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PMT16-02758 City of Menifee Permit No.: PMT1 6-02758 29714 HAUN RD. Type: Residential Plumbing <A-C CZ L MENIFEE,CA 92586 MENIFEE Date Issued 0812412016 P E R M I T Site Address: 27482 EMBASSY ST, MENIFEE, CA Parcel Number: 335-323-016 92586 Construction Cost: $800.00 Existing Use: Proposed Use: Description of REPLACE EXISTING WATER HEATER,SAME SIZE AND LOCATION Work: Owner Contractor PAMELAWORLEY ALL STAR WATER HEATERS INC 27482 EMBASSY STREET 30300 PUERTO VALLARTA WAY MENIFEE, CA 92586 MENIFEE, CA 9251541 Applicant Phone:9513010067 LAREA MILLER License Number:812894 ALL STAR WATER HEATERS INC 30300 PUERTO VALLARTA WAY MENIFEE,CA 92584 Fee Description City Amount Residential Water Heater 1 83.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 415 $115.16 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 BidgPermit-Ternplaterpt Page I 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 contractor(s)pursuant to the Contractors State License Law). Chapter!)(commencing with section 7000)of Division 3 of the Business and ri I am exempt from licensure under the Corittactor's State License Law for Professions Code and my license is In full force and effect. the following reason: License Class C-2,( � License No. 9 4 By my signature below I acknowledge that except for my personal residence Expires Sc—2a:4 S-ignature—.. in which I must have resided for at least one year priorto 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 ci I hereby affirm under penalty of perjury one of the fiollowling 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 workees 7044 of the Business and Professions Code,is available upon request when compensation,issued by the Director of Inclustrila I 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.legfinfo.ca.gov/caIaw.html. this permit is Issued. Policy# PROPERTY OWNER OR AUTHORIZED AGENT Date %0 have and will maintain worker's compensation insurance,as required by /section 3700 of the Labor Code,for the performance of the work for which a By my signature below I 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 an the property ownees behalf.I have read this number are: application and the information I have provided is correct.I agree to comply wiith all applicable city and county ordinances and state laws relating to Carrier r� building construction.I authorize representatives of this city or county to 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 OWN ER OR AUTHORIZED AGENT a I certify that in the performance of the work for which this permit is issued, lshallnotempl any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I she] Will the applicant or future building occupant handle hazardous material or a mpY w Provisions mixture containing a hazardous material equal to or grater that the P11V I In t,. in Date amounts specified on the Hazardous Materials Information Guide? MLARNING-FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 o Yes ci No UNLAWFUL,AND SHALL SUBJECTAN 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 forguidelines CONSTRUCTION LENDING AGENCY a Yes ci 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 boundary of a school? (Section 3097 Civil Code) Oyu allo 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 affirrn under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)Indicated below by the hazardous material reporting. checkmark(s)I have pla ced next to the applicable item(s)(Section 7031.5 uYes a 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRPI 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 RRP­certifted 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 themselvesorthrough their a 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( I all of or( )portion of the work,and the structure is www.epa.Roy/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 Contractor's State License Law does not apply to an owner of a c;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: 5a le.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder wilil have the burden of proving that it was not built or improved far the purpose of sale. ci No EPA Lead-Safe Certified Firm is required far this project bemuse: a 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's State License Law does not apply to an owner of a if you r project does not com p ly with EPA RRP rule please fill out the RRP Acknowledgement. N,31 �g M f W; I DATE PEIRMIT/PLAN CHECK NUMBER TYPE: OCOMNERCIAL ORESIDENTIAL CIMULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN SUBTYPE; OADDITION CALTERATION ODEMOLITION OELECTIRICAL OMECHANICAL 0 NEW ELPLUMBING 0 RE-ROOF-NUMBER OF SQUARES-- DESCRIPTION or womi Replace existing water heater. Same size and location. PROJECTADDRESS 27482 embassy st 0005S-o citv of Menifee Building & Safety Dip—t , ASSESSOR'S PARCEL NUMBER '336- -69b -OkkM LOT TRACT OWNERNAME parrelaworley AUG 2 3 2016 ADDRESS 27482einbassyst PHONE 951-679,5567 EMAIL APPLICANTNAME LaRea Miller ADDRESS 30300 Puerta Vallarta PHONE 951-301-0067 EMAIL allstar.sierra@gmall.com CONTRAcrowsNAME LaRea Miller OWNEIRBUILD—ER? OYES>940 BUSINESS NAME All 3tar Water Heaters ADDRESS 30300 P erta Vallarta Way PHONE 951-301-CO67 EMAIL alistar.slerra@gmail.com CONTRACTOR'S STATE IIC NUMBER 812894 LICENSE CLASSIFICKnON C36 VALUATION$ 800.00 SQ FT LSQFT APPLICANT'$SIGNATU CITY OF MENIFEE BUSINESS LICENSE NUMBER ING PLANNING EN(INEERING FIR-E GREEN —SMIP -DEPARTMENTIDISTRIBUTION INVOICE PAIDAMOUNT AMOUNT N5,�5 0 CASH 0 CHECK# OCREDITCARD VISVMC PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# OCREDITCARD VIWMC OWNER RUILIDERVERIFIE1 I OYES 0 No DLNUMBER -- — NOTARIZED UETTER 0 YES 0 NO City of Menife?Building& 5afety Department 29714 Houn Rdj Menifee, CA 92586 951.-67)-0'777 www,city0fn,c,tjjfee.u5 117.spectloo Request Une 95.1-24155-6213 Z m 0 M> 0 'o o Z 0 0 m f a. � - > 0 m 3 m 1 9 7� z g p z In m > CD -4 03 .0 co =0 r) 9 0 cn CO a) Cl) z m ID CL QQ 0 0 o zr 'm m �g M I (A (1) m C" mg on 0 3 Fr =v g 0 0 3 S. m M a T ZE 5, n 3 a m X o 0 JS n m 0 OF 'd 'm W, RZ CL @ tv w m C3 2L 6 m cm a �l 0 a 0 CL l:r M, OW :E Zl m m z ;; O� w w 03 -3 0 0 (D Ln mm = W w w w m ID CL c M AV m nd m Sr > C) CO n im m m -a m m 3 m CD 0) 0. 0. m a ;I < -4 , , , . - C CD cr. v M M < 6 > M = 0 m 0 M M Q C M V - F � I F a C) :3 M .. , @ 0 :E > M M m m z w e) (0 0 N) —1 A > cn 03 OD a' m 'a Emn C " V = M M m M m = 5 , m m a m U Ct o � 0 o z tb 0 LC RCD 3E C6 n rl 0 0 , , - 'n c 0. 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