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PMT18-04139
City of Menifee Permit No.: PMT18-04139 29714 HAUN RD. MENIFEE,CA 92586 Type: Residential Plumbing MENIFEE MENIFEE Date Issued: 0812112018 PERMIT Site Address: 29071 PRESTWICK RD, MENIFEE, CA Parcel Number: 338-026-010 92586 Construction Cost: $1.850.00 Existing Use: Proposed Use: Description of REPLACE EXISTING 40 GAL GAS WATER HEATER IN HALLWAY Work: Owner Contractor ALLEN MILIEFSKY A R S AMERICAN RESIDENTIAL SERVICES OF 29071 PRESTWICK ROAD CALIFORNIA INC MENIFEE, CA 92586 965 RIDGE LAKE BLVD#201 Applicant Phone:9012719700 JIM PHILLIPS License Number:765155 A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORND 965 RIDGE LAKE BLVD#201 MEMPHIS, CA 38120 Fee Description oot y 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 $116.15 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 KY Atwl LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and o 1 am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. the fallowing reason: ^ License Classc PI.- License No. �"'" ��`S� _ By my signature below l acknowledge that,except for my personal residence Expires 'JI IZO Signature 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 I)EfirRK&N have built as an owner-builder if it has not been constructed In its entirety by o I hereby affirm under pea of perjury one of the following declarations:I licensed contractors.I understand that copy of the applicable law,Section have and will maintain a certificate of consent of self-Insure forworker'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 www.Ieeinfocaeov/calaw.html. this permit is issued. Policy# Date PROPERTY OWNER OR AUTHORIZED AGENT in I have and will maintain workers compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which o By my signature below I certify to each of the following:I am the property this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act an the property owner's behalf.I have read this number are: 4 C application and the information I have provided is correl agree to comply Carrier ( Joel T-`� U� with all applicable city and county ordinances and state laws relating to �oo ) building construction.I authorize representatives of this city or county to Policy#0,?&39S-0L%3l Expires PO/ Ce 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 a I certify that in the performance of the work for which this permit is issued, I shall not emolov any persons in any manner so as to become subject to the CRY BUSINESS LICENSE# 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,(shall forthwltF)rsmply-w]_th rovisions. WIII the applicant or future building occupant handle hazardous material or a sha mixture containing a hazardous material equal to or greater that the Applican Date 3� amounts sp fied on the Hazardous Materials Information Guide? WA 1 .FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 a Yes 0 U FUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building D CIVIL FINES 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 ISCAQMD)?See permitting checklist IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldeline CONSTRUCTION LENDING AGENCY in o 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 outerboun ary of a school? (Section 3097 Civil Cade) oYes 9, OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury[hatlam 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 He Ith al Safety Cade,Section 25505 and 25534 concerning byes Ou vial reporting. checkmark(s)I have placed nett to the applicable Item(s)(Section 7031.5 oYes Na $ P/ Business and Professions Code).Any city or county that requires a permit to Date J 0 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 Contractor's State EP ENOVATION REPAIRAND 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 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 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 I )all of or( )portion of the work and the structure is www.eoa.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 Contractor's State License Law does not apply to an owner of a in An EPA Lead-Safe Certified Renovator will be responsible forthis project property who,through employees'or personal effort,builds or impraves 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. o No EPA Lead-Safe Certified Firm is required for this project because: a 1,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 rule please fill out the RRP Acknowledgement. PERMIT/PLANBUILDING & SAFETY APPLICATION • • . . i „Menifee DATE 2I l PERMIT/PLAN CHECK NUMBER -50k TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL []MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION []ALTERATION ❑DEMOLITION []ELECTRICAL [—]MECHANICAL ❑NEW ❑✓ PLUMBING [:]RE-ROOF-NUMBEROFSQUARES DESCRIPTION OF WORK Replace 40 gallon gas water heater in interior hallway. City Of Menifee Building ept, PROJECT ADDRESS 29071 Prestwick Rd,Sun City,CA 92586 AUG 2 1 2018 ASSESSOR'S PARCEL NUMBER �j• - (, R %0 LOT ° ved OWNERNAME AIIenMiliefsky G ADDRESS 29071 Prestwick Rd,Sun City,CA 92586 PHONE (619)737-6910 EMAIL APPLICANT NAME ADDRESS 1520 W Linden Street Riverside, CA 92507 PHONE (951)341-9371 EMAIL CONTRACTOR'S NAME AIRS 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$ $ 1,850.00 SQ FT L SO FT APPLICANT'S SIGNATURE DATE Z DEPARTMENT DISTRIB 10 ` CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN ` SMIP INVOICE l y' PAIDAMOUNT ` AMOUNT `1;,J• , IV,-. 1� 0 CASH Q CHECK# O CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0 CASH O CHECK A 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building&Safety Department 29714 Houn Rd. 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