PMT18-03672 City of Menifee Permit No.: PMT18-03672
29714 HAUN RD.
j MENIFEE,CA 92586 Type: Residential Plumbing
MENIFEE MENIFEE Date Issued: 07/25/2018
PERMIT
Site Address: 29218 LIDO BAY DR, MENIFEE, CA Parcel Number: 333-451-036
92585 Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING WATER HEATER WITH SAME SIZE(50 GALLON GAS)AND LOCATION.
Work:
Owner Contractor
SAUNDRA BURRUS ALL STAR WATER HEATERS INC
29218 LIDO BAY DRIVE 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92585 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 Qtv Amount ISI
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_BIdg Perm'e_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).
Chapter!)(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensum under the Contractor's State License taw for
Professions Code and my license is in full force and effect. the following reason:
License Class License No. ��.,ze2'/ By my signature below l acknowledge that,except far my personal residence
Expires .3,9 Signature �� In which l musthave resided forat least one year priorto completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
O 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 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 ,N,H,N,leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy D Date
pd have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance ofthe work for which "y my signature below l certify to each of the following:I am the property
this permit is issued.My workers 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.)agree to comply
Carrier E with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy IJ_AFI&6GiS��xQ Zf rExpires entertheabove identified property for inspection purposesf�Z
(This(This section need not to be completed is the permit Is for one-hundred Date
dollars($100)orless PROP D NER OR AUTHORIZED AGENT
O I certify that in the performance of the work for which this permit is issued, O 15,5015
f
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSED
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 hazardous material equal to or greater that the
amounts specified an the Hazardous Materials Information Guide?
WARNING:FAI U SECURE WORKER'S COMPENSATION COVERAGE 15 0Yes jtrNo
UNLAWFUL,AN SHALL SUBJECT 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($100,000),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 Districtconstruction
See permitting fro checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Airlines
Qua
CONSTRUCTION LENDING AGENCY Oyes �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) Dyes _a_,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 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
tuxes a No
Business and Professions Code).Any city or county that requires permit to - Date : y
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNE 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 MAP)
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 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-disturbfng 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 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 ofsale. O No EPA Lead-Safe Certified Firm is required forthis project because:
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 Rll out the RRP
Acknowledgement.
MOEf4M PR ® '
W
DATE O� PERMIT/PLAN CHECK NUMBER ��✓Li���
TYPE: O COMMERCIAL ❑✓RESIDENTIAL O MULTI-FAMILY O M_OBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW ✓PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace existing water heater. Same size and location.
PROJECT ADDRESS 29218 Lido Bay .
ASSESSOR'S PARCEL NUMBER D `CDT TRACT
OWNER NAME Saundra Burrus
ADDRESS 29218 Lido Bay Dr.
PHONE 951-219-8158 ._._._- .__. EMAIL
APPLICANT NAME Sierra Sprague _
ADDRESS 30300 Puerta Vallarta—
PHONE 951-301-0067 EMAIL allstar.sierrala'�.gmail.com
CONTRACTOR'S NAME Sierra Sprague OWNER BUILDER? O YES O NO
BUSINESS NAME All Star Water Heaters
ADDRESS 30300 Puerta Vallarta Way
PHONE 951-301-0067 EMAIL allstar.sierra@gmail.com
CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36
VALUATION$ 800.00 SQFT _ LSQFT
APPLICANT'S SIGNATURE
DEPARTMENT DISTRIBUTION CITY OFMENIFEE8U5INE55 LICENSE NUMBER
6URDING PLANNING ENGINEENNG FIRE GREEN ' SMIP b
INVOICE ��I PAIDAMOUNT OCASH OCHECKA OCREDITCARD VISA/MC
AMOUNT
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECKR OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Meni(ee.'3w0i+;q&Safety Deporrnient 297.T=1 F1aun Rd.Menifee, CA 9?SS6951-512-677.'
wi�,w.cltyofnleaife,.us InSpettion Regtrest Lfie 951-246.62.1 3
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