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PMT15-00973 li City of Menifee Permit No.: PMT16-00973 y�_ ^�y�. 29714 HAUN RD. Type: Residential Plumbing W LA. MENIFEE, CA 92586 MENIFEE Date Issued: 04/17/2016 PERMIT Site Address: 30406 CLEARY ST, MENIFEE, CA 92584 Parcel Number: 360-073-024 Construction Cost: $800.00 Existing Use: Proposed Use: Description of REPLACE EXISTING WATER HEATER, SAME SIZE AND LOCATION Work: Owner Contractor JOHN GRESTNER ALL STAR WATER HEATERS INC 30406 CLEARY STREET 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 Qtt i Amount I$1 Res denfaiNater eater "" t: "F. t N s� 83Q0. � ' -,..si� -'�. Building Permit Issuance 1 27.00 $111A0 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 Bidg_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 ❑ 1, 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.p/�_ ),1_ 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 DELL ATION ❑ 1 am 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 must have resided for at least one year prior to completion of Section 3700 of the Labor Code, for the performance of word 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 4& 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:http://www leginfo ca oov/caiaw htm1. permit is issued.My workers'compensation insurance carrier and policy number are: Carrier��� Property caner or Authorized gent Date Expires ��/s Policy#4�/�'/.'1��//9/> _ Name of Agent- Phone# dBy my Signature below, I certify to each of the-following: I am the property 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- 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 employ 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 4z 06`� Code,I shall f rthwith comply with those provisions. Property wne rAuthorized Agent Date Date;—� Applicant;; City Business License 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 HANDLEA 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 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 3097 Civil Code) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE Lender's Name EYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT PINO 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 AYES 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, q 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 KYES 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 ❑ 1, as owner of the property, or my employees with wages as their sole HAZARDQUS MATERIAL f EPORI'ING. compensation, will ( )all of or( ) porting of the the structure is PROPERTYAUTHORIZED AGENT not intended or offered for sale.(Section 7044,Businessss an and Professions Code; The Contractor's Stale 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 said 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 Menifee Building Dept APR 1 1ti 2015 BUILDING Meniee DATE PERMIT/PLAN CHECK NUMBER 1J _TYPE: O COMMERCIAL ✓❑RESIDENTIAL O MULTI•FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW ✓ LUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Replace existing water heater. Same size and location. PROJECTADDRESS 30406 Cleary St. ASSESSOR'S PARCEL NUMBER &C - O—G'094 LOT TRACT OWNER NAME John Grestner ADDRESS 30406 Cleary St. PHONE 951-679-3165 EMAIL APPLICANT NAME Sierra Sprague ADDRESS 30300 Puerta Vallarta PHONE 951-301-0067 EMAIL alistar.sierra@gmail.com CONTRACTOR'S NAME_.Sierra Sprague OWNEH BUILDER? O YES)OO BUSINESS NAME All Star Water Heaters ADDRESS 30300 Puerta Vallarta Way PHONE 951-301-0067 EMAIL alistar.sierra@gmail.com CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36 VALUATIONS 800.00 SO,FT LSQFT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION ` / LITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PlANNlNG ENGINEERfNG FIRE GREEN SMIP ,X` INVOICE �, PAID.AMOUNT AMOUNT OCASH 0 CHECK 4 0CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECKR O CREDIT CARD VISAIMC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd.Menifee, CA 92586 951-672-6777 www.cityofinenifee.usInspection Request Line.951-246-6213 TI 7 A N mco E m a i o a - m3 o MEp t o [ m j F w c m $ E ELo 7 u x , E m ; Jmc � yxc ^ 3 -Do9 m v S d S E GO C N w a to a a i f0 v w ~ a d m s o0 a p [a r [ � f _ d w. 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