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PMT18-03355
City of Menifee Permit No.: PMT18-03355 AV Arl 29714 HAUN RD. ';F* MENIFEE, CA 92586 Type: Pool/Spa-Residential MENIFEE MENIFEE Date Issued: 0 710 612 01 8 PERMIT Site Address: 25016 WOODEN GATE DR, MENIFEE, Parcel Number: 339-422-004 CA 92584 Construction Cost $30,000.00 Existing Use: Proposed Use: Description of 510 SQ FT CONCRETE POOL-NO SPA Work: Owner Contractor RICHARD VARGAS 25016 WOODEN GATE MENIFEE, CA 92584 Applicant License Number: RICHARD VARGAS 25016 WOODEN GATE MENIFEE, CA 92584 Phone:3232377142 Fee Description Oft r, Amount 1$) Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Electrical 1 23.35 $523.35 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.rpl 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 70D0)of Division 3 of the Business and V am exempt from licensure ynder the Contractors State Ucense Law for Professions Cade and my license is in full force and effect. the following reason: '/ ,G 04"1 el° 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 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 fallowing website: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. www.leginfo.ca-govcalaw.html. y/ Policy# r -- Date PROPERTY OWNER OR UTHORIZED AGENT ❑I have and will maintain workers compensation insurance,as required by 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: 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 the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑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# 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 scified an the Hazardous Materials Information Guide.' WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes fd No UNLAWFUL,AND SHALLSUBIECTAN EMPLOYERTO CRIMINAL PENALTIES Will the intended use of the building bythe applicant orfuture building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit far the construction or modification from South ADDITION TOTHE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guideline} CONSTRUCTION LENDING AGENCY ❑Yes opfo I hereby affirm that under the penalty of perjury there is 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 -6No -JCDWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD p]`I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of California Health al Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 material reporting. DYes No Business and Professions Code).Any city or county that requires a permit to /, �/J r +�"'A �/1 Date 7 a construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZE ENT 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 fRRP) 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 ❑1,as owner of the property,or my employee with wages as their sale employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( I 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 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a in An EPA Lead-Safe Certified Renovator will be responsible forthis 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: *,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Cade: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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION � MENIFEE DATE: - - PERMIT/PLAN CHECK NUMBER �� o33Cj PLANNING CASE NUMBER 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 0 RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK 5- •F> PROJECTADDRESS �Q�,6 `�Q[%�Lt ZIP as y ASSESSOR'S PARCEL NUMBER 3 39.Q22I)CH LOT TRACT OWNER NAME ADDRESS .SQ1G w0 r' PHONE 323 23-7 •71y7, ' / EMAIL 1r l C T 7771/ od APPLICANT NAME L/Gl� cC V GLS -r ADDRESS 07-S61b L ap a,�C O r PHONE 3Z3 23_? ( EMAIL r I c 7 7 -7 7 y CONTRACTOR'S NAME OWNER BUILDER? NIYES ONO BUSINESS NAME ADDRESS »� C m N PHONE EMAIL Ln CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION t UATION$ 3© dOO � SQ FT L SO.FT U mLICANT'S SIGNATURE �� DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING EN NG FIRE INVOICETOTAL � GREEN SMIP OWNER BUILDER VERIFIED XYES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO City of Menifee Building &Safe Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityofmenifee.us �eT � •� ENIFE &DG 5y,1 W cd ram_. A%0 r� LA.�■ I/ 'T1 a . U. WGA5 08 'WOO`)ee) GPNYe �?R�ve Lf MCAII fee I C_ No opes ithin 10' - 0"3 ' � �� w Q o¢ wimm' g Poo! Spy to PLAN REVIE ED nfo nc o C ails To d L.Lacher,R.C.E.67656 Col Engineering,Inc. 9hv !deteils . !take precedence over conflicts with site plan. 14 N \ 1 -.-._. -.--•- �. i K►Srirvc��e;� ' s� i e+vaa ' P44 NA ,. FVjFw i ral°J /�eSePla nY �DulddQn3dn H%hi i i sc^ �siteunli/� d0rdiry� I 6�r E CRY of Menifec cx t �f s Building Dept. >5� o -a— JUL 0