PMT18-02523 City of Menifee Permit No.: PMT18-02523
29714 HAUN RD. Type: Residential Plumbing
�A-CCEL/� MENIFEE, CA 92586
MENIFEE Date Issued: 05/23/2018
PERMIT
Site Address: 28927 ESCALANTE RD, MENIFEE, CA Parcel Number: 351-270-002
92587 Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL GAS WATER HEATER, SAME LOCATION
Work:
Owner Contractor
STEVEN CASE ALL STAR WATER HEATERS INC
28927 ESCALANTE ROAD 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92587 MENIFEE,CA 92584
Applicant Phone:9513010067
SIERRA SPRAGUE License Number:812894
ALL STAR WATER HEATERS INC
30300 PUERTO VALLARTA WAY
MENIFEE, CA 92584
Fee Description ON Amount f81
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 varied 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
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 Licenpse No. ecyZ'2e2f By my signature below l acknowledge that,except formy personal residence
Expires .j0 Signature�64 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 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 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 3700 of the Labor Code,for the performance of work for which ,,vww,leeinfo.ra.eov/calaw.lztml.
this permit is issued.
Policy p Date
fad 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 WPy 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 owner's behalf.1 have read this
numberare: application and the information I have provided is coned.I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city orr county
un to
Policy g � /�j C�](L Expires enter the above identified property for Inspection purpose1'�-t""`
(This section need not to be completed Is the permit is for one-hundred a � pate
dollars($100)or less PROP--"NER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit is issued, O�
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE g
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 370D of the Labor
Code,1 shall forthw co ply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Oate mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAI J SECURE WORKER'S COMPENSATION COVERAGE 15 o Yes ItyAo
UNLAWFUL,AN SHALL SUBJECfAN 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 Districtconstruction
or modification
permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Airlines
Qua
CONSTRUCTION LENDING AGENCY o Yes �MNo
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 _oNo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
1 hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractor's 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.
r�
Business and Professions Code).Any city or county that requires a permit to pYes o No pate
construct,alter,improve,demolish or repair any structure,priorto its PROPERTY OWNELt 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 Contmctor's 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 Iicensure receiving compensation for most work that disturbs paint in apre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare n for to heork that disturbs
flecl bs paint
and comply with
than
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 I,as owner of the property,or my employee with wages as theirsole 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 Contractor's State License Law 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 ofsale. o No EPA Lead-Safe Certified Firm is required forthis 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 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
1 7",
DATE PERMIT/PLAN CHECK NUMBER _Rtm_Aba_Q �_
TYPE: 01 COMMERCIAL ZRIESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME - 0 POOLISPA 0-SIGN
SUBTYPE: 0 ADDITION C,ALTERATION I.)DEMOLITION ELECTRICAL 0 MECHANICAL
ONEW MO(PLUMBING- 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPT'ON OF WORK Replace existing water heater. Same size and location.
PROJECT ADDRESS 28927 Escalnate Rd.
City of Menifee
ASSESSOR'S PARCEL NUMBER _Zepj::_q-jD 6(�Oa LOT kftjajng_Dqpt..__
OWNER.NAME Steven Case
ADDRESS 28927 Escainate Rd.
PHONE 909-615-8170 EMAIL
__-Recei
APPLICANT NAME Siena Sprague
ADDRESS 30300 Puerta Vallarta
PHONE 951-301-0067 EMAIL alistar.slerradgmaii.com
CONTRACTOR'S NAME Sierra Sprague 0 YES 0
BUSINESS NAME All Star Water Heaters
ADDRESS 30300 Puerta Vallarta Way
PHONE 951-301-0067 EMAIL allstar.sierra@gmail.com
CONTRAcrows STATE LIC NUM13ER 812894 --L—ICENSECLAS—SIFICATIO.N- C36
VALUATION$ 800-00 So FT LSQFT
APPLICANT'S SIGNATURE DATE 3
_7F2:
2e,
C[TYOF MENIFEE BUSINESS UCENSE NUMBER
DEPARTMENT DISTRIBUTION
BUILDING PLANNING ENGINEERING FIRE GREEN SNIIP X
A6PAID AMOUNT 0 CASH 0 CHECK 9 OCREDITCARD NSA/MC
PLAN CHECK FEES I PAIDANIOUNT 0 CASH 0 CHECK 4 OCREDITCARD VISAINIC...
OWNER BUILDER VERIFIED 0 YES 0-NO DL NUMBER NOTARIZED LETTER 0,YES 0 No
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