PMT18-01004 City of Menifee Permit No.: PMT18-01004
29714 HAUN RD.
"/- CCCEL/- MENIFEE,CA 92586 Type: Residential Plumbing
MENIFEE Date Issued: 0 310 6/2 01 8
PERMIT
Site Address: 29776 PEACOCK MOUNTAIN DR, Parcel Number: 340-411-030
MENIFEE,CA 92584 Construction Cost: $1,200.00
Existing Use: Proposed Use:
Description of REPLACE 50 GALL GAS WATER HEATER, SAME SIZE AND LOCATION IN GARAGE
Work:
Owner Contractor
DANIEL YBARRA AFFORDABLE WATER HEATERS AND PLUMBING
29776 PEACOCK MOUNTAIN DR INC
MENIFEE, CA 92584 28358 CONSTELLATION ROAD#698
Applicant Phone:8553459087
28358 CONSTELLATION ROAD#698 License Number:627368
VALENCIA,CA 91355
Fee Description City Amount IEi
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_Pennit_Template.rpt Page 1 of 1
CITY OF MENIFEE
ICENSED 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).
Chapter!)(commencing with section 7000)of Division 3 of the Business and o I am exempt from Rcensure under the Contractors State License Law for
Professions Code and my license is in full force and effect the following reason:
License Class(i & Yo,, o-144, License No. C�5-5 By my signature below I acknowledge that,except for my personal residence
Expires Q- <0-I K Signature in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION have
covered by this permit.I cannot legally sell a structure that I
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 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 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 370D of the Labor Code,for the performance of work for which www.leginfo.ca.gov/calaw.htmi.permit is Issued.
Policy If Date
)Q 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 q 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 polity Pwner 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 I r.,G G U r7 t with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# U, Expires A I. enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date 1 Z -7 *-(
dollars($300)or less
ROPERTY OWNER OR AUTHORIZED AGENT
D I certify that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE p `jE S -1-7
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
s Applicant e �c-- lg � Date 1�-24F-/-4 mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER' COMPENSATION COVERAGE 15 D 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($100,000),IN
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 37060FTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist
for guidelines -
-
CONSTRUCTIONLENDINGAGENCY oYes OTIo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lendfng agencyfor the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) ❑Yes fkft
OWNER BUILDER DECLARATIONS 1 have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractors License Law for the reasons)indicated below by the California Health&Safety Code,Section I5505 and 25534 concerning
checkmark(s)I have placed next to the applicable item hazardous material reporting.$)(Section 7031.5 oyes p04o
Business and Professions Code).Any city or county that requires permit to Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER 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 IRRPI
Ucense Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRPj 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
o 1,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.epv/lead or contact the National Lead Information Center at
not intended or offered for safe.(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 feVeflltee
property provided that the improvements are not intended or o r fPf Certified Firm Name:
sale.If,however,the building or improvement is sold within one gl ing Dept.
