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PMT15-03466 City of Menifee Permit No.: PMT15-03466 29714 HAUN RD. Type: Residential Plumbing �kCCELJ4? MENIFEE, CA 92586 MENIFEE Date Issued: 11/05/2015 PERMIT Site Address: 25840 TURFWOOD ST, MENIFEE, CA Parcel Number: 335-500-014 92585 Construction Cost: $700.00 Existing Use: Proposed Use: Description of REPLACE EXISTING 50 GAL WATER HEATER IN GARAGE Work: Owner Contractor RICARDO FONSECA INTER-CITY ENERGY SYSTEMS INC 25840 TURFWOOD STREET 1175 N DEL PLACE MENIFEE, CA 92585 ONTARIO, CA 91764 Applicant Phone: 9097585075 THERESA DINTERMAN License Number: 587709 INTER-CITY ENERGY SYSTEMS INC 1175 N DEL PLACE ONTARIO, CA 91764 Fee Description Q�t r Amount($) 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 $115.15 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_Bldg_Permit Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ 1 am exempt from licensure under the Contractors'State License Law for th 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 i Professions Code and my license is in full force and effect. 1::= which I must have resided for at least one year prior to completion c License Class �_ —/� License No. `. J improvements covered by this permit, I cannot legally sell a structure that I hav Expires <� ' Signature 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 th WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application i submitted or at the following Web site: ❑ I hereby affirm under penalty of perjury one of the following declarations: http://www.leginfo.ca.aov/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 or Authorized 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 section 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 buildin construction.I authorize representatives of this city or county to enter the above Carrier �Gl�iG'�t% �J//�"� 1�'L` --� �' identified propert for th 'rispection urpoSEs Policy# lc�/��� Expires / - Date 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) ❑ 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 Will 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 specified on the Hazardous Materials Information Guide? Code,I shall forthw' ply with those provisions. / DYES ❑NO Applicant; ate; ! 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 CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS DYES ❑NO ($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 ❑NO CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD 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 DYES ❑NO I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date 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(RRP) 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 State 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 ❑ 1, 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 Firm 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 purpose of sale). Firm Certification No.: ❑ I, 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 contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP A,.L.,,,,.A e,f,.e.,,e..f l� v ® "' E I—FF,E PLCK No: Permit No: City of Nienifec eq _ Li 2971 Hca�li� ��ad Building & Safety Dei Date: Date: Menefee, q� Phone: (951)6 92 6777 NOV U 5 2015 Amount: Amount Fax:(961)679-3843 115 Cic#. Ck##: Received Buliding Combination Permit To Be Coirnpiated 8]svokant Legal Description: Planning Case: F: L: Rt: R PpertyAddress: Assessararcei Number. 5 — O - 6b Project/Tenant Name: Unit 9: Fioor�: Name: Phone No. Fax No. v c� f4/-�bS= :S _ Owner Property Addr s-g 0 ! G, Unit Number Zip Code TLL LC` L �DGL.t d 1 Email Address: 4' N�e Phone No. Fax No. t'- - 14- i VYl tti L' 7 < c �GJ- �07 S Applicant Address: A Unit Number Zip Gode / /l -� QeI Email Address: Name* Phone No. ax No. �1- n� <��m a c_ d�'- iM- -$-O'73 contractor Addr�ess;� hr / State Zip Code t9 `fit c�I l contractor's City Su lness License No. Contractor's Ci Fate o�alifomia License No. Classification's t l (d C? C� Number of Squares: Square Footage Description of Work: C / / Cost of Woric$ Applicant's Signature �fC � Date: 75?Be Completed_By City Staff Only Indicate As R-Received or NIA-Not Applicable 5 Completes sets of Fully dimensioned,drawn to sale plans which include: 1 set of documents which include i Q Title Sheet ❑ Elevations Electrical Plan l ❑ t 1 ❑ Geo Tech/Soils Report(on cd only) I i Plot/Site Plan I I Q Title 24 Energy(on 8%x 4•t ❑ ❑ Roof Plan ® Mechanical Plan �I ) � ❑ Foundation Plan © Cross Section ❑ Structural Calculations Plumbing Plan i ! [] Single Line diagram for elec.services over 400 AhAP Q Floor Plan I� Structural Framing Plan to DeIBUs [j Shoring Plan j j ❑ Sound Report-Residential } Class Code: Indicate HRepair' New Construction - d