PMT18-04057 City of Menifee Permit No.: PMT18-04057
29714 HAUN RD.
r/0 MENIFEE, CA 92586 Type: Residential Plumbing
MENIFEE MENIFEE Date Issued: 08/16/2018
PERMIT
Site Address: 25950 MCCALL BLVD, MENIFEE,CA Parcel Number: 335-092-025
92584 Construction Cost: $500.00
Existing Use: Proposed Use:
Description of REMOVE AND REPLACE 40 GALLON GAS WATER HEATER IN GARAGE
Work: BTU 40,000 UEF.64
Owner Contractor
ALFREDIA&COLEMAN SMITH SANFORD&SON PLUMBING
25950 MCCALL BLVD 33173 SHORELINE DR
MENIFEE, CA 92586 LAKE ELSINORE, CA 92530
Applicant Phone:9516787299
SANFORD&SON PLUMBING License Number:742415
33173 SHORELINE DR
LAKE ELSINORE, CA 92530
Phone:9516787299
Fee Description QtV Amount I$)
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 staled,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 contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractar(s)pursuant to the Contractors State License Law).
Chapter!)(commencing with section 7000)of Division 3 of the Business and a l am exempt from licansure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class CSC, license No. "7F1Zy1S By my signature below l acknowledge that,except for my personal residence
Expires II b Signature SL ZM_ S 2 in which l must have resided for at least one year priorlo completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit I cannot legallysell a structure that
have built as an owner-builder if it has not been constructed in its entirety by
D 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 w .leeinfo.ca.eov/calasv.html.
this permit is issued. vrvr
Policy It Date
I 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 ,Ay 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 an the property owners behalf.I have read this
number are: application and the information 1 have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier NOY{7l Irx - building construction.l authorize representatives of this city or countyto
pai;cygSAwc95bj90 Expires 3I9ln� enterlhe above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Data g j ✓-�
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
D I certify that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE 4 e'-eG 0-7
workers compensation laws ol'California,and agree that IN should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Zz l� mixture containing a hazardous material equal to or greater that the
Applicant _ r Date amounts spfcified on the Hazardous Materials Informalipn Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS oyes 1a610
UNLAWFUL,AND SHALL SUBIECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intendeduse 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 District(SCAQM D)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguiderl�fdqves
CONSTRUCTION LENDING AGENCY aYes 0
1
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) aYes �lo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that lam exempt from the
Contractors License Law for the reason(s)indicated below by the California Health Code,Section 25505 and 25534 concerning
hazardous material reporting.
chsiness and
I have placed next to the applicable item(s)(Seaton 7031.5
permit 6/-L','.-- o No �'+
Business and Professions Code).Any city or county that requires permit to Jti�arU�Z- ' Date a )b 18
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER 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 IRRP)
License Law(Chapter9(commencing with Section 700D)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))censure 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 orthrough their
al,as ownerofthe property,or my employeewith wages as theirsole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all afar( )portion of the work and the structure is www.eoa.eovllead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-BOO-024-LEAD(5923).
Code;The Contactors 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 of sale. a No EPA Lead-Safe Certified Firm is required for this project because:
D I,as owner of the property am exclusively contacting with licensed
contactors 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.
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
Menifee
DATE 08/16/2018 PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL [Z]RESIDENTIAL MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN
SUBTYPE: [-]ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL
❑NEW ❑✓ PLUMBING ❑RE-ROOF-NUM6EROF SQUARES
DESCRIPTION OF WORK Replace 40 gallon gas water heater in garage BTU 40,000 UEF.64
PROJECTADDRESS 25950 McCall Blvd lr7U kO
ASSESSOR'S PARCEL NUMBER �jJ35 '0 'DZ LOT TRACT
OWNER NAME Alfredia&Coleman Smith
ADDRESS 25950 McCall Blvd Menifee,CA 92586
PHONE (310)710-2634 EMAIL
APPLICANT NAME Steven Schnierer
ADDRESS 31225 La Baya Drive Suite 213 Westlake Village, CA 91362
PHONE (818)735-7876 EMAIL swschnierer@roadrunner.com
CONTRACTOR'S NAME Sanford&Son Plumbing OWNER BUILDER? ❑YES❑✓NO
BUSINESS NAME Sanford&Son Plumbing
ADDRESS 33173 Shoreline Drive Lake Elsinore, CA 92530
PHONE (951)505-8499 EMAIL
CONTRACTOR'S STATE LIC NUMBER 742415 LICENSE CLASSIFICATION C36
VALUATION$ $500.00 SO FT L SQ FT
APPLICANT'S SIGNATURE L DATE 0 811 6/2 0 1 8
CITY STAFF USE ONLY
DEPARTMEM DISTRIBUTION � CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREE I'
INVOICE IrrI//--��---In PAIDAMOUNT
AMOUNT I " 0CASH 0 CHECK N OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER C YES C NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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