PMT14-02000 City of Menifee Permit No.: PMT14-02000
�C 29714 HAUN RD. Type: Residential Plumbing
' CE;L'^� MENIFEE, CA 92586
MENIFEE Date Issued: 08/04/2014 j
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PERMIT
Site Address: 28631 MISSION DR, MENIFEE, CA 92584 Parcel Number: 372-062-011
Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING WATER HEATER, SAME SIZE AND LOCATION
Work:
Owner Contractor -
DANIEL YE ALL STAR WATER HEATERS INC
28631 MISSION DRIVE 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92584 MENIFEE, CA 92584
Applicant Phone: 9513010067
SIERRA SPRAGUE License Number: 812894
ALL STAR WATER HEATERS INC
30300 PUERTO VALLARTA WAY
MENIFEE, CA 92584
Fee Description Qty Amount($1
Building Permit Issuance 1 27.00
c,
$111.00
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,orwhere 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
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City Of Menifee
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LICENSED DECLARATION
I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed
Chapter 9 (commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions
Professions Code and my license is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class e,31 License No. who builds or Improves thereon, and who contracts for the projects with a
Expires Signature. licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ lam exempt from licensure under the Contractors'State License Law for the
❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason:
I have and will maintain a certificate of consent of self-insure for workers' By my signature below I acknowledge that, except for my personal residence in
compensation, issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of
Section 3700 of the Labor Code, for the performance of work for which this permit is issued. improvements covered by this permit, I cannot legally sell a structure that I have
Policy# built as an owner-building if it has not been constructed in its entirety by licensed
contractors. I understand that a copy of the applicable law, Section 7044 of the
have and will maintain workers' compensation insurance, as required by Business and Professions Code,Is available upon request when this application is
section 3700 of theLabor Code,. for the performance of the work for which this submitted or at the following Web site:httoalwww.leeinfo.ca.govlcalawhtri
permit is issued.My workers'compensation insurance carrier and policy number are:
Property Owner or Authorized Agent
Carrier ' ss or g. Date
Expires x'��s Policy# a0/li&e4
6'By my Signature below, I certify to each of the following: I am the property
Name of Agent Phone# owner or authorized to act on the property owner's behalf, I have read this
(This section need not be completed if the permit is for application and the information I have provided is correct. I agree to comply
one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building
construction. I authorize representatives of this city or county to enter the above-
❑ I certify that in the performance of the work for which this permit is issued, I identified property for the Inspection purposes.
shall not cemplo ompensation
any persons in any manner so to become subject to the /�
workers compensation laws of and agree that if I should become �y�-!..
subject to the workers'compensation provisions of Section 3700 of the Labor Property Owyi r or thorized Agent Date
Code,I shall forthwith comply with those provisions.:
DD City Business License#
Date; o/ - Applicant;
WARNING: FAILURE TO SI WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000), IN ADDITION TO THE COST OF COMPENSATION, AYES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑NO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
1 hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE?
agency for the performance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
❑NO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
- I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reason(s)indicated below by the checkmark(s)I have placed OYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s)(Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, Improve, demolish, ONO SCHOOL?
or repair any structure, prior to its 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 Slate License Law (Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or OYES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than ($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
El I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation, will do ( ) all of or ( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044, Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or Improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
._..�JDTY OF 1\�ILiNflFlli
�ity of Menifee PI Ck Nn Permil No,
Building & Safety Dept. d
29714 Haun Road Date Dale.
Menifee, CA 92586 AUG 0 1 2014 %
Phone: (951)672-6777 Amount Amnunt
Fax:(951)679-3843
Received Gkp Ckp
WOO-
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case F. l RI R
Property Address: 28631 Mission Dr. Assessor's Parcel Number:
31a
Projectfrenanl Name: Unit d Floor tF:
Name: Daniel Ye Phone No. 619-204-3037 Fax No
Propedy Address Unit Number Zip Code
Owner Same as job p 92584
Email address:
Name: Sierra Sprague Phone No Fax No
951-345-4083
Applicant Address: 30300 Puerto Vallarta Unit Number Zip Code 92584
Email Address: //s�zr rs.•ierra. /rlR+! . LIJ/27J
Name: All Star Water Heaters Phone No 951-345.408 Fax No
Comrade Address: 30300 Puerto Vallarta Ciiy 5i�le CA Zip Cad
92584
Contractor CityBusiness License R Contractor's City Slate of�13fy�(r Licence NO Classiricauon C 36
Number o(squaras: r7{1y
Square Footage
Description of Work: Replace existing water heater.Same size and location, cnsI of Work:S 800.00
Applicants Signature f19 Date
49yy „- To Be Completed Fy dity staff only O -
Indicate As R-Raceived or N/A-Not Applicable
5 Comoletes Sets Of fully dimensioned,drawn to sale plan$which include: 1 set of documents whiohhodude
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo TechlSoils Report(on cd only)
❑ Plot 1 Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ rile 24 Energy(on 8!x 11)
❑ Foundation Plan ❑ Structural Calculations
❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan 8 Details ❑ Shoring Plan 1 ❑ Sound Report-Residential
Class Code, Indicate New Construction Alteration' Addition` MearWMel4ods
Work Type; Repair' Retrofit' ReWsien 10EuSting Peenit' Required? YES NO
Proposed Building Use(s): Existing Building Use(s)'
k Buildings. If Units: itStories- Will the auilding Hive'.a Basement?
Y of N
Bldg.Code Occupancy Group Indicate indicate it yES or NO Indicate all Geo-tech Haz.Zone
At Project Construetion Sprinklerod that apply: Coastal Zone
Completion: Type(s): C Of 0 Noise Zone
Required? YES or NO
Listed on Historic Resources Inventor
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board Land marF Cumin. Planning Comm.Zoning Administrator
Fee Exempt City Project Elec.Vehicle Charger Landmark Seiamlq Retrofit syeriai Caca oq
_ Olix.r»IA oval
Expedite Pfojecl(s): Child Carp City Project Green Budding Landmark Affordable Housing
For Staff Use Only �-'-
Building7Saie!y I Permit Specialist City Planning Crn:Gngineen a I L�..(: Admen I 7ransnpn4tlon fAgmi Rem Comrol
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY