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PMT18-04128 City of Menifee Permit No.: PMT18-04128 29714 HAUN RD. MENIFEE,CA 92586 Type: Residential Plumbing MENIFEE MENIFEE Date Issued: 0 812 012 01 8 PERMIT Site Address: 26141 FALSTERBOR DR, MENIFEE, CA Parcel Number: 337-104-011 92586 Construction Cost: $1,647.00 Existing Use: Proposed Use: Description of REPLACE 30GAL WATER HEATER INSIDE HOME Work: Owner Contractor ROGER TROVATA A R S AMERICAN RESIDENTIAL SERVICES OF 26141 FALSTERBOR DRIVE CALIFORNIA INC MENIFEE, CA 92586 965 RIDGE LAKE BLVD#201 Applicant Phone: 9012719700 AIRS ROOTER License Number:765155 A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIi 965 RIDGE LAKE BLVD#201 MEMPHIS, CA 38120 Fee Description Oty Amount ISI 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 $115.16 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_BIdg_Pennit_Template.rpl Page 1 of 1 J;(Y% liUi po- e Aqz!5 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contactors State License Law). I hereby affirm underpenaltyof perjury that 1 am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from licensure under the Contactors State License Law for Professions Code and my license is in full force and effect. the fallowing reason: License Class P,- License No. �`�—' ��5� By my signature below I acknowledge that,except for my personal residence Expires �I Signature `~' r in which l must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION LA ION have built as an owner-builder if it has not been constructed in its entirety by ❑i hereby affirm under pea of perjury one of the following declarations:I licensed contactors.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 www_lee'nfo.ca.eoy/calaw.html. this permit is issued. PolicyN Date D I have and will maintain workers compensatlon Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which o By my signature below l certify to each of the following:I am the property this permit is issued.My wor(ers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this number are:s application and the information I have provided Is correct.I agree to comply Carrier / I �i �'`-' with all applicable city and county ordinances and state laws relating to t, �oo building construction.I authorize representatives of this city or county to Poliicy#(J1s7fa7�sa��31 Expires enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT o 1 certify that in the performance of the work for which this permit is issued, fi I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS UCENSEM _f�" Of AA.,.. worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION uf/dipg p ee subject to the workers compensation provisions of Section 370D of the Labor epi. Cade,I shall farthwitfjtompl h revisions. Will the applicant a hazardous building occupant handle hazeryr aterial ore 31 / mixture containing a hazardous material equal to or ration tea® 201 Applican Date amounts spJ,,'.t'Red on the Hazardous Materials Information Guide? 8 WA I .FAILURETO SECURE WORKER'S COMPENSATION COVERAGE IS Dyes z . U FUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the rap D CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN lic uj i � ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant requirea permitter the construction or modifirabon �sG IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Id Coast Air Quali c[(ty Management Dis[TiSCAQMD)?see permng cec ittihklis for guideline CONSTRUCTION LENDING AGENCY DYes o 1 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 borun cry of a school? (Section 3097 Civil Code) D Yes t3TJo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjurythatlam exempt from the permitting checklist.I understand my requirements under the State of Contractors License Law for the reason(s)indicted below by the California He Ith&Safety Code,Section 25505 and 25534 concerning hazarda� rial reporting. checkmark(s)I have placed next to the applicable Items)(Section 70335 Dyes Na 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 ROPER WNER 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 EP ENOVATION REPAIR AND PAINTING RRP 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 70315 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 D1,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.epa.gov/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 D An 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 car 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: 01,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code: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. iSAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE �I2o r PERMIT/PLAN CHECK NUMBER (� TYPE: [—]COMMERCIAL [Z]RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME POOL/SPA [—]SIGN SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL ❑NEW ❑✓ PLUMBING ❑RE-ROOF-NUMBEROFSQUARES DESCRIPTION OF WORK Replace 30 gallon gas water heater inside home. PROJECT ADDRESS 26141 Falsterbor ,Dr,Sun City,CA 92586 City of Menifee Building Dept. ASSESSOR'S PARCEL NUMBER LOT TRACT OWNERNAME RogerTrovata AUG 20 2018 ADDRESS 26141 Falsterbor Dr,Sun City,CA 92586 PHONE (949)899-3887 EMAIL APPLICANT NAME ADDRESS 1520 W Linden Street Riverside, CA 92507 PHONE (951)341-9371 EMAIL CONTRACTOR'S NAME ARS Rescue Rooter OWNER BUILDER? ❑YES©NO BUSINESS NAME ADDRESS 1520 W Linden Street Riverside, CA 92507 PHONE (951)341-9371 EMAIL CONTRACTOR'S STATE LIC NUMBER 765155 LICENSE CLASSIFICATION C36 VALUATION$ $1,647.00 L SQ FT 5� APPLICANT'S SIGNATURE DATE vAr DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LIC UMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE PAIDAMOUNT AMOUNT /54 000.5H C{HECK# OCREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# 0CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O 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 z d S O 0o00 d � a m n '.�'' D � m 'pp"'�a c •r�[ F+ T m A m m 2 -< m `{ :c N O H .a h en w n+ t+ o s a d x m » " w' 'D-I v aZ m m TAO� 3 m 3 e a m n 'm m ^ n �m m Z oeq O .f1 0 M m m n MR O N a w ^ n. H ^O z z m in z 3 m c m m o21J •�c'1 » d o Z e: OT n r a -DI "fl m n w' p v'i a O y~ a d W T n r V Y a 3 m o o m nIm -i ."m' f° S 3 o .< = 'c^ m m y TI Z p m O _ O ry C n > > n c 'P' q o n el� 2 _ m F u 3 N N Z ? o o n ^ pSi a £ ° 3 N ry .,, A co N o fA d 3 ,d., 3 -« m N O W F. rrG m C n N y o y d o 0 3 x ^ m0 0 0; CO `- 3 w i ut 7 ti 1 3 3 = M m = 'm 3 n a `° m m m = X n ' ° 3 � .e N N ..e �. 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