PMT18-00847 City of Menifee Permit No.: PMT18-00847
29714 HAUN RD. Type: Residential Plumbing
SnCCEL/ MENIFEE, CA 92586
MENIFEE Date Issued: 02/27/2018
PERMIT
Site Address: 27360 BENTON POND DR, MENIFEE, CA Parcel Number: 333-432-003
92585 Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL WATER HEATER, SAME LOCATION
Work:
Owner Contractor
BRITTANY STILWELL ALL STAR WATER HEATERS INC
27360 BENTON POND DRIVE 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92585 MENIFEE, CA 92584
Applicant Phone:9513010067
SIERRA SPRAGUE License Number: 812894
ALL STAR WATER HEATERS INC
30300 PUERTO VALLARTA WAY
MENIFEE, CA 92584
Fee Description Qtv Amount I$)
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_Bldg Permil_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter!)(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 License No.
By my signature below I acknowledge that,except for my personal residence
Expires Jtl Signature ./ icr-- _ inwhich l must have resided for at least one year pdorto completion of
improvements covered by this permit.I cannot legallysell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
o I hereby affirm under penalty of perjury one of the following declaration:) licensed contractors.I understand that 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 ofthe Labor Code,far the performance of work for which wwwleeinfo.ca.eav/calaw.html.
this permit is issued.
Date
Policy#
PROPERTY OWNER OR AUTHORIZED AGENT
04 have and will maintain workers compensation insurance,as required by m signature below I certify to each of the following:I am the property
section 3700 of the Labor Code,for the performance of the work for which 19'9Y Y g
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act an the property owners behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
With all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy# 1�//G/' .P�X7/LS-Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred /9
dollars($10D)or less PROP ®D NER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit Is issued, *P)6 O`5
1 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 fo rthw' co ply with those provisions. Will the applicant or future building occupant handle hazardous material or
mixture containing a hazardous material equal to or greater that the
Applicant Dale amounts specified on the Hazardous Materials Information Guide?
WARNING:FAI U SECURE WORKER'S COMPENSATION COVERAGE IS o Yes �No
UNLAWFUL,AN SHALLSUB1ECTAN 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 Dyes �No
hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility he 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 �;LNo
OWNER BUILDER DECLARATIONS 1 have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements underthe State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concern[n
Contractors License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 i �ri No / r�
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 O�PAIRAND UTHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement EPA RENOVATION,RE PAINTING IRRPI
that he or she is licensed pursuant to the provisions of the Contractors State
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 perm it 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
01,as o ner 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.epa.aoy/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a a An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the Certified Firm Name:
property provided that the improvements are not intended or offered for •
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 o No EPA Lead Safe Certified Firm Is required for this project because:
not built or improved for the purpose ofsale.
o I,as owner of the property am exclusivel�xontracting 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, SAFFY OERMWPLA4 CHECK APPLICATION
M e n i f r
DATE O�'aLQ1 PERMIT/PLAN CHECK NUMBER C►"�t�� '��}�
TYPE: O COMMERCIAL [?]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 ZkLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace existing water heater. Same size and location.
City of MMM�nife__
PROJECT ADDRESS
27360 Benton Pons Dr. A0�J Building Dept.
22..-�� ,�e�
ASSESSOR'S PARCEL NUMBER -65a- �� VC.J oT _ TRACT FEA 7 6 .2018.
OWNERNAME Brittany Stilwell _
ADDRESS 27360 Benton Pong Dr. Receiv
PHONE 951-445-2165 EMAIL
APPLICANT NAME Sierra Sprague
ADDRESS 30300 Puerta Vallarta
PHONE 951-301-0067 _ EMAIL allstar.sierra@gmail.com
CONTRACrows NAME Sierra Sprague OWNER BUILDER? O YES ONO
BUSINESS NAME All Star Water Heaters
ADDRESS 30300 Puerta Vallarta Way
PHONE 951-301-0067 EMAIL allstar.sierra@gmail.com
CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36
VALUATIONS 800,00 SQ FT LSQFT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION I CITY OF MENIFEE BUSINESS UCENSE NUMBER
BUILDING PLANNING ENGINEERING FIREE GREEN SMIP
INVOICE 1`Fj ,,� PAIDAMOUNT 1 ,,LJ OCASH '-CHECK# OCREDIT CARD VI5A/MC
AMOUNT 11
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# C CREDIT CARD 415A/MC
OWNER BUILDER VERIFIED O YE5 O NO DL NUMBER NOTARIZED LETTER O YES () NO
-.� Cit f h,eni-,:Building Safely De artmerrt 29/14 r,Iaun Rd.menifee, r,A9_5,5695i•o72-S77?
Iul.Vgr,� 1. spection Request t'.v 951-:4E-6Z r'
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