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PMT18-04152 City of Menifee Permit No.: PMT18-04152 29714 HAUN RD. MENIFEE,CA 92586 Type: Residential Plumbing filzNll=EE MENIFEE Date Issued: 08/22/2018 PERMIT Site Address: 28234 LONE MOUNTAIN CT, MENIFEE, Parcel Number: 340-380-013 CA 92584 Construction Cost: $0.00 Existing Use: Proposed Use: Description of REPLACE EXISTING WATER HEATER WITH SAME SIZE(50 GALLON GAS)AND LOCATION. Work: Owner Contractor BETTY MCKIM ALL STAR WATER HEATERS INC 29634 CAMINO DELORES 30300 PUERTO VALLARTA WAY MENIFEE,CA 92586 MENIFEE, CA 92584 Applicant Phone:9513010067 ALL STAR WATER HEATERS INC License Number:812894 30300 PUERTO VALLARTA WAY MENIFEE,CA 92584 Phone: 9513010067 Fee Description gytr Amount 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_BIdg Permit Templale.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 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 Contractors State License law for Professions Code and my license is in full force and effect. the following reason:Z License Class License No. 1,222: Z By my signature below i acknowledge that,except for my personal residence Expires 30 Signatures 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 DECLARATION 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: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 websile; by Section 3700 of the Labor Code,for the performance of work for which www.le-info.m.gov/calaw.hurd. this permit is issued. - Policy# Date M 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 pKBy my signature below I 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 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# &Ze/'�.P/XWSExpires enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred �.4 �i�e,t. Date dollars($100)or less PROP NER OR AUTHORIZED AGENT 0 l certify that in the performance of the work for which this permit is issued, �r OI� Ishallnotemplov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# :J l 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 forthtip co ply 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 an the Hazardous Materials Information Guide? WARNING-FAI U SECURE WORKER'S COMPENSATION COVERAGE IS OYes I1440 UNLAWFUL,AN SHALL SUBJECI'AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the bulling 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 SECTIONON 3 THE COST OF COMPENSATION,CODE,INTER DAMAGES ATTORNEYS PROVIDED S Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY oyes JgNo I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility bewfthfn 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 p_No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD 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 255D5 and 25534 concerning checkmark(s)I have placed next to hazardous material reporting. to the applicable item(s)(Section 7031.5 'DYes 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 pROPERTYOWNER OR AUTHORIZED AGENT issuance,also requires the applicant for the permitto file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors State EPA RENOVATION.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 7031.5 by residence or childcare facility to he RRP-certffied 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($Soil). managers who do the paint-disturbing work themselves or through their o1,as owner of the properly,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 oAn EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the properly 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 forthis project bemuse: o 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contrectors State license Law does not apply loan owner of If your project does not comply with EPA RRP rule please rill out the RRP Acknowledgement. BUIL I DING & SAFETY PERMIT/Pl-)*� CHECK APPLICATION 1 Mel it'E! DATE PERMIT/PLAN CHECK NUMBER T " I o —L)ct1 c� TYPE: 0 COMMERCIAL [ RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW ❑✓PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Replace existing water heater. Same size and location. PROJECTADDRESS 28234 Lone Mountain Ct. 01a ASSESSOR'S PARCEL NUMBER W "✓ pV/ 010 LOT TRACT OWNER NAME Earl Block ADDRESS 28234 Lone Mountain Ct. City of Mani e PHONE 858-880-5750 _ EMAIL — AUG--Z-7�Q1� APPLICANT NAME Sierra Sprague _. ADDRESS 30300 Puerta Vallarta ewed e PHONE 951-301-0067 EMAIL allstar.sie mail.com CONTRACTOR'S NAME Sierra Sprague OWNER BUILDER? O YES O N0. BUSINESS NAME All Star Water Heaters ADDRESS 30300 Puerta Vallarta Way PHONE 951-301-0067 EMAIL allstar.sierra@gmail.com CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36 _. VALUATION$ 800.00 SQ FT _ LSO FT APPLICANT'S SIGNATURE L DATE 7 __ r, _ _ _ _- - i DEPARTMEM DISlftIBUTION _ �> CITY DF MENIFEEyBU�SINESS LICENSE NUMBER , BULl.OlNG PLANNING ENGrrI--N--EERING FIRE GREEN SMIP r INVOICE IG'15 pgiDAMOUNT OCASH OCHECKN 0CREDIT CARD VISA/MC AMOUNT �J PLAN CHECK FEES PAIDAMouNi 0CASH 0 CHECK 0 OCREDITC-ARD VJWrAC OWNER BUILDER VERIFIED OYES O NO DLNUMBER NDTARREDLETTER O YES O NO City of Menifee BtlJJding&Safey Deportment 29714 Haul?Rd.Menifee,CA 92586 951-672-67l7 wWw.dtyo(nSenlfve.us inspecrion Request Line 951-246-6213 Z + a o RX ❑ o o aai v rD� � g � ^ � � � m �A pao3NaCrru A1011 � � m x O 9 3 fd V ta�b Z a � g o o o w c a w Z O � � ' j M $ a 'n 3, T a a m 3 w O .0., a r.. n w r v m (p •° n N a A y a o1 W N >r �p 0 m CD Z � m Z N _ ry G Y y Y1 a^ w N 3 o a N dl N a O :nG 7 N w Ul cO � Erm o O = _ c 3 3 5 a m 3 ^ o n a vt X o a m ro°' 4 N .. -, w N < c tA1 m 7 .c m MU a a o' m 41 O+ .Q A w u m ^ w 0 a 9 J O ' :E = a ap A d a 3 c a :E m > > E 2w 2= mn ^ o a LI N N �M •J• 9 N a R a y S T 3 G n Q n N o � �g y 0 0 pnp ran y N � � A �` ❑ i a c o 3 a -• < .. 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