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PMT14-02420 a City of Menifee Permit No.: PMT14-02420 29714 HAUN RD. AWCCELMENIFEE, CA 92586 Type: Residential Plumbing MENIFEE Date Issued: 09/09/2014 PERMIT Site Address: 28310 OASIS VIEW CIR, MENIFEE, CA Parcel Number: 340-260-009 92584 Construction Cost: $800.00 Existing Use: Proposed Use: Description of REPLACE EXISTING WATER HEATER, SAME SIZE AND LOCATION Work: Owner Contractor DAY MEHRANG ALL STAR WATER HEATERS INC 28310 OASIS VIEW CIRCLE 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 Phone: 9513454083 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 building 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 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 Clasp License No. who builds or improves thereon, and who contracts for the projects with a Expires ZO Signatur licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLA TION ❑ I am exempt from Idensure under the Contractors'State License Law for the ❑ I 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 3 of the Labor Code, for the performance of work for which thisper improvements covered by this permit, I cannot legally sell a structure that I have Policy issued. built as an owner-building if it has not been constructed in its entirely by licensed y contractors. I understand that a copy of the applicable law, Section 7044 of the I 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:http://www Igginfo ca cov/calaw html. permit Is issued.My workers'compensation insurance carrier and policy number are: Property Owner or Authorize Agent Carrier ii'/�`i trtr� Date Expires �(' S Policy#�Li//, CrP09/o3fl Name of Agent Phone# ❑ By my Signature below, I certify to each of the following: I am the properly 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 1 certify that y the performance of the work for which this permit is issued, identified property for the inspection purposes. shall not employ any persons in any manner so as to become subject to the O workers' compensation laws of California, and agree that if I should become 6� �e..e subject to the workers'compensation provisions of Section 3700 of the Labor property 0ww� orA rued Agent Date Code, I shall forthwith comply with those provisions. Date; Applicant; � City Business License# 151=S -r f=�-�-� WARNING: FAILURE TO SE UR 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 &0 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 FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address ONO 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 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, MO SCHOOL? or repair any structure, prior to its issuance, also requires the applicant for the permit to No a signed statement that he or she is licensed pursuant to the provisions of the Contractor's Stale 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 MES 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 ❑ I, as owner of the properly, or my employees with wages as their sole HAZARDOUS MATERIAL REPOR7 ING. compensation, will do ( )all of or ( ) porting of the work, and the structure is PROPERTY OWNER ORAUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's Slate License Law does not apply to anowner a property X� who, through employees' or personal effort, builds or or Improves improves the 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 OF MENH E` P1CRN" F'elrnll Nn: QaA 29714 Haun Road Dale, Dale: O Menifee, CA 92586 9 1P.1 ILA Phone: (951)672-6777 Amount Amrnmh Fax:(951)679-3843 Ck#. ,, Ck n - _ I Building Combination Permit To Be Completed By Applicant Legal Description: Planning Case' F L Rt R Property Address: 28310 Oasis View Cif Assessors Parcel Number _ 340260009 Projectitlemant Name. Unit# Floor#: Name: Day Mehrang Phone No 951-377-0844 Fax No Properly Address Unit Number Zip Coda Owner Same as job 92584 Email Atltlress: Name: Sierra Sprague Phone No. Fax No. 951-345-40$3 Applicant Address: 30300 Puerto Vallarta Unit Number Zip Code 92584 Email Address a��5 a/: Sitrrc, n%a,�Ce rn Name: All Star Water Heaters Phone No 951-345-4083 Fax No Contractor Address: 30300 Puerto Vallarta City Menifee Slate CA Zip Code 92584 omract tense IQO Contractor's City State of 81 ti!$oxgin Licenso No Classification- C 36 Number of Squares' Z 99 Square Footage Descfip;ion of Work: Cost of Work:5 Replace existing water heater-Same size and location. 800.00 Applicant s Signature Dale: / 7o as Completed By CRY staff Only - - Indicate As R-Received or N/A-Not Applicable 5 Completes sets of fully dimensioned,drawn to sale plans which include, I set of documents which include ❑ Title Sheet ❑ Elevations ❑ Electtical Plan ❑ Gen Tech/Soils Report(on ed only) ❑ Plot/Site Plan ❑ Root Plan _ ❑ Mechanical Plan ❑ Title 24 Energy(on 9 Y x 11) ❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Structural Calculations ❑ 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' Recision 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 Indicated YES or NO Indicale all Geo-tech.-Haz.Zone At Project Construction Sprinkiered ;hat apply Coastal Zone Completion: Type(s): C Of C Noise Zone Required? YES or NO Listed on Historic Resources Inventor CITY PLANNING STAFF ONLY APPROVALS. Costal Commiss Arch.Review Board Landman Cunvn. Punning Comm.Zoning AAminisbator Fee Exempt City Project Elec.Vehicle Charger Landmark Se+ismir,Retrofit speaai case awg UlM1aain rgvai Expedite Projecl(s). ChilA Care City Project Gmen Building LnAmark Angidame Housing For Staff Use Only Building Permit Spacialisl City lahnmg CRnI Enninnenng I Admin I Iranspodauon Mgmt Rom Conucl THANK YOU FOR HELPING US CREATE A BEl TI.R COMMUNITY