PMT18-02448 City of Menifee Permit No.: PMT18-02448
29714 HAUN RD.
�l-�CCEL/� MENIFEE,CA 92586 Type: Pool/Spa-Residential
MENIFEE Date Issued: 0511812018
PERMIT
Site Address: 33911 SWEETWATER CANYON RD, Parcel Number: 384-080-013
MENIFEE, CA 92584 Construction Cost: $40,000.00
Existing Use: - Proposed Use:
Description of INGROUND GUNITE POOL ONLY, 524 SF, NO HEATER
Work:
Owner Contractor
DERRICK HARTMAN CABO POOLS
33911 SWEETWATER CANYON ROAD 27636 YNEZ ROAD L7#178
MENIFEE,CA 92584 TEMECULA,CA 92591
Applicant Phone:9514530791
ANDY SCHMADER License Number:796813
CABO POOLS
27636 YNEZ ROAD L7#178
TEMECULA,CA 92591
Fee Description QQrt Amount 1$1
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
GREEN FEE 1 2.00
SMIP RESIDENTIAL 1 6.00
General Plan Maintenance Fee-Electrical 1 23.35
$525.35
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 Temptate.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 Contractors State License Law).
Chapter9(commencing with section 7000)of Division I of the Business and ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force d eff ct. the following reason:
Ucense Class C-ti �te d�V 4;I By my signature below I acknowledge that,except for my personal residence
Expires 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
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
D 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 70"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 wehsite:
by Section 3700 of the Labor Cade,for the performance of work for which
this permit is issued. www.leginfo.ca.gov/calaw-htmi.
Policy 4 Date
D 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 ❑By 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 construction.I authorize representatives of this city or county to
Policy 4 Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
�.2dcertlfy that in the performance of the work for which this permit is issued,
-I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE g
worker's compensa on L ws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to he worke } mpensatian provisions of Section 3700 of the Labor
Code,I shal o with ply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date 14. Iy 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 ❑Yes ❑No
UNLAWFUL,AND 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 Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR C0DE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY oYes ciNo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1OW 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) o Yes ❑No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractor's License Law for the reason(s)indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable items)(Section 7031.5 oYes ❑No
Business and Professions Code).Any city or county that requires a permit to Date
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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI
License Law(Chapter 9(commencing with Section 70001 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-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
D 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.epa.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-BOO-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 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. ❑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
Cade: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: Gj"l i J PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME POO PA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION X ELECTRICAL O MECHANICAL City Of ME nifee
O NEW 1A PLUMBING O RE-ROOF NUMBER OF SQUARES Building I lept.
//
DESCRIPTION OF WORK (jV W% GU ON) No i " 018
PROJECTADDRESS ZIP c.Z,;y, ece ved
ASSESSOR'S PARCEL NUMBER LOT LOT TRACT
OWNERNAME .P<•r
ADDRESS c.l� C
PHONE �IBG 7,D�. 3`?:D EMAIL
APPLICANT NAME 11_ _
ADDRESS L- I),Z60 LAO- kY_ vj \A 3S�
PHONE q31- 112- 12-�>% EMAIL
CONTRACTOR'S NAME OWNER BUILDER? "YES VNO
BUSINESS NAME ,yL.
ADDRESS u" p5 15_�
PHONE 4,IZ;k- 1(Z l ,y EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ "iG" SO FT SZ`'� LSQ FT 1 11
APPLICANT'S SIGNATURE DATE S"
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITYOF MENIFEE BUSINESSUCENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL I GJ- GREEN SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE#i NOTARIZED LETTER O YES O NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofmenifee.us
NIF