PMT18-03430 City of Menifee Permit No.: PMT18-03430
�D' 29714 HAUN RD. Type: Residential Plumbing
i' AF MENIFEE, CA 92586
MENIFEE MENIFEE Date Issued: 07/10/2018
PERMIT
Site Address: 28942 PHOENIX WAY,MENIFEE,CA Parcel Number: 339-351-005
92586 Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REMOVE AND REPLACE EXISTING 50G GAS WATER HEATER
Work:
Owner Contractor
TOBIN ABRAMS ALL STAR WATER HEATERS INC
28942 PHOENIX WAY 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92586 MENIFEE, CA 92584
Applicant Phone:9513010067
ALL STAR WATER HEATERS INC License Number:812894
30300 PUERTO VALLARTA WAY
MENIFEE, CA 92584
Phone: 9513010067
Fee Description gtv Amount 151
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_Permk_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 contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from licensure under the Contractor's State License taw for
Professions Code and my license is in full force and effect. the fallowing reason:
Ucense Class License No.Z�22,2Se By my signature below l acknowledge that,except formy personal residence
Expires .j0 Signature �� in which l must have resided for at least one year priarto completion of
WORKER'S COMPENSATION DECLARATION improvements covered bythis permit.[cannot legallysell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
o l 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
this permit is issued. www.leeinfo.ca.eov/calaw.html.
Policy If Date
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 a BY my signature below l certify to each of the following:[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
num her are: application and the information I have provided is correct.I agree to comply
Carrier C L withal applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy#�,�j/G/y,P�Q/J'7//S Expires enter the above identified property for inspection purposes.
dol(Thlar ($section need less to 6e completed is the permit is for one-hundred �K�, Date�[��
dollarsify that
or less PROP fd NER OR AUTHORIZED AGENT
D I certify that in the performance of the work for which this permit is issued, ® �r O f
Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE J 1
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions ofSectlon 3700 of the Labor
Code,[shall forthw' cc 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:FAI U SECURE WORKER'S COMPENSATION COVERAGE IS DYes 4alNo
UNLAWFUL,AN SHALLSUBIECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FIN ES UP TO ONE HUNDRED THOUSAND DOLLARS($100,0001,IN occupant requires permit for the construction or modification from South
IN SECION3DITION TO 76 COST LABOR CODE,INTEREST, ADATTOGES AS ROVIDEOS Coast Air quality Management District(SCAQMD)?See permitting checklist
IN SECTION 37060E THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguide0nes
CONSTRUCTION LENDING AGENCY aYes (qKO
I hereby of min that under the penalty of perjury there Is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) Dyes p;No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
i hereby affirm under penalty of perjury that l am exempt from the permitting checklist.I understand my requirements under the State of
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 2S534 concerning
checkmark(s)I have placed next to the applicable item hazardous material reporting.$)[Section 7031.5 :oyes D No ��
Business and Professions Code).Any city or county that requires a permit to / /11.1= Date
construct alter,improve,demolish or repairany structure,prior to its PROPERTY OWNERORAU7'HORIZED 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 700D)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 703LS 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 properly owners and property
than($TO managers who do the paint-disturbing work themselves or through their
D1,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 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 employeev 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 ofsale. D 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
Cade:The Contractor's State License law does not apply loan owner ofa If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
DATE PERMIT/PLAN CHECK NUMBER O
TYPE: O COMMERCIAL ❑✓RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O PODI/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW ✓ LUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK. Replace existing Water heater. Same size and location.
PROJECTADDRESS 28942 Phoenix Way �211�W
ASSESSOR'S PARCEL NUMBER ' `�✓� d� LOT TRACT
OWNER NAME Tobin Abrams City Of MenifeeBuilding-Dept—'_
ADDRESS 28942 Phoenix Way
PHONE
951-301-5729 _ EMAIL ��9 2018
APPLICANTNAME Sierra Sprague RGnemyed
ADDRESS 30300 Puerta Vallarta
PHONE 951-301-0067 _ EMAIL allstar.sierra@gmail.com
CONTRACTOR'SNAME Sierra Sprague OWNERBUILDER? OYES ONO
BUSINESS NAME All Star Water Heaters
ADDRESS 30300 Puerta Vallarta Way
PHONE 951-301-0067 EMAIL allstarsierra.@gmail.com
CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36
VALUATION$ 800.00 SOFT LSQ FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT IFEEEE .--
DISTRIBUTION �D CITY Of MEN BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIR£ GREEN 1 SMIP I ------
I INVOIC I Ipi .`Cj PAID AMOUNT
AMOUNT' VI CUSN 'J CHECKk OCREOIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH 0 CHECK 0 OCREDITCARD VISA/MC
OWNER BUILDER VERYFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
Co ofMenlfee Building&Sofety Deportment 29714 Hour)Rd. MPen:fee,CA 92586 9S1 672-6777
www.citvofinenifee.us Inspection Request 1 in^9S_' 246 b.?13
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