PMT18-04469 City of Menifee Permit No.: PMT18-04469
29714 HAUN RD.
MENIFEE, CA 92586 Type: Pool/Spa -Residential
MENIFEE MENIFEE Date Issued: 0 911 3/2 01 8
PERMIT
Site Address: 25373 WATER WHEEL CT, MENIFEE, CA Parcel Number: 358-422-004
92584 construction Cost: $38.000.00
Existing Use: Proposed Use:
Description of INGROUND POOL&SPA,WITH TWO CITY STD BLOCK WALL REPAIRS FOR EQUIPMENT
Work: ACCESS, 5'x 2.5 L FT
Owner Contractor
WILLIAM &KYM NORD
25373 WATER WHEEL COURT
MENIFEE, CA 92584
Applicant License Number.
MENIFEE, CA
Fee Description Qty Amount 1S1
Swimming PooUln-Ground Spa 1 467.00
Building Permit Issuance 1 27.00
Wall/Fence,standard 1 83.00
GREEN FEE 1 2.00
SMIP RESIDENTIAL 1 5.00
General Plan Maintenance Fee-Building 1 4.15
General Plan Maintenance Fee-Electrical 1 23.35
$611.50
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_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 perjury that I am under provisions of with a licensed contractors)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. the following reason:
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 a copy of the applicable law,Section
have and will maintain a certlficate 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 Code,for the performance of work for which www.leginfo-ca-gov/calaw.htmi.permit is issued.
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 owners behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy# Expires enter the ab. ve Identified p aperty for inspection purpose .
(This section need not to be completed Is the permit is for one-hundred L ' e
dollars($100)or less Date
PROP TY OWNER UTHORIZED 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 CX 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 specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 D 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 3706 OF THE L occupant require a permit for the construction or modification from South
IN SECTION
ADDITION 7 F THEST LABOR CODE,INTEREST,AND ATTORNEYS FEES COMPENSATION,DAMAGES AS PROVIDED FOR Coast.Air Quality Management District(SCAQMD)7 See permitting checklist
for guidelines
CONSTRUCTION LENDING AGENCY D Yes ❑No
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
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable Items)(Section 7031.5 hazardous material reporting.
Dyes ❑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 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 IRRPI
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 Iicensure 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
❑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.aov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-80OA24-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a D 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. ❑No EPA Lead-Safe Certified Firm is required for this project because:
❑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 MENIFEE
DATE: PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MEC�(�}fCA[Menifee
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES BUilding Dept.
DESCRIPTION OF WORK (/!f ivl, .� SEP
PROJECTADDRESS bvh?-Z'L. ZIP V@
ASSESSOR'S PARCEL NUMBER -Ltaa-('Yglj LOT TRACT
r
OWNER NAME Arlalo.? Q
ADDRESS /�•�537 /✓/ i?�� Wh2�c-
PHONE -6 2-6 EMAIL /GL1,4,-sA1J_, tea? (L • '
APPLICANT NAME `11,C114" /Og
ADDRESS
PHONE + EMAIL
CONTRACTOR'S NAME OWNER BUILDER? -gXES O NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE /� U
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL I GREEN SMIP
OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE N NOTARIZED LETTER C YES O NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofinenifee.us ' »
e
NIF
FOOTING OPTION "A" FOOTING OPTION "B"
#4 HORIZONTAL REBAR
(USE BOND BEAM BLOCK)
6"OR 8" BLOCK
"H" rrHr.
HEIGHT FROM TOP #4 HORIZONTAL AT 3211 MAX. O.C. HEIGHT FROM TOP
OF FOOTING (USE BOND BEAM BLOCK) OF FOOTING
SEE TABLE SEETABLE"B"
FOR REBAR SIZE FOR REBAR SIZE
AND SPACING AND SPACING
LOCAWRMMINCEN OFCEW IIOCAiE RF9AR IN CENTER OF MEW
FINISH GRADE
(1)-#4 REBAR
=IIII CONTINUOUS = c
12" 1O" (2)-#4 REBAR IIII= ifee
IIII= i ng Dept.
--- =_IIII CONTINUOUS IIII=
-IIII
REVERSE _ =111�1111 13 20`18
DIRECTION OF W" W"
HOOK ON EVERY (F�I" WIDTH)
OTHER REBAR SEETABLE"A" (ETINGWIDT, �reiv
SEETABLE"B , e
ALL FOOTINGS ADJACENT TO
TABLE „A•, SLOPES BEAT LEAST 5'TO TABLE "B"
DAYLIGHTT AS SHOWN BELOW.
uHn .rWrr VERTICAL VERTICAL
REINFORCEMENT r.H rr rrWa REINFORCEMENT
3' 17" #4 @ 48"O.C. 3' 19" #4 @ 48" O.C.
4' 20" #4 @ 48" O.C. 4' 22" #4 @ 48" O.C.
5' 23" #4 @ 48" O.C. s<q,'§( 5' 29" #4 @ 48" O.C.
6' 29" #4 @ 24" O.C. BoFoM F 6' 34" #4 @ 24" O.C.
FOOTING SMIN.
NOTES: CHECK WITH THE BUILDING DEPARTMENT TO
1)THIS DESIGN DOES NOT ALLOW GRADE DIFFERENTIALS OF VERIFY IF A BUILDING PERMIT IS REQUIRED ._
MORE THAN 6"ON OPPOSING SIDES OF THE WALL THIS IS WHEN A PERMIT IS REQUIRED,THE FOLLOWING
NOT A RETAINING WALL.
