PMT19-00016 City of Menifee Permit No.: PMT19-00016
29714 HAUN RD.
` MENIFEE, CA 92586 Type: Residential Plumbing
€M� !-NEFEE MENIFEE Date Issued: 01/04/2019
PERMIT
Site Address: 30168 VIA AMANTE, MENIFEE, CA 92584 Parcel Number: 364-092-003
Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL GAS WATER HEATER, SAME LOCATION
Work:
Owner Contractor
NOEL MANTON ALL STAR WATER HEATERS INC
30168 VIA AMANTE 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 QtV Amount fa1
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
CITY OF MENIFEE G 1' etcw UJO+M
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 c❑ntractor(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. p the following reason:
License Class License No. !1 _
By my signature below I acknowledge that,except for my personal residence
Expires d Signature in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
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
by Section 3700 of the Labor Code,for the performance of work for which this application is submitted or at the following wehsite:
this permit is issued. www.tegm.fyga.goy/cc�laY{.l tm1.
Policy# _... Date
*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 V 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 ad 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
Carrier / with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy#8/(/&l./(.O fy'/2J7 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 [1 J
ROPE 0 ER OR AUTHORIZED AGENT
❑I certlfy that in t he 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 forthwith co ply with those provisions. / f �� Will the applicant or future building occupant handle hazardous material or a
Applicant _ Date /T/ mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAIL RE ECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes 4KNo
UNLAWFUL,AND ALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the intended use of the building the applicant or future building
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction
ruction modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)D)?See permitting checklist
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 VNo
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 material reporting,
Business and Professions Code).Any city or county that requires a permit to Pes ❑No
construct,alter,improve,demolish or repair any structure,prior to its Date zZ—ze—
issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNER ORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVAT10N REPAIR AND PAINTING RRP
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting t this Rule requires contractors
and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-19th
an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified firms and comply with
than($500), required practices.This includes rental property owners and property
managers who do the paint disturbing work themselves or through their
❑1,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/tead 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 ci property who,through employees'or personal effort,builds or improves the An EPA Lead-Safe Certified Renovator will be responsible for this project
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
completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.:
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 • PERMIT/PLAN CHECK NUMBER � �� .
TYPE: 0 COMMERCIAL ZRESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME O POOL/SPA C'.SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL 0 MECHANICAL
0 NEW 1I PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace existing water heater. Same size and location.
— C ty-d.
PROJECTADDRESS 30168 Via Amante Budding flee
ASSESSOR'S PARCEL NUMBER ■ �� OT TRACT
OWNER NAME Noel Manton
ADDRESS 30168 Via Amante red
PHONE 951-415-7348 EMAIL
APPLICANT NAME Sierra Sprague
ADDRESS 30300 Puerta Vallarta
PHONE 951-301-0067 EMAIL allstar.sierra mail.com
CONTRACTOR1 NAME Sierra Sprague OWNER LULL-DEL? 0 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 FT L SQ FT
APPLICANT'S SIGNATURE i_ J DATE
DEPARTMENT DISTRIBUT1001 CITY OF MENIFEE BUSINESSUCENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE CiREL:N SMIP x _
INvolf F. %'� PAID AMOUNT + O CREDIT CARD VISA/MC
AMOUNT -vn C.CASH C7CHECK#
PLAN CHECK FEES PAID AMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES D NO DL NUMBER _ NOTARIZED LETTER O YES 0 NO
C.'ity of 11 vnifee Bofldify &,S. 7j pry C)(�,p( `ttrr rrt r?S'r t tr�urr Fig, t1/f�zr i ce°,Cfl J�a fC��'S y 6672-6777
av4= -.ciP'JnJ;nt 7if <:.;.r. Inspection Request Lity 5051-2146-6213
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