Alteration' Addition MeanslMethods Wort:Typv: G Retrofit` ReuislontoExistingPenu1'Required? YE5 NO Proposed Building Use(s): Existing Building Use(s): Buildings: 9 Units: #i'stories: I Will the Building Have a Basement? V of N Bldg.Code Occupancy Group Indicate eo- Indicate if Indicate all (Gtech.Haz.Zone p At Project S rinklered YES or NO Completion: Construction that apply: Coastal Zone Type(s): C or O YES or NO Noise Zone Required? Listed on Historic Resources Inventory CITY PLANNING STAFF ONLY APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. Planning Comm.f Zoning Administrator Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofrt Specialcase:atdg. t)rndalll Case. Expedite Project(s): Child Care City Project Green Building I Landmark Affordable Housing For Staff Use Only N � J �=,Ndi,qlsalely Permit Specialist 9 City Planning Ciril Engineering EPAiVNI-Admin J Transportalion AjigmL Rent Control THANK YOU FOR HELPING US CREATE A BETTER,COMMUNITY CITY OF MENIFEE Department of Building and Safety MENI> EE: Contractor Declaration LICENSED CONTRACTORS DECLARATION: I hereby affirm under penalty of perjury that I am licensed under the provisions of Chapter 9 (connecting with Section 7000)of Division 3 of the Business and Professions code and mylicense is in full force and effect. License Class: 9 /— License No: `7^/-)0 / Exp.Date_./oC ��/t!O Contractor:�/l�f'�✓ Cam, c.. V Nam!o],,4 kw�l- OWNER BUILDER DECLARATION: I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: (Sec 7031.5 Business and Professions code. Any City or County which requires a permit to construct,alter, improve, demolish or repair any structure prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(chapter 9[commencing with Section 7000]of Division 3 of the Business and Professions Code)or that he or she is exempt there from and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars[$500.00]: ❑I,as the owner of the property,or my employees with wages as their sole compensation,will be the work,and the structure Is not intended or offered for sale(Sec.7044,Business and Professions code: The Contractor License Law does not apply to the owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such 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 he/she did not build or improve for the purpose of sale). I,as owner of the property,am exclusively contracting with license contractors to construct the project(Sec.7044 Business and Professions Code: The Contractor License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s)license pursuant to the Contractors License Law). ❑ I am exempt under Sec. ,B.&P.C.for the reason Date: Owner: WORKERS COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑I have and will maintain a certificate of consent to self-insure for worker compensation,as provided for by Section 370 of the Labor Code, for the performance of the work for which this permit is issued 01 have and will maintain workers compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Workers Compensation Insurance carrier and policy Number are: 2�/✓ Carrier: iA / 1Wtj Yi lal'L C145 G. Policy Number. O C (This section need not be completed if the permit is for one hundred dollars($100.00)or less. I certify that in the performance of the work for which this permit is issued,I shall not employ any person 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 Sec.3700 of the Labor Code,I shall forthwith comply with those provisions. i Date:_ /— Applicant: WARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SEC.3706 FOR THE LABOR CODE,INTERST,AND ATTORNEY FEES. CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction-lending agency for the performance of the work for which this permit is issued(Sec.3097,Civic C.). Lender's Name: Lender's Address: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify that I have read this application and state that the above information is correct. I agree to comply with all City ordinances and state laws relating to building construction,and hereby authorize representatives of the City to enter upon the above mentioned property for inspection purposes. Xh[ S� ��-lSl� ��r7 ✓rY���� ���%J Signature of ApplicanUAgent Print ApplicantlAgent Name Date INSPECTION INFORMATION:Work may proceed only at the direction of the field inspector. To request an inspection of work completed,call the number(951)672.4777. Inspection request must be called in the day before to assure next day inspections. 0 � � rr O 0 CJ �p (� (� D c m S n m ? _' N rrD ai 'n n -�j Ai m rt z ° r m -� o 3 r' rD r D N n .Tr a ® T T a rD Qj m D n �, N T n o m n N m < > - m , < o 0 4 o rm - ' D ID o w n a N o L� = r� (— eDD rn m N = � m O � > LA y cC CL n �' -NI n �. 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