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PMT15-03780 City of Menifee Permit No.: PMT15-03780 _ 29714 HAUN RD. �l� A—> MENIFEE,CA 92586 Type: Residential Alteration MENIFEE Date Issued: 12/08/2015 PERMIT Site Address: 28064 OAKHAVEN LN, MENIFEE, CA Parcel Number: 340-320-060 92584 Construction Cost: $1.600.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of CAP OFF SHOWER DRAIN/HOT&COLD,ADD VALVE FOR NEW SHOWER LOCATION, ADD FAN Work: LIGHT COMBO, NEW SHOWER PAN, NEW GFCI PLUG Owner Contractor GARY POTTER A AA RESTORATION INC 28064 OAKHAVEN LN 29850 2ND STREET MENIFEE,CA 92584 LAKE ELSINORE, CA 92532-2420 Applicant Phone:9514715828 KIRK MUNIO License Number.834839 A A A RESTORATION INC 29850 2ND STREET LAKE ELSINORE,CA Fee Description Owl Amount I$1 Receptacle,Switch, Outlet&Fixture 3 126.00 Plumbing Fixtures and Vents,fixtures 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 5.80 General Plan Maintenance Fee-Electrical 1 6.30 $282.10 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 ❑ ]am exempt from licensure under the Contractors'State License Law for the I hereby affirm under penalty or perjury that I am licensed under provisions of fallowing 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 in Professions Code and my license is in full force and effect. which I must have resided for at least one year prior to completion of License Class G License N . -3 93 9 improvements covered by this permit,I cannot legally sell a structure that I have Expires R-31-I V Signature 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 WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is submitted or at the following Web site: ❑ I hereby affirm under penally of perjury one the following declarations: httol/www.lecinfo.m.cov/calaw html. I have and will maintain a certificate of consentt 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. Pmperty Owner orAulhorized Agent Policy# ❑ By my Signature below, I certify to each of the following: I am the property ❑ 1 have and will maintain workers compensation insurance, as required by owner or authorized to act on the property owners behalf. I have read this 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 comply permit is issued.My workers'compensation insurance carder and policy number are: with all applicable city and county ordinances and slate laws relating to building construction.I authorize representatives of this city or county to enter the above- Carrier_('Ivnat?c,Yrti09� identifie a for the inspection purposes. Policy# CST 5607dL4Z. Expires 3-31-10 �"'' Date-r�l��y Prope Owner or Authorized Agent (This section need not be completed if the permit is for Cil Business License# V 37&3_r/A one-hundred dollars($100)or less) Y ❑ I certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION shall not emolov 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 forthwith gscomply with those provisions. DYES IN NO Applicant; 1161Ff'l'/ 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(SCAOMD)?See permitting checklist COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES ILNO 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 QNO 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 peril is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning 3097 Civil Code) hazardous material reporting. OWNER BUILDER DECLARATIONS DYES 19 NO I hereby affirm under penalty of perjury that I am exempt from the Contractors 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(S500).) 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 1-800424-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.:El 1, as owner of the property an exclusively contracting with licensed Pilo 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 No 'iltr T �£Aur-D 15rr yo 41111' who builds or improves thereon, and who contracts for the projects with a f/011ra s)ar6r Z05 Thwn 16 yr'ilo 3 OLOF licensed contractor(s)oursuanl to the Contractors State License Lawl. If vour oroiect does not rmmnly with FPA PRID redo nmmco sn..,,r lh=occ & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL MIRESIDENTIAL O MULTI-FAMILY O MOBILE H E- O POOL/SPA O SIGN SUBTYPE: C ADDITION ALTERATION 0 DEMOLITION LECFRICAL C MECHANICAL EW 0 NI O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Div at Pra Ka(VC- for Ajv&u Silo - Loc D Li' NI COMAd- PROJECFADDRESS ZSNq 04r- hl if 9 , ASSESSOR'S PARCEL NUMBER "✓LJC 7�-ObQT � TRACT l OWNER NAME ` ADDRESS 0{oq Q L< I I if PHONE EMAIL APPLICANT NAME o5 ADDRESS PHONE EMAIL CONTRACTOR'S NAME W)ZIC (Are I0 OWNER BUILDER? O YES ONO BUSINESS NAME AAA BrJQ j�B�V ADDRESS Z '96'a ZnD yT F-,*hd.'�c— PHONE q6_1 —53-g'o3-2Y EMAIL CONTRACTOR'S STATE LIC NUMBER j4�J7 LICENSE CLASSIFICATION 6-3 VALUATION$ (00# SOFT LSQFT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS UCENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE I g PAID AMOUNT AMOUNT �•'O OCASH OCHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0 CASH O CHECK# 0 CREDIT CARD VISAIMC OWNER BUILDER VERIFIED O YES C NO DL NUMBER NOTARIZED LE TER 0 YES C NO City of Menefee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 i l ^ l y ! —10021, City of Menifee Building 8 Safety Dept. ---- - --- �' 19i`� DEC 0 8 2015 Received „t LO --41 RH18842- VN �V ,1 Cn N > �. I N � n v � s = co w c Q, u a coo ly A N co --._— k CITY OF MENIFEE BUILDING AND SAFETY DEPARTMENT �l PLAN APPROVAL K REVIEWED BY DAT 'Approval of these plans shall not be construed to be a permit for,or an approval of,any violation of any provi sions of the federal,state or city regulations and ordinance F6 [ M givctt arc This s an orig nal design and mess no[6e Designed;10 3/3015 i sabjec[w veri£eation on job site and relrased or copied unless applicable fee It. Primed 10/8n_0Ii jobsite until completion. adj11s1rncnt to fit job conditions. been paid or job order placed. I ' i dr psi poncr bath.ki, Ali Dmtving q: I I Scale:0 1/3"n 7"