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PMT18-02094 City of Menifee Permit No.: PMT18-02094 29714 HAUN RD. �CCEL.A—> MENIFEE, CA 92586 Type: Residential Plumbing MENIFEE Date Issued: 0 510 1/2 01 8 PERMIT Site Address: 25810 INTERLECHEN DR, MENIFEE,CA Parcel Number: 339-123-017 92586 Construction Cost: $19,500.00 Existing Use: Proposed Use: Description of REPIPE WHOLE HOUSE WITH PEX PIPE, EXISTING WATER HEATER Work: Owner Contractor TOM WEST A R S AMERICAN RESIDENTIAL SERVICES OF 25810 INTERLECHEN DRIVE CALIFORNIA INC MENIFEE,CA 92586 965 RIDGE LAKE BLVD#201 Applicant Phone:9012719700 ANDREW ALLEN License Number:765155 A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNb 965 RIDGE LAKE BLVD#201 MEMPHIS, CA 38120 Fee Description pty Amount lEl Piping/Repiping Single Family Residential 1 163.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 8.15 $199.15 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 Marilee.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_Bidg_Pernil_Template.rpl Page 1 of 1 /�� k eo- Av__s CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects 1 hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chopter9(commencing with section 7000)of Division 3 of the Business and o 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 Claiss License No J QQ By my signature below I acknowledge that,except far my personal residence Expires 1 Signature inwhich l musthave resided for at least one year priorto completion of improvements covered by this permit.I cannot legally sell a structure that WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by D 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 Cade,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 ,MyN,,leeinfo.ca.¢ov/calaw.htmi. this permit is issued. Policy# Date �,-I 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 signature below I certify to each of the following:)am the property this permit is issued.My workers compensation insurance carrier and policy wr 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 d with all applicable city and coun lances and state laws relating to building stru loath representatives of this city or county to policy# " (� � Expires enter th dentifi erty for inspection purposes. (This section need not to be completed is the permit is f role-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT certify that in the performance of the work for which this permit is issued, -I shall not employ any perso in any manner so. to become subject to the CITY BUSINESS LICENSE# workers compensation sofC I nia,a ree that if l should become HAZARDOUS MATERIAL DECLARATION subject to the wor s co e�ion ' Ions of Section 3700 ofth Labor Code,Ishall fo Ith wit rcv Ions. / Will the applicant or future building occupant handle hazardous material or Applicant - Date 6 �f mixture containing a hazardous material equal to orgreater thatthe amounts spe lied on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATIO COVERAGE IS ❑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 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 o Yes -d-6os 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) ❑Yes 1,!IN-o OWNER BUILDER DECLARATIONS Ihave read the Hazardou daterial Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist. rider d my require under the State of Contractors License Lawforthe reason(s)indicated below by the California Heal Saf de,Section and 25534 concerning checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 hazardous eda rting. / Business and Professions Code).Any city or county that requires a permit to Ares o -V /J,S Date L construct,alter,improve,demolish or repair permit toile a prior to its ROPERTY 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(RRPI 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 he 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 ownerand 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.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 D 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. ❑No EPA Lead-Safe Certified Firm is required for this project because: D 1,as owner of the property am exclusively contracting 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 & SAFETY PERMIT/PLAN CHECK A. • • �Menifee DATE 511119 PERMIT/PLAN CHECK NUMBER 0A TYPE: []COMMERCIAL RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA 8E: SUBTYPE: [-]ADDITION ❑ALTERATION ❑DEMOLITION [:]ELECTRICAL ❑MECHANICAgU((dlll9 De pt. ❑NEW PLUMBING ❑l RE-ROOF-NUMBER OF SQUARES iVOp DESCRIPTION OF WORK fifpjZEr Ice p,pe "- + wL n Received PROJECTADDRESS I Q fJ' (L L N ASSESSOR'S PARCEL NUMBER ?,mil- la3-OI'► LOT TRACT OWNER NAME '1 V M e,—=ir ADDRESS OSS10 I r4 VE—,R L .,1 PHONE goy- 59-1 -//��ti�-1 EMAIL APPLICANT NAME A ( I LVN ADDRESS 15ol0 W L i NDJ=N 5-1 1 vI- ( 7 Ste? PHONE 95'I513EJI li -11 EMAIL CONTRACTOR'S NAME OWNER BUILDER? ❑YES NO BUSINESS NAME ,�/ `�y ADDRESS So1CJ Ll b fZlVa�—G CA .)-- PHONE Sr,�tit(. �(3?( EM CONTRACTOR'S STATE LIC NUMBER `j LICENSE CLASSIFICATION VALUATION$ erC L SQ FT _ APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP x INVOICE PAIDAMOUNT AMOUNT ' I5 •IJ O CASH O CHECK R O CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK N OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-5213 �SBty I n +��tlne.� Alhole AOLse /��X 'eeffilc City ofMenifee Building Dept. MAY 01 018 Received lb 61 7ii H 't I fob V " LAUw�Fy I G 1 i i i �I4 , 1 1 ,II l I CITY OF MENIFEE BUILDING AND SAFETY DEPARTME1 T PLAN APPROVAL REVIEWED BY r511 I DATE 'Approval of these plans shall not be construed to be a permit or,Ora n approval of,any violation of any provisions of the federal,stall or city regulations and ordinances. This set of approved plans must bi kept on the 'obsite until completion. a�Nr pr