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pmt18-02694 City of Menifee Permit No.: PMT18-02694 29714 HAUN RD. MENIFEE,CA 92586 Type: Pool/Spa-Residential MENIFEE MENIFEE Date Issued: 06/04/2018 PERMIT Site Address: 30252 COBURN CIR,MENIFEE,CA Parcel Number: 358-720-037 92584 Construction Cost: $30,000.00 Existing Use: Proposed Use: Description of INGROUND POOL&SPA 380 SQ FT Work: Owner Contractor KEN STOLPA QUALITY CUSTOM POOLS INC 30252 COBURN CIR 30138 MARNE WAY MENIFEE,CA 92584 MENIFEE, CA 92584 Applicant Phone:9516799732 HANNAH BARRETT License Number: 795820 QUALITY CUSTOM POOLS INC 30138 MARNE WAY MENIFEE,CA 92584 Fee Description O_yt Amount f$1 Swimming Pool/In-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Electrical 1 23.35 $523.35 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA_Bldg_Permit_Template.rpt Page 1 of 1 Hannah Barrett-Quality Custon CITY OF MENIFEE LICENSED DECLARATION property who builds or Improves thereon,and who contracts for the projects I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State license Law). Chapter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect the following reason: License Class 0S3 - Q Licensee No. —I CIE$'L0 By my signature below l acknowledge that,except for my personal residence Expires 2.cs I4, Signature in which I must have resided for at least one year priorto 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 O 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 forwurker'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 websile: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. www.leeinfo.ca.eov/calaw.html. Policy 8 Date have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT I ection 3700 of the Labor Code,For the performance of the work for which D By my signature below I 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 owner's behalf.1 have read this numberare: application and the information I have provided is correct.I agree to comply Carrier Cu eye.S4 Nl tf ono✓) with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy g CA 10 n o 7-1 A`I Expires '7 I 1 I11� enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT a 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 It 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 shall forthwith comp] with those provisions. Will the applicant or future building occupant handle hazardous material or Applicant O/LiP Date��F.�J� 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 Oyes (0)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 occupant require a permit for the construction or modification from South IN SECTIONON 3 06 OF T T LABOR CODE,INTEREST, AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECr10N 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for gufdelin s CONSTRUCTION LENDING AGENCY �Lyes=lo 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) 0 Yes C vb OWNER BUILDER DECLARATIONS 1 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 Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 hazardous material reporting. Business and Professions Code).Any city or county that requires a permit to \*! O a C —A Date 0,/)7 construct,after,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 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 licensure receiving compensation for most work that disturbs paint in apre-1978 and the basis for the alleged exemption.Any violation of Section 70315 by residence orchildcarefacilitytoheork that dbs painico pre-19ply th than Applicant fora permit subjects the appliranttoacivil penalty ofnot more required practices.This includes rental property owners and property than($500), managers who do the paint-disturbing work themselves or through their o 1,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 1-800424-LEAD(5323). Code;The Contractor's State License Law does not applyto an owner of a O An EPA Lead-Safe Certified Renovator will be respon site 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: a 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 fill out the RRP Acknowledgement. BUILDINGPERMIT/PLAN CHECK APPLICATION Menii,ee DATE: Lp - b PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME C>7�POOL/SPA O SIGN SUBTYPE: ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK ;4-y PROJECTADDRESS SV52 UIIpwA,y., C✓E• ZIP Z ASSESSOR'S PARCEL NUMBER ?r:k1,:;l.0 ()'3j LOT TRACT ' OWNER NAME Cbt6jQC, ADDRESS PHONE Clig-I. 4314 • 3!s"lU EMAIL APPLICANT NAME ADDRESS g o,,r 01V;8N PHONE EMAIL CONTRACTOR'S NAME J m rr OWNER BUILDER? OYES O BUSINESS NAME I cA-L6*- 006 ADDRESS gpL 3 1`I PHONE 4i5 l (o'lq q-1 8 z EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION J rS - VALUATION$ 000 SO FT L SQ FT APPLICANT'S SIGNATURE DATE [e- 4 - / B a CITY STAFF USE ONLY `'• " _.. "' ' DEPARTMENT DISTRIBUTION �_ / _ CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY: �/rJ�(/ PERMIT FEE T�• S/ SMIP .� GREEN PLAN CHECK FEE INVOICE TOTAL OWNER BUILDER VERIFIED O YES 0 NO DRIVERS LICENSE!! NOTARIZED LETTER ^ YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofmenifee.us Light 516"04U wall T spa +ir 38W T15-D= 6-deep Reef Step Light Light BetCh Q tY of Menifee 5'6"Vnyl Fnce 8 jilding Dept. 3 JN 0 4 201 Re Cowete kei,.ceiv d iu Cmm*A uj CMD A C.30- Stolpa Residence LLM 30252 99alum Cr. ULM Menifee, Ca 92584 951-434-3676 Ty6QE ENIFEE IILDING AND SAFE rY DEPARTMENT 0J APPROVAL L TY6QE ENIFEE PYA Li ry DEPART MENT TM T LDATE to nc e msfrued to be oran f _roVi 0 he ons of the felc th W 0 Ipproveet ja 2pproved P ns on the lansmisi, on the Scale: 3/32" = 1 ft.