PMT18-04402 City of Menifee Permit No.: PMT18-04402
29714 HADN RD.
MENIFEE,CA 92586 Type: Residential Plumbing
A&
MENIFEE MENIFEE Date Issued: 09107/2018
PERMIT
Site Address: 27574 RENAISSANCE CIR,MENIFEE,CA Parcel Number: 336-530-006
92584 Construction Cost: $3,475.00
Existing Use: Proposed Use:
Description of REPLACE 75 GALLON GAS WATER HEATER IN GARAGE
Work:
Owner Contractor
ROBERT BAIRD A R S AMERICAN RESIDENTIAL SERVICES OF
27574 RENAISSANCE CIRCLE CALIFORNIA INC
MENIFEE, CA 92584 965 RIDGE LAKE BLVD#201
Applicant Phone:9012719700
A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIf License Number:765155
965 RIDGE LAKE BLVD#201
MEMPHIS, CA 38120
Phone:9012719700
Fee Description Olt Amount i$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 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
S;(ya M i p5— 1*S
CITY OF MENIFEE F
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 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:
s I nn
License ClasT- License No. sS� _ By my signature below I acknowledge that,except for mypersonal residence
Expires 3 I IZO 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 LA ION have built as an owner-builder if it has not been constructed in its entirety by
❑I hereby affirm under pe 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 fallowing website:
by Section 3700 of the Labor Code,for the performance of work for which www.leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy# Date
D 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 D 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 / 1 b� �y ^ v with all applicable cityand county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy#0 ?43J75a@631 Expires_4Q/ice 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
D I certify that in the performance of the work for which this permit is issued,
1 shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If
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 forthwitF)tamph Fros rovtsions. Will the applicant or future building occupant handle hazardous material or a
A )icon Date 3� � mixture containing a hazardous material equal to or greater that the
PP amounts sp/°�Red on the Hazardous Materials Information Guide.
WA I ;FAILURETO
SECURE WORKER'S COMPENSATION COVERAGE ISDYes dNo
,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(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelfne
CONSTRUCTION LENDING AGENCY ❑Yes 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 boun try of a school?
(Section 3097 Civil Code) ayes 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 perjury
indicated below by the California He5pIth&Safety Code,Section 25505 and 25534 concerning
hazerdouwm rialreparting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 DYes 6No C/
Business and Professions Code).Any city or county that requires a permit to Date ��� 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 Contractors 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 7032.5 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
D 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 D 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. D No EPA Lead-Safe Certified Firm is required for this project because:
D 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.
i ti j
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE PERMIT/PLAN CHECK NUMBER p ' O�-
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA []SIGN
SUBTYPE: [—]ADDITION ❑ALTERATION ❑DEMOLITION ❑ELE.CTRICAL [—]MECHANICAL
[]NEW ❑✓ PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace 75 gallon gas water heater in garage.
PROJECTADDRESS 27574 Renaissance Circle. �--I
ASSESSOR'S PARCEL NUMBER^s' �OT TRACT
OWNER NAME Robert Baird t`r--
ADDRESS 27574 Renaissance Circle, Menifee, CA 92584
ILAty Ot Menifee
PHONE (951)454-9880 EMAIL Building Dept.
APPLICANT NAME ,� ) 1^'� �� 1 S
ADDRESS 1520 W Linden Street Riverside,CA 92507 Received
^Q /
PHONE (951)341-9371 EMAIL ecei V ed
CONTRACTOR'S NAME ARS.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$ $3.475.00 S FT L SQ FT �j
APPLICANT'S SIGNATU DATE 7 �S
CITY STAFF USE ONLY
DEPARTMENT DI RIBUTI CITY OF}M�ENIFEE BUSINESS LICENSE NUMBER
BUILDING P N 1 ENGINEERING FIRE GREEN SMIP V
INVOICE [11 PAID AMOUNT
AMOUNT 0CASH 0CHECK# 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT I OCASH CCHECKH OCREDITCARD VISA/Mc
OWNER BUILDER VERIFIED C YES O NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building& Safety Department 29714 Haun Rd:Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
# z D n mid
p m ti
mxm G= moo3w � a •D.� .o am ° [� Do .
_ '^ �, tom.+ w m D m 0 C y ;i z
CL
m m Z m ad rp£ z 3, o s c x & m 3ttm Ni T ' ^ 5Da
o o w w w ti; m 3 GZj m N X ti g m ^r"1
L N y O (n y ry `c 'n cn > D r
d o d o m D n
w O m m m `"' -y-1 m 0 -W Z —I
❑ m a o o < w m m D �] Z a m O
> ? m c o a o . o1D, m o enCDZ
a"i q 3 �_ 3 -« m N y, 0 5 d m m OV O (�
m O d m = " = m < In h
N O n =O N S m C i V d C O y w 0 0 n D
m 3 S Ap o ,^. = o° � " 3 0 m u' 7 n m .i
h o d . m 3 n a a " m w f/D� m ;1
�- O a y �• C m m .� ' O l J w _
d O m
m x _ m y ; CD G m
m rt d d v $ o ysA A
N S m m ' M 3
o. �n Sr n 3 m m a ' d o
^ O — o U
m O.
rL = c » m �
m d m O 0
3 ° a a m
d
H o � � •� � � a � m
m n C m x
d o e+ d d d -n m j
m m^ 3 a w
c
'o x ct ,� o
N
d b N m m 2 n C
n = mQQ
m
m O . 'r O' 0 1
FL o a 3 3 3 a w 0 in v
0 S
m
O in Z
Na n a o 3 rb < 0 ❑ ❑
N ^ O
m 0 3 o a; m a !; _ o ❑ A
w
b d
OZ a o 3 u n 3• D
a m 2 x
Q O '" v O O O a
IT W fD m M .mdr O w T
m
CD
0 7 o a rm� F ti as S
�o N nFi A N N N b Ol o D m
re .r a O O 1 �
Cry om m' v m
iW o -p � m m m = b a d 3 d A �
°—' ' y vi a ONCv N =
D
o m ? ? N mod
a £w�l1�63 oq �IO 2000 OFFICE COPY
m m a - O m
m n C n
^ In A W N t+ O It
d ;� D •? 2
m a d N > o d ° m a n T S A "� 3 rL m 2 m
n
Cn
`E z o 3 p1 v` o a
10 N O CD
D m �' C ,'» CS o -mn m y v m 3, m c p n
O (/1 2 W ri tU G d C uNi C N n N =. y
cn 3 �^ A 'L d ° ' n 'o a F a m y
d n Q (CD ° m =. o m' e z oD m y T d L3 m ° d Z
w° (O �7 3 n m 0 m m a� a m
m U7 Ort �. = c vi w m v m
n
° o m M
N
d 3 r�i n p 3 ai d m a. o� =w o
d c d 2 ''o n 'O '�, m m ° in a c `.'� an o w m
Or M
o
ID
0 m n f 3
m n N = ? FL
)c C S a C ti c
m d " f c m m c n, v m t_.
°�
lb
ex
IM v m d F
d S
N J 3@ 3 M O p p O m
G S C id m d ry �• d W
of
14 0
N O j C O
N OF w 09 3
O •n'I C m r=i m N m m N S � n
Cil
m �
W
.-P,i
p � 7
01
n 2 N m
'n lA W d On N W <
Ln n ' O 3 N O C T
Ln o. .. 3 3 N m N
a o K s o 'w
D
� D
3 3 -3
p.Tj O'
O.
yN• A � _ 7 � d 3 �`
prtj rd-r, N 1 ° n 'p
u ^ m N m 6 m
°' rt o m d f9 Sm
O. C•' N D
°
m a o 3 A