PMT17-03430 City of Menifee Permit No.: PMT17-03430
29714 HAUN RD.
'CA — MENIFEE, CA 92586 Type: Commercial Plumbing
MENIFEE Date Issued. 0 912 9/2 01 7
PERMIT
Site Address: 29950 MURRIETA RD, MENIFEE, CA Parcel Number: 338-160-017
92586 Construction Cost: $2,000.00
Existing Use: Proposed Use:
Description of REMOVE AND REPLACE WATER HEATER. SAME SIZE(40 GALLON)&SAME LOCATION.
Work:
Owner Contractor
PATRICK J.ASHER ORANGE COAST PIPE MECHANICAL INC
12707 HIGH BLUFF DRIVE SUITE 200 4060 MISSION BLVD
SAN DIEGO, CA 92584 MONTCLAIR,CA 91763
Applicant Phone:9096225400
JOSEPH PAPEZ License Number:484132
ORANGE COAST PIPE MECHANICAL INC
4060 MISSION BLVD
MONTCLAIR,CA 91763
Fee Description r t r Amount 151
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_Bldg_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractors)pursuant to the Contractors State License Law).
hereby affirm under penalty of perjury that 1 am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is In full force and effect. the fallowing reason:
License Class 6i � 3 6 Ucen§e No. y '
By my signature below I acknowledge that,except for my personal residence
Expires /)-3 1—)7 Signature in which 1 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
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 workers 7D44 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.leginfo.ca.goy/calawAtmi.
Policy N Date
❑I have and will maintain workers 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: application and the information I have provided is correct.I agree to comply
Carrier wj L CQ -K y with all applicable city and county ordinances and state laws relating to
I I C/ building construction.I authorize representatives of this city or county to
PolicylIa D " H57 N33Expires 7 j — / D 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
❑1 certify that In the performance of the work for which this permit is issued,
I shall not enrol ov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE R
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 with tJlose provisions. WIII the applicant or future building occupant handle hazardous material or a
C I/ 9 -a--7-j`7 mixture containing a hazardous material equal to or greater that the
Applicant /Oate amounts specified on the Hazardous Materials Information Guide?
WARNING:FAIL RE TO SECURE WORKE ' OMPENSATION COVERAGE IS ❑Yes )(No
UNLAWFUL,AND SHALL SUBIECTAN 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 Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ❑Yes ❑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) ❑Yes ❑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 reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
report
g.
checkmark(s)I have placed next to the applicable Item hazardous material rep
s)(Section 7p31.5 �'es ❑No r/' -L Q
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 AUTHO D AGENT
.. issuance,also requires the applicant for the permit to fife a signed statement
that he or she Is licensed pursuant to the provisions of the Contractors State EPA RENOVATION.REPAIR D 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 Ilcensure 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
Nan($S00). managers who do the palnt-disturbing work themselves 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.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 Contractors 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-Bulfder will have the burden of proving that it was
d.
- 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 o Contractors State Ucense 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.
h .
BUILDING & SAFETY, PERMIT/PLAN CHECK APPLICATON i
5
Menife2
DATE:09/27/17 PERMIT/PLAN CHECK NUMBER M1
TYPE: %COMMERCIAL O RESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME O POOL/SPA 6 SIGN
SUBTYPE: 4 ADDITION O ALTERATION O DEMOLITION •O ELECTRICAL O MECHANICAL
O NEW VePLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK Replace water heater
PROJECTADDRESS 29950 Murrieta Road ZIp !�25,8* �tacsto
ASSESSOR'S PARCEL NUMBER Zf39 ' 4 G' C)1__1 LOT L}- TRACT
OWNER NAME Patrick J. Asher
ADDRESS 12707 High Bluff Drive, Suite 200, San Diego, CA 92584
PHONE EMAIL ocpm@prodigy.net -
APPLICANT NAME Joseph Papez
ADDRESS 4060 Mission Blvd., Montclair, CA 91763
PHONE 909-622-5400 EMAIL ocpm@prodigy.net
CONTRACTOR'S NAME Joseph Papez OWNER BUILDER? ^YES 0 NO
BUSINESS NAME Orange Coast Pipe Mechanical, Inc.