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. DEC 2 f 2017 o No EPA Lead-Safe Certified Firm is required for this project because:
D 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�� r o1'a ` P
i If
�,'f7 �M',,�our project does not comply with EPA RRP rule please fill out the RRP
" s i " e Y2knowledgement
P 'CAT
7-7
DATE PERMIT/PLAN CHECK NUMBER I ' W
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 PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK WL4Wj
S 1 r n A _
PROJECT ADDRESS `I -I 1 (-Zp � re (,L L C) .�- ry-\C 1.- A r)
ASSESSOR'S PARCEL NUMBER .!'RJ ' I-�j� LOT _ TRACT
PROPERTY OWNER'S NAME
ADDRESS ? 1) --7 -1 PC a _ G C �-n c)Q V�-r- CA "--\ 1r
PHONE�� �l { - 1 EMAIL
APPLICANT NAME all , CR,�•
ADDRESS ML(i 4NC, l V
PHONE ,,OI,QC�� EMAIL
CONTRACTOR'S NAME OWNER BUILDER? 0 YES ONO
BUSINESS NAME
ADDRESS
PHONEJu5-otiot�� EMAIL W
CONTRACTOR'S STATE LIC NUMBER (�L'I�—�� LICENSE CLASSIFICATION
VALUATION$ I 12- `O G SO FT L SO FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP
INVOICE 115.I�
AMOUNT PAIDAMOUNT OCASH OCHECK# 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCAS. OCHECK# OCREDITCARD VISA/MC
OWNERBUILDERVERIFIED OYES O NO DLNUMBER NOTARIZEDLETTER 0 YES 0 NO
Building&Safet!j 0epartment29714 Hour, Rd. Menifee, 9258o 951-!i72.6
www.citynfinenifeaue Inspectrbn Reque5t Line 95_1_146-5213
o w °
� o
a �j o a3oo —I V a z MOT
° � m � m
F• ^Er (D3m 3 °° O MR"
ro
? ? c o a al s u z o' m C
Pr m
a < 3 = a = c rDcx
� m A RrL
03 c m 3 ° a m n _ = m
vi n ° A o d M �i c o N m
m
° m x o o
cc m iv 4 'v
C
C m N ~3 r
S o = fn mo °
a
w
C C .� e m
d .fir x W M w ^ c4 .� fl u p
m r. °
o �° a ° 3 w a J 92 °°° . Y
° = a _
y
r�o p o ,Z+'at fD 2 a Z m = W, - z E o
6flpx ° K rn >
a a o mm o
a > y CL
m CD
m c 1' _
^ a c a S F
3 a m ❑
^. o
n ro 4 'o 10 S s goo A
o 2 a rn
n I F 7,
c ° a u a d ° a 70
< � �
2 3
tu
3. rD-
3 3 3 m
v, o o a°•
d n
C P. O N
G a v m D
�
O
d m •o
m a d m d E
w .» ;o m 2 r0 0 o Oa
0r00o
on
z
Oil � � �
B`B o
N LL y
d \ O A 7
N � C
g v v o i
it m
a c O C
mnm v
M q
W E 5 `m Id � � � G 0
4 N *0vMEv r
p ug E c E Y, v h
>
G o
a v N v .��-•• o. m o
o w E o o c m
O .� v,
a
7-
,J'_
c n u u+ Z' c v c m o u c
m o E c
_c 3 E ar c 5 v y c v V1
Y v v Yo c 0 c c
—
L
O
m on � � .� v — � �• v m a o u e
v c o E m A u m ci m
E v v v E E c o^ o c c c o : m
o Fm 3 m u 0 .4 c 0 4 oc E
v v ,� _ ya E y n
m m r m c "Co C
E m N L o
0J N W O N C l E c m ~
Up $ •E \ a7 Y L R
c
M L 41
m o _ t v « _ .0 m w G
•3 N v c c � .v. $ a to •v — 3 a. YL° p
w c F L r u E c s
am 3 v o 8' o L' c o ' 3 B a o
v C
c d a+ O N ~ m m e d
9 3 c 7 C v m ,c a a 3 u yL° ocvo � L
m �+
m LL o .� ° = E Y 3 o m .� E 2 e w v «
2• a > N �' m o v es ay a m o n v c
L° 'c L° m o a o o E w c o c N
mbA
0 mo
5 m a v 7 ° v 2 $ = c w c ¢ 1
v 5 P ° c c o LL C° m c o m o v c
$ a Y c u o v H E y o ¢ 3 w H
m E ;; o f ,o m y o `� E l m �^ vo c U
y y y U '� E LL> JZ O y �r E ~ Z y 0CC!
±h w v YJ w a�i W e '�O-.. cp a v C!
Vf .N 7 C E W ,L, r W G w 4n '^ � 'A OC �• ra
W e `a m �°n v a d 51 m ¢ o o E e
G m IQ
.a E g W w +E m e K6 9 v p C o
?+ [ay 6 e R « O C O
c y o
U. v v m L m = 5 m m o Q E c 2 g a
O
•® c '� 1- b b ° e b •e £ E O :c
E .E A 5 a « m n e v « e a v M o
z E12 offige° a � dJ � t9
- 4 ri
LA
> N y
N
E E v`
W LU m
b
v o, e z