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PMT18-05432 City of Menifee Permit No.: PMT18-05432 29714 HAUN RD. /Z MENIFEE, CA 92586 Type: Residential Plumbing MENIFEE MENIFEE Date Issued: 11/15/2018 PERMIT Site Address: 28705 BROADSTONE WAY, MENIFEE, Parcel Number: 340-122-024 CA 92584 Construction Cost: $800.00 Existing Use: Proposed Use: Description of REPLACE EXISTING 50 GAL GAS WATER HEATER, SAME LOCATION Work: Owner Contractor VIRLIN FOOTE ALL STAR WATER HEATERS INC 28705 BROADSTONE WAY 30300 PUERTO VALLARTA WAY MENIFEE, CA 92584 MENIFEE, CA 92584 Applicant Phone: 9513010067 SIERRA SPRAGUE License Number: 812894 ALL STAR WATER HEATERS INC 30300 PUERTO VALLARTA WAY MENIFEE, CA 92584 Fee Description Qty Amount($) 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 $115.15 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee. Except as otherwise stated,a permit for construction under which no work is commenced within six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA_Bldg_Permit_Template.rpt Page 1 of 1 i DATE ��1�L��Qj PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL ORESIDENTIAL O MULTI-FAMILY C?MOBILE HOME G POOL/SPA O SIGN SUBTYPE: Q ADDITION O ALTERATION (.-%DEMOLITION O ELECTRICAL. O MECHANICAL. z 0 NEW ✓PLUMBING O RE-ROOF-NUMBER OF SQUARES _..... ._.. ".__...... DESCRIPTION 01:WORK Replace existing water heater. Same size and location. PROJECTADDRESS -28705 Broadstone WayCRY V1 irlAenifEe ASSESSOR'S PARCEL NUMBER b- ►aa � LOT TRACT BUIIdin 1 Dept. OWNER NAME Virlin Foote _ _ 2018 ADDRESS 28705 Broadstone Way PHONE 951-345-2103 EMAIL Rexeived APPLICANT NAME Sierra Sprague ADDRESS 30300 Puerta Vallarta PHONE 951-301-0067 EMAIL alistar.sierra gmail.com CONTRACTOR`S NAME Sierra Sprague OWNER 9U?LD1R7 O YES ONO BUSINESS NAME All Star Water Heaters ADDRESS 30300 Puerta Vallarta Way PHONE 951-301-0067 _ EMAIL allstar.sierra@gmail.com CONTRACTOR'S STATE LIC NUMBER 812894 LICENSE CLASSIFICATION C36 VALUATION$ 800.00 SQ IT L SQ FT APPLICANT'S SIGNATURE. ,. DATE / - _� -__ - - DEPAfiTMCNT DISTRIBUTION CITY OF MENIFEF BUSINESS LICENSC NUMOER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP X INVOICE PAID AMOUNT AMOUNT � � r�' �_ O CASH U CHECK N Q CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0 CASH O CHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES :? NO DL NUMBER NOTARIZED LETTER v^ YES O NO n.w C ity of MpnifeP. Building&Safety 0epartmerat '9724 Haut?Rd ,Mww.eitynfn1enrfee.us Iml—vion Rt quest Line Y5.1-24,5-621 ,- % e DOtad - CITY OF MENIFEE ek 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 ❑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_ License No. By my signature below I acknowledge that,except for my personal residence Expires d .20 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 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 following website: by Section 3700 of the Labor Code,for the performance of work for which ,,vww.leeinfo.ca_gov/calaw.html. this permit is issued. Policy# Date 044 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 LrBy 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 / 4/�S� with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# !?A466&dfl �2Z Z Expires�9 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 PROPE ) ER OR AUTHORIZED AGENT�.��0 o I certify that in the performance of the work for which this permit is issued, /,?(3`. 15 1 shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# �J worker's 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 forthwith co ply with those provisions. Will the applicant or future building occupant handle hazardous material or a mixture containing a hazardous material equal to or greater that the Applicant Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAIL RE ECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes ei�No UNLAWFUL,AND 914ALL 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 Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines 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 boundary of a school? (Section 3097 Civil Code) ❑Yes C�No 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 California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 �Xes o No Business and Professions Code).Any city or county that requires a permit to Date / construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER ORIZED 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(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 o 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. o No EPA Lead-Safe Certified Firm is required for this project because: ❑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. yS�°�T'�A!!'