ADDRESS 4060 Mission Blvd., Montclair, CA 91763
PHONE 909-622-5400 EMAIL ocpm@prodigy.net
CONTRACTOR'S STATE LIC NUMBER 484132 LICENSE CLASSIFICATION C36
VALUATION$ a 0 Dim- SO Fr L SQ FT
APPLICANT'S SIGNATURE v DATE 09/27/17
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESSJACENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY: ✓/
PERMIT FEE I I SMIP GREEN
PLAN CHECK FEE INVOICETOTAL
OWNER BUILDER VERIFIED "",YES '10 NO DRIVERS LICENSE# NOTARIZED LETTER G YES C NO
City of Menifee Building&Safety Department 29714 Haun Rd. N,enifee, CA 92585 951-570IBpo?Menifee
www.City0fnenifee.115 9ullding & Safety Dept.
SEP 2 9 2017
Received
STATE OF CALIFORNIA
WATER HEATING SYSTEM GENERAL INFORMATION
CEC-NRCC-PLB-01-E(Revised 01116) CALIFORNIA ENERGY COMMISSIO
CERTIFICATE OF COMPLIANCE NRCC-PLB-OS-E
Water Heating System General Information (Page 1 of 2)
Premtt N.re.;Chevron S.S.#208064 my vreParea:09/27/17
A.GENERAL INFORMATION/SYSTEM INFORMATION
01 Water Heater System Name: Chevron Food Mart-Water Heater Replacement
02 Water Heater System Configuration: Single Dwelling Unit
03 Water Heater System Type: Domestic Hot Water
04 Building Type: Nonresidential
05 Total Number of Water Heaters in Systems: 1
06 Central DHW Distribution Type:
07 Dwelling Unit CHIN Distribution Type: Standard Distribution System(STD)
B.WATER HEATER INFORMATION
Each water heater type requires a separate compliance document.
01 Water Heater Type: Small Storage-Electric
02 Fuel Type: Electricity
03 Manufacture Name: Rheem
04 Model Number: ELD40
05 Number of Identical Water Heaters: 1
06 Installed Water Heater System Efficiency:
07 Required Minimum Efficiency: Q
08 Standby Loss Percent or Standby Loss Total:
09 Rated Input: 1
10 Pilot Energy:
11 Water Heater Tank Storage Volume: 40 gallons
12 Exterior Insulation on Water Heater:
13 Volume of Supplemental Storage:
14 Internal Insulation on Supplemental Storage:
15 Exterior Insulation on Supplemental Storage:
C.PLUMBING COMPLIANCE FORMS&WORKSHEETS
Check box if worksheet is included.
For detailed instructions on the use of this and all Energy Standards compliance documents,refer to the 1016 Nonresidential Manual
Note:The Enforcement Agency may require all compliance documents to be incorporated onto the building plans.
YES NO Doc/Worksheet# Title
O O NRCC-PLB-01-E Certificate of Compliance,Declaration. Required on plans for all submittals.
O O NRCI-PLB-01-E Certificate of Installation.Required on plans for all submittals.
O O NRCI-PLB-02-E Certificate of Installation,required on central systems in high-rise residential,
hotel/motel application.
O O NRCI-PLB-03-E Certificate of Installation,required on single dwelling unit systems in high-rise
residential, hotel/motel application.
O O NRCI-PLB-21-H Certificate of Installation,required on HERS verified central systems in high-rise
residential,hotel/motel application.
O O NRCI-PLB-22-H Certificate of Installation,required on HERS verified single dwelling unit systems in high-
rise residential,hotel/motel application. LL
LL
O O NRCI-STH-01-E Certificate of Installation,required on any solar water heating O
City of Menifee
Building& Safety Dept.
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance January 2016
SEP 2 9 2017
STATE OF CALIFORNIA
WATER HEATING SYSTEM GENERAL INFORMATION
CEC-NRCC-PLB-01-E(Revised 01/16) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-PLB-01-E
Water Heating System General information (Page 2 of 2)
Pm1ea Name:Chevron 5.5.N208064 Dete R—red:09/27/17
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
Company: Signature Date:
Address: CEA/HERS Certification Identification(if applicable):
City/State/Zip: Phone:
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design
identified on this Certificate of Compliance(responsible designer).
3. The energy features and performance specifications,materials,components,and manufactured devices for the building design or
system design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the
California Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the
information provided on other applicable compliance documents,worksheets,calculations,plans and specifications submitted to
the enforcement agency for approval with this building permit application.
S. I will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s)
Issued for the building,and made available to the enforcement agency for all applicable inspections.I understand that a completed
signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building
owner at occupancy.
Responsible Designer Name: Responsible Designer Signature:
Company: Date Signed:
Address: License:
City/State/Zip: Phone:
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance January 2016