PMT16-03463 City of Menifee Permit No.: PMT16-03463 -5-CCEL/- 29714 HAUN RD. Type: Residential Plumbing A MENIFEE, CA 92586 MENIFEE Datelssued: 1012112016 P E R M I T Site Address: 31445 WILLOWOOD WAY, MENIFEE, CA Parcel Number: 372-032-003 92584 Construction Cost: $800.00 Existing Use: Proposed Use: Description of REPLACE EXISTING WATER HEATER, SAME SIZE AND LOCATION Work: Owner Contractor MICHELE CARR ALL STAR WATER HEATERS INC 31445 WILLOWOOD WAY 30300 PUERTO VALLARTA WAY MENIFEE, CA P25B4 MENIFEE,CA 92584 Applicant Phone:9513010067 SIERRA SPRAGUE License Number., 812894 ALL STAR WATER HEATERS INC 30300 PUERTO VALLARTA WAY MENIFEE,CA 92584 Fee Description Amount Residential Water Heater 83.00 Building Permit Issuance 27.00 GREEN FEE 1.00 General Plan Maintenance Fee-Plumbing 4.15 $116.15 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 Wthin 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_B1dg_Perrnit-Temp1ate.rpt Page I of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds orimproves 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 a I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effe ct. the following reason: License Class C Licenwe No. L( By my signature below I acknowledge that,except for my personal residence in which I must have resided for at least one year prior to completion of Expires Signature i&L� 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 th e Labor Code,for the performance of work for which www,.Ieginfo.ca.gov/caIaw.htrnI. this permit is issued. Policy# Date VI have and Will maintain workees compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT /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 workees compensation insurance ca rrier and policy owner or a uthorized to act on the property owner's behalf.I have read this numberare: 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 06 city or county to Policy# C,Qqq I S- 1 - 19 enter the above Identified property for inspection purposes. (Th Is section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT o I certify that in the performance of the work for which this permit is issued, I shall not emp] any persons In any mannerso 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 fo q mply with those provisions. Will the applicant or future building occupant handle hazardous material or a mixture containing a hazardous material equal to orgreater that the App­___� Date amounts specified on the Hazardous Materials Informilt"ID.n Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ciYes nNo 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 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 opla 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 th e lending agency for the performance of the work which this permit Is issued outer boundary of a school? (Section 3097 Civil Code) ci Yes cr No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQM D 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 ayes a No Business and Profiassions 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 IRRP) License Law(Chapter 9(commeneing 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 ficensure 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 RAP-certified firms and comply With an Applicant for a permit subjects the applicant to a civil pena Ity of not mom required practices.This includes renta I property owners and property than($50D). managers who do the paint-disturbing work themselves or through their cr 1,as owner of the property,or my employee with wages as their sale employees.For more information about EPA's Renovation Program visit: compensation,will do( I all of or( 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 Contractoes State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator vkrill be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements am not intended or offered for Certified Firm Name: sale.If,however,the building or improvement 15 sold Within oneyearof Firm Certification No.: completion,the Owner-Builder will have the burden 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 pmject bec�ause: o 1,as owner of the property a m 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. ,NEWSOM BUILDING & SAFETY,F`Ei LAN CHECK APPLICATION DATE to�ao wo PERMIl CHECK NUMBERpt-iiii In-In TYPE: 0 COMMERCIAL [ZIRESIQENTIAL 0 MULT14FAMILY 0 MOBILE HOME 0 POOVSPA 0 SIGN SUBTYPE: CADDITION OALTERATION QDEMOUTION OELECTRICAL OMECHANICAL 0 NEW W�LUMBING 0 RE-ROOF-NUMBER OF SCUARES— DESCRIPTION OF WORK Replace existing water heater. Same size and location. PROJECTADDREss 31445 Willowood Way qa�5% ASSESSOR'S PARCEL NUMBER LOT TRACT OWNERNAME MicheleCarr City of Menifee Building Dept— ADDRESS 31445 Willowood Way PHONE 951-505-1750 EMAL — OCT 2 0 2016 APPLICANTNAME Sierra Sprague R 0 ko V I v Ica; ADDRESS 30300 Puerta Vallarta PHONE 951-301-0067 EMAIL alistar.sierra@gmaii.com CONTRA wSNAmE. Sierra Sprague OWNERBUILDER? Cl BUSINESSNAME All Star Water Heaters. ADDRESS 30300 Puerta Vallarta Way PHONE 951-301-0067 EMAIL alistar.sferra@gmall.com CONTRACTOR'S STATE LIC NUMBER 812894 _ LICENSE CLASSIFICATION C36 VALUATIONS 800-00 SQFT L5QFT APPLICANT'S SIGNATURE DATE CITY 0 F MENI FEE iL SINESS LICENSE NUMBER ffi�L - - — D EPA" E14;TD NGINEERING FIRE IMP 'MRu EPAUMENT DISTil Ill PL4NNING ENGINEERING FIRE 6REEN SMIP =I Vol NLE PAIDAMOUNT OCASH OCHECK# 0 CREDrr CARD. YISA/MC AMOU 1 — PLAN 17 CHECK FEES PAID AMOUNT 0 CASH 0 CHECK# OCRIEDRCARID VWMC ai �'�4 OWNER BUILDER VERIFIED 0 YES 0 NO DL.NUMBER — NOFTARIZED LETTER 0 YES 0�NO City of Menifee Building&Safety Department 29714 Haun Rd.Menifee,C4 92586.951-672-6777 www,citVcfmenffee.us inspection Request Line 951-245-6213 (D -0 ,2 a E 0 g; > E U, E ID -F. ma a o E w M 0 o j- �w 0 0 0 2 E E E 0 0 _m t; 2 E E 2 E c n M a ow w w �E E o 15 1 c -@ :�� > - 8 8 �o A 2 .8 E E E 7i o 0" mw .2 cc cc E a 0 C' x C9 'Eb cc E m u o u E u 0 E wo cc o 15 E -5 c 0 0 LU wo Uw w" E 0� m % a CD 3a �o E wc E r= LU 6 m 'F 0 Z >1 X E TO w c (D C E 2 0 1 o a u 0 V cc E yw J(S z c o E 0 z .2 CO w 6 m 0 LO LU C14 E ww 0 CD E w 0 'o w U-) Q) >Ul -qf 4? 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