PMT16-02397 City of Melriiffee Permit No.: PMT16-02397
29714 HAUN RD. Type: Residential Plumbing
SACCIEL/-> MENIFEE, CA 92586
MENIFEE Date Issued: 07/26/2016
PERMIT
Site Address: 29399 CARMEL RD, MENIFEE, CA 92586 Parcel Number: 338-072-026
Construction Cost: $3,000.00
Existing Use: Proposed Use:
Description of INSTALL NORITZ NRC-98-OD-NG TANKLESS WATER HEATER WITH 3 FT GAS LINE
Work: CONNECTION,REPLACE 80'F>USTING DRAIN LINE
Owner Contractor
BRIAN O'SHEA EASY ROOTER PLUMBING AND DRAIN CLEANING
29399 CARMEL ROAD 34748 BOROS BLVD
MENIFEE, CA 92586 BEAUMONT, CA 92223
Applicant Phone:8882233216
JONATHON CARRANZA License Number: 961469
EASY ROOTER PLUMBING AND DRAIN CLEANING
34748 BOROS BLVD
BEAUMONT, CA 92223
Fee Description City Amount 151
Residential Water Heater 1 33.00
Building Permit Issuance 1 27.00
Inspections not specified 116 116.00
Inspections not specified 116 116.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 11.60
General Plan Maintenance Fee-Plumbing 1 4.15
$358.75
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 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_Pernit 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 contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjurythat I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and a 1 am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. cr the following reason:
License Class e-�lCa License No. 10 1 tfCr / By my signature below I acknowledge that,except for my personal residence
=Z Expires J3 t_ Signature in which 1 must have resided for at least one year prior to completion of
41 rovements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION I
have built as an owner-builder if it has not been constructed in its entirety by
'havrhereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
e 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,issudd 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.leeinfo.ca.aov/wlaw.htmL
this permit is issued.
Policy# ..S L,3 c 11 a 9 a y 5 Date
PROPERTYOWNER OR AUTHORIZED AGENT
D I have and will maintain workers compensation Insurance,as required by
section 3700 of the tabor Code,for the performance of the work for which o By my signature below I certify to each ofthe following:I am the property
this permit is issued.My workers compensation insurance carder and policy owner or authorized to act on the property owners behalf.1 have read this
number are:C T application and the information I have provided is correct.I agree to comply
Q G U�t '(' J"`�r6Tn o�.J! 1 vcr' . �.�,�u-�J with all applicable city and county ordinances and state laws relating to
J
Carrier 7 building construction.I authorize representatives ofthis city or county to
Policy# iSWo // D`I.2 1z Expires (o '.22- /7 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 PROPERTY OWNER OR AUTHORIZED AGENT
❑1 certifythat in the performance ofthe workfor which this permit is issued,
I shall not employ any persons in any manner so as to become subjectto the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compen50ioirprisions of Section 3700 ofthe Labor
Code,I shall fortljw'h comp y W th tl Se.pr ns. Will the applicant or future building occupant handle hazardous material or a
// mixture containing a hazardous material equal to or greater that the
Applicant Date �— 2�- 1 LO amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILUR' 'O SECURE ORKER'S COMPENSATION COVERAGE IS ❑Yes trots'
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(SCAQM D)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY Oyes 0110
I hereby affirm that under the penalty ofperjury there is a construction Will the proposed building or modified facility be within 1000 feet ofthe
lending agency for the performance ofthe work which this permit is issued outer bour�ary of a school?
(Section 3097 Civil Code) o Yes A.
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
California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazardous material reportin
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ,aes 0 No
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 OWN OR AUTODRIZED 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 IRRP)
License Law(Chapter9(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($500). managers who do the paint-disturbing work themselves or through their
01,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion ofthe work,and the structure is www.epa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a 0 An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
01,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY r •MIT/PLANr • •
Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: 0 COMMERCIAL VitESIDENTIAL O MULTI-FAMILY O MOBILE HOME 0 POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O�,PLLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 5ys�o_Q +on Lo, t- s., �' O•"� lI)({- zj•017 A)G-I
✓'wihI i N2L20=e d-Z./ .
PROJECTADDRESS p2 9 3 9 Ca✓Wt tx fZ d . r".v C. 9 as�
ASSESSOR'S PARCEL NUMBER A-j$" b- D-CQLp LOT TRACT
I
OWNER NAME r'�Q
pding & Safety Dap .
ADDRESS Cr„✓w�.p,Q, �,d ��.1•. C,-� Q a,S
PHONE sb3 - 5.5I - L9q(o EMAIL JUL 26 2016
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME 4�/.F rn L OWNER BUILDER? O YES WIND
BUSINESS NAME u `0 • C9 '.•h �w
ADDRESS 13l e-0 4 N C
n EMAIL IN OP,IA44NDEM EMPIRE _
9 PHONE ,SI'SOO'S�_ A . 0M
t{7
CONTRACTOR'S STATE LIC NUMBER q(.A t L4 U� LICENSE CLASSIFICATION C,3
!10
VALUATION$ SO OFT L SO,FT
APPLICANT'S SIGNATURE !sue DATE
CiTY STAFF USE ONLY A
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN 7 SMIP
INVOICE PAID AMOUNT
AMOUNT .� CCASH CCHECK# C)CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT I OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES C NO DLNUMBER NOTARIZED LETTER 0 YES 0 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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