PMT14-02169 City of Menifee Permit No.: PMT14-02169
29714 HAUN RD.
CCU!-/ . MENIFEE, CA 92586 Type: Residential Plumbing
s� es�r P MENIFEE Date Issued:
08/20/2014 i
PERMIT
Site Address: 29550 PAINTED DESERT DR, MENIFEE, Parcel Number: 340-170-031
CA 92584 Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING WATER HEATER. SAME SIZE AND LOCATION
Work:
Owner Contractor
DOUGLAS CANTINE ALL STAR WATER HEATERS INC
29550 PAINTED DESERT DRIVE 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92584 MENIFEE, CA 92584
Applicant Phone: 9513010067
ALL STAR WATER HEATERS INC License Number: 812894
30300 PUERTO VALLARTA WAY
MENIFEE, CA 92584
Phone: 9513010067
Fee Description ON Amount
sl e' 0
Building Permit Issuance 1 27.00
$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 Marilee. 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
City Of Menifee
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 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).
JO
WORKERS'COMPENSATION DECLA ION
❑ I am exempt from licensors 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 improvements covered by this permit, I cannot legally sell a structure that I have
permit is issued. built as an owner-building If it has not been constructed in its entirety by licensed
Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the
Zhave and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is
ction 3700 of the Labor Code, for the performance of the work for which this submitted or.at the following Web site:http,/Iwww.leginfo.m.gov/calaw.bt!nl.
permit is issued.My workers'compensation insurance carrier and policy number are:
o Carrier ii sy Property Owner or Authorized Agent Date
Expires //c r/ Policy
❑ 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-
El I certify that in the performance of the work for which this permit is issued,I identified property for the inspection purposes.
shall not emolov any persons in any manner so as to become subject to the
workers'compensation laws of California, and agree that if I should become
- subject to the workers'compensation provisions of Section 3700 of the Labor Property Qvfner p Authorized Agent Date
Code,I shall forthwith comply with those provisions. O�'501
ry City Business License#
Date; Applicant;
WARNING: FAILURE 'RIC 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, DYES 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 Cf NO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY vv SPECIFIED ON THE HAZARDOUS MATERIALS
I 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 DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address ONO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS
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 DYES 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, NO 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 State 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 �VES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from Iicensure 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($500).) CODE SECTION t 25505RIAL I�EPOR�MGD 25534 CONCERNING
❑ 1, as owner of the property, or my employees with wages as their sole
compensation, will do( )all of or( )porting of the work,and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
TY it)F MENI EF ---
"City of Menifee P'`" N'� `'"'"'"N,,
29714 Haun Road Building Dept Date t1al 1
Menifee, CA 92586
Phone: (951)672-6777 AUG 18 2014 Alpdnnt Amn°nl
Fax:(951)679-3843 Ckd ckff
Building Combination Perel. eive
To Be Completed ey plicant
Legal Description' Planning Case F I Fit R
Property Address 29550 Painted Desert Dr. Assessor s Parcel Number 340170031
Project/Tenant Name Unit# Floor#
Name; Douglas Cantine Phone No 951-679.1243 Fax No
Properly Address Unit Number Zip Code
Owner Same as job p 92584
Email Address
Name: Sierra 83
Sprague Phone Ne Fax No
951-345-40
Applicant Address: 30300 Puerto Vallarta Unil Number Zip Code
Email Address // /
S a/.S/elrrc 1'Y2 al�C a[p'i 92584
Name:
All Star Water Heaters Phone No_. 951-345.4083 Fax No
Contractor Address: 30300 Puerto Vallarta City Menifee SeteCA Zip Code 92584
contractors City Bua' Ic nse Conlractiv's City State ol$f tif8o�ia License No Classification C 36
Number of Squares. ZZ
Square.Fpotage
Description of Work: Replace existing water heater.Same size and location. cost o+Work:5 800.00
Applicant's Signature Date: g m
To as complittil By City staff Only
Indicate As R-ReciIRed ar N/A-Nol Applicable
5 Comaleas sets of fully dimensioned.drawn to sale plans which Include: 1 set of documents whim inUude
❑ Title Sheet ❑ Elevations ❑ Ejet(rical Plan ❑ Geo Tech/Soils Report(on cd only)
❑ Plot I Site Plan ❑ Roof Plan ❑ Title 24 Energy(.on 8'6 s 11
❑ McCtianical Plan )
❑ Foundation Plan ❑ Structural Calculations
❑ Cross Section ❑ Plumbing Plan
❑ Single Line diagram for elec services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan ❑ Sound Report-Residential
Class Code. Indicate New Construction Alteration' Addition' Means/Methods
Work Type; Repair' Retrofit' Revision to Existing Permit' Required? YES NO
Proposed Building Use(s): Existing Building Use(s)
#Buildings, #Units. #Stories Will the Building Have a Basement?
Y Of N
Bldg.Code Occupancy Group Indicate Indicate it 'YES or NO Indicate all Geo-tech Haz Zone
At Project Construction Sprinklored Ihat apply: Coastal Zone
Completion: Type(s); C Of O Noise Zone
kRequiia,0 tVES Ot NO
Listed on Historic Resources Inventor
CITY PLANNING STAFF ONLY
APPROVALS Costal Commiss Arch.Review Board Landma4 Comm Planning Comm.Zoning Administrator
Fee Exempt City Project Elec Vehicle Gnarger Land�rark Seisnir,Retrofit s're��al case-slag
roval
Expedite Projects) Child Care City Pmjecl Green 6oilding landmark Affordable Housinq
for Staff Use Only �..
Sudi ing:Safe, Perron SPeaaina I Lay Planning I Ll,r gmnrnrgI C 1 lran4nananon Mgmi Ranl Control
THANK YOU FOR HELPING-LS CREATE A BEl TER COMMUNITY