PMT16-03180 C" of Menifee Permit No.: PMT16-03180
29714 HAUN RD. Type: Residential Plumbing
<A-ccr=L:A—> MENIFEE, CA 92586
MENIFEE Date Issued: 09/2612016
P E R M I T
Site Address: 28535 SAND ISLAND WAY, MENIFEE, CA Parcel Number: 364-134-026
92584 Construction Cost: $1,500.00
Existing Use: Proposed Use:
Description of INSTALL 50 GAL WATER HEATER CHANGE-OUT KIND FOR KIND
Work:
Owner Contractor
LINDA MORRIS RELIABLE ENERGY MANAGEMENT INC
28535 SAND ISLAND WAY 7201 ROSECRANS AVENUE
MENIFEE,CA 92584 PARAMOUNT, CA 90723
Applicant Phone:56298455111
ARMANDO FELIX License Number:704414
RELIABLE ENERGY MANAGEMENT INC
7201 ROSECRANS AVENUE
PARAMOUNT, CA 90723
Fee Description ptz Amount 1$
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 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_Bldg_Peanit Template.rpt Page 1 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 perjurythat 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 u I am exempt from ficensum underthe Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
LicenseClass LicenseNo.) ;7C)qUIV By my signature below I acknowledge that,except for my personal residence
Expires 3131X7 Signature c4f<--ye in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
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.ieginfo.ca.gov/calaw.litmi.
Policy# Date
cil'�ave 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 o 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
Carrier 116 rJ 410 PU Q /JS!�( JZP144 with all applicable city and county ordinances and state laws relating to
—7////!7 building construction.I authorize representatives of this city or county to
Policy# t9&W5Z2N 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,KciartifV that in the performance of the work for which this permit is issued,
I shall not employ any persons in any so as to become subject to the CITY BUSINESS LICENSE#
_Iny mWe
worker's compensation laws nia a nd agree that if I should become HAZARDOUS MATERIAL DECLARATION
- - -_ V
subject to the worker's co e ovisions of Section 3700 of the Labor
Code,I shall fort�hh"' co wi use Provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date!? mixture containing a hazardous material equal to or greater that the
amounts sp fled on the Hazardous Materials Information Guide?
WARNINC CF t' COMPENSATION COVERAGE 15 0 Yes Z.
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 M ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modiflution 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 guidell
CONSTRUCTION LENDING AGENCY o Yes Z
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 boun of a school?
(Section 3097 Civil Code) o Yes
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I underst!aVWY requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California Health& e e, ction 25505 and 25534 concerning
in
Contractor's License Law for the reason(s)indicated below by the htpardous mated re
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 gRes 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 PR NER OR A—UT70—RIZED 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 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 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-certifiecl 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
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 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 1-800-424-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 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. in No EPA Lead-Safe Certified Firm Is required for this project because:
in 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 Uicense 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 ty Dept.
Z b 2016
�"�Wenifee
DATE 09/26/2016 PERMIT/PLAN CHECK NUMBER
TYPE: E]COMMERCIAL [Z]RESIDENTIAL [-]MULTI-FAMILY [-]MOBILEHOME [:]POOL/SPA E]SIGN
SUBTYPE: F]ADDITIONE]ALTERATION DDEMOLITION []ELECTRICAL F]MECHANICAL
[:]NEW [Z]PLUMBING F]RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 50 GAL WATER HEATER CHANGE-OUT KIND FOR KIND
PROJECTAIDDRESS 28535 SAND ISLAND WAY el
ASSESSOR'S PARCEL NUMBER SWt4 - VeLOT 131- TRACT 'L Z I ke
PROPERTY OWNER'S NAME LINDAMORRIS
ADDRESS 28535 SAND ISLAND WAY MENIFEE,CA.92584
PHONE (951)746-8388 EMAIL
APPLICANT NAME CONTRACTOR
ADDRESS
PHONE EMAIL
CONTRAcroR'S NAME ARMANDOFELIX OWNERBUILDER? E]YESFINO
BUSINESSNAME RELIABLE ENERGY MGMT
ADDRESS 7201 ROSECRANS AVE PARAMOUNT,CA.90723
PHONE (562)984-5511 EMAIL
CONTRACTOR'S STATE LIC NUMBER 704414 LICENSE CLASSIFICATION B C36 C20
VALUATION$ $ 1,500.00 SQ FT 2014 LSQFT
APPLICANT'S SIGNATURE DATE 09/26/2016
DEPARTMENT DISTRIBUTION CITY IYENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE � GAN SMIP
INVOICE - -1 PAIDAMOUNT
LANOUNT OCASH OCHECK# OCREDfTCARD VISA/MC
MOU
PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED C YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safe ty Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cli-yofmenifee.us Inspection Request Line 951-246-6213
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