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PMT18-03929 City of Menifee Permit No.: PMT18-03929 29714 HAUN RD. MENIFEE, CA 92586 Type: Residential Plumbing MENIFEE MENIFEE Date Issued: 0 810 812 01 8 PERMIT Site Address: 24961 SPRINGBROOK WAY, MENIFEE, Parcel Number: 341-240-022 CA 92584 Construction Cost: $800.00 Existing Use: Proposed Use: Description of REPLACE EXISTING 50 GAL GAS WATER HEATER,SAME LOCATION Work: Owner Contractor DONNA RAND ALL STAR WATER HEATERS INC 24961 SPRINGBROOK WAY 30300 PUERTO VALLARTA WAY MENIFEE, CA 92584 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 OQt Amount fSl 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_Permit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who bonds or improves thereon,and who contracts for the projects hereby affirm under penalty of perjury that l am under provisions of with a licensed cantractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License taw for Professions Code and my license is in full force and affect. the following reason: License Class C216 License No.��.,?.Q,�� By my signature below l acknowledge that,exceptformy personal residence Expires JO Signatures in which l must have resided for at least one year pdorto completion of improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by ❑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 website: by Section 3700 of the tabor Code,for the performance of work for which www.IeginIb.ca.gov/caIaw.htmL permit is issued. Policy# Date 44 have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 ofthe Labor Code,for the performance ofthe work for which p$y my signature below I certify to each of the follov ing: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.)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#z��J�L�y.P,P/R7DS Expires enterthe above identified property for inspection purposes. (This section need not to 6e completed is the permit is for one-hundred 4,- oami % ,ems Date dollarsify that or less PROPEi D NER OR AUTHORIZED AGENT o I certify that In the performance of the work for which this permit is issued, ® f I shall not emo �f_lov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE J 01 workers compensation laws of Caltfomia,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 forthwilp co ply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date mixture containing a hazardous material equal to orgreater that the amounts specified an the Hazardous Materials Information Guide? WARNING:FAICURE WORKER'S COMPENSATION COVERAGE IS oYes ;tz,No UNLAWFUL,ANU SE SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use ofthe building by the applicantor future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modiRration from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management Otstrict cons(SCtionor See permitting from checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airlines Qua CONSTRUCTION LENDING AGENCY oYes Ia,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) Dyes rNo OWNER BUILDER DECLARATIONS I 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 Contractors License Law for the reason(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. 'mYes DNj/ 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 OWNEII ORAUIHORIZED AGENT issuance,also requires the applicant for the permit to file a signed statement - that he or she Is licensed pursuant to the provisions ofthe Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRP) License Law(Chapter9(commencing with Section 7000)of Division 3 ofthe 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 D I,as owner ofthe property,or my employee with wages as their sole employees.For more Information about EPA's Renovation Program visit: compensation,will do( )all ofor( )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 Contractors State License Law does not apply to an owner ofa aAn EPA Lead-Safe Certified Renovator will be responsible forthis 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. ci No EPA Lead-Safe Certified Firm Is required forthis project because: o I,as owner ofthe 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 rule please fill out the RRP Acknowledgement 9 f DATE PERMIT/PLAN CHECK NUMBER C TYPE: O COMMERCIAL ❑✓RESIDENTIAL O MULTI-FAMILY _0 MOBILE HOME 0 POOL/SPA C SIGN SUBTYPE: O ADDITION O ALTERATION C 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 _24961 SSp�ringbbrro`okk Way- ASSESSOR'S PARCEL NUMBER _..l'S�'d�CJ'D� LOT TRACT _ OWNERNAME Donna Rand - _ City of MenifPa ADDRESS 24961 Springbroo_k Way Building Dept. PHONE 951-672-0980 EMAIL elir, 0.g10.18 APPLICANTNAME Sierra Sprague _ ADDRESS 30300 Puerta Vallarta _ PHONE 951=301-0067 _ - EMAIL allstar.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 allstacsierra@gmail.com CONTRACTOR'SSTATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36 _ I VALUATION$ 80000 _ SQFT _ LSQFT APPLICANT'S SIGNATURE DATE - DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMUER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP k_I,_. INVOICE PAID AMOUNT '\Gj. 0 CASH O CHECK ft O CREDIT CARD VISNW _AMO.UNT ✓✓ PLANCHECK FEES HAID AMOUNT 0 CASH 0 CHECK# O CKEDO CARD VIWIVIC OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER O YES O NO C,';I!of Menifee BtlJJding&$Ufpq Lkpartmrnt 29714 Noun Rd,Met?f22, CA 9_586'95i-6;2-:T/7 www.cirynfm&ntfP.esrs Jn.sr cl;ne ReG,est Lire <^ a ,yA, '^C A O �1 0 0 v =. a IA S j �n 2 CC '� rC 9 }p}w�r.� �D .A. Cl co yD C Al I+ 3' fD N N 1 N 7'r N G YI 3 T�I RI w ti v '03 ° n '?� gw ry am 7. vCfo GG << O .• ¢ Am O •+ S O N C < C Q W D 8 O S S Z w n a R �9 T o F. o c oL' No 7 (DD ;a JL q ? os Q 7 A n m m Pi+ N y -1 z ^t a Q 9. A m7 'x O m Q N J A w C c 3 N tR o 0 1 % D' wocA '� o � a -fit o z m ? w eo a m s c m a N ti ,n pp G n S N E' w O S n :01 _ V7 m a c m c a. NC", E Y T ISPo 0. CL a n y 0 0 00 g y m �. � a m N ❑ A 3 0 ¢ ^ T ? N 0 l' n �{. T T .17 m � ¢ o af4s b a ° d 3 o m I µ 72 N d N C 9 $ d I go21 'A N n O L. 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