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PMT16-01975 City of Menifee Permit No.: PMT16-01976 29714 HAUN RD. Type: Residential Plumbing S-CCELA— MENIFEE, CA 92586 MENIFEE Date Issued: 0612412016 PERMIT Site Address: 25203 RIDGEMOOR RD, MENIFEE, CA Parcel Number: 339-440-002 92586 Construction Cost: $2,135.00 Existing Use: Proposed Use: Description of 50 GALL WATER HEATER REPLACEMENT, SAME LOCATION Work: Owner Contractor MARIA GARCIA A R S AMERICAN RESIDENTIAL SERVICES OF 25203 RIDGEMOOR RD CALIFORNIA INC MENIFEE, CA 92586 965 RIDGE LAKE BLVD SUITE 201 Applicant Phone:9512769744 KENNY PEERY License Number:765074 A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNb 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, CA 38120 Fee Description O� Amount($1 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 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_Perma_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed wntractor(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 01 am exempt from Iicensure under the Contractor's State License taw for Professions Code and my license is in full force and effect. r'�! . the following reason: License Clasr ¢dDtr�c2e C3 b License No. 7��� I By mysignature below I acknowledge that except for my personal residence Expires_ fgnature �QA/L(b� in which I must have resided for at least one year prior to completion of /JI improvements covered by this permit l cannot legally sell a structure that WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by jPI hereby affirm under penalty of perjury one of the fallowing 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 Cade,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: bySectfon 3700 of the Labor Code,for the performance of work for which vnvsv.leeinfo.a.eov/calaw.html. this permit is issued. Policy N Date 01 have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which O By my signature below l certify to each of the following:I am the property this permit is issued.My worker's 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 1 have provided is correct I agree to comply with all applicable city and county ordinances and state law relating to Carrier building construction.I authorize representatives of this city or county to Polfcyg Fxpires—L — %0Q enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less i PROPERTY OWNER OR AUTHORIZED AGENT O I certify that in the performance of the work for which this permit is issued, ©3 07 I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE Y workers compensation laws of California,and agree that if I should become ZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of section 3700 of the Labor Code,I shall farthw th comply with those provisions, )) ill the applicant or future building occupant handle hazardous material or a Applicant Date _�{0 mixture containing a hazardous material equal to or greater that the Y amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SP46REWORK S COMPENSATION COVERAGE IS OYes Jrwo 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 modlfiation from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR CoastAlr Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY oYes clNo 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 Cade) O Yes 0� OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist l understand my requirements under the State of I herebyaffirtn under penalty of perjury that lam exempt from the California Contractors License Law for the reason hazzardou s)indicated below by the Health alSafety Code,Section 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicable items)(Section 7031.5 oY O No Business and Professions Code).Any city or county that requires a permit to ,_QQJj�fll Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR ORI ED !GE issuance,also requires the applicant for the permit to rile a signed statement L that he or she is licensed pursuant to the provisions of the Contactors State EPA RENOVATION.REPAIR AND PAINTING fRRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RAP)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 apre-1978 and the basis for the alleged exemption.Any violation ofSectian 703L5 by residence or childcare facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil penaltyof not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their ❑1,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.eov/lead or contact the National Lead Information Center at not intended or offered for sale(Section 7044,Business and Professions 1-80D-424-LEAD(5323). Code,The Contactors State License Law does not apply to an owner of a OAn EPA Lead-Safe Certified Renovator will he 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 Certiriation No: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. 0 No EPA Lead-Safe Certified Firm is required for this project hem use: O I,as owner of the property am exclusively contracting with licensed contactors to construct the project(Section 7044,Business and Professions Code:The Contactors State License Law does not apply to an owner of a If your project does not comply with EPA RAP rule please fill out the RAP Acknowledgement BUILDING & SAFETY PERMIT/.PERMIT/PLAN CHECK APPLICATION Meniree DATE '0�41_R/ PERMIT/PLAN CHECK NUMBER O TYPE: O COMMERCIAL 2-RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW Q7PLUMBING 0 RE-ROOF-NUMBER OF/S�QUARES DESCRIPTION OF WORKS A 2 PROJECTADDRESS O( 1r 7eE_ ASSESSOR'S PARCEL NUMBER -111I �W� LOT TRACT 9 a o OWNER NAME J C-iA ADDRESS 2Q PHONE��aW &7�J7 / 0 7 EMAIL ,,//�� APPLICANT NAME E/C ov ,,// ADDRESS l / V� S/ Cf ,�17 c3 PHONE & ('266- �0 75 EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES ONO BUSINESSNAME ADDRESS �/l�lJ PHONE W(�6 U-Q6= EMAIL CONTRACTOR'S STATE LIC NUMBER 7&j0 7-eK LICENSE CLASSIFICATION e16 C zo (f VALUATION$ /L 5, ('�y SQ FT L SO FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE I PAID AMOUNT O AMOUNT OCASH OCHECK# CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDIT 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 O Zice+ 7m 2r `L a 0 n N > � n mXy .p., .d. 0 Al .33 m z ,�—» � m O F nmm w ivF+ 0 Snm a m m °: 3w � > .a QZ v. {^f ymc"i m A w m " D y V i+ 3 O ;a M _ `L < �2 �L o o aD a 3 a °d' 5- w n Z = A m m>z -13 apnM »'H g s � mmm 3 °° ' z = 0 ' r 0 o w w £ c o m Z i 3 £ n a m -i a = o 'm m 0 m _ m cb z o ^+ O z PO o n mc � � co Q 1{{ a 3 e H 3 O p m m CD D] = It H O d N O m < R = '� d tD b c � b b 0 3 3 u n n aBL c C N N S G \�' m — m � 1 ' v m d M o C N S O O O j � a0i 6 m A d G7 G 9 3 m n $ S K a• ^ d FLy a C co m O• G V Q < n » O a m t0 N [!1 d rdf 3: rdi W d N d N m n DAD m ° f a x < o w o '� m N — d a `� m n c m m m 3 CT) � m d < O DO C y M F. C m w O D) CL O _ N c 3 3 3 m o• v r w ' v � v T � c � � Z � N �' •"• d rG 9 G n O <n » m a Z a _ ^ rr 0 O O 3 m G r.. 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