 MURRIETA, CA 92562
Applicant Phone:9512960199
PACIFIC COAST POOLS INCORPORATED License Number.852237
26499 JEFFERSON AVE UNIT E
MURRIETA,CA 92562
Phone:9512960199
Fee Description Qty Amount(S)
Swimming Pool/In-Ground Spa 1 467.00
Plumbing Fixtures and Vents, fixtures 1 116.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Electrical 1 23.35
$638.35
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_nldg_Permit Template,rpt Page 1 of 1
Brandy Coral-Premier Pools
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contacts far the projects
with a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that 1 am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code and 2my license is in full force and effect. the following reason:
License Class Cls J License No. UJZZ�� By my signature below l acknowledge that,except for my personal residence
Expires 2-11 D Signature a in which l must 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
o 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 Code,for the performance of work for which w.iyw,leeinfo.ca.eov/ralaw,lrtml.
this permit is issued.
Policy# 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 o By my signature below l certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and polity owner or authorized to act on the property owner's behalf.I have read this
number are:
,�/� �,�( application and the information 1 have provided is correct.I agree to comply
Carrier 1 tn,vw`,/�- z�1Vlc with all applicable city and county ordinances and state laws relating to
r//��
1 building construction.I authorize representatives of this city or county to
Policy#AUJC-7LY,�!� �j Expires O enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred
dollars($100)or less Date
PROPERTY OWNER OR AUTHORIZED AGENT
o 1 certify that in the performance of the work for which this permit is Issued, /1�1L/1
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# o�'50W
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject tot orker's compensation provisions of Section 370D of the Labor
Code,lshat-f rthwiti comply with those provisions. II Will the applicant or future building occupant handle hazardous material or
Applicant Date 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 D Yes xra'o—
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FIN ES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant requires permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management hecoct(SCtionor See permitting from
checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Airllnes
Qua
CONSTRUCTION LENDING AGENCY oYes o'No
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 bound fa school?
(Section 3097 Civil Code) o Yes o No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checkRst.I understand my requirements under the State of
Contractor's License Law for the reason(s)indicated below by the California H a) Safety Code,Section 25505 and 25534 concerning
hazardou to al reporting.
chsinesseckma and
I have placed next to the applicable that
(Section permit Dyes o No n � �-I�
7031.5
construct,alter,
Professions Code).Any sh or repair
air anystruct re,priorres to Its permit to Date
issuance,also r,improve, applicant for the permit ruche a signed to 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(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 Code)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-certiried 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
o1,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( I 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 owner of a o 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 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. o No EPA Lead-Safe Certified Firm Is required for this project because:
cz 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
DATE: PERMIT/PLAN CHECK NUMBER V
PLANNING CASE NUMBER
TYPE: 0 COMMERCIAL 0 RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME O'POOL/SPA O SIGN
SUBTYPE: 0 ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING 0 RE-ROOF 1NUMBER OF SQUARES
DESCRIPTION OF WORK M
PROJECTADDRESS 9, 9)% ) CVJLeU'I bl-V.Yi ZIP 1 2ITY`/
ASSESSOR'S PARCEL NUMBER 333. LpLI-- - 020 LOT TRACT
OWNER NAME
ADDRESS q9I I`6 �W ,n yY
PHONE T, . SE, 12:>2/ U L. EMAIL
APPLICANT NAME `ffu
ADDRESS
PHONE EMAIL _�
CONTRACTOR'S NAME V y nJi�15 a �l OWNER BUILDER? 0 YES 0*t(5!
BUSINESS NAME p
ADDRESS `zU�-(CLG �
PHONE -/v�A ` l� p C) EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION L'S
VALUATION$ '2 5 0-15\D SQ FT "l L SQ FT
APPLICANT'S SIGNATURE� DATE
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL GREEN VV SMIP
OWNER BUILDER VERIFIED O YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cit)(ofmenifee.us
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