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PMT16-02759 City of Menifee Permit No.: PMT16-02759 29714 HAUN RD. Type: Residential Plumbing c��CCFECA—> MENIFEE, CA 92586 MENIFEE Date Issued: D812412016 P E R M I T Site Address: 25129 SPRINGBROOK WAY, MENIFEE, Parcel Number: 339-431-003 CA 92594 Construction Cost: $800.00 Existing Use: Proposed Use: Description of REPLACE EXISTING WATER HEATER,SAME SIZE AND LOCATION Work: Owner Contractor NANCY HARRIS ALL STAR WATER HEATERS ING 25129 SPRINGBROOK WAY 30300 PUERTO VALLARTA WAY MENIFEE, CA 92584 MENIFEE,CA 925B4 Applicant Phone:9513010067 LAREA MILLER License Number:812894 ALL STAR WATER HEATERS INC 30300 PUERTO VALLARTA WAY MENIFEE,CA 92584 Fee Description City Amount($) Residential Water Heater 1 83.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 4.15 $116.16 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of ernors 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 BldgPermit—Template.rpt Page 1 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 a in under Provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. the follonviing reason: License Class C 1-21( 1 License No. 4 By my signature below I acknowledge that,except for my personal residence Expires 21-2 Signature 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 I WORKEWS COMPENSATION DECLARATION have built as a n owner-builder if it has not been constructed in its entirety by o I hereby affirrin under pena Ity of perjury one of the following decla nations: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 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 welosite: by Section 3700 of the La bor Code,for the performance of work for which this permit is issued. www.IegInFo.ca.Rov/calaw.htmI. Policy# PROPERTY OWNER OR AUTHORIZED AGENT Date Z' I have and will maintain worker's compensation insurance,as required by ection 3700 of the Labor Code,for the performance of the work for which o By my signature below I certify to each of the following:I a in the property this permit is issued.My workees compensation insurance carrier and policy owner or authorized to act on the property ownees behalf.I have read this number are: application and the information I have provided is correct.I agree to comply with all applicable city and county ordinances and state laws relating to Carrier building construction.I authorize representatives ofthis city or county to Policy# C_0<2 I 5pve' Ii — 19 enter the above identified property for inspection purposes. (This section need not to be com pleted is the permit is for one-hu mired Date dollars($100)or less PROPERTY OWN ER OR AUTHORIZED AGENT n I certify that in the performance of the work for which this permit is issued, I sha 11 not employ 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 shalj��I it�'�Ply wl"In those provistions. Will the applicant or future building occupant handle hazardous material or a Date mixture containing a hazardous material equal to or greater that the Applica J:iJ7 amounts specified onthe Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ciYes oNo UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVI L F]NES UP TO ONE HUNDRED THOUSAND DOLLARS($10D,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 AGEN ciYes; oNo 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) uYes oNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQVID permitting checklist.I understand my requirements under the State of I hereby affirm 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 placed next to the applicable item(s)(Section 7031.5 ciYes a No Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,priarto 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 Contra clues State EPA RENOVATION,REPAIR AND PAINTING IRRP) 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 a lleged exemption.Any violation of Section 7031.5 by residence or childca re facility to be RRP-certified firms and comply with a n Applicant for a permit subjects the applica nt 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 ci 1,as owner of the property,or my employee with wages as their sole em ployees.For more information about EPA's Renovation Progra in visit: compensation,will do I I all of or I I portion of the work,and the structure is www.epa.goy/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 o An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through em ployees!or personal effort,builds or im proves 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 bu rden of proving that it was not built or improved for the purpose of sa le. o No EPA Lead-Safe Certified Firm is required for this PrOjEct because: o 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 your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement DATE !> A" PERM IT/PLAN CHECK NUMBER TYPE: ()COMMERCIAL FZ]RESIDENTIAL 0MULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN SUBTYPE: OADDITION OALTERATION 0DEMOUTION OELECTRICAL OMECHANICAL ONEW R]PLUMBING 0 RE-ROOF-NUMBER OF SQUARES— DESCRIPTION OF WOR� Replace existing water heater. Same size and location. City of Man fee -DY-11sling-&-Safe y Dept. PROJECTADDRESS 25129 springbrook way 00emLA AUG 2 3--1016 ASSESSOR'S PARCEL NUMBER j!m-Lk2Pl-Qz LOT TRACT O.WNERNAIME narcyharris Recei-- d ADDRESS 25129springbrookway PH13NE 951-447:.19826 EMAIL APPLICANT NAME RaRea Miller ADDRESS 30300 luertaVallarta PHONE 951-301-OD67 EMAIL allstar.sierra@gmail.com CONTRACTOWSINIAM , LaReaMiller OWPLERSUILD�R? 0YESZ1100 BUSINESSNAME All Star Water Heaters ADDRESS 30300 uertaVallartaWay PHONE 951-301-0,067 EMAIL allstar.sierra@gmall.com CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36 VALUATION$ 8OOjOO SQ FT L SO FT —mm 0 'R—5 561 APPLICANT'S SIGNATUREZV:�—� E DEPARTMENT DI$TAIBUT101i CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP I - :INVOICE PAID AMOUNI 0 CASH 0 CHECK# OCREDITCARD VISAIMC 'VOICE ":MO U N=TC A �%,)- PLAN CHECK FEES' PAID AMOUNT 0 CASH OCHECK# 0 CREDIT C�ARD VIS�A/N'Cl OWNER BUILDER VERIN D 0 YES 0 No DL NUMBER NOTARIZED LETTER 0 YES 0 NO Cityof&,jenif, eStlildii,,g&SofetyDepaltrnent29714 flounRd. Mernfee, CA92586 951. 672-6777 www.JtyofmenI`ee.u5 inspection Request Line 9SI 246-6,7-13 zo 1- 0, v m A p 5, a m M _0 z m 0 m 0 - , 3. m m @ Z v m m 9 6 Z c 3 , = M -j m m m m ;q a 0 7K -n C RM M S' ig* CD CVI 0 n 0 M i; v on (n x to ;r a = M U) > o 3 w 2 tr a m 0, m 0 0 m CY, Ei z hi 0 j w - g ca 2 z o v m z ME U 4P& 0- (D 7r oz a m > mo =0 01 0 n M C: cm) m 0 cr M 01 0 cn > -4 La: o 0 �J 0 OL g 0 00 0 W m ct 0 4 0 0 ID n a EL z r) m w E. r� 0 4 m m m :r, I — d. # FA OM 5. n CO CL n X CL -M CL o CR I q, 0 0 n v 0 o Ro (M 0 o al a ;p m n M M CD C-- -0 C) r-3 u g CD CD :E X 0 dt LA (D c m m n Z8 m CD (D z X. a C: Z r M 2 P M Ic 3 co w 2m Mm a tr C:) CL M — 0 2 s B. a 42V ID D CD M C M -0 M M 3 g 9 0 c 1 0 0 :-; C, rz L; T % o CD a 6. < -4 w p "o 6. M M �A M 4 > -0 = M M 0 D ti r < -4 M M 2 @ z 5. rN M W D M E, > 0) cr M MM D c < 6' -- V A M M n M CT :r M 0 0 z -1 r! 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