PMT18-03817 City of Menifee Permit No.: PMT18-03817
29714 HAUN RD.
OY MENIFEE, CA 92586 Type: Residential Plumbing
MENIFEE MENIFEE Date Issued: 0 8102/2 0 1 8
PERMIT
Site Address: 28118 EAST DR, MENIFEE,CA 92587 Parcel Number: 350-092-007
Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL GAS WATER HEATER,SAME LOCATION
Work:
Owner Contractor
CHRISTINE ARREDONDO ALL STAR WATER HEATERS INC
28118 FAST DRIVE 30300 PUERTO VALLARTA WAY
MENIFEE,CA 92587 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 ON Amount 151
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 Pennit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the ContractorsState License Law),
Chapter9(commencing with section 7000)of Division 3 of the Business and 01 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:ec
License Class License No, a /„�R�'SC By my signature below l acknowledge that,except formy personal residence
Expires O Signatures to 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 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 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. lvt,,,,N,le=tnfo.ca.aov/calaw.html.
Policy# Date
have and will maintain workers 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 workers compensation insurance afffer 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.I 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 R l�✓!�G/•S/.P.P/.Y7/JS Expires enter the above Identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred dollars($100)or less �— ^44 " Date Z
PROPEK>p NER OR AUTHORIZED AGENT
0 hiall tifynot that empin the performance
persons
in any thema work for to becomes subject
issued, v �5 Q 5
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE g
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 forth w' co 5ply 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
"eEamounts specified on the Hazardous Materials Information Guide?
WARNING:FAI U SECURE WORKER'S COMPENSATION COVERAGE IS o Yes j3,N0
UNLAWFUL,AN SHALLSUBIECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant requires permit for the construction or modification from South
IN SECTIODITION N
3 THE COST LABOR CODE,INTERTION,DAMADATTOGES AS ROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 37060FTHE TABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY o Yes �D,No
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) D Yes �o,yo
OWNER BUILDER DECLARATIONS 1 have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist I understand my requirements under the State of
Contactols License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 15534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 )sYes o No
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AlIiF10RIZED 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 IRRP)
License Law(Chapter9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contactors
Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint inapre-3978
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
o I,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.eav/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 Contactols 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 for this project because:
o 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
DATE Z 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 "" ELECTRICAL O MECHANICAL
O NEW ZfWMBING C RE•ROOF-NUMBER OFSQUARES_
DESCRIPTION OF WORK Replace existing water heater. Same size and location.
PROJECT ADDRESS 28118 East-Dr.
ASSESSOR'S PARCEL NUMBER /W' _ LOT — TRQ*of Menifee _
OWNER NAME ChrIStlDe AffedOndO Building Dept.
ADDRESS 28118 East Dr. AUG 0 2 2018
PHONE 951-551-2315 _ EMAIL &v
APPLICANTNAME Sierra SpragueC�'r v�
ADDRESS 30300 Puerta Vallarta
PHONE 951-301-0067 EMAIL allstar.sierra@gmaii.com
CONTRACTOR'S NAME Sierra Sprague OWNER BUILDER? O YES ONO
BUSINESS NAME All Star Water Heaters
ADDRESS 30300 Puerta Vallarta Way
PHONE 951-301-0067 EMAIL allstar.sierra@gmail.cwm
CONTRACTOR'S STATE LIC NUMBER 812894 UCENSECLASSIFICATION C36
VALUATION$ 800.00 SOFT LSQFT
APPUCANT'SSIGNATURE
MIT
:1)
RTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBE0.
ING PLANNING ENGINEERING FIRE GREEN SMIPINVOICE
_AMOUNT 1 •15 PAID AMOUNT ,` .1 OCASH O CHECK N 0CREDIT CARD VISAFMC
PLAN CHECK FEES PAID AMOUNT 0CASH OCHECK# OCREDITCARD VISA/MC i
OWNER BUILDERVERIFIED OYES 0 No DL NUMBER NOTARIZED LETTER J YES O NO
--- City of IYJen1f R 13uftding$.Sojety lleportrnent 29714 flour Rd.Menifee,CA 92556 95 7-5 77-b777
www.cttyofinentfee.ux fnspection Request line 951 245.6.E 13
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