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PMT18-03091 City of Menifee Permit No.: PMT18-03091 29714 HAUN RD. Type: Pool/spa -Residential it MENIFEE, CA 92586 MENIFEE MENIFEE Date Issued: 06/20/2018 PERMIT Site Address: 26675 WESTBROOK CT,MENIFEE,CA Parcel Number: 338-321-002 92586 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INSTALL 300 SQ FT FIBERGLASS POOL-NO HEATER Work: Owner Contractor TODD WELLS QUALITY FIBERGLASS POOLS 26675 WESTBROOK COURT 32497 HWY 74 MENIFEE,CA 92586 HEMET,CA 92545 Applicant Phone: 9519266060 QUALITY FIBERGLASS POOLS License Number:361530 32497 HWY 74 HEMET, CA 92545 Phone:9519266060 Fee Description QtV Amount 1$1 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 staled,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 BIdg_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 contractors)pursuant to the Contractors State License Law). Chapter9(commencing with section 70001 of Division 3 of the Business and o I am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and effect. r--�� the following reason: License Class C Uceri5e No. j J J U By my signature below I acknowledge that,except for my personal residence Expires Cffy Signature � inwhich l 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 forworkers 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 37GO of the Labor Code,for the performance of work for which this permit is issued. www.leeinfo.ca.eov/calaw.html. Policy N Date D 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 ❑By my signature below I certify to each of the following:I am the property this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this number are: r�� application and the information I have provided is correct.I agree to comply Carrier (-.�aczU with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# LL-001-slaz Expires 6 VIE, enter the above identified property for inspection purpose . (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 I certify 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 K workers compensation laws ofCalifornia,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant �'— Date 01-511iff 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 COMPENSATIO4 CD ERAGE 15 O Yes �tNo 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)1 IN occupant require a permit for the construction or modification from South IN SECION306OFTDITION TO THE TLAB OF OR CODE,INTERTION,DAMADATTOGES AS ROVIDED FOR Coast Air quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR[ODE,INTEREST,AND ATTORNEYS FEES forguldelines CONSTRUCTION LENDING AGENCY crYes KNo 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) o Yes KNo OWNER BUILDER DECLARATIONS 1 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 Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable items)(Section 70315 hazardous material reporting. 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 ORAUTHORIZEDAGENi 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 apre-1978 and the basis for the alleged exemption.Any violation of Section 7032.5 by residence or childcare n for mosy to t RRP-certified frrmai and comply with than Applicant fora permit subjects the applicant toacivil 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 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 0An 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: D 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 a If your project does not comply with EPA RRP role please fill cut the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: PERMIT/PLAN CHECK NUMBER GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O 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 rj� t c j 7a ( OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS O YES 0 NO PROIECTADDRESS U4-/S- L_)-e �� ,_) `lL C� . ZIP 975-74 ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME uJJ ADDRESS //�� 7?U 2 C_F , PHONE("I�(� ( /y (-[jgt4 EMAIL APPLICANTNAME F,,`L I n ADDRESS C( PHONE r(1 Cl &— 6 EMAIL CONTRACTOR'S NAME �, �,, /� i v OWNER BUILDER? O YES*_NO BUSINESS NAME ADDRESS G // L,/ ..r C/ �('� C'(a Lf s— PHONE ( �r1 EMAIL c CONTRACTOR'S STATE LIC NUMBER Z:) LICENSE CLASSIFICATION CS VALUATION p SO FT 32 C� L SQ FT \� APPLICANT'S SIGNATUR�� DATE G� 1"CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING �� G FIRE INVOICETOTAL V GREEN SMIP OWNER BUILDER VERIFIED O YES 0 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.cityofmenifee.us r'AlNli M