PMT18-02687 City of Menifee Permit No.: PMT18-02687
29714 HAUN RD.
a Type: Pool/Spa -Residential
MENIFEE,CA 92586
MENIFEE MENIFEE Date Issued: 0 610 412 01 8
PERMIT
Site Address: 29502 ELLINGTON CT,MENIFEE,CA Parcel Number: 336-351-020
92585 Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL& SPA 515 SO FT
Work:
Owner Contractor
STEVEN LIEN ALOHA POOL&DESIGN INC
29502 ELLINGTON CT 41083 SANDALWOOD CIRCLE STE I
MENIFEE, CA 92585 MURRIETA, CA 92562
Applicant Phone:9514539728
MARK KLINGSPORN License Number:965927
ALOHA POOL&DESIGN INC
41083 SANDALWOOD CIRCLE STE I
MURRIETA, CA 92562
Fee Description QQtt t Amount($)
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_Permit_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 1 am under provisions of with a licensed contrector(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of session 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license Is in full forc and effect the following reason:
License Class 4f 'ce e No. ��-S—�Y Z 7 By my signature below I acknowledge that,exrept 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 Iegallysell a structure that I
WORKER'S COMPENSATION DECLARATI
have built as an owner-builder if it has not been constructed in its entirety by
o I hereby affirm under penalty of perju� 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 www.Ieeinfio.ca.gov/calaw.html.permit is issued. vv
Policy q Date
o 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 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 an the property owners behalf.I have read this
number are: application anP the information 1 have provided is correct.I agree to comply
Carrier with all applicpble city and county ordinances and statelaws relating to
building cons ruction.I authorize representatives of this city or county to
Policy g Expires enter the ah,ve identified property for inspection purposes..
i
(This section need not to be completed is the permit is for one-hundred ---
dollars($100)or less Date
PROPER �WNER OR AUTHORIZED AGENT
jA certify that in/theerformance of the work for which this permit is issued,I shall not emolopersons in any manner so as to become subject to the CITY BUS S LICENSE#
workers compenn laws of California,and agree that if I should become VVVVVVMATERIAL DECLARATION
subject to the wscompensation provisions of Section 3700 of the LaborCode,lshall fdrthcomply 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 on the Hazardous Materials Information Guide?
WARNING:FAIL RE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes cWo
UNLAWFUL,MD SHALL SUBIECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicantor 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 hecoDistrict(SCtionor modee ification
checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo guid Coast
fines
CONSTRUCTION LENDING AGENCY o Yes to
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) ❑yes "a
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guideand the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checkli I understand my requirements underthe State of
Contractors License Law far the reasons)indicated below by the California Health qSafety Cade,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 hazardyyusvm teripl reporting.
Business and Professions Code).Any city or county that requires a permit to °yam r��O II
Date
construct,alter,improve,demolish or repair any structure,prior to its r�'
issuance,also requires the applicant for the permit to file a signed statement PROPERTY O1WPJIR OR AUTHORIZED AGENT
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 Cade)or that he or she is exempt from licensure receiving compensation for most Painting
that disturbs paint e a pre-1978
and the basis for the alleged exemption.Any violation of Section 7032.5 by residence or childcare facility to he RRP-certified firmsan in
comply with
than
Applicant fora permit subjects the applicant taacivil Pena ltyof 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 Contractors 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. o No EPA Lead-Safe Certified Firm is required for this project because:
a 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of If your project does not comply with EPA RAP rule please fill out the RIP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DlrL
DATE: G/ PERMIT/PLAN CHECK NUMBER PIS ( O�V°r/� /
PLANNING CASE NUMBER
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY ^ 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 �WWL
PROJECTADDRESS 77 7S02— Lv4/icsTy^-) 0-7-- ZIP
ASSESSOR'S PARCEL NUMBER c ► Z0 LOT TRACT Z
OWNER NAME /'
ADDRESS 2--I $T Z vi ivy ,.✓ GT Z .f—
PHONE 0— Z-f6�'Z EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME 47q OWNER BUILDER? C YES
BUSINESS NAMEE/
ADDRESS Ilan-5 , a
PHONE ` S3 1 %l o EMAIL
CONTRACTOR'S STATE LIC NUMBER 9GS--'9Z'7 LICENSE CLASSIFICATION
VALUATION $ Z,5_19 o o SO FT L SO FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL a GREEN li SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES C NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
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www.cityofinenifee.us
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