PMT17-02826 City of Menifee Permit No.: PMT17-02826
29714 HAUN RD.
<'% E A� MENIFEE, CA 92586 Type: Residential Plumbing
MENIFEE Date Issued: 08/09/2017
PERMIT
Site Address: 28346 OASIS VIEW CIR, MENIFEE,CA Parcel Number: 340-260-012
92584 Construction Cost: $1,875.00
Existing Use: Proposed Use:
Description of REPLACE 50 GAL GAS WATER HEATER IN SAME LOCATION
Work:
Owner Contractor
JERRY JARRARD A R S AMERICAN RESIDENTIAL SERVICES OF
28346 OASIS VIEW CIR CALIFORNIA INC
MENIFEE,CA 92584 965 RIDGE LAKE BLVD SUITE 201
Applicant Phone:9012719700
ANDREW ALLEN License Number:765155
A R S INC DBA RESCUE ROOTER
1520 W LINDEN ST
RIVERSIDE, CA 92507
Fee Description OJt f Amount ISI
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_Bidg_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
hereby,affirm under penalty of perjury that I am under provisions of with a licensed contractors)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and o 1 am exempt from Iicensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Cl .l License No ��
qq By my signature below I acknowledge that,except for my personal residence
Expires 91 �� Signature inwhich l must have resided for at least one year priorto completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if R 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 ofself-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.legJnfo.ca.gov/mIaw.htmI.permit is issued.
Policy It Date
"Y"hcave and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
faction 3700 of the Labor Code,for the performance of the work for which o�Y my signature below lcertify to each of the following:)am the property
this permit is issued.My worker's compensation insurance carrier and policy 6 ner Or authorized to act on the property owner's behalf.1 have read this
number are application and the information I have provided is correct.I agree to comply
�VCwith all applicable city coon nances and state laws relating to
Cartier ,fit building stru .Iauth representatives of this city or county to
Polity# � a JG i I Expires enter th entifr arty for inspection purposes. /
(This section need not to be completed is the permit is 4r one-hundred Date 1 4
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
,orcertify that in the performance of the work for which this permit is issued,
I shall not emolov any perso in any mannersap to become subject to the CITY BUSINESS LICENSE#
worker's compensation s ofC l ia,a ree that If I should become HAZARDOUS MATERIAL DECLARATION
subject to the wor scorn ion ' ions of Section 3700 ofth Labor
Code,I shall fo ith -wit o so Ions. / Will the applicant or future building occupant handle hazardous material sure
Applicant Date S �( mixture containing a hazardous material equal to or greater that the
amounts spa fled on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATIO COVERAGE IS ❑Yes No
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($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Duality Management heconDistrict(SCAQM tionor modification
permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo guid Coast
Air
CONSTRUCTION LENDING AGENCY oYes �O
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 ,�No
OWNER BUILDER DECLARATIONS I have read the Hazardou aterial Information Guideand the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checkl1q,14ficlers a my require under the State of
Contractor's License Law for the reason(s)indicated below by the California Healt Saf de,Section and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous aria rting.
Business and Professions Code).Any city or county that requires a permit to �Tet n
construct,alter,improve,demolish or repair any structure,prior to its Date
issuance,also requires the applicant for the permit to file a signed statement ROPERTY OWNER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractor's 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 and Professions Code)or that he or she is exempt from Iicensure 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 fines 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 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.e oa.Rov�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 ❑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 for this project because:
o 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.
