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PMT17-03997 City of Menifee Permit No.: PMT17-03997 _ 29714 HAUN RD. Type: Residential Plumbing �!-1CCELikk.' MENIFEE, CA 92586 MENIFEE Date Issued: 11/07/2017 PERMIT Site Address: 29059 PRESTWICK RD, MENIFEE, CA Parcel Number: 338-026-009 92584 Construction Cost: $5,000.00 Existing Use: Proposed Use: Description of SEWER LINE BURST,4"MAIN LINE 40 L FT, 15 LFT OF KITCHEN 2"LINE Work: Owner Contractor RUSSELL YANKIE ACCURATE LEAK LOCATORS ING 29059 PRESTWICK RD 26025 NEWPORT ROAD#A 413 MENIFEE, CA 92584 MENIFEE, CA 92584 Applicant Phone:8883335325 MIKE FALCO License Number.850152 ACCURATE LEAK LOCATORS INC 26025 NEWPORT ROAD#A 413 MENIFEE, CA 92584 Fee Description p1t r Amount ISI 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 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_ mit_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 perjurythat 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 ❑I am exempt from Iicensure under the Contractor's State License Law for Professions Code and my license Is in full force and effffe�ct, ^1 the following reason: License Class - - 3G License No. By my signature below l acknowledge that,except for my personal residence Expires O Signature in which I must have resided for at least one year prior to completion of �T_� improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMP NSATION 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 ,nww,leeinfo.ca.eov/calaw.html. this permit is issued. policy# Inr4 ooat o8 1 —CC) Date o 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.1 have read this number are: . application and the information I have provided is correct.I agree to comply [-(v'fvL rt'r�i{LfJfL l/\Skl'anC�. withalla applicable and ordinances and state laws to Carrier��=-- .� r �- 11 � �^�f� O PP W county g building construction.I authorize representatives of this city or county to Policy If VJfit., 100A Cola Expires 3O f enter the above identified property for inspection purposes. (This section need not to he completed is the permit is for one-hundred dollars($100)or less Date PROPERTY OWNER OR AUTHORIZED AGENT ❑1certify that In the performance of the work for which this permit is issued, OI,V/n�� I shall not emolov 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 with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date 11 7 / mixture containing a hazardous material equal to or greater that the r= amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATIOA COVERAGE IS 0 Yes 22 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($10D,OD0),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 0 Yes '. I hereby affirm that under the penalty of perjury there is a construction Will the proposedbuilding or modified facility be within'1000 feet of the lending agency for the performance of the work which this permit IsIssued outer boundary of a school? (Section 3097 Civil Cade) ❑Yes"?lido— 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 al Safety Cade,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ,-,h�arza�rdous material r p ing. Business and Professions Code).Any city or county that requires a permittoJ— Date construct,alter,improve,demolish or repair any structure,prior to its PRO E TY OWNER 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 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 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($500). managers who do the paint-disturbing work themselves or through their ❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( J portion of the work,and the structure is www.eoa.aov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-80D-424-LEAD(5323). Cade;The Contractors State License Law does not apply to an owner of a 0 An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was �/'' not built or improved for the purpose of sale. f 4waEPA Lead-Safe Certified Firm is required for this project bemuse: ❑1,as owner of the property am exclusively contracting with licensed V contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. BUILDING : APPLICATION � Menifee DATE: II PERMIT/PLAN CHECK NUMBER �Q TYPE. O C MMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK /twE.� �,nQ, ��,�, .� // rAci ct (1 / PROJECTADDRESS ! ©� —1 {�C2b{-w cis (-a ZIP `a Ga ASSESSOR'S PARCEL NUMBER ?j3�$ - �Ip—( fioT _ TRACT OWNER NAME 1`t.L.SS alll I,Q.. ADDRESS PHONE /9,f% EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME c Q_ OWNERBUILDER? OYES$NO BUSINESS NAME o� e..q 9 c.tol',$ ADDRESS C9 t.-U O S J2 d- A C Ll I PHONE OS 333 53,2S EMAIL p CONTRACTOR'S STATE LIC NUMBER 1 SO I S P— LICENSE CLASSIFICATION 1/3 VALUATION $ jn(�b , o SOFT LSQFT f t APPLICANT'S SIGNATURE DATE 1 CITY STAFF USE ONLY _ DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER �c BUILDING PLANNING ENGINEERING FIRE BY: �E J PERMIT FEE tell. SMIP GREEN PLAN CHECK FEE INVOICETOTAL I OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES O NO City of Menifee Building& Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.Ci tyofineni fee.uS City of Menifee Building Dept. NOV 0 l 2011 Received U � C�' Q- I C'MI BUILDING A D SAFETY D-PARTMENT PLAN APPR AL REVIEWED DATE 'Approval of these plans shall not be construed to lue a pl-r-nit for,or an approval of,any violation of any provisions of the federal,state or city r regulations and ordinances. This set of approved plans must be kept on the jobsite until completion.