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PMT18-04058 City of Menifee Permit No.: PMT18-04058 29714 HAUN RD. Type: Residential Electrical MENIFEE,CA 92586 MENIFEE MENIFEE Date Issued: 08/16/2018 PERMIT Site Address: 30520 LONE PINE DR, MENIFEE, CA Parcel Number: 358-682-001 92584 Construction Cost: $1,000.00 Existing Use: Proposed Use: Description of INSTALL U/G ELEC WITH 220A DISCONNECT FOR FUTURE ABOVE GROUND SPA,U/G ELEC WITH Work: 110A FOR FUTURE BBC, U/G GAS LINE FOR FIRE PIT AND FUTURE BBQ, SLEEVED UNDER PROPOSED PATIO COVER Owner Contractor SCOTT SPENCER BILL&DAVE'S LANDSCAPE MAINTENANCE INC 30520 LONE PINE DRIVE 1153 HARLEY KNOX BLVD MENIFEE,CA 92584 PERRIS, CA 92571 Applicant Phone:9519436455 DAVE LEIDENFROST License Number:751707 BILL&'DAVE'S LANDSCAPE MAINTENANCE INC 1153 HARLEY KNOX BLVD PERRIS, CA 92571 Fee Description Qtv Amount(SI Receptacle,Switch,Outlet&Fixture 2 121.00 Inspections not specified 116 116.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Building 1 5.80 General Plan Maintenance Fee-Electrical 1 6.05 $249.85 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_Pennit_Template.rpt Page 1 of 1 90ve bea.0 Fae5} - CITY OF MENIFEE g7ilk vw-e' \--ahA5axe2 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 7000)of Division 3 of the Business and O I am exempt from[!censure under the Contractor's State License Law for Professions Code+and 1my license is in full force and effect. '"7 the following reason: License Class jieer�a t S 0 ! By my signature below I acknowledge that,except for my personal residence Expires jgnature — 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 1 WORKER'S COMP SATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by o l hereby affirm under penalty of perjury one of the fallowing 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 fallowing website: by Section 3700 of the Labor Code,for the performance of work for which wtv-i.ieginfo-ca.gov/calaw-htmi.permit is issued. Policy# Date o 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 O 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 numberare: Uc-), r— application and the information 1 have provided is correct.I agree to comply Carrier r with all applicable city and county ordinances and state laws relating to ` r'� building construction.[authorize representatives of this city or county to Policy tl�lCdd0 L�v Epires 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, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE 11 worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shal scans. Will the applicant or future building occupant handle hazardous material or Applicant forth 'th c plywi a se�aZi _Dat_hl� mixture containing a hazardous material equal to or greater that the amounts specified an the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes ONO 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 District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY oYes allo I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet ofthe lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) Oyes ONO OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the C California Health al Safety Code,Section 25505 and 75539 concerning Contractor's License Law for the reason(s)indicated below by the checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting. oYes o No Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWN ER 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(RRP) 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 70315 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 a 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( )portion of the work,and the structure is swvw.epa.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professans 1-BOD-424-LEAD(5323). Code,The Contractor's State License Law does not apply to an owner of a oAn 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 sate. O No EPA Lead-Safe Certified Firm is required for this project because: ri 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 rill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: �j PERMIT/PLAN CHECK NUMBE PLANNING CASE NUMBER TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O&qof Jfee SUBTYPE: O ADDITION O ALTERATION O DEMOLITION @'ELECTRICAL O MECHANICAL Building I ept. O NEEW' -0-PLUMBING O RE-ROOF NUMBER OF SQUARES - DESCRIPTION DESCRIPTION OF WORK —� L i AUG 1 F 2018 A L t-�pp'�� Q ed PROJECTADDRESS V , _!J �,,II�� PI�/v ` /L ASSESSOR'S PARCEL NUMBER t� �L . cDk LOT TRACT OWNER NAME CZT 1QC>> C� C C ADDRESS IC) A ` 01, �� PHONE DS ) l V ^ L/51c4 / EMAIL APPLICANTNAM`E� 1 } I/tee �/fO ADDRESS JI d 50 t"1 G� ems` r ( ` PHONE �S ( 3 lJ S EMAIL VJ r r C 0✓V\ CONTRACTOR'S NAME OWPNER BUILDER? O YES O NO BUSINESS NAME ADDRESS Q PHONE I'S 5'y y s-S EMAIL CONTRACTOR'S STATE LIC NUMBER O ) -151-Jrn LICENSE CLASSIFICATION VALUATION$ SO FT L SO FT / APPLICANT'S SIGNATURE DATE OTYSTAFFUSEONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE Pb INVOICE TOTAL I C;)VA °tS I GREEN — SMIP X OWNER BUILDER VERIFIED OYES O ND DRIVERS LICENSE# NOTARIZED LETTER 0 YES O NO City of Menifee Building &Safety Department 129714 Haun Rd., Menifee,CA 92586 (951)672-6777 www.cityofmenifee.us ENIF