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PMT18-00870 City of Menifee Permit No.: PMT18-00870 29714 HAUN RD. �ACCEI Al MENIFEE, CA 92586 Type: Residential Plumbing MENIFEE Date Issued: 02/28/2018 PERMIT Site Address: 29917 BUENA TIERRA, MENIFEE, CA Parcel Number: 336-201-031 92586 Construction Cost: $900.00 Existing Use: Proposed Use: Description of EXCAVATE 3 FT DEEP IN FRONT OF HOUSE TO REPLACE CLEAN OUT FOR SEWER LINE Work: Owner Contractor TONY GONZALEZ SOMATDARY INCORPORATED 29917 BUENA TIERRA P O BOX 2667 MENIFEE, CA 92586 CULVER CITY, CA 90231 Applicant Phone: 7143498239 VICTOR MEDINA License Number.771663 SOMATDARY INCORPORATED P O BOX 2667 CULVER CITY, CA 90231 Fee Description Qty. Amount 15i Plumbing Fixtures and Vents,fixtures 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 5.80 $149.80 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 carded 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 PennR_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 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 ❑I am exempt from licensure under the Contractor's State License Law for Professions Code my license is in full force and effect.) --t the following reason: License Cl ssC ��Cb(o �2 Licens No. ' �� ✓S By my signature below l acknowledge that,except for my personal residence Expires� 3� ""l Signature In which I must have resided for at least one year priorto completion of WO ICER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that I have built as an owner-builder if it has not been constructed in its entirety by 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 forworkers 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.leeinfo.ca.eov/calaw.html. this permit is issued. Policy# �? 1110 Date o I have and will maintain workers compensaLion 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 worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number are: application and the information I have provided is correct.I agree to comply Carrier with all applicable city and county ordinances and state laws relating to building condruction.I authorize representatives of this city or county to Policy# Expires enter the bovei ntifiedpropertyforinspectionpurpos s. (This section need not to be completed is the permit is for one-hundred Z Date dollars($100)or less PRf5PERTY O NER OR AUTHORIZED AGENT D I certify that in the performance of the work for which this permit is issued, 3SI shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE It worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall ort it comp) v/�(�ittlhrf[ho�sse�provisions. rf J Will the applicant or future building occupant handle hazardous material or Applicant ILP /u'YV 4 Date 22/b mixture ca alning a hazardous material equal to or greater that the amounts s ecified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION OVERAGE IS o Yes 0 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($1(10,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Q alir Management District tSC construction or See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast Air es CONSTRUCTION LENDING AGENCY D Yes No 1 hereby affirm that under the penalty of perjury there is a construction Will the pro used building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer bou ary 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 California earth&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)indicated below by the hazardou mate=�� checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes No 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 OW AR OR 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(RRP License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractdrs 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 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.epa.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-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 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 If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. -71 DATE: !/ Z I PERMIT/PLAN CHECK NUMBER ' OD O TYPE: O COMMERCIAL VRESIDENTIAL. O MULTI-FAMILY O MOBILE HOME O POOL/SPA OSIGN SUBTYPE: O ADDITIO)N O ALTERATION O DEMOLITION O ELECTRICAL MECHANICAL 0NEW PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTIOry OF WORK wa die i'vI , °Ldj Cl/ PROJECT ADDRESS "I I 1 Ib lI-�✓I I� IW� ZIP ASSESSOR'S PARCEL NUMBER ziyXo �� LOT �i� TRACT p�S OWNER NAME j y 0 vi X4 ADDRESS - YnIC V✓�. PHONE I YI /�,�A , !!'�� EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME U�}'1 I N OWNER BUILDER? O YES NO BUSINESS NAME ,,,, (' J L7��` ADDRESS O go S` (r{A �C � Lx m v woo 00 PHONE (310 EMAIL CONTRACTOR'S STATE LIC NUMBER Z1 I W0 3 LICENSE CLASSIFICATION n 00 VALUATION$ O 0- Q L 5Q FT �l APPLICANT'S SIGNATURE DATE L� I CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I ACCEPTED BY: PERMIT FEE I SMIP GREEN ( — PLAN CHECK FEE INVOICETOTAL [OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE N NOTARIZED LETTER O YES O NO .'✓'oVSv.CIt!O%'i�ariij°L'.LL' PLOT/SITE PLAN RE OPERTY LINE City of Menifee Building Dept. FEB 2 8 2018 CM C3 eceived "i v ram.. C - = MENIFEE Bu JG AND SAFET DEPARTPe;ENT PL :PPROVAL w :IVED BY DATE i these plans shall not be construed to boa permitfor,or an a my violation of any provisions of the federal,state or city p a° t; ,nit ordinances. This set of approved plans must be kept on the Vl DU �� w 5 completion. N L O FRONT PROPERTY LINE Property Owners Name �� C 11v-Z-1 kl G Property Address m 11 ?KU �� l ��(l� Ci(� I �Bb —