PMT18-02633 City of Menifee Permit No.: PMT18-02633
29714 HAUN RD.
'ACCELA- MENIFEE,CA 92586 Type: Residential Plumbing
MENIFEE Date Issued: 05/29/2018
PERMIT
Site Address: 29962 WESTLINK DR,MENIFEE,CA Parcel Number: 340-112-009
92584 Construction Cost: $2,263.00
Existing Use: Proposed Use:
Description of REPLACE 40 GAL GAS WATER HEATER IN GARAGE
Work:
Owner Contractor
GLENDA RILEY AFFORDABLE WATER HEATERS AND PLUMBING
29962 WESTLINK DRIVE INC
MENIFEE, CA 92584 28358 CONSTELLATION ROAD#698
Applicant Phone: 8553459087
GREGORY GUERRY License Number:627368
AFFORDABLE WATER HEATERS AND PLUMBING INC
28358 CONSTELLATION ROAD#698
VALENCIA, CA 91355
Fee Description 01t rr Amount 1$)
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
Gee. Gu - Abby
CITY OF MENIFEE tl�d ��,�5
LICENSED DECLARATION property who builds or improves there_on;and tra r t eH projects
I hereby affirm under penalty of perjurythat 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 ❑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 C 3 Sa License No. e--Z 3 6 By my signature below I acknowledge that,except for my personal residence
Expires.q-7�0-1`5 Signature in which l 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
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 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 www.leginfo.ca.gov/calaw.htmi.permit is issued.
Policy Date
PROPERTY OWNER OR AUTHORIZED AGENT
',O'have and will maintain worker's compensatlon insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which D By my signature below I certify to each of the follow(ing: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 1 have provided is correct.I agree to comply
Carrier r c co cp )p .(r with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# L,7Sh SO3ZcPeq 710e Expires r-�oI -O ( —f e( 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
D 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 If
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 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applicant Date S-('S'L amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SE WORKER'S COMPENSATION COVERAGE IS Dyes mN
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES 6010
0
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000I,IN Will the tended use of the building by the applicant orfuture building
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 forguidelines
CONSTRUCTION LENDING AGENCY nYes goo
1 hereby affirm that under the penalty of perjury there is a construction Will t e 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 (lo
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
California Health&Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazardous material reportin .
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5
Business and Professions Code).Any city or county that requires a permit to Oyes Ao Date -
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AU IZEDAGENT
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 EPA RENOVATION,REPAIR AND PAINTING(RRPI
License Law(Chapter9(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 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
❑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.eoa.Rov/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 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 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.
BUILDING s . IT/PLAN ':
/
ti.
iAlerifee
DATE PERMIT/PLAN CHECK NUMBER ca
i
TYPE: O COMMERCIAL RESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME O POOL/SPA 0 SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
ONEWPLUMBING ORE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
PROJECTADDRESS ZG q& WCS+� Nk 12 0'1
ASSESSOR'S PARCEL NUMBER 3�-�0 . ;ice" �� I LOT TRACT
PROPERTY OWNER'S/NAME a�d� ,� City Of Menifee
ADDRESS/2C`l G I G-2- I�� n�-� I V2 , Pp.
PHONE `I -5 I - y �'�"I �J EMAIL MAY 2 9 2010
APPLICANT NAME
ADDRESS [A G n,
PHONE -�10� EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES ONO
BUSINESS NAME Lk jNegoaS
ADDRESS 1fj/�� o1l
PHONE �j j5'�L l�s �.�"1� EMAIL
CONTRACTOR'S STATE LIC NUMBER ����i/�� LICENSE CLASSIFICATION
VALUATION $ 2 2 Ci'3 SOFT L SQ FT q
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT AMOUNT 11�'1� �� I� 0CASH 0 CHECK N 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH 0 CHECK# 0CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES 0 NO
Qry of Nleni ee Building w Safety Oepartmient 29714;-'aun Rd. Pl4enifee, CA 92586 951-672-5777
,vwvv.ciryofinenifee.us Inspectfon Request Line 951-246-6213
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