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PMT18-03422 City of Menifee Permit No.: PMT18-03422 29714 HAUN RD. Type: Pool/Spa -Residential 4-Al MENIFEE,CA 9258E MENIFEE MENIFEE Date Issued: 0 7/0 912 01 8 PERMIT Site Address: 25749 RIDGEMOOR RD, MENIFEE, CA Parcel Number: 339-332-004 92584 Construction Cost: $23,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 310 SQ FT Work: Owner Contractor JOSEPH GALLOWAY DIAMOND VALLEY ENTERPRISES 25749 RIDGEMOOR RD 41097 QUAIL RD MENIFEE, CA 92584 HEMET, CA 92544 Applicant Phone:9512326451 STEVE CLARK License Number:955482 DIAMOND VALLEY ENTERPRISES 41097 QUAIL RD HEMET, CA 92544 Fee Description ,Qtv Amount($1 Swimming Poolfln-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 3.00 General Plan Maintenance Fee-Electrical 1 23.35 $521.35 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_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 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 Contractor's State License Law for ' Professions Code and my license is in full force and effect. G the following reason: License Class �_-z-5 -;�-7 License No. By my signature below I acknowledge that,except for my personal residence Expires_ zz //J 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:) licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure for worker's 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 webslte: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. www.leginfo.ca.gov/calaw.htm]. Policy# Date ❑I 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 on the property owner's 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 ;entep the above' ntified property inspection purposes. (This section need not to be completed is the permit is for one-hundred dollars($100)or less Date OWNER OR AUTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is issued, .w�� I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#�,%5 ' worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's c ensation provisions of Section 3700 of the Labor Cade,I shall forthwi mply with se Isions. Will the applicant or future building occupant handle hazardous material or a Appli t X Date / mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WAR :FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes ®No 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 Quality Management District(SCtionor modification permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes tYNo 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 &No 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 Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 2S534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material rortmg. Business and Professions Code).Any city or county that requires a permit to ciYes d N Q�/ q y/ Date_— construct,alter,improve,demolish or repair any structure,prior to its p R 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 Ill 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 icensure receiving compensation for most work that disturbs paint in apre-1978 and the casts for the alleged exemption.Any violation a civil it Section of not o residence or childcare facility to be RRP-certified firms and comply with than Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This Includes rental property owners and property than($500J. P p y 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.epa.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 Contractor's State License Law does not apply to an owner of a &An EPA Lead-Safe Certified Renovatorwill 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-Bullder will have the burden of proving that it was not built or improved for the purpose of sale. dNo EPA Lead-Safe Certified Firm is required for this project because: o I,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. t BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION p ` MEN FEE DATE: PERMIT/PLAN CHECK NUMBER l GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: Q COMMERCIAL O RESIDENTIAL G MULTI-FAMILY O MOBILE HOME ®POOL/SPA O SIGN SUBTYPE: (F)ADDITION O ALTERATION ()DEMOLITION O ELECTRICAL O MECHANICAL ®NEW ()PLUMBING ORE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS()YES (ENO PROJECT ADDRESS ZIP ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME ADDRESS y� /D OD�L ,Q• PHONE EMAIL APPLICANT NAME ADDRESS • J..%� � � _/� 7 zSY� PHONE EMAIL CONTRACTOR'S NAME //C OWNER BUILDER? ()YES@NO BUSINESS NAME Ale ' ADDRESS PHONE ��/—Z�Z�G�= 1 EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION $ ,� G'� SQ FT L SQ FT APPLICANT'S SIGNATURE DATE CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIF�EE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE ID NI107SS INVOICE TOTAL I GREEN SMIP OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityofmenifee.us