PMT18-03429 City of Menifee Permit No.: PMT18-03429
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Plumbing
MENIFEE MENIFEE Date Issued: 07110/2018
PERMIT
Site Address: 31683 BRENTWORTH ST, MENIFEE,CA Parcel Number: 372-441-002
92584 Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REMOVE AND REPLACE EXISTING 50G GAS WATER HEATER, SAME SIZE AND LOCATION.
Work:
Owner Contractor
BROOKE REED ALL STAR WATER HEATERS INC
31683 BRENTWORTH 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92584 MENIFEE,CA 92584
Applicant Phone: 9513010067
, CA License Number:812894
Phone:9513010067
Fee Description Qtv Amount($)
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 carded 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_8Idg_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 pedurythat I am under provisions of with a licensed contractar(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and o 1 am exemptfrom Iicensure under the Contractor's State License Law for
Professions Code and my license is in full force and effpeecL the following reason:
License Class License No '9451 By my signature below l acknowledge that,except for my personal residence
Expires /J/O Signature pi� In which I most have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that
have built as an owner-builder If it has not been constricted in Its entirety by
❑1 hereby affirm under penalty of perjury one of the following declaration:) 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
this permit is issued. www.leeinfo.ca.eov/calaw.btml.
Policy g Date
pd 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 of the work for which psBY my signature below 1 certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carrier and polity 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/ with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
POliryft,gFI%1 �j�,P, 7al Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Oate
dollars($10D)or less PROP ld NER OR AUTHORIZEDAGENi
of certify that in the performance of the work for which this permit is issued, ® �/ O��
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE aJ
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 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 an the Hazardous Materials Information Guide?
WARNING:FAI UU SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes �Nci
UNLAWFUL,ANDSHAM SUBJECT 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(SCAQM D)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY oyes jallo
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 '91No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that 1 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 con7�n
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
Bus 'pYes o No
construct,
Professions Code)demo Any orrep irany structure,
uiresprior to its Ito Date / y
issuance,alsoalter,quires h demolish for the permitofile signed to PROPERTY OWNER 0,RAUTHORIZED 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 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 Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint inapre-197B
and the basisfort he mitsdects th applicn. violation Of Section of not o residence or childcare facility to be RRP-cert�ed firms and comply with
than
Applicant fora permit subjects the applicant too civil penalty of not more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves at through their
D 1,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( )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 aAn 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. a 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
Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP role please fill out the RRP
Acknowledgement
BUILDING & SAFETY .ERMIT/PLANCH ECK APPLICATIO
DATE PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL ❑✓RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION. O ELECTRICAL O MECHANICAL
ONEW WVLUMBING ORE-ROOF-NUMBEROFSQUARES_
DESCRIPTION OF WORK Replace existing water heater. Same size and location.
PROJECTADDRESS 31683 Brentworth_St. V ,4V)
ASSESSOR'S PARCEL NUMBER 3 2 'L I - o nz LOT TRACT
OWNERNAME Brooke Reed _ __ _ C' of Menefee
ADDRESS 31683 Brentworth St. Building
PHONE 951-757-9277 EMAIL -_ JUL 09 2018
APPUCANTNAME Sierra Sprague _ Rece_ Received-
ved—
ADDRESS 30300 Puerta Vallarta
PHONE 951-301-0067 _ EMAIL allstar.sierra@gmail.com
CONTRACTOR'S NAME Sierra Sprague OWNER BUILDER? O YES C NO
BUSINESS NAME All Star Water Heaters _
ADDRESS 30300 Puerta Vallarta Way _
PHONE 951-301-0067 EMAIL alistar.sierra@gmail.com
CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36
VALUATION$ 800-00 SQFr ._ . LSQFT -
APPLICANT'S SIGNATURE DATE.-'� _.
DEPARTMENr DISTRIBUTION TN_ CITY-�FF�MILEEN�NIFEE BUSINESS LICENSE NUMBER r
BUILDING PLANNING ENGINEERING TIRE GREEN I SMIP
INVOICE 1 I. PAID AMOUNT
AMOUNT O CASH O t:.I{ECKN C CAEDIT CARD VISAJMC
PLAN CHECK FEES PAID AMOUNT C CASH 0 CHECK x O cREDIr CARD vlsVMc
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER YES O NO
City of lvlenifee Building&Safety Deportment 29714 Haul?Rd,M.enifee,CA92586 95 7-6 72-677 7
WWLV.City0f,nIen1feP. 15Inspection Request Line 951-246-6213
G m ° � `e n 47 n ^ a n mM
nma
IM m a .'y^c mn + tor�r
O 3 a ttl = _N LL m a. T Q 10
S a IDS O n 3 DD r1 a A, Z A s
m r
m
42 c't oO o $ w' o XI G m -D1 b ,-'
zOD
- n F w
m ► m m m p1 s W F) m Z -I
ro m a n m \ ~ IRI
7 2 p m
N am w C N O fl w. N b U n O W
O O
O
in a• o Z
3 3 ' m g w n n °: CA
Oz
GI
3 m x a > > G) Pit
C ry
a Y+
o n Q
_'
N o 0
Q C
m O Y' O n c m N w K
w e w c ro Np n > > O W C
no = 3 3 m3
oT a =
ro N
y j O � � y A � � F m N ❑ $/�
N d nn 3 ro 0)
�
Qos 3co
EL
`J cmCD
roa
CD
D o (D '° A a m o ' 3
00 N D Q
Q � orosj' �' Nrli
t,/t i1� o3�-E2�I ► r COPY
3 3 n 91
1O ao -j m91
v w > > m v a s w m A c g z e z
o O s — N c > ; n a -r ? m c O
O 2 ° 5 3 = a < co w m
c i CD
(CD to
N c
o°v tNJ1 n-1i m Er c N 2 m c n m 3 ��—, > W
ao
7 m m •�• m N ^n •�
7 a N -1 S. 3 ro O 3 •a, n n a t�D
'— R m 3 0 CR3 9:
° w C m a v a o I »
c o' �o D. a fD 'a 3 o w
I-OL
3
fD
o.
.m^. a N o o g $ m w 3.
g z N > > ,
N 5
o W ° 3 o d 3o m ° w
Cy
w m a 3 = 3
c $
c q C; n
." O c a in
p
CA
La
m 4 O W v =
Oto
O F O w 7•
G A µ N
c a '^ e a C�
o a a �• m m '' 3 � f° �
3 a 3 a 'm 3 Fa
^• c » o a 3 G
c °— N o a
m
T
a \ [ 3 V
C N FL
C. A N
O 07