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PMT16-02837 City of Menifee Permit No.: PMT16-02837 29714 HAUN RD. Type: Residential Plumbing <A-CCI=-Lj-;> MENIFEE, CA 92586 ...... MENIFEE Date Issued: 08129/2016 P E R M I T Site Address: 29769 WINTER HAWK RD, MENIFEE, CA Parcel Number: 338-342-011 92586 Construction Cost: $2,000.00 Existing Use: Proposed Use: Description of REPLACE WATER HEATER SAME SIZE/LOCATION 50 GAL IN GARAGE Work: Owner Contractor JAMES HOGGATT AFFORDABLE WATER HEATERS AND PLUMBING 29769 WINTER HAWK RD INC MENIFEE, CA 92586 28358 CONSTELLATION ROAD#698 Applicant Phone: 8553459087 DANIEL MATA License Number:627368 AFFORDABLE WATER HEATERS AND PLUMBING INC 28358 CONSTELLATION ROAD#698 VALENCIA, CA 91355 Fee Description Qtv 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 $115.15 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of error$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_Permit Template.rpt Page I of I 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). Chapter9(commencing with section 7000)of Division 3 of the Business and a 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 following reason: License Class License No. By my signature below I acknowledge that,except for my personal residence Expires-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 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 of the 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 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 website: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. www.leginfo.ca.gay/calaw.htmi. Policy It Date o I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which ci 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 on the property owner's 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 of this city or county to Policy# Expires 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 ci I certify that in the performance of the work for which this permit is issued, I shall not emp] 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 shall forthwith comply with those provisions. 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 amounts specified on the 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 CIVIL FINES UP TOONE 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 for guidelines CONSTRUCTION LENDING AGENCY o Yes o No I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 100CI 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) o Yes o No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMID 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.S oYes 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 JRRP) 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 pa int In a pre-1978 a nd the basis for the a Ileged exam ption.Any violation of Section 703 1.5 by residence or childcare facility to be RRP-certifiled firms a nd com p ly With a n Applica nt for a permit subjects the applica nt to a civil pena Ity 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 o 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 I I portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-80G-424-LEAD(5323). Code;The Contractoes State License Law does not apply to an owner of a ci 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. a 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:7he Contractoes 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. 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 perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and cz I am exempt from licensure under the Contractor's State License Law for Professions Code and my license i.s in full for e and effect. the following reason: License Ct-ss se No. By my signature below I acknowledge that,except for my personal residence Expir Signatur _&& 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 W=KER'S�COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by a I hereby affirm under penalty of perjury one of the followmg 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 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 of the Labor Code,for the performance of work for which www.IeeInfa.�.gov&aIaw.html. this permit is issued. Date Policy If PROPERTY OWNER OR AUTHORIZED AGENT ci I 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 rz By my signature below I certify to each of the following:I am the property this permit is issued.My WOTkees compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number are: application and the information I have provided is correct.I agree to comply Carrier Joe N with all applicable city and county ordinances and state laws relatingto building construction.I authorize representatives of this city or county to Policy#%���60 Expires enter the above identified property for inspection purpases. