PMT18-03296 City of Menifee Permit No.: PMT18-03296
29714 HAUN RD.MENIFEE, CA 92586 Type: Residential Plumbing�
MENIFEE MENIFEE Date Issued: 07/03/2018
PERMIT
Site Address: 27728 VANILLA CT,MENIFEE, CA 92585 Parcel Number: 331-380-027
Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL GAS WATER HEATER,SAME LOCATION
Work:
Owner Contractor
ROD NAKAYAMA ALL STAR WATER HEATERS INC
27728 VANILLA COURT 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92585 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 O0rt Amountis
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_Permil_Template.rpl 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 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 ficensure underthe Contractor's State License law for
Professions Code and my license Is in full force and effect. the following reason:
License Class License No.L/'&,9!z By my signature below l acknowledge that,except formy personal residence
Expires O Signature _%�� , in which l must have resided for at least one year priorto completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that
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 ofself-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 webshe:
by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. www.IeRinfo.ca.gcry/caIaw.Ii1m[.
Policy If Date
M 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 ofthe work forwhich Wy my signature below l 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
numberare: application and the information I have provided is correct I agree to comply
Carrier G L with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this dty,or county to
Polity#_,��r/L�S�.P.P/R70.S Expires enter the above identified property for inspection purposes./(This section need not to be completed is the permit is for one-hundred —e4 "hsOs�_ Date,L,L,4 dollars($100)or less PROP 1d NER OR AUTHORIZED AGENT
IVA
o I certify that in the performance of the work for which this permit is issued, O / O
I shall not ern ploy any persons in any manner so as to become subject to the CITY BUSINESS LICENSE J
worker's compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,i shall forth vi 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:FAII U SECURE WORKER'S COMPENSATION COVERAGE IS o Yes 'tyNo
UNLAWFUL,AN SHALLSUB1ECf 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($100,000),IN occupant requires permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCtionor See permitting from
checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airlines
Qua
CONSTRUCTION LENDING AGENCY Ayes ,qND
I hereby affirm that under the penalty of perjury there Is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) o yes IN_,No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD
I hereby affirm under penalty of perjury that l am exempt from the permitting checklist.I understand my requirements underthe State of
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)1 have placed next to the applicable item hazardous material reporting.$)(Section 7031.5 `Oyes O No
Business and Professions Code).Any city or county that requires a permit to Dale
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER ORAl7THORIZED 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 EPA RENOVATION.REPAIR AND PAINTING(RRP)
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 far most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensor ationre ffi mosty to RRPthat disturbffied painico pre-19ply th
than
Applicant fora permit subjects the applicant tpacivil penalty of not more required practices.This includes rental property owners andproperty
than($500). managers who do the paint-disturbing work themselves or through eir
col,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.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 Contmctols State License Law does not apply to an owner of oAn 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 ofsa le. o No EPA Lead-Safe Certified Firm is required for this project bemuse:
o I,as owner of the property am exclusivefy.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
v u;
DATE Ulm PERMIT/PLAN CHECK NUMBER "1
TYPE: 0 COMMERCIAL ❑✓RESIDENTIAL O MULTI-FAMILY C MOBILE HOME O POOL/SPA o SIGN
SUBTYPE: O ADDITION o ALTERATION O DEMOLITION C ELECTRICAL 0 MECHANICAL
O NEW ✓PLUMBING G RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace existing water heater. Same size and location.
Cit T�of M- nifee
PROJECT ADDRESS
27728 Vanilla Ct. Building )ept.
ASSESSOR'S PARCEL NUMBER �J'-650-6, LOT TRACT JUL 02 2018
OWNER NAME Rod Nakayama ADDRESS 27728 Vanilla Ct. e' GQp
�
PHONE 951-275-2556 EMAIL
APPLICANT NAME Sierra Sprague
ADDRESS 30300 Puerta Vallarta
PHONE 951-301-0067 EMAIL allstar.sierra@gmail.com
CONTRACTOR'S NAME Sierra Sprague OWNER RUILDER7 O YES ONO
BUSINESS NAME All Star Water Heaters
ADDRESS 30300 Puerta Vallarta Way
PHONE 951-301-0067 EMAIL allstar.sierra@Ggmail.com
CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36
VALUATION$ 800.00 SQ FT L SQ FT
APPLICANT'S SIGNATURE. DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING PfRE GREEN SMIP k�
INVOICE `y. PAIDAMOUNT 1
AMOUNT :J O C SH C CHECK* O CREOITCARD VIWMC
PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZEDLE17ER O YES O NO
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