PMT15-01943 City of Menifee Permit No.: PMT15-01943
' 29714 HAUN RD. Type: Residential Plumbin
*ACCeL. ?` MENIFEE, CA 92586 9
MENIFEE Date Issued: 0 710 9/2 01 5
PERMIT
Site Address: 31437 HALLWOOD CT, MENIFEE, CA Parcel Number: 372-032-016
92584 Construction Cost: $1,381.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50-GAL WATER HEATER, SAME LOCATION
Work:
Owner Contractor
JAMES CUTLER A R S AMERICAN RESIDENTIAL SERVICES OF
31437 HALLWOOD COURT CALIFORNIA INC
MENIFEE, CA 92584 965 RIDGE LAKE BLVD SUITE 201
Applicant Phone: 9012719700
ANDREW ALLEN License Number: 765155
A R S INC DBA RESCUE ROOTER
965 RIDGE LAKE BLVD SUITE 201
MEMPHIS, CA 38120
Phone: 9513419371
Fee Description PA Amount($)
,ta ».; ME:.0Q__
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 lhereunderwhen 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
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 c Code:The Contractor's License Law does not apply to an owner of a property
License Class C3 License No who builds or improves thereon, and who contracts for the projects with a
Expires 1J Signatur _ 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
❑ 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 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.
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
7I 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.leginfa.ca.govicalaw,html.
permit is issued.M workers'compensation insurance carrier and policy number are:
/ Property Owner or Authorized Agent Date
Carrier 1, (a✓
Expires G0 I � Policy �61
❑ 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 hav provided is cor ct. I agree to comply
one-hundred dollars($100)or less) with all applicable cityount finances and a laws relating to building
construction. au . ere ntatives of th' y or county to enter the above-
❑ I certify that in the performance of the work for which this permit is issued, I identified I fo spectlon pur
shall not employ any persons in any manner so as to become subjec to th 4
workers' compensation laws of California, and agree th 'f I sh e is
subject to the workers'compensation provisions of ion of Labor property Owner or Authorized Agent Date
Code,I shall forthwith comply with those provisi
City Business License#
Date; � I � Applica ,
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 ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES Jn;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 WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name ❑YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address P'NO 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 ❑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, .'ENO 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 p�gES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any Z CHECKLIST. I UNDERSTAND MY REQ MENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIF " A HE D SAF Y
a civil penalty of not more than($500).) CODE, SECTION 25505 A 4 CONIC NG
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATER ORl'
compensation, will do ( )all of or ( )porting of the work, and the structure is PROPERTY Oft+ H�3 IZED AGE
not intended or offered for sale. (Section 7044,Business and Professions Code, </ i
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
& SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE �I PERMIT/PLAN CHECK NUMBER Q q
TYPE: " COMMERCIAL N) RESIDENTIAL C> MULTI-FAMILY C. MOBILE HOME <% POOL/SPA C, SIGN
SUBTYPE: ADDITION C)ALTERATION 0 DEMOLITION C) ELECTRICAL C; MECHANICAL
ONEW " PLUMBING ORE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 0 kfL- fe_1Aer4I 0 6A5 IN &ARA&C
PROJECTADDRESS -] HprLLWDO,D L.I
ASSESSOR'S PARCEL NUMBER 3".- ®__)�Q--01(0 LOT TRACT
OWNER NAME I`J 1 L.�L(Z
ADDRESS t-0 µt+LL WD 0 P Z_ City of Menifee
t.
PHONE 1KI 45t- 327� EMAIL
APPLICANT NAME r+DlLE— Y-ILct-
ADDRESS Z20 /� L OEL` 5T �✓c.f310&-
PHONE C+f J`( J(q t 7 5 7 ( EMAIL
CONTRACTOR'S NAME 5cvi IZO 0 0--5 OWNER BUILDER? OYES O
BUSINESS NAME
ADDRESS NOEN I� 2
PHONE 9 j i ( �°j1 f ` EMAIL
CONTRACTOR'S ' r1
CONTRACTOR'S STATE LIC NUMBER LICENSE LASSIFICATION
VALUATION$ F L SO FT
APPLICANT'S SIGNATURE DATE Q /
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN 1 SMIP /�
INVOICE
AMOUNT I PAID AMOUNT 0CASH C'CHECK q iy CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT `,.'. CASH 0CHECKk %CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED " YES 0 NO DL NUMBER NOTARIZED LETTER <) YES 0 NO
City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-572-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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