PERMIT/PLANBUILDING & SAFETY APPLICATION
ItMenifee
DATE -7 PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ADDITION ❑ALTERATION ❑DEMOLITION []ELECTRICAL [-]MECHANICAL
❑NEW ,JnPLUMBING []RE-ROOF-NUMBEROFSQUARES
DESCRIPTION OF WORK G QL Sv IOn a cr hcafc•� h jqt><+c ��c.a{Yon
PROJECTADDRESS VIew
ASSESSOR'S PARCEL NUMBER �JQ� -���, LOT TRACT
OWNER NAME Je yr �.f r
ADDRESS JR.jLj1p , e4i CGS lVjenj (-A IF105f
PHONE rl.w - ('7.1 • 0 yoo EMAIL
APPLICANT NAME l Lr�
ADDRESS `I`J&x, ` ;1-1Z7
PHONE qS- I '.'�y l - `t3"1 1 EMAIL
CONTRACTOR'S NAME OWNER BUILDER? ❑YES NO
BUSINESS NAME C-je- o-N-
ADDRESS I S L- (4C• Si-- ,ve-s>,Ae c_N GkSa•7
PHONE -5 1 , I f 1 -1,3'T 1 EMAIL
CONTRACTOR'S STATE LIC'NUMBER -7(�SIS-�- - LI ENSE CLASSIFICATION C-
VALUATION $ L SO FT
APPLICANT'S SIGNATURE DATE �I9Il�
OTYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP X
INVOICE
AMOUNT • 1 PAID AMOUNT 11 -CASH 0CHECK# %CREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT \ OCASH C:CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED C=YES 0 NO DL NUMBER NOTARIZED LETTER C YES ,`, NO
City of Menifee Building &Safety Department 29714 Houn Rd. Menifee, CA 92586 9.51-672-6777
www.cityoflnenifee.Us Inspection Request Line 951-246-6213
a
m o .�
i e N ; E
a '
c 3 O
E
y w x nd m w v o
wkrc p 'c Ina•�,1 I- c 3 In m �o
O Y :6 Q °
> K 7
M N 1p O d a N « dl
T'0 d W a d C m C ?+ p
W p Q O O T
o w a =y o mM° m e w
OC3 3 3 c L a s « E f
.9 6 pp C ^ E Y O O O
Q E � ° c u
1 N � Ip vl u`. � N L 3 a � •C d gyp,
�• U' LL •a U V G V W N
c
l.1 c J O j y V N t+ O C W
N 3 O C 7 N a C u V 'p
❑ ❑ •-I W o[ L d d lan m O O C
eu u U w
T^• m `a a z u v
a U
2l 3 .c ?i a
C W � O N E u O t u
m
F o 2 p L d E e v
N n o° o
" �+ d > N 'a o
y a O a > c•6 `o Y yyyayyy��� in to U
' •� E ~ d U S m C N C
T U W a a+ C U
Noon
J o " -
9 > > o` E c 34
p u v E
Wv � 3 v E u 'SIn v
K - d d 76 yaI d •C c a C
« ¢ a d t4 CF C x iI 0 0
F U' c c m A .10.
• r d .- 9 = a d « E E ryry Cry
y N O -ts
LO a v c E
S r d d a u E w _ Z o 'n E vl
�S' d T m v E v E 00 e I�C
t ��'• d o « .�d.. c w o v u o E p y ry cry
� o Z Q � w � m v o c •9 �' L c a
F U O U Fes- cA C v
.o c o o d
z a
w O a Y M qp O
J Y O C Z L hp W C 7 .0 C N Y `y a « m
QS yc m d a d a
U u E W ,� N N N d T Z a y U w U d d ' d E
ON =�j
z — 0 3 ~ 2 m 'o c u rci o m m m y
W `o FY � EEsv � 33 � 3x
LLWzu a Z �
06.e• 'CI N Q 1-I +d+ F d U E N tV tii
� w � � 3xdu�aicpz 49
a W w �, +• �+ a Q m m o 0
H R'pu o. Qin u (9 33 of m .'{+ z 5
i
_
o °
N LL y
C, ?
Q. G N Ul d tg = m
zv � v vYvy� � v
N d J J
3 q 3 0 0 a a,
c a
Iq Y 2' m Y juj
K
i E v
`m
w 3 c c H
C E
J LL 12 ` 0 N 1V
o - T^ *
LL J o m E s o m o` v `'
c m
BM
Y W N '^ hp N 'O 1
u w Z' m = m D u C
3 YLi E Yo ? w N c v N t @�
.� y m w° v m .a �, c �j x1
E Y m
r m LO v u W �' +`+ ix `
c m fn m o
d c m ° E w m o y N E ui m
y 2 wa cY C Fy' M
m uT N .= L a N N U 1 ❑ n
ry m 'C Y L m C Yry •�' J -p Y Q �1�
m w 3 N .a°- w C N E �
m A E \ O = O 1YA W
o c Yn E u
3 a+ o o
o. �
Lo L^ c J ; v w w tJ
u
L J
c o E a s i° d z a a J i. 3 Y m m
> �. c E 'G 3 o H me o o 'u° m c
-43
L Y Y u •J C E = LL E p
m E L um. .mc o E y ° �, o °` E fi3 i c ci a .
�' 1'' w a
p� �°i n E ii t o
rii w 3 J *' = Ym o• c 1 O v O C
W C C m �°n m
yN Y w '�c
V Y Y E N G W B W j :+ m w i7 a U U
a w s 3 E " o w w � a 0 N o m
J _
<+ u ci Ly o '5
m N 1 i tl'OW K E v n J E A m w wo' m m o 3 = Q n sFLm
m Z N 3 E W m z x x v, m u 9 ❑ r M W
lL C ui 1p i.: CO ai O .�4-� `.� vii .�-1 �N-I '� c N Y N
H cLi 7 y ui
a y u u E E v m
L
U o. ❑ z 8 ¢