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWN ER OR AUTHORIZED AG E NT o I certify that in the performa rim 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 It 00315545113 w rk e com nsation lawsof Califo)Kia,and agree thatif I should become HAZARDOUS MATERIAL DECLARATION o ers subject to iiie rker"c n ti Provi " ns of Section 3700 of th Labor to h 0 P rov' isions. it th sslev Will the applicant or future building occupant handle hazardous material ora mixture coptaining a hazardous material equal to or greater that the amounts sfecified on the Hazardous Materials Information Guide? WA FAILURE TO S&6RE WORKER'S COMPENSATION COVERAGE IS m Yes No UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES )(I Win the intended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HU N DRED THOUSAND DOLLARS($100,0(10),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 SECIION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guld Il CONSTRUCTION LENDING AGENCY 0yes Fs I hereby affim 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 boodary of a school? (Section 3097 Civil Code) a Yes nNNJo ad OWNER BUILDER DECLARATIONS I have ad th ous arterial of ation Guide and the SCAQ1MD /V under the State of an permitting ch:cHkIIst.'1dnde.-M, y ro'cmirements I hereby affirnn under penalty of perjury that I am exempt from the Califorma,11ealth&Sa o Secti 505 and 25534 concern! g Contractor's License Law for the reason(s)indicated below by the hazar material I checkmark(s)I have placed next to the applicable itern(s)(Section 7031.5 0Y No ' Business and Professions Code).Any city or county that requires a permit to Da construct,alter,improve,demolish or repair any structure,prior to its P E OWNE A T IZEDAGENT issuance,also requires the applicant for the permit to file a signed statement A= that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI 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 com pensation 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 childca re facility to be RAP-certifted firms and comply with an Applicant for a permit subjects the applicant to a civil Pena Ity of not more required practices.This includes rental property owners and property than($500). managers who do the paint-ifisturbing work themselves or through their o 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 I all of or I I 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 n An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or persona I 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 a No EPA Lead-Safe Certified Firm is required for this project because: not built or improved for the purpose of sale. cz 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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE PERMIT/PLAN CHECK NUMBER , r�D\T 0�;k TYPE: OCOMMERCIAL )(RESIDENTIAL 0MULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN SUBTYPE: OADDITION OALTERATION ODEMOUTION OELECTRICAL OMECHANICAL ONEW YPLUMBING 0 RE-ROOF-N UMBER OF SQUARES_ DESCRIPTION OF WORK WfPL��, I PROJECTADDRESS 4A-1(61� ��4 ASSESSOR'S PARCEL NUMBER LOT f7 42 TRACT PROPERTY OWNER'S NAME \ArkQS AMC ADDRESS wloo� mr4je W PHONE oM - tm - EMAIL APPLICANT NAME 1)&6xa ADDRESS 4AOCNC, COr- �OA PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER?—C,YES 0 NO BUSINESS NAME hk��Lk yQA-Ta A�� ADDRESS PHONE 5- 90 EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION 0 VALUATION$ SQF LSQFT I APPLIC DATE (, Iqpk IV, CITY STAFF USE ONLY DEPARTMENT D15TKIBUTION LITY OF MENIFEE BU51NE55 ULLN�E NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE I PAIDAMOUNT AMOUNT I 1 0 CASH 0 CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT I I OCASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES 0 NO DLNUMBER NOTARIZEDLETTER 0 YES 0 NO City of Ailenifee Building&Safe(v DeportMent 29 714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofmenifee-us Inspection Request Line 951-246-6213 z EL G) > 0 0 gm> � = * C, 'o z F. ca w m . . , 5 5 0 m No 3 rL El m , -F EL rt m " m m m z o M 0 GI CL ir ir om S, ma -10 43 1 0 1= FF M w 0 0 cn C� ur 0 :t::r 71 m > zz- -k� !t m sc 0 @ c cnK wo 0 0 CM 0 CD 0 rL cr '0 w O�K 6 0 H. MI > m 0 m w of. 0 rn I t ol vo - 0 w 0 LLK A 41b M L? 10 0 Ck w 0 -IL T CD .0 Vi 1,41 L 0 vo c .2:E c _8888 -Z �j .. E .15 E f 2 0. iz ly; w .,d mu Cw x, w i !q E 9 Y 0' iL 0 E r ui Z5 t2 7m V !S —'EM -Z -it U w 0 c mw 0 a t-W m 3 Jc, §3 c. ca 'E 3m: M c > — t :; :E E 5 - m 0 I -. r, V - 0 f- 0 .L. �v -� L� - E Q w w ='� t . - 2� Z -2 cg, — 1 .0 1. 1 — 0 0 u E to w V a,t o 0 MO a V It- M U 0 u > 0 -2 4 0 0 a c 'ro 1 0 R V- W J'w 2 1 = = Jl J2 Z WL V= 10 LU 2 M,: I a -a > EL c VI; lt_ c —m c > : C. Em o m J5 F= w 0 u C Z a Z !41 0 XI E zt! LU al w Z:l N ME —0 cc 0 z c5 4 c� ni -4 Lr; 3A 6 CIS 6 C,: w