PMT18-04589 City of Menifee Permit No.: PMT18-04589
29714 HAUN RD. Type: Residential Plumbing
MENIFEE, CA 92586
MENIFEE MENIFEE Date Issued: 09/2012018
PERMIT
Site Address: 27690 TATE RD, MENIFEE, CA 92585 Parcel Number: 336421-012
Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL GAS WATER HEATER, SAME LOCATION
Work:
Owner Contractor
RONALD GANGER ALL STAR WATER HEATERS INC
27690 TATE ROAD 30300 PUERTO VALLARTA WAY
MENIFEE, CA 92585 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 Q�t Amount
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_eldg Permil_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 D I am exempt from Iicensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
Ucense Class License No. By my signature below 1 acknowledge that,except for my personal residence
Expires O Signature � in which l must have resided for at least one year pdorto completion of
improvements covered by this permit.I cannot legallysell a structure that 1
WORKER'S COMPENSATION DECLARATION 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 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 vvww le=info.ca.eov/calaw.latml.
this permit is issued.
Policy# Date
44 have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which "y 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 property owner's behalf.I have read this
number are: application and the information 1 have provided is correct.I agree to comply
Carrier CG with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# PALL�7wjr 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 PROPR9>016NER 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# �J l
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,1 shall forthwiIji co ply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Dated mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAI U SECURE WORKER'S COMPENSATION COVERAGE IS Dyes :D;No
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($100,000),IN occupant require a permit for the construction or modification from South
IN SECTION N TO
06 OF
LABOR CODE,INTERTION,DAMAGES
ST, A AND
S Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 37060E THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY DYes ❑No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) ❑Yes m_No
OWNER BUILDER DECLARATIONS 1 have read the Hazardous Material Information Guideand the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
/
checkmark(s)I have placed nett to the applicable item hazardous material reporting.$)(Section 7031.5
Business and Professions Code).Any city or county that requires a permit to .DYes ❑No
Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNEROR 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRP)
License Law(Chapter 9(commencing with Section 70001 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
D I,as owner of the property,or my employee with wages as theirsole 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.epv/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 Contractor's 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. 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 Contractor's 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.
{Ilp MMNn,
Tl day `V'SS"
'� ® n• •- (�r>t•, 1#1(a .'
DATE a`�0,�� PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL ✓❑RESIDENTIAL O MU_LTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: ,O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW ✓ WMBIN_G U RE-ROOF-NUMBER OF SQU_ARES_, __ '
DESCRIPTION OF WORK Replace existing water heater. Same size and location
PROJECTADDRESS _27690 Tate Rd. Ok
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNERNAME Ronald Ganger
ADDRESS 27690 Tate Rd.
j PHONE 951-679-7012 EMAIL
APPLICANTNAME Sierra Sprague_
! ADDRESS 30300 Puerta Vallarta
PHONE 951-301-0067 EMAIL allstar.sierra@gmail.com —
CONTRACTOR'S NAME Sierra Sprague _ OWNFR LtUiLC EN? 0 YES_NO —I BUSINESS NAME All Star Water Heaters
ADDRESS 30300 Puerta Vallarta Way r
PHONE 951�301 0067 EMAIL allstar.sierra@gmail.com _ t
+ CONTRACTOR'SSTATE LIC NUMBER 812894. LICENSE CLASSIFICATION C36
VALUATION S' 800.00 -
1 - - - -
SQ FT _ L SQ FT _
APPLICANT'S SIGNATURE DATE
DEPPATMENT DISTRIBUTION CITY OF MCNIFEE BUSINESS UCENSF NUMUEI:
I FUILDING PLANNING ENGINEERING FIRE GREL'N SMIP
ua':niCP r PAIDANIDIINff
ALiC,Ift 1 C CASH O CHECK k O'CREDIT CARD NSA/MC
I PLAN CHECK FEES PAID AMOf/NT I O CASH 0 CHECK R '>CREDIT CARD VISA/MC
DWNER BUILDERVERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
LLtq qi r?fnyeE 8;/ ''itm R• Syt ...�.... r _. .- .' City Of Menlfes
Building Dept.
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