PMT17-00938 City of Menifee Permit No.: PMT17-00938
29714 HAUN RD.
SACCELh? MENIFEE,CA 92586 Type: Residential Plumbing
MENIFEE Date Issued: 03/29/2017
PERMIT
Site Address: 26945 PINHURST RD,MENIFEE, CA Parcel Number: 338-061-006
92586 Construction Cost: $8,500.00
Existing Use: Proposed Use:
Description of REPLACE 2"DRAIN UNDER CONCRETE&3"DRAIN UNDER CONCRETE FROM WASHER
Work: LOCATION TO BATHROOM TO FRONT CLEANOUT
Owner contractor
LAURA CLOUGH ACCURATE LEAK LOCATORS INC
26945 PINEHURST RD 26025 NEWPORT ROAD#A 413
MENIFEE, CA 92586 MENIFEE,CA 92584
Applicant Phone:8883335325
TONY FALCO License Number: 850152
ACCURATE LEAK LOCATORS INC
26025 NEWPORT ROAD#A 413
MENIFEE,CA 92584
Fee Description QA Amount IS)
Piping/Repiping Single Family Residential 1 163.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Plumbing 1 8.15
$199.15
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 staled,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_Permit_Template.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 o I am exempt from licensure underthe Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class C License No. Z:.Au F�-7 a By my signature below I acknowledge that,except for my personal residence
Expires /j Signature in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that 1
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed In its entirety by
❑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 www.leginfo.ca.gov/calaw.htmi.permit is issued.
Policy# w-lalqualeel Date
❑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 ❑By my signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
number are:: 1 application and the information I have provided is correct.I agree to comply
Carrier 104clI ar_ Jro rJ withal]applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# bt. d-o� Expires__/�2/3 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 employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply wit ose 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:FAI TO CURE WORKER'S COMPENSATION COVERAGE 15 o Yes o�No
UNLAWFUL,AND;HAUL SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES Will the intended use of the building bythe applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit forthe 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 ❑Yes FNo
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 /-b 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
Contractors License Law for the reasons)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting. _— ..
s _._
oyes �CFIo
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 NE R 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRP)
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($500). managers who do the paint-disturbing work themselves or through their
❑1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.gov/lead or contact the National Lead Information Center at
not intended or offered forsale.(Section 7044,Business and Professions 1-80G-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a
property who,through employees'or personal effort,builds or Improves the o An EPA Lead-Safe Certified Renovator will be responsible forthis project
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. in No EPA Lead-Safe Certified Firm is required for this project because:
❑I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING i A APPLICATION
Menifee
DATE PERMIT/PLAN CHECK NUMBER t 09 39
TYPE: v'COMMERCIAL Z!5�RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: 0 ADDITION O ALTERATION O DEMOLITION O ELECTRICAL C MECHANICAL
ONEW ,YPLUMBING ORE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK /l /LJ (./ By C'UN B
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PROJECTADDRESS 2��ppTiN� ♦��—�
ASSESSOR'S PARCEL NUMBER 3;�p "C�(�t-C�(o LOT TRACT b
OWNER NAME
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PHONE q ,/ [/(� - _��Q(o EMAIL
APPLICANT NAME S ,o 10/)cwg G 6
ADDRESS A IaOyjP O I
PHONE ��l_�y� 4a� y EMAIL td 2$ l )M
CONTRACTOR'S NAME —;rOAIY OWNER BUILDER? O YES O.' ,NO
BUSINESSNAME O� Y/JALJ c'� Gr /•U
ADDRESS U
PHONE c.�,�) _�c[� _(�,� EMAIL
CONTRACTOR'S STATE LICC NUMBER f SQ�� LICENSE CLASSIFICATION
VALUATION $ W60MB SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE
OTYSTAFFUSEONLY
DEPARTMENT 015TRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT AMOUNT I I OCASH OCHECK# O CREDRCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
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:heck A License - License Detail Page 1 of
Contractor's License Detail for License # 850152
DISCLAIMER:A license status check provides information taken from the CSLB license database. Before relying on this
information,you should be aware of the following limitations.
CSLB complaint disclosure is restricted by law(B&P 7124.6)If this entity is subject to public complaint disclosure,a link for complaint disclosure will appear below.Click on the
link or button to obtain complaint and/or legal action information.
Per B&P 7071.17,only constructlon related civil judgments reported to the CSLB are disclosed.
Arbitrations am not listed unless the contractor fails to comply with the terms of the arbitration.
Due to workload,there may be relevant information that has not yet been entered onto the Board's license database.
Business Information
ACCURATE LEAK LOCATORS INC
26025 NEWPORT ROAD#A 413
MENIFEE, CA 92584
Business Phone Number:(888)333-5325
Entity Corporation
Issue Date 11/19/2004
Expire Date 11/30/2018
License Status
�fhis license is current and active.
IIp 11 information below should be reviewed.
Classifications
B-GENERAL BUILDING CONTRACTOR
C36-PLUMBING
Bonding Information
Contractor's Bond
his license filed a Contractor's Bond with WESCO INSURANCE COMPANY.
Bond Number: 04WB053042
Bond Amount: $15,000
Effective Date: 01/01/2016
ontractor's Bond History
Bond of Qualifying Individual
he qualifying individual ANTHONY MICHAEL FALCO JR certified that he/she owns 10 percent or more of the voting
tock/membership interest of this company;therefore,the Bond of Qualifying Individual is not required.
ffective Date: 11/19/2004
Workers'Compensation
This license has workers compensation insurance with the PACIFIC COMPENSATION INSURANCE COMPANY
Policy Number:WA002681
Effective Date: 12/30/2016
Expire Date: 12/30/2017
Workers'Compensation History
ttps://www2.cslb.ca.gov/OnlineSetvices/CheckLicenscII/LicenseDetail.aspx?LicNum=850152 3/29/201