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PMT14-02383 City of Menifee Permit No.: PMT14-02383 ' GG�1..1�. MENIFEEE,E, CA 92586 um 29714 Type: Residential Plumbing C '. MENIFEE Date Issued: 09/05/2014 PERMIT Site Address: 32778 KENDAL CT, MENIFEE, CA 92584 Parcel Number: 372-310-009 Construction Cost: $999.00 Existing Use: Proposed Use: Description of REPLACE 75 GALLON WATER HEATER IN GARAGE Work: Owner Contractor JAMES GILBERT WATER HEATERS ONLY INC 32778 KENDAL CT 970 E MAIN STREET#200 MENIFEE, CA 92584 GRASS VALLEY, CA 95945 Applicant Phone: 5302743001 STEVEN SCHNIERER License Number: 374573 WATER HEATERS ONLY INC 970 E MAIN STREET#200 GRASS VALLEY, CA 95945 Fee Description Qtv Amount($1 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 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 i i 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 74 3 � J License Class (' tc, License No. -7 who builds or Improves thereon, and who contracts for the projects with a Expires S . t Signature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION _) - ❑ 1 am exempt from Ilcensure under the Contractors'State License Law for the rDf-`hereby affirm under penalty of perjury one of the following declarations: following reason: ✓(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, cannot legally sell a structure that have permit is Issued. built as an owner-building if It has not been constructed In its entirety by licensed Policy# Sue,.- CY49 contractors. I understand that a copy of the applicable law, Section 7044 of the ❑ 1 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 the Labor Code, for the performance of the work for which this submitted or at the following Web site:hftj);//`www.leginfo.ca,gov/caiaw.html. permit is issued.My workers'compensation insurance carrier and policy number are: Carrier Property Owner or Authorized Agent Date Expires 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.. 1 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- 0 1 certify that in the performance of the work for which this permit is issued,I identified property for the inspection purposes. shall not emoloy any persons In any manner so as to become subject to the l IG I workers' compensation laws of California, and agree that if I should become cy�� '-"..i )4 subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Property Owner or Authorized Agent Date Date; c!151 14 Applicant; ��%w_--�'-~ City Business License# �;3,S3 WARNING: FAILURE TO SECURE 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, []YES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES 64AO -EQUAL TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDING AGENCY 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 Lender's Address ,,�_�,,{{NO FROM THE SOUTH COAST AIR QUALITY MANAGEMENT LK'' DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR OWNER BUILDER DECLARATIONS GUIDE LINES 1 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 []YES 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, >�N,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 DES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from licensors 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($500).) CODE, SECTION 25505, 25533 AND 25534 COh{CERNING ❑ 1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING. compensation, will do ( ) all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044, Business and Professions Code; " The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). CITY Y OF MENIFEF, Menifee PLCKNo P r 't o: , D� 29714 Haun Road Building &i Safety Dept. Date: Date Menifee, CA 92586 bI 4 H Phone: (951)672-6777 SEP 0 5 2014 Amount: Amoun111OO Fax:(951)679-3843 Ck#: Ck#: I Re Building Combination Permit owed To Be Completed By Applicant Legal Description: YO Planning Case: F: L: Rt: R: Property Address: Assessor's Parcel Number: 32778 Kendal Court �j"� , 310-00C1 Project/Tenant Name: Unit#: Floor#: Name. James Gilbert 951e 587-1200 Fax NO. Property Address: Owner 32778 Kendal Court Unit Number Zip Code 92584 Email Address: Name: Steven Scllnlerer Phone No. Fax No. 951-241-6876 Applicant Address: Unit Number Zip Code 25251 Alessandro Blvd, Moreno Valley, CA 92553 Email Address: Name: Water Heaters Only Inc. Phone No. Fax No. 530-274-3001 Contractor Address: City St to Zi Code 970 E Main Street # 200 Grass Valle �A �5945 Contractor's City Business License No. Conir 74573ty State of California License No. Classification: Number of Squares: Square Footage Description of Work: Replace 75 Gallon Water Heater In Garage Cost of Work.$ 999.00 Applicant's Signature Dale: September 4, 2014 To Be Completed By City Staff Only Indicate As R-Received or N/A-Not Applicable 5 Completes sets or fully dimensioned,drawn to sale plans which include. 1 set of documents which include ❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Goo Tech/Soils Report(on cd only) ❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 1A x 11) ❑ Structural Calculations ❑ Foundation Plan El 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:HRepair* Retroft` Revision to Existing Permil" 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 if YES or NO Indicate all Geo-tech.Haz.Zone At Project Construction Sprinklered that apply: [::::�Coastal Zone Completion: Type(s): C Of C YES or NO Noise Zone Required? Listed on Historic Resources Inventory CITY PLANNING STAFF ONLY APPROVALS: Costal Commiss Arch. Review Board Landmark Comm. I Planning Comm.Zoning Administrator Fee Exempt: City Project Elea Vehicle Charger Landmark Seismic Retrofit special Case:alag. ,Pp..l Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing For Staff Use Only Building/Safely Permil Specialist City Planning Civil Engineering I EPWM-Admin Transportation Mgml. I Rent Control THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY