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PMT15-03285 City of Menifee Permit No.: PMT15-03285 29714 HAUN RD. Type: Residential Plumbing '(�kCCEL/-> MENIFEE,CA 92586 MENIFEE Date Issued: 10/2212015 PERMIT Site Address: 28652 AMBORELLA WAY, MENIFEE, CA Parcel Number: 364-213-011 92584 Construction Cost: $1,000.00 Existing Use: Proposed Use: Description of REPLACE EXISTING 40-GAL WATER HEATER, SAME LOCATION Work: Owner Contractor RENEE TAYLOR TRUTEAM OF CALIFORNIA INC 28652 AMBORELLA WAY 260 JIMMY ANN DRIVE MENIFEE,CA 92584 DAYTONA BEACH, FL 32114 Applicant Phone:3863042222 ED PONCE License Number:221517 TRUTEAM OF CALIFORNIA INC 260 JIMMY ANN DRIVE DAYTONA BEACH,CA 32114 Phone:9517226905 Fee Description Div Amount ISI Residential Water Heater 1 83.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 4.15 $116.15 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 Pennit_Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ lam exempt from licensure under the Contractors'State License Law for thi I hereby affirm under penalty or perjury that I am licensed under provisions of following reason: Chapter 9 (commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence k Professions Code and my license is in full force and effect. which I must have resided for at least one year prior to completion o License Class X License . A2/:5'-/�� Improvements covered by this permit, I cannot legally sell a structure that I haw Expires p113b� Signature �_�.- C� built as an owner-building if it has not been constructed in its entirety by license( contractors. I understand that a copy of the applicable law, Section 7044 of IN WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is submitted or at the following Web site: ❑ 1 hereby affirm under penalty of perjury one of the following declarations: hftp,//www.leciinfo.ca.ciov/calaw.html. I have and will maintain a certificate of consent of self-insure for workers' compensation,issued by the Director of Industrial Relations as provided for by Date Section 3700 of the Labor Code, for the performance of work for which this permit is issued. Property Owner orAulhorized Agent Policy# ❑ By my Signature below, I certify to each of the following: I am the propert, < I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read thi: mo Sin 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to compl! permit is issued.My workers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to buildinc construction.I authorize representatives of this city or county to enter the above Carrier.4/1 ' gq/'faR r o identified Qraperty for the Ins tion purposes. Policy# 011E ItC jWg15-53 Expires 646/101 �6eC��-'U � `^ Date/ 17-h Property Owner or Authorized Agent (This section need not be completed if the permit is for City Business License# one-hundred dollars($100)or less) ty ❑ I certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION shall not employ any persons in any manner so as to become subject to the Nil the applicant or future building occupant handle hazardous material or a workers'compensation laws of California, and agree that if I should become mixture containing a hazardous material equal to or greater that the subject to the workers'compensation provisions of Section 3700 of the Labor amounts`a cified on the Hazardous Materials Information Guide? Code,I shall forthwith comply with those provisions. DYES E O Applicant; Date; Will the Intended use of the building by the applicant or future building occupant require a permit for the construction or modification from South WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES EYNO CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of a school? LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES KNO CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAOMD I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I understand my requirements under the State of agency for the performance of the work which this permit is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning 3097 Civil Code) hazardous material reporting. OWNER BUILDER DECLARATIONS ❑YESRJO I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's 1 zi !— Date / zX License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT next to the applicable item(s)(Section 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, EPA RENOVATION,REPAIR AND PAINTING(RRPI 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 The EPA Renovation,Repair and Painting(RRP)Rule requires contractors provisions of the Contractor's Stale License Law(Chapter 9 (commencing with receiving compensation for most work that disturbs paint in a pre-1978 Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with she is exempt from licensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their a civil penalty of not more than($500).) employees.For more information about EPA's Renovation Program visit: www.epa.gov/lead or contact the National Lead Information Center at ❑ I, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323). compensation,will do( )all of or( )porting of the work, and the structure is not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this project who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.if,however, Certified Finn Name: the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved for the Firm Certification No.: purpose of sale). ❑ 1, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firm is required for this project because: contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who contracts for the projects with a licensed contractors)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. iPERMIT/PLAN • ?Menifee DATE 10/22/2015 PERMIT/PLAN CHECK NUMBER TYPE. ]COMMERCIAL RESIDENTIAL Q.MULTI-&AMILY OMOBILEHOME POOL/SPA QSIGN SUBTYPE QADDITION EJALTERAT�ION DEMOLITION []ELECTRICAL QMECHANICAL Q✓ E []NEW PLUMBING lREROOF•NUMBEROFSQUARES. DESCRIPTION OF WORK Replace 40 gallon water heater City of aennifeDept. PROJECTADDRESS 28682 Amborella Way qj$ ASSESSOR'S PARCEL NUMBER 304,213.011 LOT TRACT Receive PROPERTY OWNER'S NAME Renee Taylor ADDRESS 28652 Amborella Way,Menifee,CA 92W PHONE (714)323-9462 EMAIL APPLICANT NAME Ed Pence ADDRESS 475 Rivera St, Unit:D,Riverside, CA 92501 PHONE (951)722-6905 EMAIL CONTRACTOR'S NAME Truteam Of O'A lrio r - OWNER BUILDER? AYES QN0 BUSINESS NAME ADDRESS 476 Rivera St, Unit:D.Rivensicfa,CA 92601 PHONE (951)683.4429 EMAIL CONTRACTOR'S STATE LIC NUMBER 221517 LICENSE CLASSIFICATION Q2 VALUATIONS $1,000.00 SO FT 2374 L SO FT APPLICANT'S SIGNATURE DATE 10/22/2015 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION - CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAIDAMOUNT GG AMOUNT ( . \� ���•,J O CASH C;CHECK R O CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 'CASH C:CHECK IT OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Maun Rd. Menifee, CA 92586 951-572-6777 www.cityofinenifee.us inspection Request Line 951-246-6213 CERTIFICATE OF COMPLIANCE CFIR-ALT-01-F Prescriptive Residential Alterations (Page 1 of 3) Project Name: Ronep Taylor•28652 Amboralio Way Datp PropaTod: 2015.10-22 A.General Information DI Project Name Renee Taylor 0$ pats prepared . 2015.1422 03 Project Location 28652 Amborella Way 04 Building Front Orientation 0 (deg) City Of Menifee OS [A City Menifee 06 Numoarof Dwelling DnitS 1 6p with Additions 07 21p Code 92584 08 Fuel Typo Natural gas 09 Climate Zone 10 10 TotalConditioned Floor Area 2374 1 11 Building Type Single family 12 Slab Area 0 — Exceptions to Minimum Ages 13 Project Scope Water heating 14 Solar Reflectance and No Exceptions Minimum Thermal or SRI B.Building Insulation Details(Section 150,2(b)1) This section does not apply to Shls project. C.Roof Replacement(Section 150.2(b)IH) Tha sampn Jocs nol appal tP rim prole6. D.Fenestration/Glazing Allowed Areas and Efficiencies(Section 150,2(b)1) This section does not apply to this project. Regntration Number:215-A6366659A-11001KI0000.0000 Registration Date/nme: 2075.10-220BAB:g3 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013-1.006 Report Ganerated:2 015 4 0-2 2 WA&14 Schema Version:2013.1.006 CERTIFICATE OF COMPLIANCE CFIR-ACT-01-E Prescriptive Residential Alterations (Page 2 of 3 E.Fenestration Proposed Areas and Efficiencies-Add(Section 150.2(b)1A) This section does not apply to this praiser. F.Fenestration Proposed Areas and Efficiencies-Replace(Section 150.2(b)10) This section does not apply to this project. G.Space Conditioning(SC)Systems-Heating/Cooling(Section 150.2(b). This section does not apply to this project. H.Water Heating Systems(Section 150.2(b)16) 01 02 03 04 05 O6 02 08 09 10 11 12 13 14 is Water Number of Water Back-up Water Heating Water- Heater Heating Heating Standby Extttlar Dwelling Unit DHW System In or Heating Heater water Storage Ford Type gated. flared Efflcieney Efideney ... Insulation solar Central OHW system System DHtribahm System "caters In Input Type input wine Savings Distribution Type Name Type Type System vuo;_ typo Valp4 (gerce ) -R-Value Fraction Type This field This field Natural Energy section setlbn Thlsfieldorsectianis Standard distribution WHS p1 DNW Boller 1 40 gas Btu/Hr 40000 Astor lEfl .6l arisnot 16 arts not notapplicable system applicable applicable I.Space Conditioning Systems And Water Heating Systems In Multifamily Dwelling Units This section does not apply to this project. Registration Number:215-A6366659A-000000000.0000 Registration Date/Tnne: 201610-22 OD:48:25 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013-1.006 Report Generamd:2015-10-22 09:48:14 Schema Version:2013.1.006 CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E Prescrfptive Residential Alterations (Page 3 of 3) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Compliance documentation Is accurate and complete, eocumentathm Author Name: Decomenlnpan Author Sigmtum: Edward Ponce Company: simartufo pate Masao Contractor Services 2015.10.22 09:48:25 Address CWHERSCertlficaaon ldentificallchinf. pllablel: 1015 N MARKET BLVD an/state/Zip: Intent: SACRAMENTO CA 95834 9164194012 Responsible Person's Declaration statement I certify the following under penalty of hriuM under the laws of the State of California: 1. Theinformationp.Wed on this Certificate of Compliance is Me and correct. 2. 1 am eligible under Divblon 3 of the Business and Professions Code to accept rospondlullty for the building design or system design identified on this Certificate of Compliance(responsible designer). 3. That the energy feature;and performance specifications,materi.1k, n.pcnenb,and manufannred dafes hit the building design or rystem design Identified on this Certificate ofCrnpllameconform to the refinements of 24,part l and Part 6of the Callrorele Code of Ragulallbm. 4. The building deal,.fiamume or getem design lemur¢.Identified an this Certificate:ofCompliance are consulter with the Information promded on other applicable compliance documents,worksheets, calculations,plans and specifications submlned to the onforcemer"geney for approval with thle building permit appllmtler. S. I will ensure that a registered copy of thls Certificate.of Carmilanco shag be made available with the building permiesl issued for the building,and made avalable to the enforcement agency for all appllcabla Inspections.)understand that registered ropy of this prlaicate of Compliance is;poi to be induded with the documentation the builder provides to the building owner at acwVanry. Respondble Designer Name: - - - Responsible Cmagrar SignaNre: e, � Edward Ponce company: Date Signed: Masco Contractor Services 2015,10-22 09:48:25 Address: - Licanw: 1035 N MARKET BLVD 221517 Citytstate/bp: Phone: SACRAMENTO(A 95834 916-419-4012 Wgdallysighedby CidCERni. This di a(gnaher,is provided in order to secwe the content afous repeated document any in no wayimpliea Regfelmtbn Provide maWnsibility for the ecturary offhe information. Registration Number:215-A6366659A-0GWOGG00-0 Registration Data/Time: 2015-10-2209:48,25 HERS Provider.CaICERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013-1.006 Report Genemted:2015.10.22 09t411:14 Schema Version:2013.1.006