PMT18-03818 City of Menifee Permit No.: PMT18-03818
29714 HAUN RD. Type: Residential Plumbing
MENIFEE,CA 92586
MENIFEE MENIFEE Date Issued: 08/02/2018
PERMIT
Site Address: 25704 MOUNTAIN GLEN CIR, MENIFEE, Parcel Number: 335-470-023
CA 92585 Construction Cost $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL GAS WATER HEATER, SAME LOCATION
Work:
Owner Contractor
JAIME VENEGAS ALL STAR WATER HEATERS INC
25704 MOUNTAIN GLEN CIRCLE 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92585 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 QQrt Amount IS1
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 requidng 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_Templale.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 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 Law for
Professions Code sa�nd my license is in full forte and effect. the following reason:
License Class / Lice'nse— NoOQ Z.,ZZ91/ By my signature below l acknowledge that,except formy personal residence
Expires 4X Signature Ail. 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 I hereby affirm under penalty of perjury one of the following declarations:l licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent ofselFlnsure 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.leginfa.ca.eav/calaw.html.
Policy# Date-
44
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 DCBy 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 owners behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
Carrier C G with all applicable city and countyordinancesand state laws relating to
'/ building construction.i authorize representatives of this city or county to
Policy#'jj%4 ��Lz f Expires enter the above identified property for Inspection purposes.
(Thlars($section need l not to 6e completed fr the permit is for ore-hundred ess ��4 Date
dollarsify that
on the PROP NER OR AUTHORIZED AGENT
o I certify that in the performanceny thema work for which this permit is issued, 151 O(5
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# :J
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 comply 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:FAIU SECURE WORKER'S COMPENSATION COVERAGE IS oYes ikoo
UNLAWFUL,AN SHALLSUB1ECf 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($100,000),IN occupant require a permit for the construction or modification from South
IN SECTION ON TO
06 OF
LABOR CODE,INTERTION,DAMAGES
ST; A AND
FOR Coast Air Quality Management District(SCAQMD)7See permitting checklist
IN SECTION 37060E THE LABOR CODE,INTEREST,ANO ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY oYes (oNo
I hereby affirm that under the penalty of perjury there Is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) oYes ioNo
OWNER BUILDER DECLARATIONS 1 have read the Hazardous Material Information Guide and the SCAQMO
I hereby affirm under penalty of perjury that l am exempt from the permitting checklist.I understand my requirements under the State of
Contractors license Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item hazardous material reporting.$)(Section 7031.5 byes 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 OWN
ER 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 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 in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to he RRP-certTmed 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
a1,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.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 Contractors 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 issold within one yearof Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose ofsele. o No EPA Lead-Safe Certified Firm is required for this project because:
a 1,as owner of the property am exclusively contacting with licensed
contactors to construct the project(Section 7D",Business and Professions
Cade:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
y
DATE �j �_ PERMIT/PLAN CHECK NUMBER
TYPE: 0 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 O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace existing water heater. Same size and location.
PROJECTADDRESS 25704M--,,,,o��untain Glen Cir
ASSESSOR'S PARCEL NUMBER '7/Y'7-4-V - 00,75 LOT TRACT
OWNER NAME Jaime Venegas City of Menifee
u MdIng 0ept--.
ADDRESS 25704 Mountain Glen Cir
PHONE
951-238-8340 _ EMAIL AUG 02 201
APPLICANTNAME SierraSprague ed
ADDRESS 30300 Puerta Vallarta
PHONE 951-301-0067 EMAIL alistar.sierra@gmail.com
CONTRACTOR'S NAME Sierra Sprague _ OWNER BUILDER1 O YES ONO
BUSINESS NAME All Star Water Heaters
ADDRESS 30300 Puerta Vallarta Way
PHONE 951-301-0067 EMAIL allstar.sierra@gmaii.com
CONTRACrOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36
VALUATIONS 800.00 _ _SQ FT LSQ FT
APPLICANT'SSIGNATURE h -L DATE 6
DEPARTMENT DISTRIBUTION J CITY OF MENIFEE BUSINESS DCENSE NUMBER
.BUILDING PUNNING ENGINEERING FIRE GRLEN , T.P P
AMMOUNT PAIDAMOUNT `(J� OCASH r�CHECKK OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK B OCREDITCARD WWMC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Men:fee fluII(IMg&'Sufety Department'9714Own?Rd Manifee,CA 92586 95 1-6 72-677.�
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