PMT15-03703 City of Menifee Permit No.: PMT15-03703
29714 HAUN RD.
�A-CCELA? MENIFEE, CA 92586 Type: Residential Plumbing
MENIFEE Date Issued: 1113 012 01 5
PERMIT
Site Address: 29388 OAK CREST CT, MENIFEE,CA Parcel Number: 340-300-032
92584 Construction Cost $999.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL WATER HEATER IN GARAGE
Work:
Owner Contractor
ROBERT ASTAMENDI WATER HEATERS ONLY INC
29388 OAK CREST COURT 970 E MAIN STREET#200
MENIFEE,CA 92584 GRASS VALLEY, CA 95945
Applicant Phone: 8008358345
STEVEN SCHNIERER License Number.374573
WATER HEATERS ONLY INC
970 E MAIN STREET#2D0
GRASS VALLEY, CA 95945
Phone:8187357876
Fee Description gty Amount 1E1
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 slated,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_Pennit_Template.rpt Page 1 of 1
City Of Menifee
r.LICENSED DECLARATION ❑ lam exempt from licensure under the Contractors'State License Law for IN
following reason:
I hereby affirm under penalty or perjury that I am licensed under provisions of
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 it
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 CI as L-�'� License No. 37�/S'73 improvements covered by this permit, I cannot legally sell a structure that I haw
Expires 3l I Signature�r7.. C built as an owner-building if it has not been constructed In its entirety by licenset
contractors. I understand that a copy of the applicable law,Section 7044 of thk
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: htto:/Iwww.lecinfo.ca.cov/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 orAuthorized Agent
Policy# I-S D ay my Signature below, I certify to each of the following: 1 am the proper!
❑ I have and will maintain workers' compensation insurance, as required by downer or authorized to act on the property owners 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 buildini
construction.I authorize representatives of this city or county to enter the above
Cartier ideCnt�iied—property for the inspection purposes.
Policy# Expires - �`^^'� Date Al30 tl
Property Owner or Authorized Agent
(This section need not be completed if the permit is for
one-hundred dollars($100)or less) City Business License# 03S8S 3
HAZARDOUS MATERIAL DECLARATION
❑ I certify that in the performance of the work for which this permit is issued,1
shall not employ any persons in any manner sta 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 r 1s�pec�ified on the Hazardous Materials Information Guide?
Code,I shall forthwith comply with those provisions. ❑YES J"-r
Applicant;�_2_( Date; r(I 3C> 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 ❑YES [JO
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 ❑YES�tl
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.
NO
OWNER BUILDER DECLARATIONS Date
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the reason(s)indicated below by the chec kmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT
next to the applicable item(s)(Section 7031.5. Business and Professions Code: EPA RENOVATION.REPAIR AND PAINTING RRP Any city or county that requires a permit to construct, alter, improve, demolish, ( )
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 properly 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 EPKs Renovation Program visit:
❑ I, a property, www.epa.gov/lead or contact the National Lead Information Center at
s owner of the p perry, 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 Cade;
The Contractor's Slate License Law does not apply to an owner of a properly ❑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 Firm Certification No.:
Purpose of sale).
❑ 1, as owner of the property an exclusively contracting with licensed El 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
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
' Menifee
DATE 9t 3a 1- PERMIT/PLAN CHECK NUMBER -
TYPE: O COMMERCIAL *ESIDENTIAL 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 kae,_ e -_T� Gm-rq Ne
Building & Safety Dep
PROJECTADDRESS 'Z.9388 Qck CCeS+- a. NOV 3 p 2015___
ASSESSOR'S PARCEL NUMBER 3L�(D''2 - Q3;1 LOT TRACE
:e6yE? s
OWNER NAME _�06e,d- }a
ADDRESS Z9328 0Gk Cres-V C,+. M e CA gzs8°}
PHONE 951- 746-zcx z EMAIL
APPLICANT NAME r ' , /
ADDRESS 31225 La 3� a .�"�!ZL3 �.KSd-)c.�V CA a 13(o Z
PHONE $I8.735-787(o EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES O N.
BUSINESS NAME n/1 t I
ADDRESS 97o E l• la - w 2� Gt'0. Vcdj CA 95q4S
PHONE 530-2-74-36Gf EMAIL
CONTRACTOR'S STATE LIC NUMBER 3?4573 LICENSE CLASSIFICATION C3(o
VALUATION$ ggCj,pp SO FT L SO FT
APPLICANT'S SIGNATURE SQL DATE 1d 3p LS
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP X
INVOICE GG PAIDAMOUNT O
AMOUNT �� ' `v �`5 '%5 CASH O CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# 0 CREDIT CARD VISA/MC
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.cityofmenifee.us Inspection Request Line 951-246-6213
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