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PMT16-04500 City of Menifee Permit No.: PMT16-04500 29714 HAUN RD. Type: Residential Plumbing 5ACCELA> MENIFEE, CA 92586 MENIFEE Date Issued: 12/2812016 P E R M I T Site Address: 26146 BALDY PEAK DR, MENIFEE, CA Parcel Number. 338-251-020 92586 Construction Cost: $1,500.00 Existing Use: Proposed Use: Description of REPLACE 40 GAL WATER HEATER, SAME SIZE&LOCATION Work: Owner Contractor STEVEN LEACH AFFORDABLE WATER HEATERS AND PLUMBING 26146 BALDY PEAK DR INC MENIFEE, CA 92586 28358 CONSTELLATION ROAD#698 Applicant Phone:8553459087 DANIEL MATA License Number:627368 AFFORDABLE WATER HEATERS AND PLUMBING INC 28358 CONSTELLATION ROAD#698 VALENCIA, CA 91355 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 carfied 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_Perrnt-TeMplate.rpt Page 1 of I CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe prcjects 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). Cha pter9(com mencing with section 7GOO)of Division 3 of the Business and a I am exempt from licensure under the Contractoes State License Law for Professions Code an d my license is in full forcai and effect. the following reason: 1 4 No. By my signature below I acknowledge that,except for my personal residence Licari Cl�� 2== E.pir:��4% Slgnature� J in which I must have resided for at least one year priarto completion of (�� 1// improvements covered by this permit.I cannot legallysell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by cs 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 workees 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.legfnfo.ca.gay/calaw.html. Policy# Date iI have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT el,tion 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 worker's compensation insurance carrier and policy owner or authorized to act on the property ownees behalf.I have read this number are: application and the information I have provided Is correct.I agree to comply rk'K, C with all applicable city and county ordinances and state laws relating to Carrier V — /), building construction.I authorize representatives of this city or county to Poficy#VIY�WSILMQQ _Expires I enter the above identified 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 o I certify that in the performance of the work for which this permit Is issued, I shall not emoloy any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 05051-a' workeescomp sation laws of California d agree that if I should become HAZARDOUS MATERIAL DECLARATION subjecttothew rker'scompens ion visions of Section 3700 of the Lapis Code,isha o with comp se prov ns. Will the applicant or future building occupant handle hazardous material or a Appill Date mixture containing a hazardous material equal to or greater that the annountt�s s9pe ified on the Hazardous Materials Information Guide? WAR a:FAILURE TO ESERE WEORKER'SCOMPENSATION COVERAGE IS cs Yes 0 UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVI L FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000 Will the intended use of the building by the applicant or future building ),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Qua lity Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guicielif��( CONSTRUCTION LENDING AGENCY oyes 0 1 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 b dary of a school? (Section 3097 Civil Code) o Yes 0 OWNER BUILDER DECLARATIONS I have/eadthe Hazardous Material InVirriation Guide and the SCAQMD permitting checklist.I understand mXrequirements undertheState of I herebyaffirm under penaltVof perjurythat I am exemptfrom the C I`f " HaaIth&SafeTVLQae, ction25505an 25534concerning contraictoes License Law for the reason(s)indicated below by the h:,',Or' 'm: checkmark(s)I have placed next to the applica ble Item(s)(Section 7031.5 Eo Business and Professions Code).Any city or county that requires a permit to 7, construct,alter,improve,demolish or repair any structure,prior to its �41'71/Z rg,/; Date issuance,also requires the applicant for the permit to file a signed statement (�WfflftV_NER O�,91MCTAIE-DAGENT that he or she is licensed pursuant to the provisions of the Contractoes State EPA RENOVATION,REPAIR AND PAINTING IRRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Business a rid 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 a n Applica nt for a permit subjects the applicant to a civil pena Ity of not more required ismalces.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their cs 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( )all of or( )portion of the work,and the structure is www.epa.gov/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 ci An EPA Lead-Safe Certified Renovator will be responsible for this project property who,th rough am ployees'or persona I 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. rs No EPA Lead-Safe Certified Firm is required for this pmject because: 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 role please fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION �,,,&V Wenifee PERMIT/PLAN CHECK NUMBER DATE /\u TYPE: O- COMMERCIAL )(RESIDENTIAL OMULTI-FAMILY " MOBILEHOME OPOOL/SPA OSIGN SUBTYPE: OADDITION CALTERATION 0DEMOUTION CELECTRICAL OMECHANICAL ONEW %,PLUMBING 0 RE-ROOF-NUMBER OF SQUARES— DESCRIPTION OF WORK PROJECTAIDDRESS ASSESSOR'S PARCEL NUMBER 06t'OLOT —UY2-� TRACT PROPERTY OWNER'S NAME ADDRESS -q,(0�0(0 C�A PHONE kijl�, EMAIL APPLICANT NAME oAp-4�, Ii., w,\A-% ADDRESS tAtAC PJIC, PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? 0 YES ONO BUSINESS NAME ADDRESS PHONE %(A,5 - 00 EMAIL CONTRACTOR'S STATE LIC NUMBER LMSIA LICENSE CLASSIFICATION VALUATION $ SQF9 LSQ FT APPLI NrS SIGNATURE4Z— ----------WkTE N�—A� CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION Lily 01-mENIF=EEBU INESS LICENSE NUMBER PLANNING ENGINEERING -REEN SMIP BUILDING FIRE G INVOICE PAIDAMOUNT 0 CASH 0 AMOUNT IF)- 1 '5 1 CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES I PAIDAMOUNT 0 CASH 0 CHECK If 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED 0 YES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO City0f fV7-11f9e SUdding&Scfety Depertment29714,�Oun Rd. Menifee, CA 92586951-672-6777 www.dtyofmenifee.us Inspection Request Line 951-246-6213 n M, ;a I m om > (0) 9DZ Fn r, m EL 3 z m I 0 . A M 3: a m 0 m fwl z 0 00. n > ;, M EP -R p o - X F 0 0 > - , W a m -n o 0 0 Z4 > z CL ct n > wq 0 M Et m all = w E: = 0 > z -1 0 -M m m EY (a CO) 0 CD 3 m 3 Ac- CD 0 M z 3 cn Q 3 CD (D rn 9L :E 5' EL :E 0 rn 77 0 0 !r 3 L3� q o n :E 3 r) M 5,1 0 m co OL OID C-3 3 3 F 90 0 w 0 = 3 W < 3 C. iF 3 > P. E: E3 M 0 2. ER ur 3 m w R C N 0 P 3 046-00 LU 0 0 LU Al. 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