PMT15-03950 City of Menifee Permit No.: PMT15-03950
_ 29714 HAUN RD.
'<ACCEL_A? MENIFEE,CA 92586 Type: Residential Plumbing
MENIFEE Date Issued: 1 212 212 01 5
PERMIT
Site Address: 29239 MESA CREST WAY,MENIFEE,CA Parcel Number: 340431-012
92584 Construction Cost: $2.000.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL WATER HEATER IN GARAGE
Work:
Owner Contractor
MIKE MORIN A R S AMERICAN RESIDENTIAL SERVICES OF
29239 MESA CREST WAY 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
1520 W LINDEN STREET
RIVERSIDE, CA 92503
Phone:9513419371
Fee Description Qtv Amount 151
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
$115.16
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_Bleg_Permit_Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ lam exempt from licensure under the Contractors'State License Law for it
following reason:
I hereby affirm under penalty or perjury that I am licensed under provision f
Chapter 9(commencing with section 7000)of Division 3 of Bus' and By my signature below I acknowledge that, except for my personal residence
Professions Code and mY license is in full force and eff which I must have resided for at least one year prior to completion
License Claps License N improvements covered by this permit, I cannot legally sell a structure that I he%
Expires � I N 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 it
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one of the following declarations: htto•//www.leainio.ca.aov/ralaw.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 proper
12 I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property own" ' "half. I have read th
tion 3700 of the Labor Code, for the performance of the work for which this application and the info n I provid correct. I agree to comp
permit is issued.M workers'oompe sation insurance tamer and policy number are: with all applicable ordinan le laws relating to buildir
construction. t sentative of this city or county to enter the above
Carrier �'c identifie rop the ction purposes. _
Policy# We Z69�� a 3 ( Expires 0 Date
p Property Owner or Authorized Agent
(This section need not be completed if the permit is for City Business License#
one- Bred 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 person 'n any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or:
workers'compensation I of omia, and agree that if I should become mixture containing a hazardous material equal to or greater that the
subject to the work" m ion provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide?
Code,I shall fo with those provisions. DYES D4Jg0
� Z2 � 7i
Applicant, Date; L ` 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 checklis
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for -aguidelin
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES :NO
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 cute
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary af a school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES 6NO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Inform 'on Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I unders my irements under the State of
agency for the performance of the work which this permit is issued (Section California Health&Safe ode lion 25505 and 25534 concerning
3097 Civil Code) hf�zya�rdoua materia rti
OWNER BUILDER DECLARATIONS — S D
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
❑ 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 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).
❑ I, as owner of the property an exclusively contracting with licensed 0 No EPA Lead-Safe Certified Finn 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.
SAFETYBUILDING & PERMIT/PLAN CHECK APPLICATION
'Wenifee
DATE a f 5 PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION []ALTERATION []DEMOLITION []ELECTRICAL [:]MECHANICAL
[_]NEW MPLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Imo( acc- L-i 1H So Gak- ULAS ItJ GAa-Auc
PROJECTADDRESS rA LW
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME L,(- yq Oft-I&J
�? y o enl ee
ADDRESS q �A �Z r s-r U Building & Safety Dept.
PHONE ��L{ ;�.��p USy� EMAIL 2 2015
APPLICANT NAME Av3CJ2cv5 LL-t-"
ADDRESS I ha " W LI N✓J�N Zt vz¢G,06 P.CP.IV2
PHONE `'5 k 3LA 1 9/3� ^I 1 EMAIL
CONTRACTOR'S NAME IhLSCCUe- o -1 -GX OWNERBUILDER? ❑YESANO
BUSINESS NAME
ADDRESS C Isla w I-INo� 5, .SI�
PHONE IS1 3-I� 9'5'1 ( / EMAIL
CONTRACTOR'S STATE LIC NUMBER -h �5 LICENSE C- ' SIFICATION L
VALUATION$ Q00( Q LSO FT
APPLICANT'S SIGNATURE DATE 12,' �2 '2
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAIDAMOUNT 0, ,15
AMOUNT �' OCASH OCHECK# OCREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Deportment 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
w �• D 47 en} D m m r�'117 a
_-O; Fa � o `e w f7' n yTNm
Pi n� N s O. m m w w = m -nat3w' � ~ -A-I 'o oa. Z m � z0 �
L` CC m rt rt
n H m
0 m G y y Z C
_ O .a O y X
C
m m m N v iu n a y o nZ N r m m
v , 3 „ f0 o am :, 3 m N O p D n
O ,3e,
0 o W W ,» w m 3 Ev
/r O m (� X m 3 m-TI
O M< °
a •°, n 3 3 E a E 0 `° °' a y m O .w., n
m 3 m 2 a O a m m y Z o m O
o ? m 'c ° a a av oN Z
ct
cm
N N o n O N rSr Wi. A c ^ v 1 °09_ ct
a y N
ry m O V m m m^ .=.a m = m .
3 N n n m N LPw rZl
n w C y w 4 3 O N
rt G y = o ^' m
.N* vi �n E D 10 m ' D
z ; o a m
T
O /v
c a mcm
Oi N S ,
O w
°, > >• a 9 N N G A
�•
n
'm w m on �, =ti � '0 3 $
= m 3 a n o w m �
m
ti G C rt N rn
ur 2 .y. w^ F -n m io
IrtV a Il �p N n W
° O 2 f'wt a
w = » O n n
113
ct
C N a F+
O + N N , Hwy.
m N 3 4 m a m - o
A
a y c u 3 D
'n O 3
ct
0 o a .. 3 �. o 0rT
0
S
W * H n o ° 3
'o O
3 w •' m n m' o o c m 2 0 .
E -ir T• F F' y ;
a a
� 3
A w c
a n z o n
N » N
,� d � � � 3 N ? W N N Q � W J N In A 'p •?�
'n
C .=N•r 2 O r m m a a m
w M m m N < -c�i d �' F v 3
�O d
n O .. -
w n i Dr I � � y �, m ppn > > z � m 3
m N •• >
m I a .00 m d � � o
pq y m � m d
•C L. lm� C D 0 m ,30 m o 05 o n O ry S rDD
cm o c c °..' m - o
d z n v m �, 3 :^ 0 c ,N+ as m m
dID 0
m e,R m ja S = F C S rt i < 6 d C
N � OA a N m ydj d C S =n
Om O N O
o £ �*
M
m ° m -mi vi o '° 3 o p a a £
VXv
— m
so a
N O C O =n O
W O d K 0 0
O
�. n, 3 n £ < N O S
a v
J d o o 3 m o T
3 3 vim, m
(/) O m O j idr �i S O �^
- 3 y
m p m w A
2
d Q m 3 M
of T N
O O