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PMT18-05645 City of Menifee Permit No.: PMT18-05645 29714 HAUN RD. A MENIFEE, CA 92586 Type: Residential Plumbing MENIFEE MENIFEE Date Issued: 11/28/2018 PERMIT Site Address: 25815 BALSAM FIR CIR, MENIFEE, CA Parcel Number: 335-480-045 92585 Construction Cost: $1,243.00 Existing Use: Proposed Use: Description of REMOVE AND REPLACE 50 GALLON GAS WATER HEATER IN GARAGE Work: Owner Contractor ARKADI SHKOLNIK A R S AMERICAN RESIDENTIAL SERVICES OF 25815 BALSAM FIR CIRCLE CALIFORNIA INC MENIFEE, CA 92585 965 RIDGE LAKE BLVD#201 Applicant Phone: 9012719700 A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNb License Number: 765155 965 RIDGE LAKE BLVD#201 MEMPHIS,TN 38120 Fee Description Qty Amount($) 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_Bldg_Permit_Template.rpt Page 1 of 1 CITY OF MENIFEE vectka 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 Contractors State License Law for Professions Code and my license is in full force and effect. the following reason: License Class Pt_ License No. 2CPS��S� _ By my signature below I acknowledge that,except for my personal residence Expires 3 I 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 LA ION have built as an owner-builder if it has not been constructed in its entirety by ❑I hereby affirm under pea 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 www.leginfo.ca.gov/calaw.htmi. this permit is issued. Policy# Date PROPERTY OWNER OR AUTHORIZED AGENT o I have and will maintain workers compensation insurance,as required by 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 be—,,^ ;/ U� with all applicable city and county ordinances and state laws relating to Carrier 1 1 / , r building construction.I authorize representatives of this city or county to Policy#(>%?63 DS-D& 3 1 Expires t0lllZe 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 PROPERTY OWNER OR AUTHORIZED AGENT o 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# 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 forthwitfp th rovisions. Will the applicant or future building occupant handle hazardous material or a 3� mixture containing a hazardous material equal to or greater that the Applican Date amounts sp Red on the Hazardous Materials Information Guide? WDA 1 .FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS a Yes FUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building 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 guideline�/ CONSTRUCTION LENDING AGENCY o Yes o 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 boCun ary of a school? (Section 3097 Civil Code) ❑Yes No OWNER BUILDER DECLARATIONS 1 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 He Ith&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardou ri ri 31 reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes �dNo Business and Professions Code).Any city or county that requires a permit to 29= Date construct,alter,improve,demolish or repair any structure,prior to its ROPER 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 Contractors State EP ENOVATION 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 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: o 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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION t MENIFEE DATE: / PERMIT/PLAN CHECK NUMBER Ang W L4q GRADING/ PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: Q COMMERCIAL O RESIDENTIAL (2)MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: QADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW OPLUMBING ORE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK Replace 50 gallon gas water heater in garage. OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS Q YES ONO PROJECT ADDRESS 25815 Balsam Fir Circle ZIP 92585 ASSESSOR'S PARCEL NUMBER !� '�Ov ' (:)"f5LOT TRACT OWNER NAME Arkadi Shkolnik City of Menifee ADDRESS 25815 Balsam Fir Circle, Sun City, CA 92585 Building Dept. PHONE 951-902-3864 EMAIL NOV 2 8 2018 APPLICANT NAME J Y\t 1 S 64 ADDRESS 1520 W Linden Street, Riverside, CA 92507 PHONE 951-341-9371 EMAIL CONTRACTOR'S NAME ARS Rescue Rooter OWNER BUILDER? OYESQNO BUSINESS NAME ADDRESS 1520 W Linden Street, Riverside, CA 92507 PHONE 951-341-9371 EMAIL CONTRACTOR'S STATE LIC NUMBER 765155 LICENSE CLASSIFICATION C36 VALUATION$ 11243 SO FT L SQ FT APPLICANT'S SIGNATURE DATE l /� CITY STAFF USE OiVLY DEPARTMENT DIST"IBUTIE0 ACCEPTED BY: CITY O/�F,M�ENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNNEERING FIRE C>✓ INVOICE TOTAL 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.cityofmenifee.us ENIFE STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS —WATER HEATER CEC-CF1R ALT-01-E(Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF111-ALT-01-E WATER HEATER Prescriptive Residential Alterations for Water Heater (Page 1 of 2) A. GENERAL INFORMATION Site address: Building Type: ❑ Single Family Dwelling 25815 Balsam Fir Circle ❑ Multi Family Dwellings City, Zip Code: MENIFEE, CA Climate Zone: 10 G. WATER HEATING SYSTEMS (Section 150.2(b)1G) 01 02 1 03 04 05 06 07 08 09 10 11 12 13 14 15 Water Water Water #of Water Fuel Rated Rated Heating Heating Standby Exterior Back-Up Central Dwelling Heating Heating Heater Water Heater Type input Input Efficiency Efficiency Loss(`Y} Insul. Solar DHW System Unit DHW System System Type Heaters Storage Type Value Type Value R-Value Savings Distribution System Identification Type in Volume Fraction Type Distribution or system (gal) Type Name WH DHW Stor 1 50 gas btu 38k EF n/a n/a n/a n/a n/a WATER HEATING SYSTEMS Water heating compliance for an alteration is described in Section 150.2(b)1G. For single dwelling a gas or propane water heater,with a storage tank of 60 gallons maximum I or instantaneous(tankless)can be used.Dwelling Unit distribution systems are limited to Standard 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 natural gas 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.Multi-family central systems must use certified equipment as defined under Section 110.1 and 110.3. NOTE: If the proposed installation does not meet the requirements allowed specifically for alterations,use form CFIR-NCB-01 to document the water heater alteration. Instructions for sections with column numbers are given below: 1. Water Heating System Identification or Name:enter a unique name for the Water Heating System. 2. Water heating 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;combined hydronic are when the water heater will provide both space conditioning and domestic hot water. 3. Water heater type:For non-central systems only Small Storage or Small Instantaneous are allowed. For centfftV)t�f pft&om Large Storage,Small Storage, Heat Pump,Boiler,Large Instantaneous,Small Instantaneous or Indirect. Building Dept. NOV 2 g 2018 Received CERTIFICATE OF COMPLIANCE CF1R-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 fi s serving multiple dwelling units enter the total number of water heaters. !ib•� 5. 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 1D multi-family central systems enter the total storage volumes 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. rz 8. Rated Input Value: Enter the numeric value of rated input. lrrrt:�t 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. 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. t 14. Central DHW Distribution System: For multi-family buildings with using a central distribution system a demand recirculation system with at least two distributio 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. x 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 Control.If non-central electric water heater this must be Standard,no recirculation system shall be installed. DOCUMENTATION AUTHOR'S DECLARATION STATEMENT h.rr • I certify that this Certificate of Compliance documentation is accurate and complete. Name: aOwner VAuthorized agent ❑Contractor Signature: Company: ARS Rescue Rooter ntr3jc. r license#: 76515 Address: 1520 W Linden St P ne. 951-341-9371 City/State/Zip: Riverside, CA 92507 Date: For assistance or questions regarding the Energy Standards,contact the Energy Hotline at: 1-800-772-3300. City Of Menifee Building Dept. NOV 2 8 2018 Received