PMT18-02536 City of Menifee Permit No.: PMT18-02536
29714 HAUN RD.
�CCEL./> MENIFEE,CA 92586 Type: Residential Plumbing
MENIFEE Date Issued: 05/24/2018
PERMIT
Site Address: 27861 MAYWOOD BEND DR, MENIFEE, Parcel Number: 333-300-001
CA 92584 Construction Cost: $6,000.00
Existing Use: Proposed Use:
Description of REMOVE AND REPLACE EXISTING TUB SAME LOCATION DRAIN&FIXTURES. MINOR DRYWALL
Work: REPAIR
Owner Contractor
BRENT FULLER MAROUNI INDUSTRIES INC
27861 MAYWOOD BEND DR 4572 LINDEN AVENUE
MENIFEE,CA 92585 LONG BEACH,CA 90807
Applicant Phone:7142255252
RAGHI SALG License Number.960577
MAROUNI INDUSTRIES INC
4572 LINDEN AVENUE
LONG BEACH,CA 90807
Fee Description Oft Amount f$1
Building Permit Issuance 1 27.60
Inspections not specified 129 129.07
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 6.45
$163.52
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 building 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 Rldn P.r it T.mM.1.rM Pan.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 D I 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 22 License No. / t.057 7 _ B m signature below I acknowledge that,except for m
y y g g p y personal residence
Expires /S/Jze/9 Signature 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 DECLARATION 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 this permit is issued. www.leginfo.ca.gov/calaw.htmi.
r�
Policy#SZIbS0 4 3 21 9&76 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 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 (s'{:6 IR-t/I Lt/silk Au/C $fR D ZES I ,L le with all applicable city and county ordinances and stale laws relating to
building construction.I authorize representatives of this city or county to
Policy If Expires � J2o/$ enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred
dollars($100)or less Date
PROPERTY OWNER OR AUTHORIZED AGENT
o 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 BUSINESS 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
Applicant Date 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 IS D Yes 6196
o
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($100,0001,IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guideline
CONSTRUCTION LENDING AGENCY ❑Yes ffNo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 3000 feet of the
lending agency for the performance of the work which this permit Is issued outer boundary of a school?
(Section 3097 Civil Code) ❑Yes m 1
OWNER BUILDER DECLARATIONS 1 have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that t am exempt from the permitting checklist.I understand my requirements under the State of
Contractors License Law for the reason(s)indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable items)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to oyes � Qd Date 2 Q '$
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORI EZ DAGEbENT
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 receivingcompensation for most work that disturbs
and the basis for the alleged exemption.Any violation of Section 7031.5 by p paint in a comply
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
o 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.aoy/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 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. ❑No EPA Lead-Safe Certified Firm Is required for this project because:
D 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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL GIESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA 0 SIGN
SUBTYPE: "ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK .fV 9DG L gArH
PROJECT ADDRESS 2 7f 6 { o111r'AJ ZIP 112595
2/
ASSESSOR'S PARCEL NUMBER 2jj ✓K/' T TRACT
OWNER NAME R -T (/ L ^ R
ADDRESS `Z 6 ( LJOXWT\ GrAjj:> J)R , MEAlIVECE 0,A 91Z 513s
PHONE cS 1 - 66 3 _29 y 9 EMAIL
APPLICANT NAME L
ADDRESS 3111 ,. AftRALqA60 AA114.1-ligidp fj
PHONE 7/L/_/ 3 Z _ /)/ I EMAIL
CONTRACTOR'S NAME R{j(1 Af 1 141 V S-flit 1 -S OWNER BUILDER? O YES O NO
BUSINESS NAME
ADDRESS S L1n! 1/G J.ed C cH CA $b
PHONE 7/41_ 22 S -57-5 2 EMAIL
CONTRACTOR'S STATE LIC NUMBER 9(0377 LICENSE CLASSIFICATION
VALUATION$ 6 dV p SO FT L SQ FT
APPLICANT'S SIGNATURE DATE
MYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL GREEN SMIP
OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee,CA 92586 (951)672-6777
www.cityofmenifee.us
NIF
City of Menifee r
Building Dept.
MAY 242018 �-
Received
r co
CCIO
CITY OF MENIFEE
BUILDING AND SAFE DEPARTMENT
PLAN APPROVAL
REVIEWED BYlk-
DATE
'Approval of these plans shall r&tl&construed to be a permit for,Oran '
approval of,any violation of any pr r4hions of the federal,state or city
regulations and ordinances, This of approved plansmust be kept on the
jobsite until completion.
b I '-IAYVv0A>
/41 Al6fC- - CA I ?
ry
MAROUNI INDUSTRIES INC
of ifee
4572 LINDEN AVENUE City Building Dept.
LONG BEACH ,CA 90807 MAY 2 4 2018
Ph:714-225-5252 Received
Marouni Industries Inc authorizes RAC- Hip -5AL671Y to
pull the permits needed from the City of
for the property located at
Thank you for your cooperation
VINC T DOCHE /President
A notary Public or otlyt oflteer campletMy this certificate verifies only the
identity of the 1mAvid"whe sitpMd she document to whlch'this certificate
is attached,and not the ttdthftth",accttraty.err validity of that document.
State of Cal ornia^
County of
f
Subscribed aM sworn toaaf.,,ptmecil before me on this .�"` , yday
Io&,by
proved to me on the basis
�IAHE hP+YAAtiDAI! ' of sat a'orY v encgtn-bet per r5ts►_who apP a�before me.
Comm'tssiw,4!2CS7206
?ublic-Cziifornia
Orange ODUT4.
c rr c:-tria Jan 15,2a39J �