PMT15-01839 I
City of Menifee Permit No.: PMT16-01839
29714 HAUN RD. Type: Residential Plumbing
MENIFEE, CA 92586 i
MENIFEE Date Issued: 0 7101/2 01 5
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PERMIT
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Site Address: 28043 CALLE CASERA, MENIFEE, CA Parcel Number: 336-304-001
92585 Construction Cost: $999.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 40 GAL WATER HEATER, SAME LOCATION
Work:
Owner Contractor
CBABRINC WATER HEATERS ONLY INC
28043 CALLE CASERA 970 E MAIN STREET#200
MENIFEE, CA 92585 GRASS VALLEY, CA 95945
Applicant Phone: 8008358345
STEVEN SCHNIERER License Number: 374573
WATER HEATERS ONLY INC
970 E MAIN STREET#200
GRASS VALLEY, CA 95945
Fee Description CRY Amount
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
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City Of Menifee
LICENSED DECLARATION
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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.
License Class License No. S� Code:The Contractor's License Law does not apply to an owner of a property
who builds or improves thereon, and who contracts for the projects with a
Expires 6131 7 Signature licensed contractor(s)pursuant to the Contractors State License Law). '.
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensure under the Contractors'State License Law for the
�Lhereby 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 must have resided for at least one year prior to completion of
Section 3ssu of the Labor Code, for the performance of work for which this im improvements covered b this permit, I cannot legally sell a structure that I have permit is issued. P Y P 9 Y .
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
❑ 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,00v/calaw,htmi.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier Property Owner or Authorized Agent Date
Expires Policy#
y 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 forwhich 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 Property Owner or Authorized A Code, I shall forthwith comply with those provisions. P Y gent Date
Date; 7 �"� City Business License# y�'� a IIS Applicant; �Z .��
-�"'�
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, TYES 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 11�620 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 AYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
�,60
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 Cade: �I BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, dem C'"olish, O 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 ES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from icensure 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING,
compensation, will do ( ) all of or ( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply,to an owner of a property X_ �- ---who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not Intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
Menifee
DATE 07/01/2015 PERMIT/PLAN CHECK NUMBER rj—
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL
❑NEW ❑✓ PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
Building 81 Safety Depi:.
DESCRIPTION OF WORK Replace 40 Gallon Water Heater In Garage
JUL 0 1 2015
PROJECTADDRESS 28043 Calle Casera
ASSESSOR'S PARCEL NUMBER � - '�I LOT TRACT
OWNER NAME Cbarr Inc.
ADDRESS 28043 Calls Casera Sun City,CA 92585
PHONE (951)301-9181 EMAIL
APPLICANT NAME Steven Schnierer
ADDRESS 31225 La Baya Drive Suite 112 Westlake Village, CA 91362
PHONE (818)735-7876 EMAIL
CONTRACTOR'S NAME Water Heaters Only OWNER BUILDER? ❑YESQNO
BUSINESS NAME Water Heaters Only
ADDRESS 970 E Main Street#200 Grass Valley, CA 95945
PHONE (530)274-3001 EMAIL
CONTRACTOR'S STATE LIC NUMBER 374573 LICENSE CLASSIFICATION C36
VALUATION$ $999.00 SO FT L SO FT
APPLICANT'S SIGNATURE DATE 07/01/2015
e
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT \ <%CASH 0 CHECK 0 C.%CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT i CASH C CHECK# CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED "YES D NO DLNUMBER NOTARIZED LETTER 11 YES i NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee,us Inspection Request Line 951-246-6213
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