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
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EPAUMENT DISTil
Ill PL4NNING ENGINEERING FIRE 6REEN SMIP
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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
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