PMT18-01298 City of Menifee Permit No.: PMT18-01298
29714 HAUN RD. Type: Residential Plumbing
-[;kCGEL;W,> MENIFEE, CA 92586
n�•°^-^'"""^'" MENIFEE Date Issued: 03/22/2018
PERMIT
Site Address: 25106 WOODEN GATE DR, MENIFEE, Parcel Number: 339-421-020
CA 92584 Construction Cost: $1,680.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL GAS WATER HEATER IN GARAGE
Work:
Owner Contractor
EDGAR SANTOYO A R S AMERICAN RESIDENTIAL SERVICES OF
25106 WOODEN GATE LANE CALIFORNIA INC
MENIFEE,CA 92584 965 RIDGE LAKE BLVD#201
Applicant Phone: 9012719700
ERNESTO CARRANZA License Number: 765155
A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIr
965 RIDGE LAKE BLVD#201
MEMPHIS,CA 38120
Fee Description Qtv Amount($1
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.
Page 1 of 1
AA_Bldg_Perrnit_Template.rpt
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 in I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect./ the following reason:
License Class C�� License No. G By my signature below I acknowledge that,except for my personal residence
Expires [ —� Signature In which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements 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 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 ,,a„Nw.ieeinfo.ca.eov/calaw.html.
this permit is issued.
pogo,# fg* Date
❑I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which a By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carder and policy owner 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/ \ 6Cf s�'�'J with all applicable city and county ordinances and state laws relating to
�,p��/p 7 building construction.I authorize representatives of this city or county to
Policy# W 4'r'')� 5�(IVis LXplres /0 enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
❑I certify that in the performance of the work for which this permit is issued,
I shall not emolov any persons in any manner so as to become subject to the CITY BU51NESS LICENSE#
worker's 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
Applicar� —L Date �' Z Z / mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 o Yes o 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 Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 37060E THE LABOR CODE,INTEREST,AND AT FEES forguidelines
CONSTRUCTION LENDING AGENCY oYes oNo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 100D 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) O Yes O No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist.I understand my requirements under the State of
California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable items)(Section 7031.5 ayes a 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 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(RRP '
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 Cade)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( )portion of the work,and the structure is www.eoa.eov/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 taw does not apply to an owner of a O 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.
& SAFETYPERMIT/PLAN
• ♦ APPLICATION
skMenifee
DATE 3 PERMIT/PLAN CHECK NUMBER
TYPE: []COMMERCIAL RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION []ALTERATION ❑DEMOLITION []ELECTRICAL []MECHANICAL
❑NEW PLUMBING ❑RE-ROOF-N UMBER OF SQUARES
DESCRIPTION OF WORK C C
TPc —
PROJECTADDRESS AIS U CJ DOcsr-3 C CA l
ASSESSOR'S PARCEL NUMBER 3'SA • Ga►- Cho LOT TRACT
City of Mem ee
OWNER NAME (�j U
Building t.
ADDRESS Co Cc erj% LL et�1F6j- C,h. gjt�PHONE qU9-�Ly..., (,� EMAIL 18
APPLICANTNAME Rece'ved
ADDRESS F V6 eA -,i
PHONE 91.3 1 ?-:.11 G?j"I( EMAIL
CONTRACTOR'S NAME jZ66Ccjo OWNERBUILDER7 [-]YES ONO
BUSINESS NAME
ADDRESS ltiAo L VGt!-S� A
PHONE 94E51-2�t41_a*� t EMAIL
CONTRACTOR'S STATE LIC NUMBER '7�,�(.�y LICENSE CLASSIFICATION
VALUATION$ I Lo SSO SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE
-
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP h
INVOICE PAID AMOUNT
AMOUNT �• ,�5• O CASH O CHECK k O CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# 0CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO
City of Menefee Building&Safety Department 29714 Houn Rd. Menefee, CA 92586 951-672-6777
evww.cityofinenifee.Lis Inspection Requesr Line 951-246-6213
00o -n 4� n tnD � npmp�7y
'c m F+ s m m w eH m N GI H AUIm
w N i+ sc m m S[n � � E1° wm '� �
¢ 3 a m
o H �7 m +' S Z
v0 m M w umm a ?, c xu' m � 1° 3w' � N '1 O o_r•• O `daD
o ' o w w a .°1. o -. y z X m e-ri
d $_ = N = v ad w C m � D >
E o m 3 3 c o o m m m Q m Z i
O EL
�_ 3 m c o < = c^ m a Z o m O
3 -nf 'A o tEr
(n
o = o n O
qq
o
3 m H " SO3 n a 1D
n
0
Etin m n, £ m m m Q. •
u 2 CT > > O m
m
e w s a m m o Er » v.
oo > > m v = m O1 G1 a
o. o 3
0 El
3 n a �e u
E i ?3 ,� 3 C 6 m
,.,• c o <
s
N a. i 'v
y S m m d `t am m
m o S
3
m •,
uaCi N 'm�• < = S
m '.�
m
3 3 m U a r �n 3oom
v
a 2 3 c n m
n n rL z c n
n oln c 4° a pp
m S 3 0 m a m y m - o c
3 Er ORn
a m nEL
•
0 o -mi m haw + v •c < in
3 '• 0
T m m
s 55 m o v
a'o n a a H w om"i S n > > i
01
a DO
' c 0 MN y ? S. m
as e1y0i n .mi
m 2 m a pop ¢ ,°�
f0 I N j 'mp d Of 1 K
m m m ro m
' wy'og v v
f m U• -1 y,•� n
pq S 3
A c 3 CI/^�
n m o w
N » » m m
H Z w' c a ° .� w w 3 3 v eT �• w m o: mm
o rt O N r m m a a n 3 m 3 f0 n
n m D
m <
^ o m c °N° a o m < m ° 3 m
c U _ d M
m v
r' n O 1 ° m n z °'� c c Er,
m n obi °
m yNN, �i lr' 3 m n o ,°. 3 `w' d m D E
l�' 1 D' m or •o ^ m c m o C o m _ o » w_ m
fD
'w c
CC •� 3 a a �
o n m e w _. a •. .�i
o i m n m N c o a o m I
£
V C7 T O V) 3 rn C S N N 0 W H
ti n z oo' 3 o e o � o c � �
m w v w
� �' ° ° 3 o w o 'a -•
° -' o. m c R
n ° m 0°
rt � o c o � 3 m o O1 nn
A C C 10 N O •G D
G
o m j fD Z
ct
N
0 T N
° °
� 1
1