PMT16-02602 City of Menifee Permit No.: PMT16-02602
29714 HAUN RD.
<A-CCEL/-> MENIFEE, CA 92586 Type: Residential Plumbing
MENIFEE Date Issued: 0 8/1 012 01 6
PERMIT
Site Address: 29514 AVIDA DR, MENIFEE, CA 92584 Parcel Number: 339-223-003
Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL WATER HEATER, SAME SIZE AND LOCATION
Work:
Owner Contractor
GLENDA ARELLANO ALL STAR WATER HEATERS INC
29514 AVIDA DR 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92584 MENIFEE,CA 92584
Applicant Phone:9513010067
LAREA MILLER License Number: 812894
ALL STAR WATER HEATERS INC
30300 PUERTO VALLARTA WAY
MENIFEE, CA 92584
Fee Description Amount ibl
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 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_BIdg_Permit Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe 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 Contractors State License Law for
Professions Code and my license is in full force and effea the following reason:
License Class C `,( License No. JJrr
T By my signature below lacknowledge that,except for My personal residence
ExpiresR-2:04�p,Sfgnature in which l must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
o I hereby affirm under penalty of perjury one ofthe 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 ofthe Labor Code,for the performance ofwork for which wwev,lezinfo.a.eov/alaw.html.
this permit is issued.
Policy# Date
have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
/section 3700 ofthe Labor Code,for the performance ofthe work for which o By my signature below l certify to each ofthe 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 1 have provided is correct.I agree to comply
Carrier I'fl — with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy#Ji,JC pres O �� — � / 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
❑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 become 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 370D ofthe Labor
Code,Ishall fin itD Amply wi,h those provisions. —�^ ) - mill xture
applconticant ining afuture building occupant
equal
lto or greater
thahazardoust
material or
6 L/� mixture containinga hazardous material equal to prgreater thatthe
Applica te /J Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes ❑No
UNLAWFUL,AND SHALL SUBJECIAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use ofthe 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 forguidelines
CONSTRUCTION LENDING AGENCY oYes ❑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 ofthe
lending agency for the performance ofthe work which this permit is Issued outer boundary of a school?
(Section 3097 Civil Code) ❑Yes o No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that l am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes o 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 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 WRPJ
License Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe 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 orthrough their
ci 1,as owner ofthe property,or my employee with wages as theirsole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all ofor( )portion ofthe work,and the structure is www.ena.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 oAn 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. o No EPA Lead-Safe Certified Firm is required for this project because:
o 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.
Iwo
.1.
vc1. Q
ui-
DATE PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL [Z]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 ✓ PLUMBING ORE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace existing water heater. Same size and location.
PROJECTADDRESS 29514 avi/d�a dr
ASSESSOR'S PARCEL NUMBER"` ' 2'�P5--w LOT 3 TRACr
OWNER NAME glenda arellano
ADDRESS 29514 avida dr
PHONE 951-852-1707 EMAIL
APPLICANT NAME La Rea Miller
ADDRESS 30300 Puerta Vallarta
PHONE 951-301-0067 EMAIL allstar.sierra@gmaii.com
CONTRACTOR'S NAME LaRea Miller OWNER BUILDER? O YES O NO
BUSINESS NAME All Star Water Heaters
ADDRESS 30300 Puerta Vallarta Way
PHONE 951-301-0067 EMAIL allstar.sierra@gmaii.com
CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36
VALUATION$ 800.00 SQ FT LSQ FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN ( SMIP
INVOICE
AMOUNT I 5 F I
PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISAIMC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED 'J YES `.J NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Sofety Deportment 29714 Houn Rd.Menifee, CA 92586 951-672-6777
www.citycfinenifee.us Inspection Request Line 951-246-6213
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