PMT16-03465 City of Menifee Permit No.: PMT1 6-03465
29714 HAUN RD.
'1;kCCIEI-A--> MENIFEE,CA 92586 Type: Residential Plumbing
MENIFEE Date Issued: 10/2112016
P E R M I T
Site Address: 29806 CORAL TREE CT, MENIFEE, CA Parcel Number: 340-073-014
92584 Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING WATER HEATER, SAME SIZE AND LOCATION
Work:
Owner Contractor
JAMES PETTERSON ALL STAR WATER HEATERS INC
29806 CORAL TREE COURT 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92584 MENIFEE,CA 92584
Applicant Phone:9513010067
SIERRA SPRAGUE License Number: 812894
ALL STAR WATER HEATERS INC
30300 PUERTO VALLARTA WAY
MENIFEE,CA 92584
Fee Description City Amount($)
Residential Water Heater 1 83.00
Building Permit Issuance 27.00
GREEN FEE 1.00
General Plan Maintenance Fee-Plumbing 4.15
$1115.15
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 bufliding operations being carded 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_Pemii1-Temp1ate.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 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 Ciao—C-?�'( c License No. a L( By my signature below I acknowledge that,except for my personal residence
Expires Signature I.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
WORKER'S COMPENSATION DECLARATION have built as a n owner-builder if it has not been constructed in its entirety by
a 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 a nd 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. wiviv.leginfiti.ca.gowricalaw.htmil.
Policy# Date
V have and will maintain workerrs 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 a in the property
this permit Is issued.My worker's compensation insurance ca rrier and policy owner or authorized to act on the property ownees 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 A-r.r-_ building construction.I a uthorize representatives of this city or county to
Policy#g I�C c aqq-I q"F'�p r—., enter the above identiffied 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
a I certify that in the performance of the work for which this permit is issued,
I she 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 shall In it!b mply 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,/_'__,o� Date amounts specified on the Hazardous Materials Informatio.n Guide?
tLARNING-FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS uYes ONO
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the Intended use of the building by the applicant or future building
AND CJVIL FIN ES 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 forguidellnes
CONSTRUCTION LENDING AGENCY Oyes ONO
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 100D feet of the
lending agency for the performa nce of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) Oyes ONO
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permittling checklist.I understand my requirements underthe 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 Oyu c 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 Contractoes State EPA RENOVATION,REPAIR AND PAINTING(RRPJ
License Law(Chapter 9(commencing wifth 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 exampidon.Any Violation of Section 7031.5 by residence or childcare facility to be RRP-certhfied firms and comply with
a n Applicant for a permit subjects the applicant to a civil penalty of not mom required practices.This Includes rent@(property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
c 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( )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 a nd Professions 1-800-424-LEAD(5323)o
Code;The Contractor's 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 employeee 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. o No EPA Lead-Safe Certified Firm Is required for this project because:
a 1,as owner of the property am exclusively contra citing 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
BUJLDING�& SAFETY PERIVINPLAN CHECK APPLICATION
Menif-ep
DATE PERMIT/PLAN CHECK NUMBER
TYPE: OCOMMERCIAL ORESIDENTIAL CMULTI-FAMILY OMOBILEHOME OPOOLISPA OSIGN
SUBTYPE: CADDITION CALTERATION 0DEMOUTION OELECrRICAL OMECHANICAL
ONEW RIPLUMBING 0 RE-ROOF-NUMBER OF SQUARES—
b8cwpnoN OF WORK Replace existing water heater. Same size and location.
PROJECTADDRESS 29806 Coral Tree Ct CGSS LA
ASSESSOR'S PARCEL NUMBER :3LV0-0—G-0jq LOT TRACT
OWNER NAME Patterson James rjtv oi Menit'
ADDRESS 29806 Coral Tree Ct j3u'ilding DePI
PHONE 714-478-7721 EMAIL OCT 7
APPLICANT NAME Slerra Sprague
30300 Puerta Vallarta
ADDRESS Received
PHONE 951-301-0067 EMAIL alIstar.sierra@gmail.com
coNTRAcrotes NAME SIENTEI SPragUe QWNERBUILDER? OYES)tNO
BUSINESSNAME All Star Water Heaters
ADDRESS 30300 Puerta Vallarta Way
PHONE 951-301-0067 EMAIL alistar.sierra@_gmall.corn
CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36
VALUA11ONS 800-00 SO FT L SO FT
APPLICANT'SSIGNATURI--._..,�f��� DAT
MPARTMENT DISTRIBUTION ICENSENUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
= I kk5o k-t—) I PAID AMOUNT 1 1\45-�5 1 0 CAV 0 CHECK# 0019DITCARD VISA/MC
PLAN CHECK FEES I PAIDAMOUNT L 0 CASH OCHECK# OCREDITCARD VISAIMC
OWNER BUILDER VERIFIED OYES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO
City of monffee Building&Safety Deportment 29714 Houn jRd. Menifee,CA 92586 951-672 6777
www.citycfmeniFee.us Inspectlon Request Line 951-2246-6213
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