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PMT18-04361
City of Menifee Permit No.: PMT18-04361 29714 HAUN RD. A h- MENIFEE,CA 92586 Type: Residential Plumbing MENIFEE MENIFEE Date Issued: 0 910 412 01 8 PERMIT Site Address: 29058 MERCURY CIR, MENIFEE, CA Parcel Number: 340-161-024 92584 Construction Cost: $1,900.00 Existing Use: Proposed Use: Description of REPLACE 50 GALLON GAS WATER HEATER IN GARAGE Work: Owner Contractor JOSEPHINE DUNGO A R S AMERICAN RESIDENTIAL SERVICES OF 29058 MERCURY CIRCLE CALIFORNIA INC MENIFEE, CA 92584 965 RIDGE LAKE BLVD#201 Applicant Phone: 9012719700 A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNI/ License Number:765155 965 RIDGE LAKE BLVD#201 MEMPHIS,CA 38120 Phone:9012719700 Fee Description qQt r Amount($1 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 building 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 projects I hereby affirm under penalty of perjury that I am under provisions o ith a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of th si a o I am exempt from licensure under the Contractor's State License Law for Professions Code and�mzylicense Is In full force and effe the following reason: License Class C- J� License 2 By my signature below I acknowledge that,except for my personal residence Expires 7-v Signature in which I 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 ❑1 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 worker'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 this permit is issued. www.leeinfo.ca.eov/calaw.html. Policy# Date En have and will maintain worker's compensatlon insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which D 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 on the propertyowneab6alf.I have read this number are: application and the information ed is correct.I agree to comply ( d� �. with all applicable city a nces and state laws relating to Carrier buildingcon! a ' e 4,�s r-t� tt presentatives of this city or county to Policy#(A7&5 J (,7' Expires 0 f O enter[he a led prop 'nspection purposes. (This section need not to be completed is the permit is for one-hundred Date r dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑I certify that in the performance of c hich this permit is issued, I shall not emolov any persons i r so as to become subject to the CRY BUSINESS LICENSE# workers compensation I ' r ' nd agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the work i provisions of Section 3700 of the Labor Code,I shall f wi co ply wit hose provisions. � Will the applicant or future building occupant handle hazardous material or a Applf Date � O/ mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 D Yes ❑No UNLAWFUL,AND 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 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(SCAQMD)7 See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes ❑No 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) ❑Yes o No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I 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 al Safety Code,Section 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicable items)(Section 7031.5 pYes 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 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 fRRPI 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 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 owners and property than($500). managers who do the paint-disturbing work themselves or through their O I,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.Rov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-BOD-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a ❑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 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. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑1,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. .AMjVf/W BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE DATE PERMIT/PLAN CHECK NUMBERWE S 04W TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN SUBTYPE: [—]ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL []MECHANICAL [—]NEW ❑✓ PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Replace 50 gallon gas water heater in garage. PROJECT ADDRESS 29058 Mercury Circle ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME Josephine Dungo ADDRESS 29058 Mercury Circle Menifee, CA 92584 City of 04enifee PHONE (951)355-3710 AA EMAIL Building Dept. APPLICANTNAME �1'U- Pkp? SEP 0 ' ?W8 ADDRESS 1520 W Linden Street Riverside,CA 92507 Received 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$ $ 1,900.00 L SO FT J APPLICANT'S SIGNATURE DATE I D CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP TF INVOICE 4 I 1 1 PAIDAMOUNT -, AMOUNT V ) 0CASH OCHECKM O CREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT - CASH 0CHECK# OCREDITCARD 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 ®�o zd s °, 0N 0 e�i D CC A n K D tnfi m m D Q�n� 'f7 n N m � � \!�19 5 s a m ,^ x S m M 3 w' Di a' a Z a _ s p° D z m o c 3 '^+ o obi 3 4�i N m r u�i O D a m m M. w ? n m n x y' C2 m _ m N i T m n w• D o ' o w p=p £ ,"• m .°J_c �. N d K rY �_ R N = 3 c = o= o m a m ie m In u(D�`i O y 2 Z = m z U) v ,°-r T o ° ' m io -°i. n a 3 g N o m W O " = A O S O C ^ e0°i C ° w d 0 0 n o Z < 3 N X c 3 m iv » o. m 3 o _ 3 m n ° 0 c c m ao 3 ^ m n m O n a w m N I 3 0 ° ry T y> 2 m -n N N C E• O S W �' w .7 G tlq �• a io' ^. P ci �- O O. 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