PMT18-03280 City of Menifee Permit No.: PMT18-03280
29714 HAUN RD.
,,li MENIFEE,CA 92586 Type: Residential Plumbing
MENIFEE MENIFEE Date Issued: 06/29/2018
PERMIT
Site Address: 29091 SILVER STAR DR, MENIFEE, CA Parcel Number: 340-351-002
92584 Construction Cost: $1.237.50
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL GAS WATER HEATER IN GARAGE
Work:
Owner Contractor
BENJAMINE TIGILAU A R S AMERICAN RESIDENTIAL SERVICES OF
29091 SILVER STAR DRIVE CALIFORNIA INC
MENIFEE, CA 92584 965 RIDGE LAKE BLVD#201
Applicant Phone:9012719700
JIM PHILLIPS License Number:765155
A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNb
965 RIDGE LAKE BLVD#201
MEMPHIS, CA 38120
Fee Description Oft Amount IE)
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
$115.16
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_aldg_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).
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:
7 �
License Class (o License 5 By my signature below I acknowledge that,except for my personal residence
Expires Signatu 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 COMPENSA7 DEC TION have built as an owner-builder if it has not been constructed in its entirety by
❑I hereby affirm and r pe of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will mainta 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 www.leginfo.ca.gov/calaw.htmi.permit is issued.
Polity p
Date
❑I 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 ❑By my signature below I certify to each of the fallowing:I am the property
this permit is issued.My workers compensation insurance carrier and polity 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 agreeto comply
\I/\ '` with all applicable city and county ordinances and state laws relating to
Carrier ICJ r, building construction.I authorize representatives of this city or county to
Policy#10d21 3DS4�L3 1 Expires D rS 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 PROPERTY OWNER OR AUTHORIZED AGENT
❑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 q
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 forth ith o q'w'tff"th� provisions. // Will the applicant or future building occupant handle hazardous material or a
Applican \ - Date 1 — hj�' mixture containing a hazardous material equal to or greaterthat the
amounts specified an the Hazardous Materials Information Guide.
W NI :FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ayes ❑No
N FUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
D CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($300,000),IN occupant require a permitfor the construction or modification from South
ADDITION 7O 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 guidelines
CONSTRUCTION LENDING AGENCY ❑Yes ❑No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 10DO 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 ❑No
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 al Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5
oyes ❑No
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 PROPERTY OWNER 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRPI
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 Cade)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 workthemselves or through their
❑I,as owner of the property,or my employee with wages as their sale employees.For more information about EPA's Renovation Program visit:
compensation,will do( I all of or( I portion of the work,and the structure is www.epa.gov/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 ❑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:
❑I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Cade:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RAP rule please fill out the RRP
Acknowledgement.
�1
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 06/29/2018 PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION []ELECTRICAL ❑MECHANICAL
❑NEW ❑✓ PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace 50 gallon gas water heater in-gasp o("LL e
PROJECTADDRESS 29091 Silver Star Dr.Menifee Ca.92584
ASSESSOR'S PARCEL NUMBER No— s2a-cc& LOT TRACT
OWNERNAME BenjamineTigilau
ADDRESS Same as project address Building Dept.
PHONE (951)376-7636 EMAIL JUN 2 9 2018
APPLICANT NAME Jim Phillips
ADDRESS 1520 W Linden Street Riverside,CA 92507 ReceReceived-
ved-
PHONE (951)341-9371 EMAIL
CONTRACTOR'S NAME ARS Rescue Rooter OWNER BUILDER? ❑YES QNO
BUSINESS NAME
ADDRESS 1520 W Linden Street Riverside,CA 92507
PHONE (951)341-9371 EMAIL
CONTRACTOR'S STATE LIC NUMBER 765155 LICENSE CLASSIFICATION C36
VALUATION$ $ 1,237.50 FT L SQ FT
APPLICANT'S SIGNATURE DATE a'G
_ cr
DEPARTMENT DISTRIB TI \< I
CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP
INVOICE I PAIDAMOUNT
AMOUNT 5' li O CASH O CHECK N O CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK# 0CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Deportment 29714 HGun Rd. Menifee, CA 92586 951-672-6777
www.cityoj`menifee.us Inspection Request Line 951-246-6213
j Z
wD m n MD 9mcm Fri
�a
CL
m p u m m m .d. 3 pip 'O n Z 'M -^ y m n
CC C C 3 D m n m m <' s y Z
A G N C C O O j O 00 G. :� m � 0
,d„ w In O IN A n C n Z = m D a m
v o 3 0 o fD o F 'm , 3 to �N m r N O mDz
3 m c m m o m `El. w v < m o D Z C.
