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PMT18-03299 City of Menifee Permit No.: PMT18-03299 29714 HAUN RD. MENIFEE, CA 92586 Type: Pool/Spa -Residential MENIFEE MENIFEE Date Issued: 07/02/2018 PERMIT Site Address: 30926 YOUNG DOVE ST, MENIFEE, CA Parcel Number: 360-451-008 92584 Construction Cost: $20,000.00 Existing Use: Proposed Use: Description of INSTALL 36 X 20 POOL AND 7 X 7 SPA WITH UG GAS FOR FUTURE FIRE PIT Work: Owner Contractor OSCAR LARA , 30926 YOUNG DOVE STREET MENIFEE, CA 92584 Applicant License Number: OSCAR LARA 30926 YOUNG DOVE STREET MENIFEE, CA 92584 Phone:8017082994 Fee Description OQt y Amount($I Swimming Pool/In-Ground Spa 1 467.00 Plumbing Fixtures and Vents,fixtures 1 116.00 Building.Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 3.00 General Plan Maintenance Fee-Electrical 1 23.35 $637.35 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 eldg_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 perjurythat 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 Contractors State License Law for Professions Code and my license is in full force and effect, the following reason: License Class License 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 ❑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.leginfo-ca.gov/calaw.htm].permit is issued. Policy# /`/ /s Date $€RW ❑I have and will maintain worker O TY O HER OR AUTHORIZED AGENT s compensation insurance,as required by C/ section 3700 of the Labor Code,for the performance of the work for which 8. 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: application and the information I have provided is correct.I agree to comply Carrier with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# Expires enter Identified property for inspection purpos (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less s PROPERTY OW NER OR AUTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# workers compensation laws of California,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 mixture containing a hazardous material equal to or greater that the amounts sp ified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes 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 Quali Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidest Air in CONSTRUCTION LENDING AGENCY ❑Yes o I hereby affirm that under the penalty of perjury there is a construction Will the propo d building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boun ry of a school? (Section 3097 Civil Code) ❑Yes o OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements underthe State of C Health al Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the alifo checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ha dausis material reporting. es ❑No Business and Professions Cade).Any city or county that requires a permit to �� Date construct,alter,improve,demolish or repair any structure,prior to its p OPERTY 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 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 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 01313). managers who do the paint-disturbing work themselves or through their adl,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.epa.aov/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 ❑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. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑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 Acknowledgement. f BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION _ MENIFEE ` DATE: PERMIT/PLAN CHECK NUMBER FWID ' 037-0I01 GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: O.COMMERCIAL 4`RESIDENTIAL O MULTI-FAMILY O MOBILE HOME AOL/SPA OSIGN SUBTYPE: O ADDITION O ALTERATION t%DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK Addi&j oo o O 1 OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS O YES O NO PROJECTADDRESS 3 6 YoJn oje— -9+- ZIP L ASSESSOR'S PARCEL NUMBER bU0 61 'OOr LOT TRACT OWNER NAME ca ADDRESS 73(!)qg6 y QjA Jc PHONE got - 70'R-d-y EMAIL 063 cd. CO APPLICANT NAME ADDRESS -)— PHONE nt_'79`b_ot44 EMAIL g a4riJ. L'v-, CONTRACTOR'S NAME OWNER BUILDE BUSINESS NAME Building Dept. ADDRESS JUL 0 2 20% PHONE EMAIL Received CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ SQFT LSQFT APPLICANT'S SIGNATURE DATE OTYSTAFF USE ONLY AN DEPARTMENT DISTRIBUTION ACCEPTED BY: f ,`1;. �I CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE P Y�,'•�' ICI �� INVOICE TOTAL 3-1 .3C3 GREEN SMIP OWNER BUILDER VERIFIED YES O NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES NO City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92S86 (951)672-6777 www.cityofinenifee.us NIF