PMT16-01072 City of Menifee Permit No.: PMT16-01072
29714 HAUN RD. Type: Residential Plumbing
� A—> MENIFEE, CA 92586
r-1-1La — MENIFEE Date Issued: 04/08/2016
PERMIT
Site Address: 25294 COUNTRY FAIR DR, MENIFEE. CA Parcel Number: 339-372-005
92584 Construction Cost: $9,623.00
Existing Use: Proposed Use:
Description of REROUTE NEW 3/4"MAIN HOT WATER LINE FROM WATER HEATER TO MASTER BEDROOM,
Work: REROUTE HOT WATER LINE FROM WATER HEATER TO LAUNDRY ROOM TO KITCHEN ISLAND
SINK WITH PEX IN ATTIC&COPPER IN WALL
Owner Contractor
KEVIN&SONIA KELLY A R S AMERICAN RESIDENTIAL SERVICES OF
25294 COUNTRY FAIR DR CALIFORNIA INC
MENIFEE, CA 92584 965 RIDGE LAKE BLVD SUITE 201
Applicant. Phone:9512769744
CASEY MCCABE License Number! 765074
A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNli
965 RIDGE LAKE BLVD SUITE 201
MEMPHIS, CA 38120
Fee Description Q1t r Amount 181
Piping/Repiping Single Family Residential 1 163.00
Building Permit Issuance 1 27.00
Inspections not specified 129 129.07
GREEN FEE 1 1.00
General Plan Maintenance Fee-Plumbing 1 8.15
$328.22
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_Sidg_Permil_Templale.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contraciar(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Lawfor
Professions Code and mylicceense is in full force and effect. _ the following reason:
License Clast(OANE� License N ZIO✓07Y By my signature below I acknowledge that,except for my personal residence
Expires Signature / in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
❑I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website:
by Section 3700 of the labor Code,for the performance of work for which www.Ieginfo.ca.Rov/ca1aw.html.permit is issued. ,n,
Policy# Date
❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Cade,for the performance of the work for which ❑By my signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
number are: application and the information I have provided is correct I agree to comply
,�/� with all applicable city and county ordinances and state laws relating to
Carrier 4I''�,W' 4i. /�G15� (s o? building construction.I authorize representatives of this city or county to
Policy#ryG/�`i55) Expires !0(//1 enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($300)or less PROPERTY OWNER OR AUTHORIZED AGENT
❑I certify that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to became subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of section 3700 of the Labor
Code,I shall forthwith comply with thos provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant - _ te mixture containing a hazardous material equal to or greater that the
amounts spf fled on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes Q No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($300,000),IN
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelin Coast Air Quality Management District(SCAQMD)?See permitting checklist
igk
CONSTRUCTION LENDING AGENCY ❑Yes PNO
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) ❑Yes O-1146'
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous r aterial reporting.
Business and Professions Code).Any city or county that requires a permit to oyes o
Date
construct,alter,improve,demolish or repair any structure,prior to its 7
ft PERTY R OR AUTHORIZED AGENT
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 Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRPI
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from Iicensure receiving compensation for most work that disturbs paint In a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certiflied firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves orthrough their
❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Finn is required for this project because:
❑I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
• • •
Menifee
DATE PERMIT/PLAN CHECK NUMBER IPMA0, ( I a'
TYPE: O COMMERCIAL 0 ESIDENTIAL O MULTI-FAMILY O MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: O ADDITION ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
ONEW POPRUMBING ORE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK ACCOAlf- tleLV 3 L _,_ Q 4/1 n-
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PROJECTADD SS ZSZ,Ry
ASSESSOR'S PARCEL NUMBER /�.'7 1 I ld' ,� LOT �5 I TRACT AS =44
OWNER NAME 1/eOCn
ADDRESS pZ�Z/'4 I.EJ G�.i f Ar:
PHONE (�/� b7 Z• ^�ji j?j%f// 11 EMAIL
APPLICANT NAME
ADDRESS Q+X, 11
PHONE 7`Sr II lJ" EMAILGMc�rb ��C'� SiSY°'FY+�i Gam'►
CONTRACTOR'S NAME,,,,"�/ d AW, /1(� �?�}//�5 OWNER BUILDER? O YES O NO
BUSINESS NAME Al W,1 � / �' /�
ADDRESS '/030 of i Awl fr g25S_3
J - It PHONE " b1�9 EMAIL U M
CONTRACTOR'S STATE L/IC NUMBER 74a Sj7 Y LICENSE CLASSIFICATION
VALUATION$ SO FT L SO FT,/ /
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEEBSN ICE BER
BUILDING PLANNING ENGINEERING FIRE GREEN 1 SMIP o /J
INVOICE
AMOUNT 7 2 ; O• PAID AMOUNT OCASH CHECKp UCREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISAIMC
OWNER BUILDERVERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 HDun Rd. Menifee, CA 92586 951-572-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
PLOT/SITE PLAN
REAR PROPERTY LINE
City of Menifee
fTY OF MEiVIFEE Building & Safety Dept.
_
UILDING AND SAFETY DEPA llEl4TYaj APR 0 8 2016
'LAN APPROVAL
Received
EUIEWED
DATE
Approval of these plans shall no'1 roiutraed:c he a permit or,or an
pprnval of,any violation of any prop isions of the federal,state or city
egulations and ordinances. This set f approved plans must he kept on the
obsite until completion.
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