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PMT16-03545 City of Menifee Permit No.: PMT1 6-03545 29714 HAUN RD. <A—CCELA—> MENIFEE, CA 92586 Type: Residential Plumbing MENIFEE Date Issued 11/07/2016 P E R M I T Site Address: 29183 EL DORADO WAY, MENIFEE, CA Parcel Number: 351-232-006 92587 Construction Cost: $800.00 Existing Use: Proposed Use: Description of REPLACE EXISTING WATER HEATER,SAME SIZE AND LOCATION Work; Owner Contractor ELIZABETH JARAMILLO ALL STAR WATER HEATERS INC 29183 EL DORADO WAY 30300 PUERTO VALLARTA WAY MENIFEE, CA 92587 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 Qtv Amount 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�131cig_PermILTemplaterpt Page 1 of 1 City Of Menifee LICENSED DECLARATION 11 1 am exempt from licensure under the Contractors'State License Law for the I hereby affirm under penalty or perjury that I am licensed under provisions of following reason: Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that,except for my personal residence in Professions Code and my license is in full force and effect. which I must have resided for at least one year prior to completion of License Class 74- License No. PIRP improvements covered by this permit, I cannot legally sell a structure that I have built as an owner-building if it has not been constructed in its entirety by licensed Expires Un-, Zo Signature contractors. I understand that a copy of the applicable law, Section 7044 of the WORKERS'CO ION DECLARATIO Business and Professions Code,is available upon request when this application is 0 1 hereby affirm under penalty of pedury one of the following declarations: submitted or at the following Web site: I have and will maintain a certificate of consent of self-insure for workers' hfto.,I/www.ieqfnfo.ca.gov/calaw.htmi. compensation,issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of work for which this Date permit is issued. Property Owner or Authorized Agent Policy# 0 By my Signature below, I certify to each of the follovving: I am the property OV, I have and will maintain workers' compensation insurance, as required by owner or authorized to act an the property owner's behalf. I have read this section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to comply permit is issued.My workers'wmpensafion insurance carder and policy number are. with all applicable city and county ordinances and slate laws relating to building construction.I authorize representatives of this city or county to enter the above- Carrier ide I'll d rop!!��fttr the inspection purposes. Policy# eA,5, erfW9a1&Expires RX//A :?02� -Date Properlyodwrigol'Authorized Agent (This section need not be completed if the permit is for one-hundred dollari-(_$1 00)or less) City Business License# 0 1 certify that in the performance of the work for which this permit;s issued,I HAZARDOUS MATERIAL DECLARATION shall not emplo any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a workers'compensation laws of California,and agree that if I should become mixture containing a hazardous material equal to or greater that the subject to the workers'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide? Code,I shall forthwith comply with those provisions. DYES 0 NO Applicant; Date; Will the intended use of the building by the applicant or future building occupant require a permit for the construction or modification from South WARNING, _'��A�ILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ES ONO ($'100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of a school? LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES 0 NO CONSTRUCTION LENDING AGENC I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm that under the penalty of pedury there is a construction lending permitting checklist.I understand my requirements under the State of agency for the performance of the work which this permit is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning 3097 Civil Code) hazardous material reporting. OWNER BUILDER DECLARATIONS DYES ONO I hereby affirm under penalty of pedury that I am exempt from the Contractor's Date License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT next to the applicable item(s)(Section 7031.5.Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, EPA RENOVATION,REPAIR AND PAINTING(RUP or repair any structure, prior to its Issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors provisions of the Contractor's State License Law(Chapter 9(commencing with receiving compensation for most work that disturbs paint in a pre-1 978 Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childrare facility to be RRP-cerlified firms and comply with she is exempt from ficensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property Violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their a civil penalty of not more than($500).) employees.For more information about EPNs Renovation Program visit www.epa.gov/lead or contact the National Lead Information Center at 1, as owner of the property, or my employees with wages as their sole 1-800424-LEAD(6323). compensation,will do( )all of or( )porting of the work, and the structure i's not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property 0 An EPA Lead-Safe Certified Renovator will be responsible for this project who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, Certified Firm Name: the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). Firim Certification No.: 0 1, as owner of the property an exclusively contracting with licensed 0 No EPA Lead-Safe Certified Firm is required for this project because: contractors to construct the project(Section 7044, Business and Professions Code:The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who contracts for the pmjects with a licensed Wntractor(s)pursuant to the Contractors State License Lawt If vour nrnipp.t dnp. nnt mmniv with rPA PPP nila nl­­r.11­ft��omn "fox. " U, ;�"It &D mW DATE IkWiv PERMIT/PLAN CHECK NUMBER ftA nAa 0 26CAP-5 TYPE: 0 COMMERCIAL ZRESIDEN-nAL 0 MULTI-FAMILY -0 MOBILE HOME 0 POOL/SPA Q SIGN SUBTYPE; OADDITION OALTERA71ON ODEMOLITION OELECTRICAL OMECHANICAL 0 NEW RJLUMBING 0 RE-ROOF-NUMBER OF SQUARES_ DESCRIPTION OF WORK Replace existing water heater. Same size and location. PROJECTADDRESS 29183 El Dorado Way - -- *�_,� ASSESSOR'$PARCEL NUMBER LOT BuilakAgiDept OWNER NAME Elizabeth Jaramillo NOV 9 2 2w- ADDRESS 29183 El Dorado Way PHONE 213-304-1421 -- EMAIL — Received APPLICANTNAME Sierra Sprague ADDRESS 30300 Puerta Vallarta PHONE 951-301-0067 EMAIL allstar.slerra@gmall.com CONTRAcroWS NAME Sierra Sprague 0 YES.460 BUSINESS NAME All Star Water Heaters ADDRESS 30300 Puerta Vallarta Way PHONE 951-301-0067 EMAIL alistar.sierra@gmail.com CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36 VALUATION$ 800-00 SQ FT L SO FT APPLICANT'S SIGNATURE TE I-DEPARTMENT DISTRIBUTION BUILDING PLANNING ENGINEERING FIRE GREE SMIP = I kz!� PAID.AMOUNT OCASH OCHECK9 0 CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/K4C OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO City of Metgfee f3,jildfing & 5afety Deparvnefit29714 Haun Rd.lVienifee, CA 92586-951-672-6777 vvww.cityofweriifee�us Inspection ReqUest Line 951-246-6213 _0 E 0 E $2 .2 t 2 Ic L2 0 Ae Ic CL w 2 Mo m m 0 0 ba tic E to w LU 4; 0 14 3: , w W z E E 0 0 .0 S: c CL —bD c .2 c > zz w w all m w E o .5 B E li t 0 v 8c, — , W >4 w m w 0 M -, 0 u , , W , E ',5 90 x o " Em .2 o 3,L Z Q ly w 2 E oil r c Ix -2 E m E J9 f w w 0 u no c F6 -a �o t2 E m E o *15 a m 0 UJ 0 c 0 w ly rn m c 3 a LU — 0. 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