PMT18-05105 City of Menifee Permit No.: PMT18-05105
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Plumbing
MENIFEE MENIFEE Date Issued: 10/23/2018
PERMIT
Site Address: 29389 PAINTED DESERT DR, MENIFEE, Parcel Number: 340-170-021
CA 92584 Construction Cost: $925.00
Existing Use: Proposed Use:
Description of REPLACE PRESSURE REGULATOR IN MAIN WATER LINE WITH 1"PRESSURE REGULATOR
Work:
Owner Contractor
JOHN HARTUNG SOMATDARY INCORPORATED
29389 PAINTED DESERT DR P.O. BOX 2667
MENIFEE, CA 92584 CULVER CITY, CA 90231
Applicant Phone: 7143498239
VICTOR MEDINA License Number: 771663
SOMATDARYINCORPORATED
P.O. BOX 2667
CULVER CITY, CA 90231
Fee Description QQtt( Amount($)
Sewer 1 150.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee- Plumbing 1 7.50
$185.50
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 Contractor's State License Law for
Professions Code and my license is in fullforce and effect.1� /_ the following reason:
License Class 1Z CL""C 9�ice e t. 1 No. 1 `1 (J v
By my signature below I acknowledge that,except for my personal residence
Expires`Q Z 0 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
❑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
issued.
www.leginfo.ca.gov/calaw.html.
this permit is
Policy# g I I 1 °i lJ Date
❑I 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 ❑By my signature below 1 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 I have provided is correct.I agree to comply
.0 YV V r J Sv !V with all applicable city and county ordinances and state laws relating to
Carrier. �1 building construction.I authorize representatives of this city or county to
Policy# Expires 0 [i enter the above identified property for inspection purposes.
(This section need not to be completed is the permit i for one hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
❑1 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#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's ompensation provisions of Section 3700 of the Labor
Code,I shall forthwi comp) thos provisions. 7 Will the applicant or future building occupant handle hazardous material or a
Applicant Date b �7 mixture containing a hazardous material equal to or greater that the
amounts s ecified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑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($300,000),IN ion occupant require a permit for the construct or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SC ion or See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ❑Yes c/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 ❑No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the zardous m776
l reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Yes ❑NoBusiness and Professions Code).Any city or county that requires a permit to Date U -&
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 Contractor's State EPA RENOVATION,REPAIR AND 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 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 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. ❑No EPA Lead-Safe Certified Firm is required for this project because:
❑I,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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ,_,: MENIFEE
AV
r. ._ .,.r
DATE: I� 2 PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: COMMERCIAL RESIDENTIAL MULTI-FAMILY MOBILE HOME POOL/SPA SIGN
SUBTYPE: ADDITION ALTERATION D DEMOLITION C ELECTRICAL MECHANICAL
NEW LUMBING RE-ROOF NUMBER OF SQUAR S
DESCRIQTION OF WORK e/ 'j>r J Vr Y'
PROJECT ADDRESS I 24��j NIAI of e iced b r. ZIP
ASSESSOR'S PARCEL NUMBER LOT pi TR
(,� �.�17/of
Menifee
OWNER NAME Y,✓� _ A Building Dept,
_4T
ADDRESS OCT 2
PHONE EMAIL
%Uft(APPLICANT NAME ! • K I "` e cV i v
ADDRESS
PHONE �i �� EMAIL
CONTRACTOR'S NAME (vm �I OWNER BUILDER? YES NO
BUSINESS NAME
ADDRESS I 0q LA I•� -
PHONE Q EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ J • SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE
OTYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE _T
INVOICE TOTAL GREEN SMIP
OWNER BUILDER VERIFIED YES Cr NO DRIVERS LICENSE# NOTARIZED LETTER YES NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 041
www.cityofinenifee.us
PLOT/SITE PLAN
CITY OF MEcMI OPERTY LINE
BUILDING AND SAFETY D ,E—t ,
VEWED
VAS
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*Approval of these plans shall not b onstrued to be a per-Ilt tor,or an cm
approval of,any violation of any provis ns of the federal,state or city
regulations and ordinances. This set of ap roved plans must be kept on the
jobsite until completion, P'nifee
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FRONT PROPERTY LINE
Property Owners Name
Property Address
City of Menifee Building&Safety Department 29714 Haun Rd.Menifee,CA 92586 951-677-672-677
wwwcityofinenifee.us