PMT18-04270 City of Menifee Permit No.: PMT18-04270
29714 HAUN RD.
I ifk MENIFEE, CA 92586 Type: Residential Plumbing
MENIFEE MENIFEE Date Issued: 09/11/2018
PERMIT
Site Address: 31829 FEATHER CREEK DR, MENIFEE, Parcel Number: 372-211-020
CA 92584 Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL GAS WATER HEATER, SAME LOCATION
Work:
Owner Contractor
INGRID FLORES ALL STAR WATER HEATERS INC
31829 FEATHER CREEK DRIVE 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92584 MENIFEE, CA 92584
Applicant Phone:9513010067
License Number: 812894
Fee Description ,gtv Amount 1$1
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 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 builds or improves thereon,and who contracts for the pmjects
1 hereby affirm under penalty of perjury that I am under provisions of with a licensed contractors)pursuant to the ContractorsState License Law).
Chapter!)(commencing with section 7000)of Division 3 of the Business and a 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:
License Class License No. 'PI'm' By my signature below l acknowledge that,except formy personal residence
Expires 9 •O Signature �� In which l must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION Improvements covered by this permit.I cannot legallysell a structure that 1
have builtas an owner-bulider iflt 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 website:
by Section 3700 of the Labor Code,for the performance of work for which ynyw.leeinfo.ca.eov/calaw.lztml.
this permit is issued.
Policy It Date
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 Wily mysignature 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 relatingto
building construction.I authorize representatives of this city or county to
Policy# s�/r/G����Wj'Expires enter identified property for inspection purposes.
(This section need not to be completed is the permit Is for one-hundred Date
dollars($100)or less PROP JdY NER OR AUTHORIZED AGENT
o Icertify that in the performance of the work for which this permit is issued, O !fir Of�
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# -.l J 1
workers compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthw 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 on the Hazardous Materials Information Guide?
WARNING:FAT U SECURE WORKER'S COMPENSATION COVERAGE IS o Yes hyNo
UNLAWFUL,AN SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant requires permit for the construction or modification from South
IN SECTIODITION N
306 OF T T LABOR CODE,INTERDAMADATGES TPROVIDEDS Coast Air Quality Management District(SCAQM D)?See permitting checklist
IN SECTON 37060FTHE TABOR CODE,INTEREST,AND ATTORNEYS FEES forguideiines
CONSTRUCTION LENDING AGENCY oyes ("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 outer boundary of a school?
(Section 3097 Civil Code) o Yes 'a No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
1 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 Code,Section 25505 and 2SS34 concerning
checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 pYes a No
hazardous material reporting.
Business and Professions Code).Any city or county that requires permit to4 5:22f. Date
construct.alter,improve,demolish or repair any structure,prior to its PROPERTY OWNE 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 JRRPI
License Law(Chapter9(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 Iicensure 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 ownersand property
than($500). managers who do the paint-disturbing work themselves or through their
01,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( )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 ciAn 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. o No EPA Lead-Safe Certified firm Is required for this project because:
o I,as owner of the property am exclusively contacting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contactors State License law does not apply to an owner of If your project does not comply with EPA RAP rule please fill out the RRP
Acknowledgement
i
s
Y
DATE %aq PERMIT/PLAN CHECK NUMBER tM'2)) t0� �-
TYPE: O COMMERCIAL ✓❑RESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME 0 POOL/SPA 0 SIGN _
SUBTYPE: 0 ADDITION 0 ALTERATION t:DEMOLITION O ELECTRICAL 0 MECHANICAL
G NEW PLUMBING G RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace existing water heater. Same size and location.
PROJECTADDRESS 31829 Feather Creek Dr.
ASSESSOR'S PARCEL NUMBER 3_71R__6 ___ LOT _ TR)ay Of Manifee--_
OWNER NAME -
Ingrid Flores Building Dept.
ADDRESS 31829 Feather Creek Dr.
PHONE 951-834-5806 EMAIL ec
APPLICANT NAME Sierra Sprague _
ADDRESS 30300 Puerta Vallarta
PHONE 951-301-0067_ EMAIL allstar.sierra@gmail.com_______
CONTRACTOR'S NAME Sierra Sprague _ OWNER BUILDER? < YES NO
BUSINESS NAME All Star Water Heaters _
ADDRESS 30300 Puerta Vallarta Way
PHONE 951-301-0067 EMAIL allstar.sierra@gmail.GOm
CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36
VALUATIONS 800.00 SQFT _ _ __.. LSQFT �7
APPLICANT'S SIGNATURE DATE p`
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS UCENSE NUMBER '
BUILDING PUINNING ENGINEERING FIRE GREEN 1�� SMIP x
INVOICE PAID AMOUNT yG OCASH OCHECK# 0CREDIT CARD MSMMC.
AMOUNT `6AS
PLAN CHECK FEES PAID AMOUNT OCASH OCHECKB OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
Y C;:y of Men jee E3uu,: LC.. R[ CA P 58C 9 u7^-67?7
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