PMT16-00387 City of Menifee Permit No.: PMT16-00387
29714 HAUN RD. Type: Residential Plumbing
ACCELA—> MENIFEE,CA 92586
MENIFEE Date Issued: 02116/2016
PERMIT
Site Address: 26786 SUMMERWOOD CIR, MENIFEE, Parcel Number: 360490-009
CA 92584 Construction Cost: $999.00
Existing Use: Proposed Use:
Description of REPLACE 40 GAL WATER HEATER IN GARAGE
Work:
Owner Contractor
DOUG&MARY TREZ WATER HEATERS ONLY INC
26786 SUMMERWOOD CIR 970 E MAIN STREET#200
MENIFEE,CA 92584 GRASS VALLEY, CA 95945
Applicant Phone: 8008358345
STEVEN SCHNIERER License Number: 374573
WATER HEATERS ONLY INC
970 E MAIN STREET#200
GRASS VALLEY, CA 95945
Fee Description ON Amount($I
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_Bldg_Permit_Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION
- I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed
Chapter 9(commencing with section 7000)of Division 3 of the Buslness and contractors to construct the project(Section 7044,Business and Professions
PrafasMons Codeaad mv license is in full force and effect. Code:The Contractors License Law does not apply to an owner of a property
License Class G3(a ,Licensec^No.37'}S73 who builds or Improves thereon, and who contracts for the projects with a
Expires5 3 i Signature licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
1 ' ❑ lam exempt from Iicensure under the Contractors'State License Law for the
,,
•�hereby affirm under penalty of perjury one of the following declarations: following reason:
I have and will maintain a certificate of consent of set-insure for workers' By my signature below I acknowledge that,except for my personal residence In
compensation,Issued by the Director of Industrial Relations as provided far by which I must have resided for at least one year prior to completion of
Section 3700 of the Labor Code,for the performance of work for which this improvements covered by this permit,I cannot legally sell a structure that 1 have
permit Is issued.Policy# Lisa3built as an owner-building if it has not been constructed in its entirety by licensed
049 contractors.I understand that a copy of the applicable law,Section 7044 of the
'I have and will maintain workers'compensation insurance, as required by Business and Professions Cade,is available upon request when this application is
'section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:httolAvww.leainfo.n.aov/celaw.html.
permit Is Issued.My workers'compensation Insurance center and policy number are:
Cartier _ _ _ - Property weer or Agent Date
Expires Palley#
Name ofAgenc Phone# By.my Signature below, I certify to each of the following:I am the property
owner or authorized to act on the property owners behalf. 1 have read this
(This section need not be completed If the permit is for application and the Information I have provided Is correct 1 agree to comply
one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building
construction.I authorize representatives of this city or county to enter the above-
0 1 certify that in the performance of the work for which this permit is issued,I Identified property for the Inspection purposes.
shall not employ any persons in any manner so as to become subject to the
workers'compensation laws of California,and agree that if I should become�/�, ZI 11o11(e'
subject to the workers compensation provisions of Section 37DO of the Labor Code,I shall forthwith comply with those provisions. property Owner orAuthoraekiAgent Date
` City Business License#
Data, ( ��o Applicant; �S�-
WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100.000),IN ADDITION TO THE COST OF COMPENSATION, AYES OCCUPANT HANDLE HAZARDOUS MATERIAL OR A
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE,INTEREST,AND ATTORNEYS FEES -11NO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY V SPECIFIED ON THE HAZARDOUS MATERIALS
I hereby affirm that under the penalty of perjury there Is a construction lending INFORMATION GUIDE?
agency for the performance of the work which this permit Is issued(Section WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name AYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
ONOemu^ DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES �^
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME: 9�cyey,% v�%e ter-
License Law for the reason(s)indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s)(Section 7031.5.Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct,alter,Improve,demolish, SCHOOL?
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
provisions of the Contractor's State License Law(Chapter 9(commendrg with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from Iicensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not mare than($500).) CODE SECTION 25505 25533 AND 25534 CONCERNING
❑ 1, as owner of the property, or my employees with wages as their sale HAZAF(DOUS MATERIAL WOWING.
compensation,will do( )all of or( )porting of the work,and the structure is PROPERTY OWNER ORAUTHORIZEO AGENT
not intended or offered for sale.(Seaton 7044,Business and Professions Code; �AA
The Contractor's State License Law does not apply to an owner of a property X- 5:laa��C...�
who, through employees'or personal effort builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement Is sold within acre year of completion,the Owner-
Builder will have the burden of proving that it was not built or Improved for the
purpose of sale).
SAFETYAPPLICATION
Menifee
DATE 0 2/1 612 0 1 6 PERMIT/PLAN CHECK NUMBER
TYPE: [-]COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL
❑NEW [Z]PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace 40 Gallon Water Heater In Garage City of Menifee
uI
PROJECT ADDRESS 26786 Summerwood Circle
101.
ASSESSOR'S PARCEL NUMBER 0'�wi LA0-' LOT TRA
OWNER NAME Doug&Mary Trez
ADDRESS 26786 Summerwood Circle Menifee,CA 92584
PHONE (714)348-8715 EMAIL
APPLICANT NAME Steven Schnierer
ADDRESS 31225 La Baya Drive Suite 112 Westlake Village, CA 91362
PHONE (818)735-7876 EMAIL
CONTRACTOR'S NAME Water Heaters Only Inc. OWNER BUILDER? ❑YES❑✓NO
BUSINESS NAME Water Heaters Only Inc.
ADDRESS 970 E Main Street#200 Grass Valley,CA 95945
PHONE (530)274-3001 EMAIL
CONTRACTOR'S STATE LIC NUMBER 374573 LICENSE CLASSIFICATION C36
VALUATION $ $999.00 SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE 02/16/2016
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION 1� CITY OF MENIFEE BUSINESS UCENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN l SMIP
INVOICE PAID AMOUNT
AMOUNT .15 O CASH O CHECK H O CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH O.CHECK# 0CREDIT 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.cityofinenifee.us Inspection Request Line 951-246-6213
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