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PMT18-02087 City of Menifee Permit No.: PMT18-02087 29714 HAUN RD. Type: Residential Plumbing MENIFEE, CA 92586 Fw.m.,e R+4xse MENIFEE Date Issued: 0 5101/2 01 8 PERMIT Site Address: 28876 BIARRITZ CT,MENIFEE,CA 92584 Parcel Number: 364-122-026 Construction Cost: $800.00 Existing Use: Proposed Use: Description of REPLACE EXISTING WATER HEATER-SAME SIZE AND LOCATION Work: Owner Contractor WILLIAM EMBERTON ALL STAR WATER HEATERS INC 22876 BIARRITZ COURT 30300 PUERTO VALLARTA WAY MENIFEE,CA 92584 MENIFEE,CA 92584 Applicant Phone:9513010067 ALL STAR WATER HEATERS INC License Number.812894 30300 PUERTO VALLARTA WAY MENIFEE,CA 92584 Phone:9513010067 Fee Description gyt Amount(El 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 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_Perrnit_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 o 1 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 CZ6 License No. ppQ��.P R'l By my signature below l acknowledge that,except for my personal residence Expires .30 Signature �..5�i�.m._ In which l must have resided for at least one year prior to completion of WORKER'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 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 websile: by Section 3700 of the Labor Code,for the performance of work for which www.leeinfo.ca.eov/calasv.lrtml. this permit is issued. Policy# Date pd 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 My my signature below 1 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 Carrier E with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Polity# 1F(q G�s_P��X)(L Expires enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundredyez Date dollars($1o0)or less PROP OWNER OR AUTHORIZEDAGENT o I certify that In the performance of the work for which this permit is issued, ® 15 G O� I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# :J 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 fort co ply with those provisions. Will the applicant or future building occupant handleharardous material Ora Applicant Date mixture containing a hazardous material equal to orilreater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAI U SECURE WORKER'S COMPENSATION COVERAGE IS o Yes (04go UNLAWFUL,AN 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 IN SECTION 3 06 OF T T LABOR CODE,INTERTION,DAMAGESDATTORNEYS EYSFEES FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,ANDATTDRNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes ("O 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 lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) o Yes gNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMO 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&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting. Business and Professions Cade).Any city or county that requires apermit to byes o No � - 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 Code)or that he or she is exempt from Iicensure 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 01,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 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. o No EPA Lead-Safe Certified Firm is required for this project because: o I,as owner of the property am exclusively.contmcting with licensed contactors to construct the project(Section 7044,Business and Professions Cade: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 .......... DATE PERMIT/PLAN CHECK NUMBER TYPE: o COMMERCIAL WI RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA 0 SIGN SUBTYPE: Q ADDITION 0 ALTERATION 0 DEMOLITION 00 ELECTRICAL 0 MECHANICAL O NEW 71PLUMBING OFtE-ROOF-NUMBEROFSQUARES+-.--____ DESCRIPTION OF WORK Replace existing water heater. Same size and location. PROJECT ADDRESS 28876 Biarritz Ct. ASSESSOR'S PARCEL NUMBER ----- TRACT OWNER NAME William Emberton ADDRESS 28876 Biarritz PHONE 619-438-2874 EMAIL ----------- APPLICANTNAME Sierra Sprague- ADDRESS 30300 Puerta Vallarta PHONE 951-301-0067 EMAIL -allstar.sierra@gmail.com CONTRACTOWSNAME Sierra Sprague OWNER BUILDER? 0 YES ONO BUSINESS NAME All Star Water Heaters ——— ADDRESS 30300 Puerta Vallarta Way PHONE 951-30.1.-0067 - EMAIL alistar.sierra@gmail.com CONTRACTOR'S STATE LIC NUMBER 812894 LICENSECLAS51FICATION C36 VALUATIONS 800-00 SQ FT LSQFT APPLICANT'S SIGNATURE DATE-, --6F--E BUSINESS LICENSE NUMBER DEPARTMENT DISTRIBUTION CI MEWE BUILDING PLANNING ENGINEERING FIRE GREEN SMIP ___f IV OCREDIT CARD VISA/MC INVOICE PAIUAMOUN7 OCASH 0CHECK# AMOUNT INVOICE 7 MOUNT PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK#_ OCREDITCARD VISA/MC OWNER BUILDERVERIFIED, OYES 0 No D-L NUMBER NOTARIZED LETTER OYES 0 NO ­.__.Cjty0ftMnft8 fit CA 5.258C9';BUi1dln91)ept* I5 J 246.621-3 MAY 2018 Received ved � ryr � � m -• �'' ° a r ai se - jam v.0 01 C sf2t� < a p O T y �.>s gon � r 3w � N 06 d N u a ! 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