2)FENCE HEIGHTS ARE REGULATED—CONSULT ZONING INSPECTIONS ARE REQUIRED:
1)FOOTI ornv-t,nr rewr..---
REGULATIONS BEFORE BEGINNING CONSTRUCTION. � STTEEEULIINPLLACE AND SUPPORTED 3"ABOVE AN
LL
3)NO WATER COURSE OR NATURAL DRAINAGE SHA BE CITY 1v MOM OF THE SURROUNDING EARTH/DIRT.
OBSTRUCTED. E I AR AND
4)GROUT ONLY THE CELLS CONTAINING REBAR. THIS WALL BUILDI � �r �R P 1• �I�PRIOR
IS NOT DESIGNED FOR ALL CELLS TO BE GROUTED. PLAN�'r1M7rAP'TEOUT
5)ALL REBAR TO BE ASTM SPEC.A615,GRADE 40 MINIMUM. R GROUT IS PLACED-PRIOR TO ANY
6)ALL REBAR LAP SPLICES TO BE 2411 MINIMUM. DECORATIVE CAP PLACEMENT.
7)ALL MASONRY UNITS TO BE ASTM C-90 GRADE N.
B)REBAR TO BE CENTERED IN MASONRY CELLS.
WESTERN RIVERSIDE COUNTY CODE UNIFORMITY PROG@*1
*SEE PAGE 2 FOR ADDITIONAL INFORMATION* I&I
CITY OF MENIFEE
DISCLAIMER: fth e plansALTERNATE DESIGNS MAY BE POSSIBLE anWHEN PROVIDED WITH AN ENGINEEREDand rdin �9spt� p �n� I e tL
ANALYSIS. USE OF THIS STANDARD DESIGN co letion.
MqdWWSA
IS AT THE USER'S RISK AND CARRIES NO
IMPLIED OR INFERRED GUARANTEE AGAINST (951
FAILURE OR DEFECTS.
11 FAX(951)6793843 1 y 4/2014 1 Www.CTTYOFMENIFEE.US I PAGE 1 0F2
REBAR PLACEMENT
ILLUSTRATION FOOTING OPTION B
10 (TYPICAL)
ALL REBAR SPLICES
24" MIN. OVERLAP
ga
(TYPICAU
ONLY CELLS AND BOND BEAM
COURSES WITH REBAR TO BE
GROUTED
(DO N_SOUL)GROUT ENTIRE WALL-USE
GROUT STOP MESH AS APPROPRIATE)
wW
q
pa
FOOTING OPTION A '
fTYPICAI)
s
ALL REBAR SHALL HAVE A
MINIMUM OF 3"CONCRETE
COVER AT FOOTINGS
i
S
DESIGN PARAMETERS: WESTERN txmElxsloEcouNn n coeuNlrownrrrPRoGwAM
ACTIVE SOIL PRESSURE(PSF) =30 "`-"' CITY OF MENIFEE
!ASSIVE.SOIL BEAR[NG(PSF) =150 BUILDING DEPARTMENT
(;OEFFICIENT OF FRICTION, - =0'25 ENIRE '
ALLOWABLE SOIL BEARING;(PSF) =-1500
WIND=60MPH,EXPO$WREC.. - i' FREESTANDING BLOCK WALL
SEISMIC: -
NA=13,NV=1.6,Z=0.4,SOIL PROFILE=SO
(951)6728777 29714 HAUN ROAD,MENIFEE,CA 92586
-- :---- -- - FAX(951)679.3843 -1 2/24/2014- - WWW.CRYOFMENIFEE.US 1 PAGE20F2, -
We,William and Kym Nord grant permission to secure permits for our owner builder pool project at 25373 Water Wheel in Menifee,
to Mark Brownlee a thi at 18. is allows us to continue with our daily workwhile securing our permits.
William Nord: Date:
Kym Nord: Date:-4WOl
See Attached Notarized
Document Dated
city of Menifee
Building Dept.
SEP 13 2018
Received
CALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California }
County of. L�m1a }
On before me, 1D��4 —D nl�rlti� JAWn t t11,11C
[ I (Here insert name a uue o e o J I
personally appeared ( NJud Dric) ll Ab rAr��,t�ir�
who proved to me on the bagis of satisfactory evidence to be the person(s) whose
name(s) is/afe-subscribed to the within instrument and acknowledged to me that
he/she/#iey executed the same in his/her/their authorized capacity(ies), and that by
his/her/t4eirsignature(s) on the instrument the person(s), or the entity upon behalf of
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
WITNESS my hand and official seal. SOLANGE N.TAMBWE
y COMM.tl2203119
F= NPlery PYEIc•Oeri y
/aalOEOOUaW
NTY
\� MY Comcmm FxPins Jun.29,a0a1 w
ry ublic S nature (Notary Public Seal)
ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM
Thisformcomplieswith current California statutes regardingnotary wording and,
DESCRIPTION OF THE ATTACHED DOCUMENT Jneeded,should be completed and attached to the document Acbrowledgments
from other states may be completedfor daomnents beingsent to that state so long
` as the wording does not require the California notary to violate California notary
1i f kmv.
(TUe or scdption of attached document) • State and County information must be the State and County where the document
signer(s)personally appeared before the notary public for acknowledgment
• Date of notarization must be the date that the signer(s)personally appeared which
(Title or description of attached document continued) must also be the same daze the acknowledgment is completed.
• The notary public must print his or her name as it appears within his or her
Number of Pages Document Date — —� commission followed by a comma and then your title(notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
notarization.
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helsheldwy,—is/ere)or circling the correct forms.Failure to correctly indicate this
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Impression must not cover text or lines. If seal impression smudges,re-seal if a
(Title) sufficient area permits,otherwise complete a different acknowledgment form.
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the county clerk.
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Indicate the capacity claimed by the signer. If the claimed capacity is a
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2015 Version www.NotaryClasses.com 800-873-9865 • Securely attach this document to the signed document with a staple.
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