PMT18-03673 City of Menifee Permit No.: PMT18-03673
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Plumbing
MENIFEE MENIFEE Date Issued: 07/25/2018
PERMIT
Site Address: 29884 LAMPREY, MENIFEE, CA 92586 Parcel Number: 338-351-019
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
JOHNNY NGUYEN ALL STAR WATER HEATERS INC
29884 LAMPREY 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92586 MENIFEE,CA 925B4
Applicant Phone:9513010067
ALL STAR WATER HEATERS INC License Number:812894
30300 PUERTO VALLARTA WAY
MENIFEE,CA 92584
Phone:9513010067
Fee Description qty, Amount W
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 Bldg_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who antracts for the projects
1 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 a 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:
Umnse Class License No. '?Z .9 By my signature below l acknowledge that,except for my personal residence
Expires '9 Signature S
_ In which l must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that I
have built as an owner-builder if it has not been constructed in Its entirety by
o 1 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 websile:
by Section 3700 of the Labor Cade,for the performance of work for which tyinv_Ieeinfo.ca.eov/calaw,html.
this permit is issued.
Polity# Date
44 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 "y 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 owners behalf.I have read this
number are: application and the information 1 have provided is correct.I agree to comply
Caller C G with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Polity# Bg6'4�2ax Expires enterIdentified property for inspection purposes.
(This section need not to be completed is the permit Is for one-hundred Date
dollars($100)or less PROP 1d NER OR AUTHORIZED AGENT
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# 11
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 forthw" cor ply with those provisions. Will the applicant or future building occupant handle hazardous material or
Appllcant Date mixture containing a hazardous material equal to orgreater that the
amounts specified an the Hazardous Materials Information Guide?
WARNING:FAI U SECURE WORKER'S COMPENSATION COVERAGE IS o Yes I[yNo
UNLAWFUL,AN SHALL 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 DOLIARS($100,000),IN occupant requireapermit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management econt(SCAQM tionor modee ification
South
st
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY Oyes toNo
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 'o_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
Contractors License Law for the remon(s)indicated below by the California Health&Safety Cade,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to `caYes D No
construct,alter,improve,demolish or repair any structure,prior to its Date y /s
Issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNk7i OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRPI
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-disturbing work themselves or through their
a 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.euv/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800424-LEAD(5323).
Cade;The Contractors State License Law does not apply to an owner of a 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 of sale. o No EPA Lead-Safe Certified Firm is required for this project bemuse:
D 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 notapply to an owner of a If your project dam not comply with EPA RRP rule please fill out the RRP
Acknowledgement
o
J
DATE _ PERMIT/PLAN CHECK NUMBER VI"I J 1 O `i
TYPE: O COMMERCIAL ❑✓RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA__O SIGN---.—
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION C ELECTRICAL O MECHANICAL
O NEW PLUMBING C RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace existing water heater. Same size and location.
PROJECTADDRE55 29884 Lamprey
ASSESSOR'S PARCEL NUMBER ✓O I V I I LOT TRACT .-
OWNERNAME Johnny Nguyen
ADDRESS 29884 Lamprey
PHONE 714-553-8568 EMAIL
APPLICANT NAME Sierra Sprague
ADDRESS 30300 Puerta Vallarta _
PHONE 951-301-0067 _- __ EMAIL alistar.sierra@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 allster.sierra@gmaii.com
CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36 _
VALUATION$ 800.00 Q FT L SO FT
APPLICANT'S SIGNATURE _„ __ DATE_ 2-f
DEPARTMENT DISTRIBUTION CITY OF MENIFEE'BUSINE55 LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIF
INVOICE ( I� , PAID'AMOUNT O CASH OCHECKB OCREDITCARD WWMC
AMOUNT
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECKR 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DLNUMBER ry�-= -- NOTARIZED LETTER C YES NO
City of Men{fee Bu;ldmy,S Safely Depot towos 25714 Nnun Rd.Menifee, CA 92588951-G724,77'
wWW.cityofnienifeE,.w Inspection Re0est Line 951-24C-6213
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