�!!'fE''JF rht.iFCRNI33A ggpg �` �p'9p'� ;�,p�y s �3 3 1'?3�.,SIDEN•:6.""F.M..AL 3 EII i ii'fs.d��i'S— !uF`J A C tom.R 4•�E i ER CEC-CF1RALT-01-E(Revised W14) 40 CALtFOr'tb1Vc EE1Ert{3Y Co}fiiSSIOA€ CERTIFICATE OF COMPLIANCE N,?;a >v�alz-AST-oi->t wAT�>��TIrR -- Pies;:�,catareektesedentialAfteaatians ft�rtiklaterHeater _.— (pagelJ���?r�p� - — ---- _ r enifee Suildiri A. GENERAL INFORMATION Dept. �Ae address: 6czitt�ingT�Opt": Sin le Family Dwelling 1?d17DS , '� o ©re �y g v g NOV4 2018 _� _._ Multi Family Dwellings pity, zip Code: enifee --- cll>�ate zc�ne1N.P96. et'ved to G. .AL ATEF HEATING SYST E:�ie� Water 02 r}3 04 05 05 07 08� 09 10 — it 12 13 _ 14 J 15 Water Water Water p of Water Fuel Rated Rated Heating heating Standby Exterior Back-Up} Central N,vellin T ` 8 Heating Heating Heater Water Heater Ty pe Input Input Efficiency Efficiency Loss{%) Insul. Solar DHW System Unit DHW r System r} System Type Heaters Storage Type Value Type Value i R-Value Savings distribution system identification Type in Volume I d or system (gal) ! Fraction Type Distribution ; Name lit Tvpe Whirlpool DH � 1 50 Gas 62 © R-16 Standard TMA`IEP HEAT-il'+iG sysivvis Water heating compliance for an alteration is described in Section 150.2(b)!G.For single dwelling a gas or propane water heater, .with a storage tank of 60 gallons maximum or instantaneous(tankless)can be used.Dwelling Unit distribution systems are limited to St andard trunk and branch or demand recirculation for gas or propane water heater,Demand recirculation is not allowed for electric,water heater.if there is no natur-i connected to the building,an electric water heater may be replaced with another electric water heater.However,changing from gas to electric is not allowed. MUTT'r_entral systems must use certified equipment as defined under Section 110.1 and 110.3. NOTE:If the proposed installation does not meet the requirements alloyed specifically for alterations,use form CF111-NCB-01 to document the water healer alteration. lnstru riiatts for sections with column numbers am even below: I. grater Heating System identification or Narne:enter a unique name for the Water Heating System. 2. theater beating system type: Domestic Hot Water(DHW),Hydronic,Combined Hydronic,or Central,DHW is for domestic hot water,hydronic is a water heating system used for space heating only;cornt3ined hydronic are when the water heater will provide both space conditioning and domestic hot water. 3. Water heatertype: For non-central systems only Small Storage or Small Instantaneous are allowed.For central systems pick from Large Storage,Small Storage, Heat rump,Boiler,Large Instantaneous,Small Instantaneous or Indirect. CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E WATER HEATER::] Prescriptive;Residential Alterations for Water Heater (page 2 of 2) 4. uumber of water heaters in system:In single-family and multi-family with water heaters in each dwelling visits the value is 1.For multi-*anvil cc:;fi di systens serving multiple dwelling units enter the total number of water heaters. 5. Water heater volume(gal):tank capacity in gallons.For individual water heaters for c 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- S. Rated Input Value:Enter the numeric value of rated input. 9. Heating Efficiency Type:Energy Factor,AFUE,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-value if exterior insulation on the storage tank is installed 13_ Rack-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 0I4W 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 Control. If non-central electric water heater this must be Standard,no recirculation system shall be installed. DOCUMENTATiON AUTHOR'S DECLARATION STATEMENT ~-- •1 certify that thisCertifitate of Compliance documentation is accurate and complete. Name:Sierra Sprague oOwner a Authbrfzed agent Xontractor Signature: Q Company: A tar W aters _.__.._. contractor rice e; -- Address: 30300 Puerta Vallarta Phone. 951-301-0067 City/state/zip- Menifee, CA 92584 Date: �� �� For assistance or questions regarding the Energy Standards,contact the Energy Hotline at: 1-3300-772-3300.