PMT18-02763 City of Menifee Permit No.: PMT18-02763
29714 HAUN RD.
// MENIFEE,CA 92586 Type: Pool/spa-Residential
MENIFEE MENIFEE Date Issued: 06/06/2018
PERMIT
Site Address: 23617 BADGER CREEK LN, MENIFEE, Parcel Number: 351-230-004
CA 92587 Construction Cost: $47,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL& SPA 439 SO FT
Work:
Owner Contractor
TONY&MARSHA SPAAN INFINIUM CONSTRUCTION
23617 BADGER CREEK LN 43020 BLACKDEER LOOP STE 106
MENIFEE, CA 92587 TEMECULA,CA 92590
Applicant Phone:9517979476
OLY PATTERSON License Number:976676
INFINIUM CONSTRUCTION
43020 BLACKDEER LOOP STE 106
TEMECULA, CA 92590
Fee Description Of. 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 7.00
General Plan Maintenance Fee- Electrical 1 23.35
$526.35
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 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 O I am exempt from licensure under the Contractor's State License Law for
Professions Coral7my lice a is in full force and effect. the following reason:
License ClassC� Uc rt e No. 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
❑1 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 wvnv.leeinfo.ca.eovlcalaw.html.
this permit is issued.
PolicyN
Date
VI have and will maintain worker's compensation insurance,as required by PR PERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which 2y 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 owners behalf.I have read this
number aLa: r _ application and the information I have provided is correct.I agree to comply
A^t I 0(�� /'i-i'�1 V1� ' I .ns r with all applicable city and county ordinances and stale laws relating to
Carrier Y V L.1 LL I 'o a .1/V l building construction.t authorize representatives of this city or county to
Policy#%00018577/expires anter b abovefidentified property for inspection purposes. / ]r(y
(This section need not to be completed is the permit is for one-tundred Date Lc l� U
dollars($100)or less PROPERTY OWNERIOR AUTHORIZED AGENT
❑1 certify that in the performance of the work for which this permit is issued, 07b^'f 0- 19! _Q
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE$1 7b 2
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the99=
ers compensation provisions of Section 3700 of the Labor
Code,I shall f isions. Will the applicant or future building occupant handle hazardous material or a
ApplicantDate lY- mixture containing a hazardous material equal to or greater that the
amounts s cified on the Hazardous Materials Information Guide.
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS O Yes 7o
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(SCAQMDI?See permitting checklist
IN SECTION 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguideli s
CONSTRUCTION LENDING AGENCY DYes 71
1 hereby affirm that under the penalty of perjury there is a construction Will the pr9posed building or modified facility he within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer bogI of a school?
(Section 3097 Civil Code) ❑Yes V1'No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the
C California Health&Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the
hazardous meA'MaDlti
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes o NoBusiness and Professions Code).Any city or county that requires a permit to ttfV!
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTH RIZED BENT
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 fRRPI
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-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 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.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 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
Ou� Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ME'NIFEE
DATE: I PERMIT/PLAN CHECK NUMBER O-D C�1(off
PLANNING CASE NUMBER
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME V POOL/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
PROJECTADDRESS I (/?, CA W& ZIP
ASSESSOR'S PARCEL NUMyyB��ERr�''O � LOT � TRACT
OWNERNAME TVLIMAr, SO bl,d/1
ADDRESS t,/
PHONE rJT - �Na- EMAIL
APPLICANT NAME D ,,/� ,j/�oG(&�,� 1
ADDRESS (%� I
PHONE 9�5t EMAIL /
CONTRACTOR'S NAME q C OWNER BUILDER? O YES VNO
BUSINESS NAME w�'1WiAMS J
ADDRESS _;� t
PHONE q5, & . 9&5/ EMAIL /i
CONTRACTOR'S STATE LIC NUMBER q7 j LICENSE CLASSIFICATION C5
VALUATION $ D IU/o SO FT - 13� {/ J
1 L SQ FT
APPLICANT'S SIGNATURE DATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: eq� CITY OF MENIFEE BNE_ SSJ,ICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE O k%
INVOICE TOTAL emu/•3SI GREEN SMIP
OWNER BUILDER VERIFIED OYES () 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.cityofinenifee.us w
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