PMT18-04035 City of Menifee Permit No.: PMT18-04035
29714 HAUN RD. Type: PoollSpa-Residential
1 / MENIFEE,CA 92586
MENIFEE MENIFEE Date Issued: 08/15/2018
PERMIT
Site Address: 32350 MADDY CT,MENIFEE,CA 92584 Parcel Number: 362-450-027
Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA,391 SQ FT
Work:
Owner Contractor
DAN&JAMIE TREMBLY PACIFIC COAST POOLS INCORPORATED
32350 MADDY CT 26499 JEFFERSON AVE UNIT E
MENIFEE, CA 92584 MURRIETA, CA 92562
Applicant Phone:9512960199
BRANDY CORAL License Number:852237
26499 JEFFERSON AVE UNIT E
MURRIETA, CA 92562
Fee Description Qy Amount 151
Swimming Pooltin-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_BIdg Permil_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 perjury that 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 o I am exempt from licensure under the Contractor's State License Law for
Professions Cod and my license is in full force and effect. �7 the following reason:
License Class License No. C�JZ.Z� I By my signature below l acknowledge that,except formy personal residence
Expires 2�Signature _ in which l 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
❑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 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 website:
by Section 3700 of the Labor Cade,for the performance of work for which ,m„w leeinfo.ca.eov/plow html.
this permit Is issued.
Polity g 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 forwhich a 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 polity owner or authorized to act on the property owner's behalf.I have read this
number am:/�/�� application and the information I have provided is correct.I agree to comply
Carrier f/II IA, "s`- t71f/��- with all applicable city and county ordinances and stale laws relating to
p building construction.I authorize representatives of this city or county to
Policy 11 V"1�1. 7�,O _ Expires. O enter the above identified property for inspection purposes.
(This section need not to be 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, �jr/�b/y
I shall not emalov any persons in any manner so as to become subject to the CITY BUSINESS LICENSER ®,5j5o w
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,Ishat ithwit comply with those provisions. f' I Will the applicantor future building occupant handle hazardous material or
Applicant Date I mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS a Yes
UNLAWFUL,AND SHALLSUBIECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use ofthe building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant requires permit for the construction or modification from South
ADDITION 306OFIO THE TLAB OF ORCODE,INTERDAMADATTOGES AS ROVIDEOS Coast Air Quality Management District(SCAQMD)7 See permitting checklist
IN SECTION 37060E THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldelineess
CONSTRUCTION LENDING AGENCY a Yes O'NO
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
fending agency for the performance of the work which this permit is issued outer bound fa school?
(Section 3097 Civil Code) o Yes 0 Na
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) . r Safety Code,Section 25505 and 25534 concerning
hazardou to al reporting.
chsiness and
I have placed next to the yapplicable y that r(section permit oyes o No n �—
Businessand Professions Code).Any city or county that requires a permit to `/ Date
construct,alter,improve,demolish or repair any structure,prior to 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 fRRP)
License Law(Chapter9(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]!censure 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-certifled firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental properly owners and property
than($500). 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.eoa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-BOD-424-LEAD(5323).
Code,The Contractor's State Ucense 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. a No EPA Lead-Safe Certified Firm is required for this project because:
a 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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER /�
TYPE: COMMERCIAL 4 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME V1'OOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK bl�PROJECTADDRESS (11\' Jv1 Zip �Z
ASSESSOR'S PARCEL NUMBER 3 OT TRACT
OWNER NAME 4- fZ)')'`t�. T
ADDRESS] 72 �
PHONE "60- ` �l� "1 J " ly EMAIL
APPLICANT NAME
ADDRESS W✓ � �
PHONE EMAIL
CONTRACTOR'S NAME <AfiWNER BUILDER? O YES CYKD
BUSINESS NAME
ADDRESS u
PHONE Gj'�_l —CfCO ^'7 EMAIL
CONTRACTOf 15�TE LIC NUMBER LZ�J� LICENSE CLASSIFICATION CS
VALUATION$ 25 L. O V d SQ FT L SO FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIFE ACCEPTED BY:
INVOICE TOTAL 05aa 3 GREEN , SMIP
OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofinenifee.us r`
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-Apor val of these olans shall not be construed to be a