PMT17-01266 City of Menifee Permit No.: PMT17-01266
29714 HAUN RD.
�!-�CCEL/-> MENIFEE, CA 92586 Type: Residential Alteration
MENIFEE Date Issued:
04I24/2017
PERMIT
Site Address: 27565 BOSTON DRIVE, MENIFEE, CA Parcel Number: 335-273-031
92586 Construction Cost: $10,300.00
Existing use: 1 &2 Family Residence Proposed Use:
Description of 2 BATHROOM REMODELS, DEMO FIBERGLASS TUB/SHOWER, INSTALL NEW SHOWERS,
Work: REPLACE VALVES,TILE SHOWER WALL AND BATHROOM FLOOR.
Owner Contractor
THOMAS FISH FITZHAUER CONSTRUCTION INC
27565 BOSTON DRIVE 1114 E TRUSLOW AVENUE
MENIFEE,CA 92586 FULLERTON, CA 92831
Applicant Phone:7145161120
MENIFEE,CA License Number: 1007403
Phone:7143132739
Fee Description O._yt Amount IEI
Plumbing Fixtures and Vents,fixtures 8 141.00
Building Permit Issuance 1 27.00
Inspections not specified 129 129.07
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 6.45
General Plan Maintenance Fee-Plumbing 1 7.05
$311.67
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_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 D 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 GM , 3(!LSI9 License No. LWI�O-7l y g g p y personal residence
ram— B my signature nature below I acknowledge that,exce tfor m
Expires 9'3 O"Z017 Signature Veer 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 I
c 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
this permit is issued. www.Iexin fa.ca.gov/calaw.html.
Policy#
Date
11 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 D 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 owner's behalf.I have read this
number are: 11ll�� application and the information I have provided is correct.1 agree to comply
Carrier bC STe�\llS - CC with all applicable city and county ordinances and state laws relatingto
p » building construction.I authorize representatives of this city or county to
Policy# Expires 0L7 enter the above identified property for inspection purposes.
(This section need not to he 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,
Ishallnotemolov 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 t ith comply with those provisions. i� Will the applicant or future building occupant handle hazardous material or a
K Applicant Date —2 ` mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:kILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes d6ho
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($500,000),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 forguidelines
CONSTRUCTION LENDING AGENCY ❑Yes 40
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 boundary of a school?
(Section 3097 Civil Code) o Yes 01go
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
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
hazardous at ri I r porting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes X. �s ,J
Business and Professions Code).Any city or county that requires a permit to Date \Z_l—�7
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY O TIER 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 r EPA RENOVATION,REPAIR AND PAINTING(RRPI
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 properly
than($500), managers who do the paint-disturbing workthemselves or through their
❑I,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.eov/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
property who,through employees'or personal effort,builds or Improves the D An EPA Lead-Safe Certified Renovator will be responsible for this 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. 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 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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
"'Menifee
DATE '2 1 PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL * RESIDENTIAL O MULTI-FAMILY O MOBILE HOME OPOOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OFWORI�,� /}T%*L00t,\ berlo i SNc,u�G�,
Sn
PROJECT ADDRESS �y pU (—TT ' 19?h�I`6, r c2
ASSESSOR'S PARCEL NUMBER 3 35 -Z-13--031 LOT -1 D TRACT
OWNER NAME U(Y) F
ADDRESS
q Z 5(a , I 0STON 17. n-�`�.I(- U/\ CT-T meniteo
1fl PHONE - 1'72 -0D(07 EMAIL BUIIdin9 &SB Y
APPLICANT NAME 5T- ItcN I Pig a_ APR 2 4 2011
ADDRESS 1 i 0MT (- C A
PHONE ��- 31�-Z,7� EMAIL
CONTRACTOR'S NAME NbZ - OWNER BUILDER? O YES C NO
BUSINESS NAME 9,uF(L C..t2 CT-6 vC,-vM,0 04
ADDRESS 1�U Camvu- ptuc- P7(L L,IV CA LD 7-
PHONE bt) S-79- 507c1 EMAIL
CONTRACTOR'S STATE LIC NUMBER AW071t03 LICENSE CLASSIFICATION $ ((O Cw 1p C3
VALUATION$ 1 C)1 3C0 ' SO FT L SO FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITYO ENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN I SMIP
INVOICE 31� G"j'1 PAIDAMOUNT O A/AMOUNT l CASH OCHECK# OCREDITCARD VIS MC
PLAN CHECK FEES PAIDAMOUNT I OCASH O CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92596 951-672-5777
www.cityofinenifee.us Inspection Request Line 951-246-6213
clr
RUl
Fish Final Scope PLAT
REVII
Guest:
Demo shower enclosure&remove vinyl flooring-half bath demo (leave vanity area) *APArogti
R/R toilet epprow a
Install Acrylic shower pan lo6S$eu
-saw cut for new drain location approx. 30"
Install 12"x 12" porcelain tile on shower walls to ceilings-stacked-grout joints 1/8"—total 83s.f.
-use bullnose for all exposed edges(includes walls/niches/window)
Install (2) niches—location TBD by client
Install 6" glass mosaic band across all walls-total up charge 6 s.f. ....�
Install (2)grab bars w/backing CL
Install new valve and trim O
-Raise shower head 10" U 1
Install 12"x 12" porcelain floor tile—diagonal-grout joints 1/8"—total 30s.f.
Install bullnose tile as base—total 121f. V'
LL
Paint walls/ceiling and door—total 189 s.f.
City of Menifee
Building & Safety lDept,,
APR 2e81 ``
Received
DF0EA
)IAA
r�
. : 'VED BY
l
/ der\te�epq.
%h o'M Sagokv
j
� I J
FEE
SAFFY DI
I AL v
i
A not be woM
ant'P t
I v i i This set of aW
I
I i
I �
t
f.,
i .
�h
Fish Final Scope
Master: 3pRTMENT
Demo shower enclosure&remove vinyl flooring-half bath demo (leave vanity area)
R/R toilet
Install new acrylic tub enclosure
Dl
-move drain 2" (should be within sandbox)
Install (2)grab bars w/backing—location TBD by Client aobeg"MO 0f,or1
hefeder�I�sabotdtM
Install new valve and trim ,donnrdstpekePt
-Raise shower head 10"
Install 12"x 12" porcelain floor tile—diagonal-grout joints 1/8"—total 30s.f.
Install bullnose tile as base—total 121f.
Paint walls/ceiling and door—total 189 s.f.
01 ek-
QR
f
s
o y _njLoi_
�y
O\VJ SOW
G
Tool