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PMT18-04857 City of Menifee Permit No.: PMT18-04857 29714 HAUN RD. MENIFEE, CA 92586 Type: Pool/Spa -Residential MENIFEE MENIFEE Date Issued: 1 010 5/2 01 8 PERMIT Site Address: 31751 QUILT WAY,MENIFEE, CA 92584 Parcel Number: 360-700-026 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of IN GROUND POOL AND SPA 378 SQUARE FEET WITH 3 LIGHTS Work: Owner Contractor YOLANDA ALVAREZ PACIFIC COAST POOLS INCORPORATED 31751 QUILT WAY 26499 JEFFERSON AVE UNIT E MENIFEE, CA 92584 MURRIETA, CA 92562 Applicant Phone:9512960199 PACIFIC COAST POOLS INCORPORATED License Number:852237 26499 JEFFERSON AVE UNIT E MURRIETA, CA 92562 Phone: 9512960199 Fee Description QQt rr Amount IS) Swimming Pool/In-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 carded 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 Brandy Coral-Pren'fier Pools CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects 1 hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter!)(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 Code and- my license is in full force and effect. the following reason: License Class 1..7� License No. 652.2_-_�Q By my signature below l acknowledge that,except for my personal residence Expires Z�l�' Signatures y� CC k inwhich l must have resided for at east one year prior to completion of Improvements covered by this permit.I cannot legallpsell 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 following declaration:) 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 Cade,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 this permit is issued. www.leeinfo.ca.gov/caiaw.lmnl. Polity It Date ❑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 for which a 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 policy owner or authorized to act on the property owners behalf.I have read this number am: 'n' �.{ �,�/ application and the information 1 have provided is correct.I agree to comply Carrier�1 trV ''` UWti�- with all applicable city and county ordinances and state laws relating to ��..II//�� — �j building construction.I authorize representatives of this city or county to Policy It AWC II��L75OI Expires O ly 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, m ®��)ta_y,q') Ishallnoteolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE R ��JJ��g WW workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to th orkers compensation provisions of Section 3700 of the Labor Code,lshal f rthwit comply with those provisions. I_r, Will the applicant or future building occupant handle hazardous material or Applicant Date ,2,0 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 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 IN SECTION ON TO 06 OF LABOR CODE,INTEREST, ADATTOGES AS ROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 37060E THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelineess CONSTRUCTION LENDING AGENCY a Yes Wo I hereby affirm that under the penalty of perjurythere 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 bound/ f a school? (Section 3097 Civil Code) o Yes o No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guideand the SCAQMD I hereby affirm under penalty of perjury that l 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) Safety Cade,Section 25505 and 25534 concerning hazardou to al reporting. checkmark(s)I have placed next to the applicable items)(Section 7031.5 oYes o No Business and Professions Code).Any city or county that requires a permit to Date (1' 1 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 Contractors 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 far 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 he 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 ownerof the property,or my employee with wages as theirsole employees.For more information about EPA's Renovation Program visit: compensation,will do( I all of or I )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-EAD(5323). Code;The Contractors State License Law does not apply to an owner of a aAn 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. o No EPA Lead-Safe Certified Firm is required for this project because: o 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 t i, MENIFEE ok DATE: L PERMIT/PLAN CHECK NUMBER PLANNING CASE NUMBER TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME OOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL ONEW OPLUMBING �0REE-ROOF NUMBER OF SQUARES �/�� DESCRIPTION OF WORK 1701 �' JJ �— J y v I PROIECTADDRESS ZIP ASSESSOR'S PARCEL NUMBER ' cI d' DL LOT TRACT OWNER NAME ^-� (W �� City ol Menifee ADDRESS -J1 l�q p1' �l. Building Dept. PHONE ��` I,\ ZZZZ EMAIL APPLICANT NAME ADDRESS Received PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES ONO BUSINESS NAME E ADDRESS L Yg PHONE �' lQ [�) EMAIL CONTRACTOR'S STATE LIICC NUMBER �Q Z_L-,7� LICENSE CLASSIFICATION VALUATION$ b-DID /SO F/TJ L SO FT APPLICANT'S SIGNATURE P �-1' DATE USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LI SECEN NUMBER BUILDING PLANNING ENGI EKING FIRE INVOICETOTAL 11 V522. 39 GREEN 1411 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.cityofmenifee.us NIF