PMT18-03277 City of Menifee Permit No.: PMT18-03277
29714 HAUN RD.
® MENIFEE,CA 9258E Type: Pool/Spa-Residential
MENIFEE MENIFEE Date Issued: 06/29/2018
PERMIT
Site Address: 27134 REDRIVER DR, MENIFEE,CA Parcel Number: 335-481-013
92585 Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of 355 SQ FT POOL AND SPA WITH 3 LIGHTS
Work:
Owner Contractor
MUHAMMAD&MAHASEN ABUFARHA PACIFIC COAST POOLS INCORPORATED
27134 REDRIVER DRIVE 26499 JEFFERSON AVE UNIT E
MENIFEE, CA 92585 MURRIETA, CA 92562
Applicant Phone:9512960199
PACIFIC COAST POOLS INCORPORATED License Number: 852237
26499 JEFFERSON AVE UNIT E
MURRIETA, CA 92562
Phone: 9512960199
Fee Description Qtv Amount($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 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_Permi[ Template.rpt Page 1 of 1
Brandy Coral-Premier Pools
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjurythat I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapters(commencing with section 7000)of Division 3 of the Business and a I am exempt from Iicensure under the Contractors state License Law for
Professions Code and my license is in full force and effect. �f the following reason:
Ucense Class CIS3 fe
License No. UJcZ2Z I By my signature below l acknowledge that,except for my personal residence
Expires 24 1 Y Signature in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
a I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure forworkees 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
this permit Is Issued. www.leeinfo.ca.eov/calaw.html.
Policy If 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 a By my signature below l 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 owner's behalf.1 have read this
number are:�l1� C1,� application and the information I have provided is correct.I agree to comply
�Carrier I W with all applicable city and county ordinances and state laws relating to
�/q (ji]zS � �r building construction.I authorize representatives of this city or county to
Polity R Vvl���tY /7Zr I Expires O enter the above identified property for inspection purposes.
(This section need not to he 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, �G/Sl�L/t
I shall not employ any persons ®
in any manner so as to become subject to the CITY BUSINESS LICENSE 150W
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject tot orker's compensation provisions of Section 3700 of the Labor
Code,Ishal f rthwit comply with those provisions. I� Will the applicant or future building occupant handle hazardous material or
Applicant Date � mixture containing a hazardous material equal to orgreater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 a Yes ea.
UNLAWFUL,AND SHALL SUBIECTAN 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 hecoDistrict(SCtionor See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airllnes
Qua
CONSTRUCTION LENDING AGENCY oYes ;i
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 bound Prof a school?
(Section 3097 Civil Code) a Yes o No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD
I hereby affirm under penalty of perjurythatlam 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 H a)e . c Safety Code,Section 25505 and 25534 concerning
hazard ou to al reporting-
chsiness k(s)I have glared next to the applicable item(s)(Section 7031.5
permit >� u
ayes ❑No
Business and Professions Code).Any city or county that requires permit to Date
construct,alter,improve,demolish or repair any structure,priorto 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 700D)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 Iicensure 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 ownersand property
than($500). managers who do the paint-disturbing work themselves or through their
a 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.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 71)44,Business and Professions 1-80D-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. o No EPA Lead-Safe Certified Frm is required for this project because:
o 1,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
Acknowledgement
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
A
DATE: UL�U1 (, �j PERMIT/PLAN CHECK NUMBER
GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME OOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBIINGG O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK
OCCUPANCY GROUP I CONSTRUCTION TYPE SPRINKLERS O YES O NO
PROJECT ADDRESS 0�1 K-P-d y k yu Y JU 1 �L UL�\fUR UT�`
ASSESSOR'S PARCEL NUMBER 3�.,j4(Z� LOT I,TR,A,�CT
OWNER NAME i(I�,V'AtY�LI,W �5 !v' Va I1 a,V f�k - —
ADDRESS V*
PHONE IJI FL'-I- $� EMAIL
APPLICANT NAME ao
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME L A,V ;�6 8" " ' OWNER BUILDER? OYES NO
BUSINESS NAME
ADDRESS - U,V V
PHONE C 1 2 EMAIL
CONTRACTOR'S STATE LIC NUMBER tS ZZ J_7 LICENSE CLASSIFICATION
VALUATION$ DDID SO,FT L SO FT f
APPLICANT'S SIGNATURE DATE
OTYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENISINEERING FIRE
INVOICETOTAL 22.E GREEN SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd. Menif e, CA 92586 (951)672-6*�7
www.cityofinenifee.us Ity of Uenifee
Building Dept.
JUN 2 9 2018
Received
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