PMT18-02632 City of Menifee Permit No.: PMT18-02632
29714 HAUN RD.
MENIFEE,CA 92586 Type: Residential Plumbing
MENIFEE MENIFEE Date Issued: 06/07/2018
PERMIT
Site Address: 25666 LEAH LN, MENIFEE,CA 92586 Parcel Number: 335-373-007
Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL GAS WATER HEATER, SAME LOCATION
Work:
Owner Contractor
JUAQUIN AYALA ALL STAR WATER HEATERS INC
25666 LEAH LANE 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92586 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 City Amount f$1
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 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)pumuantto the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and a 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 Class License No. Q��.Q�� By my signature below I acknowledge that,except for my personal residence
Expires O Signature in which l must have resided for at least one year prior to completion of
improvements covered bythis permit.I cannot legallysell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
❑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 bythe Director of Industrial Relations as provided for this application is submitted or atthe following website:
by Section 3700 of the Labor Code,for the performance of work for which ,, w,leeinfa.ca.eov/calaw.html.
this permit is Issued.
Policy# Date
('ed 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 "y my signature below I 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.I have read this
number are: L application and the information I have provided is correct.I agree to comply
Carrier C with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy#&yzy ��B[�Zlx Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred
� Date
dollars($100)or less PROPP D NER OR AUTHORIZED AGENT
n I certify that in the performance of the work for which this permit is issued, �" / �i
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 forthw' co ply with those provisions. Will the applicant or future building occupant handle hazardous material or
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAI U SECURE WORKER'S COMPENSATION COVERAGE 15 o Yes ;gFlo
UNLAWFUL,AN SHALLSUBIECT 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 coct(SCAQM tionor See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY oyes (o.No
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 agencyfor the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) o Yes -,kNo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
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 al Safety Code,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 byes o No �
Business and Professions Code).Any city or county that requires a permit to
construct,alter,improve,demolish or repair any structure,priorto its Date y /�
issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNE9 OR AUTHORIZED AGENT
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 be RRP-certffied 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 ownersand property
than($500). managers who do the paint-disturbing work themselves or through their
n 1,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 Contractor's State License Law does not apply to an owner of a n 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:
01,as owner of the property am exclusivel'y.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.
vq
DArT _ PERMIT/PLAN CHECK NUMBER
_ _TYPE: O COMMERCIAL f; RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA 0 SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL.
Ci NEW PLUMBING O RE-ROOF-NUMBER OF SQUARES
DF:r.RIPTION OF WORK Replace existing water heater_ Same size and location.. _
City of Menifee
— —Building Dept, -
PROJECrADDRESS _ 25666 Leah Ln
ASSESSOR'S PARCEL NUMBER LOT _ TRAcrMAY 2 9 1018
OWNER NAME Juaquin Ayala- RecerivW-
ADDRESS 25666 Leah Ln V
PHONE 951-679-6092 _ _ EMAIL
APPLICANT NAME Sierra Sprague p„
i ADDRESS 30300 Puerta Vallarta .,
PHONE 951 301-0067 EMAIL allstar.sierra gmall com
CONTRACTORS NAME Sierra Sprague oVq;dER BUILDER,'? O YES O NO
BUSINESS NAME All Star Water Heaters
ADDRESS 30300 Puerta Vallarta Way
PHONE 951-301-0067 EMAIL allstacslerra@gmail.com
CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36 _ I!
VALUATIONS 800_00 SQFT LSQFT
APPLICANT'S SIGNATURE L - DATE
DEFA i 1[NT DISPoGLITIDN CITY OF MENIFEE BUSINESS LICENSE NUMBER ,
BUILDING PLANNING ENGLVEERING FIRE CiIiEEPJ `� aNIIP w 1
INVOIC€ 11 ^_-E
NIO11N1' //'' -i -
. I -JC'CASH '-CHECKX V GREDR CARD VISA/MC
PLAN CHECK FEESMOVNT 0CASH 0 CHECK 4 OCREDITCARD VISA/MC y91
• OWNER BUILDER VERIFIED OYES ^ NO DL NUMBER NOTARIZED LETTER O YES C NO
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