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PMT17-03585 City of Menifee Permit No.: PMT17-03585 29714 HAUN RD. '!\CCELA7 MENIFEE, CA 92586 Type: Residential Plumbing MENIFEE Date Issued: 1 010 612 01 7 PERMIT Site Address: 31587 LINDA LEE DR, MENIFEE, CA Parcel Number: 360-240-023 92584 Construction Cost: $6,500.00 Existing Use: Proposed Use: Description of REPAIR 12 L FT OF EXISTING SEWER LINE, 3" Work: Owner Contractor ELAINE KRUEGER A R S AMERICAN RESIDENTIAL SERVICES OF 31587 LINDA LEE DRIVE 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 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, CA 38120 Fee Description Qtv Amount f$1 Sewer 1 150,00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 7.50 $185.50 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 Men'rfee.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_Templatesix Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects I herebyaffirm 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 a 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 Cl ppff License No By my signature below l acknowledge that,except for my personal residence Expires N 1 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 ofthe 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 workers 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.leefnfo.ca.eov/calaw.html. Policy# Date ,�Lhave and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT Section 3700 ofthe Labor Code,for the performance ofthe work for which ❑�Y my signature below I certify to each ofthe folioWng:I am the property this permit is Issued.My workers compensation insurance carrier and policy w>( ner 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 r with all applicable city and coup nances and state laws relating to ��pp building c stru .I auth representatives ofthis city orcounty to Policy# (y7 Expires enter th dentifi erty for inspection purposes. (This section need not to be completed is the permit is f rone-hundred dollars($100)or less Date PROPERTY OWNER OR AUTHORIZED AGENT certify that in the performance of the work for which this permit is Issued, I shall not employ any persnp in any manner sW to become subject to the CITY BUSINESS LICENSE# workers compensation s of C I' nia,a re that If I should become HAZARDOUS MATERIAL DECLARATION subject to the wor com e�ion ions of5ection 3700 ofth Labor Code,I shall fo Ith "wit o ov' ions. / Will the applicant or future building occupant handle hazardous material or a Applicant Dale G , mixture containing a hazardous material equal to or greater that the amounts spe 'fied on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION 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 Alt Quality Management District(SC construction or See permittingfrom checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast Airlines Qua CONSTRUCTION LENDING AGENCY ❑Yes -d�Nci 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) ❑Yes Plo OWNER BUILDER DECLARATIONS I have/read the Hazardou atenal Information Guide and the SCAQMD I hereby affirm under penalty of perjury that lam exempt from the permitting checklist. nder my require under the State of Contractors 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 erica rting. 1&& Business and Professions Code).Any city or county that requires a permit to 0 L6 �� construct,alter,improve,demolish or repair any structure,prior to itsDate issuance,also requires the applicant for the permitto file a signed statement ROPERTY OWNER OR AUTHORIZED AGENT that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING fRRPI 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 o penationf re for ity to eorkt that ertified firmsanicomre-197ply h than Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property ownessand property than($S00). managers who do the paint-disturbing work themselves or through their al,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 ofthe work,and the structure Is www.epa.govAead 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 ❑An EPA Lead-Safe Certified Renovator will he 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. ❑No EPA Lead-Safe Certified Firm is required for this project bemuse: o 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 Ifyour project does not comply with EPA RRP rule please fill out the RRP Acknowledgement BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee 191111111�1- DATE /0�V/7 PERMIT/PLAN CHECK NUMBER ' Q TYPE: ❑COMMERCIAL ORESIDENTIAL MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA [-]SIGN SUBTYPE: [—]ADDITION. []ALTERATION ❑DEMOLITION []ELECTRICAL ❑NUC gl� *itee ❑NEW PLUMBING ❑RE-ROOF-NUMBER OF SQUARES----BuUding & Safety D©pt. DESCRIPTION OF WORK rff214 ce I ol-r+ J�' 5 11 h C PROJECTADDRESS 6 e y- 00r I9C198VE)d ASSESSOR'S PARCEL NUMBER a go-QllL40-C83 LOT TRACT OWNER NAME Gf/p e h f e r- ADDRESS Lee ( e CA 9a58 PHONE e07- 7 70- OS&e? EMAIL APPLICANT NAME /� Ilee) ADDRESS IQo W -Zindeli 5i- i(,evj1 e CA PHONE ;S-1 -3ell 9,371 EMAIL CONTRACTOR'S NAME 5 Q Q O OWNER BUILDER? ❑YES NO BUSINESS NAME J p � ADDRESS S O tL) CC en cX .P/1-5fae r (c)J yv7 PHONE ' _S/ 3'-f 1 �73 7 / EMAIL CONTRACTOR'S STATE LIC NUMBER �j LICENSE CLASSIFICATION VALUATION$ `0 SC7 O L SO FT APPLICANT'S SIGNATURE DATE L) CO / 7 DEPARTMENT DISTRIBUTION CITY OF MEN I FEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP /C INVOICE ��//�� PAID AMOUNT AMOUNT W 0CASH 0 CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK H OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER 0 YES Q NO City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-5777 www.cityofinenifee.us Inspection Request Line 951-245-6213 3lS $-�--L ri o, Zee Or OYY OF MENIFEE BUILDING AND SAFETY DEPARTMENT N � -€'tAI14' APPROVAL--}--- n City of Menifee REVIEWED BY ( 10 0l![ I1 ^ '" Building& Safety Dept. DATE OCT 0 6 Z017 `Approval of these plans shall not be construed to be a permit for,or an (9c0 five approval of,any violation of any provisions of the federal,state or city regulations and ordinances. This set of approved plans must be kept on the jobsite until completion. r i keola,, /.jr�'/ r Tyr • 3" sewn- /c �ris�i r � I 1 r i