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PMT18-05184 City of Menifee Permit No.: PMT18-05184 AV AV 29714 HAUN RD. Ar MENIFEE, CA 92586 Type: Residential Plumbing MENIFEE MENIFEE Date Issued: 10/25/2018 PERMIT Site Address: 26960 MCCALL BLVD, MENIFEE, CA Parcel Number: 338-052-007 92586 Construction Cost: $1,900.00 Existing Use: Proposed Use: Description of REPLACE EXISTING 40 GAL GAS WATER HEATER, SAME LOCATION Work: Owner Contractor WILLIAM SCHLABACH OASIS PLUMBING& DRAIN SERVICE INC 26960 MCCALL BLVD 43980 MAHLON VAIL CIRCLE MENIFEE, CA 92586 TEMECULA, CA 92592 Applicant Phone: 9513036404 ROCCO VOLPE License Number: 771930 OASIS PLUMBING&DRAIN SERVICE INC 43980 MAHLON VAIL CIRCLE TEMECULA, CA 92592 Fee Description QQt rr 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_Permit_Template.rpt Page 1 of 1 accc 0 \)olee - 0061:50 CITY OF MENIFEE A��nLICENSED DECLARATION property who builds or improves thereon,and who conts 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 full force and effect. the following reason: License Class C- 3 Licen e No. O By my signature below I acknowledge that,except for my personal residence Expires dt=,15 Signature X, Ile — 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 www.lesinfo.ca.eov/calaw.html. this permit is issued. 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 ❑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 with all applicable city and county ordinances and state laws relating to Carrier building construction.I authorize representatives of this city or county to Policy# Expires enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred dollars($100)or less Date PROPERTY OWNER OR AUTHORIZED AGENT KSI ertify that in the performance of the work for which this permit is issued, ������II 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 compensation provisions of Section 3700 of the Labor Code,I shaZ117 t comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date�J �� .�9 mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAI URE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes - No UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES i Will the intended use of the building by the applicant or or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construct modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SC ion r See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY o Yes Cd_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 "lo 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&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous mat Vial reporting. / _ Business and Professions Code).Any city or county that requires a permit to CrOles do / Oater u-2J Aa construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNE R 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(RRPI 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 a 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 ❑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 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. DATE: iaP�A PERMIT/PLAN CHECK NUMBER I V GRADING/ PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: Q COMMERCIAL ;,.RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA Q SIGN SUBTYPE: QADDITION p ALTERATION Q DEMOLITION p ELECTRICAL Q MECHANICAL O NEW QPLUMBING ORE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK �� ti �� ��n �j��� 1�.4Jr ,}� _w OCCUPANCY GROUP CONSTRUCTION TYPE p SPRINKLERS O YES ONO PROJECTADDRESS )0 c1 MCCA N L1 MQ4 UA ZIP j,sj c ASSESSOR'S PARCEL NUMBER 3�•( � •an LOT TRACT Cif Buildin-"'"free OWNER NAME w., l 11i1 c h L Aj A�:�"1 9 De ADDRESS j(>9 C> I-LAIi I M CA 9,-�.5e�, I T 25 PHONE 10- W l '7 5) EMAIL APPLICANT NAME VD I �' 'vq+ ADDRESS CJ 3 `73=> M/}N�� 0A !�J /V'1CCm CA S) PHONE EMAIL C>A, u (L%61A6 CONTRACTOR'S NAME U Mbi`16 ILV/C t- Lam• OWNER BUILDER? C)YES, NO BUSINESS NAME n ADDRESS y3c� o 1�,�}�L n V��i� 1`c� TJeicc,(4 CA PHONE EMAIL i CONTRACTOR'S STATE LIC NUMBER � , / `r LICENSE CLASSIFICATION C " .3 L VALUATION $ J ej.x}:�J SQ FT L SQ FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION ACCEPTED BY:IL L2- CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICE TOTAL S . GREEN .� SMIP OWNER BUILDER VERIFIED YES NO DRIVERS LICENSE# NOTARIZED LETTER YES NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityofinenifee.us CERTIFICATE OF COMPLIANCE CF1111-ALT-01-E WATER HEATER Prescriptive Residential Alterations for Water Heater (Page 2 of 2) 4. Number of water heaters in system:In single-family and multi-family with water heaters in each dwelling units the value is 1. For multi-family central systems serving multiple dwelling units enter the weal number of water heaters. S. Water heater volume(gal):tank capacity in gallons. For individual water heaters for a dwelling unit this will be 60 gallons or less. If instantaneous,enter n/a. For multi-family central systems enter the total storage volume. 6. Fuel Type:Gas, Propane,Electric(Only if natural gas is not available) 7. Rated Input Type: Enter the equipment input rating type,for gas or propane fired units are Btuh,for electric fired system the units are kW. 8. Rated Input Value: Enter the numeric value of rated input. 9. Heating Efficiency Type: Energy Factor,AFiUE,or Thermal Efficiency. From product literature or a California Energy Commission directory. 10. Heating Efficiency Value: Enter the value from product literature or a California Energy Commission directory 11. Standby Loss(percent):Applies only to large storage water heaters,Enter n/a for small storage or instantaneous water heaters. 12. Exterior Insulation R-Value: Enter the R-v;3lue if exterior insulation on the storage tank is installed 13. Back-up solar savings fraction: If compliance requires a back-up solar system,indicate the solar contribution (e.g.,0.30). External calculations are required. 14. Central DHW Distribution System: For multi-family buildings with using a central distribution system a demand recirculation system with at least two distribution loops must be installed.This requirement applies to any building with eight or more units. If the system is non-central or project is individual units enter n/a. 15. Dwelling Unit DHW Distribution Type: For a Central DHW this field shall be Standard.If non-central then pick from Standard, Demand Recirculation—Manual Control,Demand Recirculation—Sensor Cmtrol.If non-central electric water heater this must be Standard,no recirculation system shall be installed. DOCUMENTATION AUTHOR'S DECLARATION STATEMENT • I certify that this Certificate of Compliance documentation is accurate and complete. Name: ❑Owner [a Authorized agent o.(ontractor Signature: Val 'Company: p C�1—(.—> 8,,'. _�)A Z D/L c . Contractor lice se#: Address: 93V6?:: H Phone: City/State/Zip: �C/'1cC �1 CA �i�s 7 Date: )b� _J J la For assistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300.