PMT18-03265 City of Menifee Permit No.: PMT18-03265
Ar e' 29714 HAUN RD. Type: Pool/Spa-Residential
�r MENIFEE,CA 92586
MENIFEE MENIFEE Date Issued: 06128/2018
PERMIT
Site Address: 305956 VIEW RIDGE LN, MENIFEE, CA Parcel Number: 364-290-055
92584 Construction Cost: $30,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL AND SPA,400 SF, U/G GAS AND ELEC LINES FOR BBQ WITH WATER SUMP
Work; PUMP
Owner Contractor
CHRISTINA WORM A CUT ABOVE CONSTRUCTION POOLS&
30595 VIEW RIDGE LANE LANDSCAPE INC
MENIFEE, CA 92584 26025 NEWPORT ROAD#A533
Applicant Phone: 9512447754
CHRIS YOUNG License Number.672202
A CUT ABOVE CONSTRUCTION POOLS&LANDSCAPE INC
26025 NEWPORT ROAD#A533
MENIFEE, CA 92584
Fee Description Qtv Amount(SI
Receptacle,Switch, Outlet&Fixture 1 116.00
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
Inspections not specified 116 116.00
GREEN FEE 1 2.00
SMIP RESIDENTIAL 1 4.00
$732.00
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 Templale.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 ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the fallowing reason:
License Class - 5� License P 22'J 2�
J By my signature below 1 acknowledge that,except for my personal residence
Expires �O 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
❑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 workers 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.leeinfo.ca.eov/calaw.h[mI.
this permit is issued.
Polity g Date
O 1 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 an the property owner's behalf.I have read this
number are: r application and the information I have provided is correct.I agree to comply
Carrier (-YT1- with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Polity ll (��133✓Y Expires « enter the above identified property for inspection purposes.
(This section need not to be completed is the permi is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
a I certify that in the performance of the work for which this permit is issued, Apr / �G z _
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE 0 o^��
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's3ompensation provisions of Section 3700 of the Labor
Code,I shall forthwi co p�y with eprovisions. C_ Will the applicant or future building occupant handle hazardous material or
Applicant ate 2- O mixture containing a hazardous material equal to or greater that the
amour pecified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE KER'S MPENSATION COVERAGE IS ❑Yes No
UNLAWFUL,AND SHALL SUBIE PLOYER 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($300,000),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 37(16 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ❑Yes �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 boundary of a school?
(Section 3097 Civil Code) ❑Yes 00
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
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 item(s)(Section 7031.5 hazardous repo i g.
Business and Professions Code).Any city or county that requires a permit to Wes 1 zi ,
construct,alter,improve,demolish or repair any structure,prior to its Date_I ' //�'1_
Issuance,also requires the applicant for the permit to file a signed statement PROPER NER OR AU f 4\E`NT
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION REP IR AN PAINT NG P
License Law(Chapter 9(commencing with Section 70D0)of Division 3 of the The EPA Renovation,Repa airline(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-certtfied 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
❑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 a 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. a No EPA Lead-Safe Certified Firm is required for this project bemuse:
In I,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 rule please fill out the RRP
G �Q� , / � ' A Acknowledgement
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
l 7
DATE: (� GYM 7 J PERMIT/PLAN CHECK NUMBER tj- O
GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: O COMMERCIAL "ESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION ELECTRICAL O MECHANICAL
O NEW ¢PLUMBING 0 RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS O YES VNO
PROJECTADDRESS C.fiJ�-IS' �I P(OW L NG ZIP
ASSESSOR'S PARCEL
�NUMBER ✓�Y`'1'OF'1� � LOT TRACT
OWNER NAME l�'I+ ( S7*N I/�Vt'�-✓YI /� /-e- L City of Menifee
ADDRESS �S S S/G (//E `/A// 1U 10Lc �N�
Building Dept.
PHONE CIS_( ^ z / - c7d 7 EMAIL
APPLICANT NAME CN-2c, lIl(Ft/� d
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME JS PuiLS OWNER BUILDER? OYES 1,AO
BUSINESS NAME �` / n� //
ADDRESS n Z4,-0 Z��//S�-J�N� &V 1 -43
PHONE Qj.(/`Z%' C ! �� EMAIL
CONTRACTOR'S STAAT2TEE�LIC NUMBER �P�ZZ�� LICENSE CLASSIFICATION
VALUATION$ FT yr' L SQ FT
APPLICANT'S SIGNATURE DATE
OTYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION ACCE TED Y: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL , co GREEN SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 w (951)672-6777 a
ww .cityofinenifee.us
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