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PMT16-01549 City of Menifee Permit No.: PMT16-01549 _ 29714 HAUN RD. Type: Residential Plumbing '�ACCELA? MENIFEE, CA 92586 MENIFEE Date Issued: 05/17/2016 PERMIT Site Address: 27141 FAMILY CIR,MENIFEE, CA 92586 Parcel Number: 335-452-042 Construction Cost: $2,150.00 Existing Use: Proposed Use: Description of REPLACE EXISTING 40 GAL WATER HEATER Work: Owner Contractor YVONNE KRANS A R S AMERICAN RESIDENTIAL SERVICES OF 27414 FAMILY CIRCLE CALIFORNIA INC MENIFEE, CA 92586 965 RIDGE LAKE BLVD SUITE 201 Applicant Phone:9012719700 ANDREW ALLEN License Number:765155 A.R S INC DBA RESCUE ROOTER 1520 W LINDEN ST RIVERSIDE, CA 92507 Fee Description Oty Amount IS) 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 building operations being carded 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 propertywho builds or improves thereon,and who contacts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contactors State License Law for Professions Code and my license is in full force and effect the following reason: License Clas (-3(,. License N By my signature below I acknowledge that,except for my personal residence I1 Expires %1 IO STgnature 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 1 WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by D 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 workers 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 w„ww.Ieeinfo.ca.eov/calaw.html. this permit is issued. Date Policy R PROPERTY OWNER OR AUTHORIZED AGENT AKhave and will maintain workers compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which .QBy 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 ar application and the infor o I have dad 1 ect.I agree to comply Ig with all applicable c' coun nanc state laws relatingto Carrier V t / p building const u(I au ' repre tive of this city or countyto Policy b�b9 Expires�� / enterth eiden' rape r e npurposes. (This section need not to be completed is the permit is for one-hundred Date Cl27—� dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT g,kertify that in the performance of the work for which this permit is issued, I shall not employ any persons in any manner so as"come subject to the CITY BUSINESS LICENSE q workers compensation law a' rma,and hat if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers m tion pro ' i of Section 3700 of the Labor Code,I shall forth y with t owsions. 1 Will the applicant or future building occupant handle hazardous material or a ��-IL mixture containing a hazardous material equal to or greater that the Applicant Date amounts spp%Med on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS DYE 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($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY D Yes o No 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 hou�ry of a school? (Section 3097 Civil Code) ❑Yes d No OWNER BUILDER DECLARATIONS I have read the Hazard Maier nformation Gui and the SCAQMD permitting checkl . rider d my requirem under the State of I hereby affirm under penalty of perjury that I am exempt from the California He Sa ode,Section 25 and 25534 concerning Contactors License Law for the reason(s)Indicated below by the �rdo ria p checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 DYe ❑N � Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER 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 licensure 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-certified 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 or through their o 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.epa.gov/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 Contactors State License Law does not apply to an owner of a D 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 D No EPA Lead-Safe Certified Firm is required for this project bemuse: not built or improved for the purpose of sale. o 1,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. PERMIT/PLANBUILDING & SAFETY • • • Menifee DATE 5-- / — CP PERMIT/PLAN CHECK NUMBER TYPE: ❑COMMERCIAL [D RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION []ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL ❑NEW ❑✓ PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Replace water heater.40 gallo gas in garage. PROJECTADDRESS 27414 Family Circle c^ City of Menifee ASSESSOR'S PARCEL NUMBER '635 -LA5g CLAZ LOT TRACT OWNER NAME Yvonne Krans ADDRESS 27414 Family Circle Menifee, CA 92586 Received PHONE (951)269-8426 EMAIL APPLICANTNAME Andrew Allen ADDRESS 1520 W. Linden St. Riverside, CA 92507 PHONE (951)341-9371 EMAIL CONTRACTOR'S NAME Rescue RooterARS OWNER BUILDER? ❑YES❑✓NO BUSINESS NAME ADDRESS 1520 W. Linden St. Riverside, CA 92507 PHONE (951)341-9371 EMAIL CONTRACTOR'S STATE LIC NUMBER 765155 LICENS SSIFICATION c36 VALUATION$ $2,150.00 SQ.FT / LSQFT APPLICANT'S SIGNATURE w Q'I DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP �C INVOICE //�� G PAIDAMOUNT AMOUNT „ -V5 IIrJ• IS CASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH ^CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER O YES 0 NO City of Menifee Building&Safety Department 29714 Houn Rd. 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