PMT16-04358 City of Menifee Permit No.: PMT16-04358
29714 HAUN RD. Type: Residential Plumbing
<A-CCIEU� MENIFEE,CA 92586
MENIFEE Date Issued: 12/2712016
P E R M I T
Site Address: 30263 NAPA ST, MENIFEE, CA 92584 Parcel Number., 360413-008
Construction Cost: $5,000.00
Existing Use: Proposed Use:
Description of REINSTALLALL HOT AND COLD WATER LINES,3/4"MAIN FEED TO HOT&COLD MANIFOLDS,40
Work: L FT COLD LINES,30 L FT HOT LINES, 1/2"TO ALL FIXTURES,300 L FT
Owner Contractor
STEPHANIE GARLAND DIAMOND PLUMBING
30263 NAPA STREET 24147 FALCONER DRIVE
MENIFEE, CA 92584 MURRIETA, CA 92562
Applicant Phone: 9515415500
STEPHANIE GARLAND License Number. 1005504
30263 NAPA STREET
MENIFEE, CA 92584
Phone:9093422659
Fee Description Div Amount
Plumbing Fixtures and Vents, fixtures 10 151.00
Piping/Repiping Single Family Residential 1 163.00
Building Permit Issuance 1 27.00
GREENFEE 1 1.00
General Plan Maintenance Fee-Plumbing 1 15.70
$357.70
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of emors 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_Pe"it Template.rpt Page 1 of I
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe projects
I hereby affirm under penalty of perjurythat I am under provisions of with a licensed contractor(s)pursuantto 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 Class License No. By my signature below I acknowledge that,except for my personal residence
Expires_Signature in which I m ust have resid ed for at least one yea r prior to completion of
improvements covered by this Farm it.I ca nnot lega Ily sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-buifder 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.u.gov/calaw.ht I
policy#
ci I have 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 ci 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 owners behalf.I have read this
number are: 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 this city or county to
Policy# Expires enter the above identified prop for ins�pejcon purposes.
(This section need not to be completed is the permit is for one-hundred t:�L� Date -7-7
dollars($100)or less
PROPERTY OWNER OR AUTHORIZED AGENT
ci I certify that in the performance of the work for which this permit is issued,
I shall 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 forthwith comply with those 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 specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS oYes oNo
UNLAWFUL,AND SHALL SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS($100,0001,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 for guidelines
CONSTRUCTION LENDING AGENCY o Yes o No
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 boundary of a school?
(Section 3097 Civil Code) o Yes o No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
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 oYes o 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRP)
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-certified 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
o 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 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 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. o No EPA Lead-Safe Certified Firm is required forthis project because:
)(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 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.
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DATE liv-0 PERMIT/PLAN CHECK NUMBER
TYPE: F-ICOMMERCIAL 50RESIDENTIAL EIMULTI-FAMILY OMOBILEHOME []POOL/SPA [:]SIGN
SUBTYPE: FIADDITION []ALTERATION ODEMOUTION [_]ELECTRICAL [:1MECHP&g-"yO' MenIf*
[:]NEW HPLUMBING 0 RE-ROOF-NUMBER OF SQUARES ng & Safety Dept.
DESCRIPTION OF WORK R-e-wr Q IXA-f- Q-� Od I h0t A 0-0 DEC 2 7 2 16
V 1,C c- 5�>\,kv'l-7-e CA \j-3o-2re-\r PpeeiWd
PROJEcTADDRESS 3 D 2- 6 3 1-�c��o- S+ o-e- 0-'A ot z
ASSESSOR'S PARCEL NUMBER 3(PC) - 415 LOT 133 TRACT 28 50Z>
PROPERTY OWNER'S NAME -Stc P in o' �0'y-%
ADDRESS M-cjr\j-Cf 4
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&v \oy\a 2-119 IIA5n D Vyl
PHONE EMAIL
APPLICANT NAME
ADDRESS -?)02-ia
PHONE -542- - 7-to ,59 EMAIL AD-r\o�r\(� 211C
CONTRACTOWS NAME E5�C6GILJ`) VC I e Z_ - _OWNERBUILDER? [-]YES[NNO
-D� 0, LLC,
BUSINESS NAME
ADDRESS LAD 5 '7 S 0-0-k 0 O-V- > 8 �- 1)2- 7
A
PHONE b4l — GFOOD EMAIL
CONTRACTOR'S STATE LIC NUMBER 10D 5 5 CD LICENSE CLASSIFICATION —C,3(o IXVLI;%Iq
VALUATION$ 5 , oco SO FT LSQFT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS L
BUILDING PLANNING ENGINEERING FIRE GREEN MIP
INVOICE PAIDAMOUNT -10
AMOUNT ;EERING OCASH C)CHECK# OCREDITCARD VISVMC
PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 No DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Soj'ety Department 29714 Houn Rd, Menijee, CA 92586 951-672-6777
wwvv.cityofrnenifee.us ln-s�oectioo Request Line 951-246-6213
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