PMT18-04396 City of Menifee Permit No.: PMT18-04396
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Plumbing I/Ar
MENIFEE MENIFEE Date Issued: 09/17/2018
PERMIT
Site Address: 31489 CORDERRO LN, MENIFEE, CA Parcel Number: 372-410-001
92584 Construction Cost: $1,500.00
Existing Use: Proposed Use:
Description of INSTALL 50 GALL GAS WATER HEATER IN GARAGE,SAME SIZE AND LOCATION
Work: MODEL#PROG50-38U RH62EC1
Owner Contractor
AMANDA CARR AIR TEMPERATURE SPECIALISTS
31489 CORDERRO LN 26820 ADAMS AVE STE 100
MENIFEE, CA 92584 MURRIETA,CA 92562
Applicant Phone:8885881602
VIC LUNA License Number:763576
AIR TEMPERATURE SPECIALISTS
26820 ADAMS AVE STE 100
MURRIETA, CA 92562
Fee Description ON Amount I$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
$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 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 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 ❑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 [zO C364-1I Uc s N0. /f6,1657
J� By my signature below I acknowledge that,except for my personal residence
Expires 5,1 Signature f 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 legally sell a structure that I
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 website:
by Section 3700 of the Labor Code,for the performance of work for which
this permit is issued. www.leginfo.ca.aov/calaw.html.
Policy# Date
❑I 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 o By 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 uA,4- GC or J%f.� r with all applicable city and county ordinances and state laws relating to
',• [� building construction.I authorize representatives of this city or county to
Policy# lUSr7S+roT Yq 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 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 CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the work s compensation provisions of Section 3700 of the Labor
Code,I shall fo i comply ith those provisions. pf Will the applicant or future building occupant handle hazardous material ore
Applicant Date / mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FA URE TO ECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes We
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)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelin�
CONSTRUCTION LENDING AGENCY ❑Yes dNa
I hereby affirm that under the penalty of perjury there is a construction WIII 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 boun ry of a school?
(Section 3097 Civil Code) o Yes o
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&�afety Code,Section 25505 and 25534 concerning
hazer ous ma[er reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es o No
Business and Professions Code).Any city or county that requires apermit to �,�. Date
i
construct,alter,improve,demolish or repair any structure,prior to its pROPE 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 IRRPI
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 or through their
❑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.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 o 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. o No EPA Lead-Safe Certified Firm is required for this project because:
o I,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.
1
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION �, MENIFEE
DATE: 9 G PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL O 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 O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK CLAI
PROJECTADDRESS ZIP
ASSESSOR'S PARCEL NUMBER 'b 1 A —40-MI LOT 1010 TRACT 3I�
OWNERNAME
ADDRESS F
PHONE Tf5l �j6 �b e f EMAIL
APPLICANT NAME 1-7 Aelz- dG Gc.Yv�a--
ADDRESS See IWI,4 %,- -rd//
PHONE !E�!!T ` ZS'756S6 EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES O NO
BUSINESS NAME
ADDRESS
PHONE 5-25'1( EMAIL
CONTRACTOR'S STATE LIC NUMBER —76 61 LICENSE CLASSIFICATION Calfcv
VALUATION$ SOFT LSQFT
APPLICANT'S SIGNATURE DATE f1
r /
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL I`SjS GREEN SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES 0 NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofinenifee.us �P.
ENIFE
v
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
Residential Alterations WATER HEATER REPLACEMENT (page 1 of 1)
Project Name: Amanda Carr Climate Zone# #of Stories
1
General Information
Site Address:31489 Corderro Court Enforcement Agency: Date:9/10/18
Menifee
Building TypeXSingle Family ❑ Multi Family Circle the Front Orientation:N.E.S.W,or degrees
2951 Project Type: ❑Alterations ❑Envelope O Fenestration 0 Roof ❑
Conditioned Floor Area(CFA): HVAC Replacement or Change Out ❑Duct Replacement X Water
Heater
NOTE:This form is not to be used for Newly Constructed Buildings or Additions
WATER HEATING
[.in u•ntvr healers and bnilerc(ru hnd�rlantcnir tun under(DHIf1 heaters and/nx/omit a/rare heating. lndiridunt du•c/ling DF/IVhenrers nmat
begasnrpmpmrefrred•andmavnnterreed50gnllanc Honraterplpelnedationfram the DHlp heater to the kitchen(s)and on all
corder round har water ri es is ma uircd in all cam anent arks cs in all clinurre zones.
External Tank
Water Renter Type/FuelDistribution Type Number In Tank Energy Factor or Insulation
Typca (Standard.Recirculating)= System Capacity(gal) Thermal Efficiency R-Values
Gas Recirculatinq 1 50 38
1.Indicate Tepe(Storage Gas,heat Pump.1nstmaaaeaus,ete•J
2.Reciradating systemx sensing nndtiple duelling units shall meet the recirculation requirements a f$150(u). The Prescriptive requirements du
not alhm•the installation of a recinadaring(rater/lealrhlg syr1W11 for Slligle dlrelling ants.
3.The ertemal water heating tank and pipesshall be insulated to meet the requirements ofV50().
Contractor's,(Documentation Author's/Responsible Building Designer's/Owner's),Declaration Statement
• 1 certify that this Certificate of Compliance is accurate and complete.
• 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building
design identified on this Certificate or Compliance.
• 1 certify that the energy features and performance specifications for the building design identified on this Cenificate of
Compliance conform to the requirements of Title 24.Parts I and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance arc consistent with the information provided to
document this building design on the other applicable compliance forms,worksheets,calculations.plans and specifications
submitted to the enforcement agency for approval with this building permit application.
Name: Signature:
Company: AIR TEMPERATURE SPECIALIST Date: 9/10/18
Address: 26820 ADAMS AVE STE 100 License: 763576
City/Slote/Zip: MURRIETA,CA 92562 Phone:(888) 588-1602
Far assistance or questions regarding Ilse Energy Standards,contact the Energy Hotline x.1-809-772-3300.
f