PMT18-04192 City of Menifee Permit No.: PMT18-04192
29714 HAUN RD.
//Ar MENIFEE, CA 92586 Type: Pool/Spa -Residential
MENIFEE MENIFEE Date Issued: 0 812412 01 8
PERMIT
Site Address: 30556 BUCKBOARD LN, MENIFEE, CA Parcel Number: 358-450-008
92584 Construction Cost: $25,000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA,485 SF,NTH U/G GAS&ELEC LINES FOR FUTURE BBO AND U/G GAS
Work: LINE TO FIRE PIT
Owner Contractor
HENRY OLIVO PACIFIC COAST POOLS INCORPORATED
30556 BUCKBOARD LANE 26499 JEFFERSON AVE UNIT E
MENIFEE, CA 92584 MURRIETA,CA 92562
Applicant Phone:9512960199
BRANDY CORAL License Number:852237
PACIFIC COAST POOLS INCORPORATED
26499 JEFFERSON AVE UNIT E
MURRIETA, CA 92562
Fee Description QtV Amount IS7
Receptacle, Switch,Outlet&Fixture 1 116.00
Swimming Pool/In-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
Inspections not specified 116 116.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Building 1 5.80
General Plan Maintenance Fee-Electrical 1 29.15
$765.95
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 staled,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_Permft 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).
Chapter9(commencing with section 7000)of Division 3 of the Business and o 1 am exempt from licensure under the Contractor's State License Law for
Professions Code aan�n-d- my license is in full force and effect. the following reason:
Ucense Class License No. UJZ.Z 3J By my signature below l acknowledge that,except for my personal residence
Expires 2-1 Signature a in which I must have resided for at least one year priorto completion of
Improvements covered by this permit.I cannot Iegallysell a structure that 1
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
a I 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 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 webs@e:
by Section 3700 of the Labor Code,for the performance of work for which www.leeinfo.ca.eov/calaw latml.
this permit is issued.
Policy R Date
01 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 for which ❑By my signature below l certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and polity owner or authorized to act on the property owners behalf.I have read this
numberar/ee:1n1 �,{ �,)'( application and the information I have provided is correct.I agree to comply
Carrier t/II W "s�- UIV��- with all applicable city and county ordinances and stale laws relating to
'I/� p-71,�—t�7 �i building construction.I authorize representatives of this city or county to
Policy AlLit AnclZ I _ 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
❑I certify that in the performance of the work for which this permit is issued, ®�js�/� I.I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSER `f 1J w
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject tot orkers compensation provisions of Section 3700 of the Labor
Cade,lshal, rthwit complywith those provisions. l Will the applicant or future building occupant handle hazardous material or
Applicant 1 Date` ,D mixture containing a hazardous material equal to orgreater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS a Yes
ewo—
UNLAWFUL,AND SHALLSUB1ECi AN EMPLOYERTO CRIMINAL PENALTIES Will the intended use of the bullding by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDREDTHOUSAND DOLLARS($100,00D),IN occupant requires permit for the construction or modification from South
ADDITION SECTION
3 THE COST LABOR CODE,INTERTION,DAMAGESDATTORNEYS
PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 37060FTHE LABOR CODE,INTEREST,AND gTTORNEYS FEES farguldelineess
—
CONSTRUCTIONLENDINGAGENCY oyes ;f
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 boundd ryof a school?
(Section 3097 Civil Code) o Yes o No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMO
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractors License Law for the reason(s)indicated below by the Califomira, Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable items)(Section 7031.5 hazadou reporting.
oeso e
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 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 MRPI
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
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.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-81ID-424-LEAD(5323).
Code;The Cntractars State Ucense 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 yearof 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 1,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 0 MENIFEE
DATE: PERMIT/PLAN CHECK NUMBER P 1 vl
GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME POOL/SPA O SIGN
SUBTYPE: (j)ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW OPLUMBING ORE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK Y ✓I
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERSOYES ONO
PROJECTADDRESS euciA e jaggi ZIP
ASSESSOR'S PARCEL NUMBER dro� 4nb-CCF, LOT TRACT
OWNER NAME 1 M)
ADDRESS l7 tc iclo ( Lk/r' City of Menifee
O� �`)L4 — �,.Y23� EMAIL Building e .
PHONE 1
APPLICANT NAME Le-rn 1/ OD AUG 24 2018
ADDRESS Roxeceaved
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? ()YES NO
BUSINESS NAME V0�
ADDRESS v, ('(,�,
PHONE { (p C)I L� EMAIL
CONTRACTOR'S STATE LIC NUMBER Yl 1a / LICENSE CLASSIFICATION
VALUATION$ 0^� IN UL) a SO FT L SO FT
APPLICANT'S SIGNATURE DATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL U(a, , 016 GREEN ,— SMIP
OWNER BUILDER VERIFIED O YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee,CA 92586 (951)672-6777Fa,
www.cityofinenifee.us
ENIF
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FTE PLAN REVIE 'Approval of the a plans shall trot be constru to be a pen
to approval of,anj violation of 14.prov'asions of a federal,s
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odd L.Lacher,R.C.E.87656 johsite unfit co pledon,
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OLIVO RESIDENCE