PMT18-02848 City of Menifee Permit No.: PMT18-02848
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Plumbing
MENIFEE MENIFEE Date Issued: 06/1112018
PERMIT
Site Address: 29420 THORNHILL DR,MENIFEE, CA Parcel Number: 338-061-018
92586 Construction Cost: $2,677.00
Existing Use: Proposed Use:
Description of 40 GAL GAS WiER HEATER REPLACEMENT,LOCATED IN CLOSET
Work:
Owner Contractor
LAFIERCE SYARSH A R S AMERICAN RESIDENTIAL SERVICES OF
29420 THORNHILL DR CALIFORNIA INC
MENIFEE,CA 92586 965 RIDGE LAKE BLVD.#201
Applicant Phone:9512769744
CHRISTINA CALHOUN License Number.765074
A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIr
965 RIDGE LAKE BLVD.4201
MEMPHIS,CA 38120
Fee Description Qtv Amount f$i
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
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractors)pursuant to the Contractors State License Law).
Chapter!)(commencing with section 7D00)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force 3ridleffect. the following reason:
License Class L sV Lie s o.I�O By my signature below 1 acknowledge that,except for my personal residence
Expires 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 DECLA TIO 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 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.leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy# Date
12111. ve and will maintain workers compensatlon 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
With all applicable city and county ordinances and state laws relating to
Carrier Ct1_� building construction.I authorize representatives of this city or county to
Policy# —f iG31-S-nR G31O/Jxpwes enterthe above identified property for inspection purposes.
(This section need not to be completed is the permit is or 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, ��•,rj',-�u
I shall not employ any persons in any manner so as to became subject to the CITY BUSINESS UCENSE# ��J/�.....te/J
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the war scompe eatl in rgnsofS 3700 of the Labor
Code,I shall f [h co 1 ose visi Will the applicant or future building ecal equal
lhandl
or hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applican J Date l amounts n
s.stp.e�cified on the Hazardous Materials Information Guide?
WAR N (LURE TO SEC WORKER'S COMPENSATI COVE GE IS Dyes y, 0
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant orfuture building
AND CIVIL FINES UP TO ONE HUNDREDTHOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or madiFication 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 D Yes -oho
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 `e440
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 equire under the State of
Californ' Ith&Safe a ion nd 25534 cancer ing
Contractor's License Law for the reason(s)Indicated below by the haza pus aterial r
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 y p
Business and Professions Code).Any city or county that requires a permit to 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 IRRP)
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 7031S 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
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.ena.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-80D-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 of sale. o No EPA Lead-Safe Certified Firm is required for this 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.
AL
DATE: PERMIT/PLAN CHECK NUMBER
TYPE: "COMMERCIAL Y�RESIDENTIAL MULTI-FAMILY ' MOBILE HOME ! POOL/SPA C SIGN
SUBTYPE: ADDITION ALTERATION -_ DEMOLITION ELECTRICAL MECHANICAL
. , NEW V4LUMBING 1`1 RE-ROOF NUMBER OF SQUARESS I n I
DESCRIPTION OF WORK 416 C-,j G, !w, Y -V�' I Y1Si da- ejo
ce
p 1 1f1
PROJECTADDRESS Z, qZ,0 V nr1'�lryh�W �C • 2 ZIP �JZ,S^ J,
ASSESSOR'S PARCEL NUMBER II J-,J D _M(-0� KOT ;/ TRACT d-1 O
OWNER NAME �N OLC L ��,r ie,f&p,
ADDRESS SAME AS JOBSITE
PHONE ✓) COI"` 7OZ('� EMAIL
APPLICANT NAME Y, i n U✓l
ADDRESS
I
PHONE EMAIL
CONTRACTOR'S NAME RIGHTIME HOME SERVICES OWNER BUILDER? YES 7-NO
BUSINESS NAME AIRS
ADDRESS 3030 MYERS ST RIVERSIDE CA 92503
PHONE 600 660 0675 EMAIL CCALHOUN@ARS.COM
CONTRACTOR'S STATE LIC NUMBER 765074 LICENSE CLASSIFICATION C10 C20 C36
VALUATION$ Z 0677 SQ L SQ FT
APPLICANT'SSIGNATURE DATE
CITYSTAFF USEONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
PERMIT FEE 1115.15 SMIP GREEN (�
PLAN CHECK FEE INVOICE TOTAL `15 !,457�
OWNER BUILDER VERIFIED :i YES C' NO DRIVERS LICENSE# NOTARIZED LETTER YES O NO
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