d. M M N y m t N m n
3 m
0 o w m -F,. ami �, m N
m T n m m c � o c m m m �" y In 1 D D
o m 3 3 F o Md 1 -1 O d Z
m < °—' m m x l m d
j m B o o a a aofD
3 o 0 n v o' m 3 o a Ul
m .. x 3 d '° 3 x a m in' 3 u, m -w CDCD C O�
mN QOZ <dm S wp m.O N
D -nm w cm Oowm a d 0 0
mD
Q m
o.d3 m Fvi, n cm $l omi �
S c o
ty
M
m rNe d C d ^ 1 N In <a d O
C O
o
I m O
g o m a m
N d fD d G
n �n ^ 3 m H M
O
d �
n
f. m
d — !� =
o 3 C'
N CL
O of �
n
^m
I m n Z n
^ n0
w > � O � d m S A �n I-� ❑
(0 3 p m n m r 0 C_ OQ
O n
n.
'O d n c �p d y
E. 3
O O D
3 3 * m m d
r' H m .dr O m N fFD
w w �j S
O OA
A ` 2
Od0 .di n rds 2 m 0 ? d
m m m o 3 m o
r d v m m
u o o C 2 0
m 3
d m n m C
o n F, .d. 3 a c m o =. cC m m
w w r � m ° 3 Fw O p z
m w c m
3 ^ W
C
O �N LL
J ma
d \ m J
w C a
W
F d u O N m C m h
3 v T c N a C
W. u 3
' o •i c v '° N a s ✓1
a LL a o v e v e r �r
o Y xc o1
w = O a E m u
U > m n U m 'u i+ ' J
d
v w o v
w 1
N o u C ^\
E •� a"i o � w a v w a m �
a w U CO m v o y > vYi Vp
O a U N N C a U O
m C Y O E em y m N u Y m Ih
a a N
vOi o = c C C O aa+ ry
O L m
u 1 [] n
Y
0
3 w c a o c ��°, m u a `a ,d,• o c
3 v o ti c L vNT a m u E c =
.- Y O >.
Ea w m n v a o ° s a d m v m
a m W
75
>
3 ` g
Y
m o LL o 0 > c E u 3. ° N 'g
C a m C a L 0 mC O m u
C ` O Y W a o F :+ Y
_ m o w O N ° — u Z m
y C = E
�.+ m ate+ N Y J W. OL a J a 6 m C W ¢
u `o > > t E u E a c o c •�
m ,4 C u W O O. E iy Y o Y N !? to Z d 3 V e
N a Y Y V= J = >• N Y y O' C I O C ❑
O N a� Y d tJ a C aa. W C N w O C FQ'.
N •N = E 'L V
4 m a 3 E m o a t' > oC m
CL a-i W w C a`+ 6 a' 3 u u a 0 > N l <
ji ¢ m a > w vi > m _ N m 'm' 'p G m O u c
m ; « a u m > J = 3 L E w
y T C7 Y Y y
a J ami a a a w W 5 N = O
d E
C_ y .S F- 9 9 « •w 9 O Y Y 1° O Y / 111^1 O
w 0 Z d .a.. .m m m �. x m a o 3 0 ¢ m ` ` n d
a 3 J m m d d d
F a Z N E W S' 1� S S N W fC V C U z Y C
uuq W T . .a. 'Ny
_ E v
w u - O • Z U ¢ U W
o_