PMT18-02384 City of Menifee Permit No.: PMT18-02384
29714 HAUN RD. Type: Residential Plumbing
�CCEL/-> MENIFEE,CA 92586
MENIFEE Date Issued: 0 511 612 01 8
PERMIT
Site Address: 27086 WENTWORTH DR, MENIFEE,CA Parcel Number: 336-060-006
92586 Construction Cost: $2,515.00
Existing Use: Proposed Use:
Description of REPLACE 40 GAL WATER HEATER INSIDE CLOSET
Work:
Owner Contractor
DORTHA SCHNEBLY A R S AMERICAN RESIDENTIAL SERVICES OF
CALIFORNIA INC
965 RIDGE LAKE BLVD.9201
Applicant Phone:9512769744
A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIU License Number:765074
965 RIDGE LAKE BLVD.#201
MEMPHIS,CA 38120
Fee Description ,OQrt Amount l5l
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 Wilding 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_Permit Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter9(commencing with section 700D)of Division 3 of the Business and n I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force a ffect. he following reason:
License Class ( 20 L.3�.P Lic s o.-t/1 By my signature below l acknowledge that,except for my personal residence
Expires Signature I in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DE[lA TIO 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 wabsite:
by Section 3700 of the Labor Code,for the performance of work for which www.leginfa.m.aov/ alaw.html.
this permit is issued.
Policy# Date
�'tirave 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 O 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 L.l with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# I(OS1SS' 3(0«xpires enter the above identified property far Inspection purposes.
(This section need not to be completed Is the permit is to,one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit is issued, OJ't�
::JJ��.-..eV!
I shall not employ any persons in arty manner so as to become subject to the CITY BUSINESS LICENSE If
LA
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the war a{s comp"9!PpbnjRcav61lzns ofS 370D of the labor
Code,l shall f th co pl( 1 use visf ill the applconticant ining a future hazardous
ing matericupant al equal to or greatehazarr
ousthat
material or
mixture containing a hazardous material equal to or greater that the
Appl(can Date L IS amounts specified on the Hazardous Materials Information Guide?
WAR N • ILURETOSEC WORKER'S[OMPENSATI COVE GELS oyes VNo
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($20D,0001,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 aYes VNo
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 `nguo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
hereby affirm under penalty aF perjury that I am exempt from the permitting checklist.I understand equire under the State of
Contractor's License Law far the reason(s)indicated below by the Califomi a Ith&Safe ec ion 2 nd 25534 cancer ing
haza pus aterial
checkmark(s)I have placed next to the applicable Items)(Section 7031.5 $� p
Business and Professions Code).Any city or county that requires a permitto Date
construct,alter,improve,demolish or repair any structure,prior to its PROP N ORIZED 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 Contractor's State A RENOVATION REPAIR AND PAINTING IRRPI
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 be RRP-certified firms and comply with
an Applicant for a permitsubjects 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
O1,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( 1 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-BOD-424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a 0An 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:
01,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 ifyour project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
rct
-� 'lenifee
DATE: PERMIT/PLAN CHECK NUMBER T Z
TYPE: L COMMERCIAL ': RESIDENTIAL J MULTI-FAMILY C MOBILE HOME � POOL/SPA O SIGN
SUBTYPE: ADDITION -'ALTERATION DEMOLITION ^ ELECTRICAL MECHANICAL
NEW b<PLUMBING RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK '40 (&GS 0. �� CJ�O-Q.-�
G 1 ,
PROJECTADDRESS 2.108LQ L/Jejn.� LA30r „ y7(', ZIP ZS'
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME _Z: 16Af\ N)
ADDRESS SAME AS JOBSITE City of Menifee
PHONE &S-1) -669 - ) qZ3 EMAIL Building t
APPLICANTNAME nC.l I�w1l MAY 15 2018
ADDRESSy,�G_
(5OV °PHONE
C¢Ca O �lo'Z S EMAIL
CONTRACTOR'S NAME RIGHTIME HOME SERVICES OWNER BUILDER? -- YES NO
BUSINESS NAME AIRS
ADDRESS 3030 MYERS ST RIVERSIDE CA 92503
PHONE 800 660 0675 EMAIL CCAL.HOUN@ARS.COM
CONTRACTOR'S STATE LIC NUMBER 765074 LICENSE CLASSIFICATION C10 C20 C36
VALUATION$ Z LS S L SQ FT pp
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY:
PERMIT FEE c, SMIP 0, 1
GREEN
PLAN CHECK FEE INVOICETOTAL
OWNER BUILDER VERIFIED YES NO DRIVERS LICENSE N NOTARIZED LETTER `.! YES :, NO
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