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PMT18-04422
City of Menifee Permit No.: PMT18-04422 29714 HAUN RD. Type: Residential Plumbing MENIFEE, CA 92586 MENIFEE MENIFEE Date Issued: 09/11/2018 PERMIT Site Address: 29076 STONE RIDGE ST, MENIFEE, CA Parcel Number: 340-421-015 92584 Construction Cost: $800.00 Existing Use: Proposed Use: Description of REPLACE EXISTING 50 GAL GAS WATER HEATER,SAME LOCATION Work: Owner Contractor MARK NORBURN ALL STAR WATER HEATERS INC 29076 STONE RIDGE STREET 30300 PUERTO VALLARTA WAY MENIFEE, CA 92584 MENIFEE, CA 92584 Applicant Phone: 9513010067 SIERRA SPRAGUE License Number.812894 ALL STAR WATER HEATERS INC 30300 PUERTO VALLARTA WAY MENIFEE, CA 92584 Fee Description QQrt Amount($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_Peonit_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). Chapter!)(commencing with section 7000)of Division 3 of the Business and ❑1 am exempt from licensure under the Contractor's State License law for Professions Code and my license is in full force and effect. the following reason: License Class ?7 License No. ��.Q� By my signature below l acknowledge that,except for my personal residence Expires .C30 Signature m 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 D I hereby affirm under penalty of perjury one of the following declaration:) 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 sysyay.leeinfo.ca.eov/caWw.lrtml. this permit is issued. Policy g Date 44 have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the La bar Code,for the performance of the work for which pi my signature below l 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 ownefs 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 Poligg tPtZgle�?a S Expires enterthe above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred _'4" - Date dollars($100)or less PROP NER OR AUTHORIZED AGENT D I certify that in the performance of the work for which this permit is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If J V 1 workers compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 370D of the Labor Code,i shall forthwJjjh co ply with those provisions. Will the applicant or future building occupant handle hazardous material or mixture containing a hazardous material equal to or greater that the Applicant Date amounts specified on the Hazardous Materials Information Guide? WARNING FAI U SECURE WORKER'S COMPENSATION COVERAGE IS 0Yes 'nQNO 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 require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air antQuality Management District(SCtionor modee ification checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCf1ON LENDING AGENCY Dyes loNo - Iherebyaffirmthatunderthepenaltyofperjurythereisaconstruction 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) D Yes �DMo 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 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material report % Business and Professions Cade).Any city or county that requires permit DYes D No to Date .i/ construct,after,improve,demolish or repair any structure,prior to its PROPERTY OWNENOR 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 700D)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 Dl,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 aAn EPA Lead-Safe Certified Renovator will he 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 w81 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: D 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 If your project does not comply with EPA RAP rule please fill out the RRP Acknowledgement. DATE u .0 PERMIT/PLAN CHECK NUMBER TYPE: 0 COMMERCIAL QRESIDENTIAL O MULTI-FAMILY 0 MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION C DEMOLITION C ELECTRICAL O MECHANICAL i 0 NEW .7PLUMBING ORE-ROOF-NUMBEROF SQUARES_„ DE_CIWTION or WORK Replace existing water heater. Same size and location. City of Menifee _ Dept. PROJECTADDRESS 29076 .Stone Ridge St. G124D�- -BuTding' 1 -ept. ASSESSOR'S PARCEL NUMBER Or,) LOT _ TRACT 1.O 2018- OWNER NAME Mark NOrbUM _ _ ADDRESS 29076 Stone Ridge St. _ �Ce1VE' PHONE 951-837-8976 EMAIL ' APPLICANTNAME Sierra Sprague I ADDRESS 30300 Puerta Vallarta PHONE 951-301-0067 _ EMAIL allstar.sierra@gmail_com__,._ I CONTRACTOR'S NAME Sierra Sprague 04VNER BUILDER? YES -'•NO 777 BUSINESS NAME All Star Water Heaters ADDRESS 30300 Puerta Vallarta Way _ J PHONE 951 y301-0067 EMAIL allstacsierra@gmail.com —� — I CONTRACTOR'S STATE LIC NUMBER 812894 _ LICENSE CLASSIFICATION C36 — IIII VALUATION$ 800.00 _ SQ FT LSQ FFr/ 1 APPLICANT'S SIGNATURE DATE�/ O f P� DEPARTMENT DISTRIBUTION i CITY Of NIENIFEE BUSINESS UCENSE NUMBER j BUILDING MANNING ENGINEERING FIRE GREEN PAIDA SN11P INVOIC[ MOUNT _ �1 � P CASH '-�'CHECY,H __C CREDIT CARD VI$A/MC PL r%N CHECK FEES PAID AMOUNT O CASH O CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER O YES C NO :;g:.�)/✓:eni}.r: 3 ddu y " q....�..,pzpa;.: r:.L e7;"-','!au�l fsr,.l :2rifee. .:r y'k=u 95'-57�.6!'T lnspotti-. �fmst!.ire95:;i45-n213 m nt A N (y I 1r w a 3•c yry a © I V7 ? g 0 fjJ rn W N F+ s• d (D O S O (3p a rNj, ,� '.' •$ N d I17 ct T n n ,dr, n 3 A t5 1y m ry 'v 2 O 0 It N 10 N 0 CDl o "EL 774mCD 11I m y u, -mac < _ m w ° u y n D1`DG1 t,9 ry CD Cp n• CL m O 1 _ m n K O at 3 3 J c N j %o � n N n C N rp N N Y O rD O N _ R Q C � � ,� .� L✓, H ��" � Iv � n c N'OHO I N 9 cr j J o. d n 'E a as = � a m � _ • n � j � � w ? v wt� �• m g N m ro o ry 2 w � eta m m o N a oL b -i d 0 J N u a s NIHI O � � a U m n n c ID. 7 o m n a m3 .Z7� z k "'IC /c o J N J Vi 7 0 J n p. 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