pmt18-05022 City of Menifee Permit No.: PMT18-05022
29714 HAUN RD. Type: Residential Plumbing
MENIFEE, CA 92586
MENIFEE MENIFEE Date Issued: 10/17/2018
PERMIT
Site Address: 28891 DEL MONTE DR, MENIFEE, CA Parcel Number:
92584 Construction Cost: $800.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING 50 GAL GAS WATER HEATER,SAME LOCATION
Work:
Owner Contractor
PATRICK QUIOCHO ALL STAR WATER HEATERS INC
28891 DEL MONTE DRIVE 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 city 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
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 l am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter!)(commencing with section 7000)of Division 3 of the Business and O 1 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 License No.
— By my signature below l acknowledge that,except for my personal residence
Expires O Signature -- in which i must have resided for at least one year priorto completion of
WORKER'S COMPENSATION DECLARATION
O improvements covered by this permit.I cannot legally sell a structure that I
Ol hereby affirm under penalty of perjury one of the following declarations; have built as an owner-builder if it has not been constructed in its entirety by
B 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 website:
this permit is issued, www.IeRinfo.ca.goy/caIaw.html.
Pollcya
Date
Qd 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 O$y my signature below l certify to each of the follmvinit:I am the property
this permit is Issued.My workers 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
Carrier G L with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of thb city or county to
PaliryR &eZ�R7/1 E Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred � �
dollars($300)or less Date
PROPEFITY
NER OR AUTHORIZED AGENT
o 1 certify that in the performance of the work for which this permit is issued, O
I shall not employ any persons in any manner so as to become subject tothe CITY BUSINESS LICENSE
workers compensation laws of California,and agree that if I should become
subject to the workers compensation provisions of Section 3700 of the Labor HAZARDOUS MATERIAL DECLARATION
Code,I shall forthw' co ply with those provisions. Will the applicant or future building occupant handle hazardous material or
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAI U SECURE WORKER'S COMPENSATION COVERAGE IS a Yes :n'No
UNLAWFUL,AN SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UPTO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the Intended use of the building by the applicant or future building
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)7See Permitting checklist
for guidelines
CONSTRUCTION LENDING AGENCY Dyes la 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 perm it is issued outer boundary of a school?
(Section 3097 Civil Code) Oyu 'ONo
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 255D5 and 2S534 concerning
checkmark(s)I have placed neat to the applicable item(s)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to .GYes ONo
construct alter,improve,demolish or repair any structure,priorto its �'=' - Date
issuance,also requires the applicant for the permit to fileasigned statement PROPERTYOWNEA ORAUTHORIZED AGENT
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
Business and Professions Code)or that he or she is exempt from Iicensure The EPA Renovation,Repair and Painting(RRP)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-1978
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
r managers who do the paint-disturbing work themselves or through their
01,as owner of the property,or my employee with wages as theirsole 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.eoa.epv/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-80OA24-LEAD(5323).
Code,The Contractors State license Law does not apply to an owner of a
property who,through employees'or personal effort,builds or Improves the O 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. In No EPA Lead-Safe Certified Firm is required for this project because:
O 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 role please fill out the RRP
Acknowledgement.
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DATE �Q�l�1t�Li�'z PERMIT/PLAN CHECK NUMBER _9riy0
TYPE: o COMMERCIAL ❑✓RESIDENTIAL O MULTI•FAMILY O MOBILE H_0_M_E_ O POOL/SPA C_SIGN_.
( SUBTYPE: O ADDITION O ALTERATION o DEMOLITION O ELECTRICAL O MECHANICAL
CI_N_EW_FPLUMBING uRE-ROOF-NUMBEROF SQUARES
__
DESCRIPTION OF WORK Replace existing Water heater. Same size and location.
PROJECT ADDRESS 28891 Del Monte Dr.
ASSESSOR'S PARCEL NUMBER LOT TRACT Cify_Of_Menifee-
OWNER NAME
Patrick Quiocho Building Dept.
— -
ADDRESS _28891 Del Monte Dr. DcT��1118-
PHONE 901-487-3604 EMAIL
ive
APPLICANTNAME Sierra Sprague
I ADDRESS 30300 Puerta Vallarta
PHONE 951-301-0067 EMAIL allstar.sierra@gmail.com _
R,
CONTRACTOR'S NAME Sierra Sprague ___ __ OWNER BUILDER? �' YES •->NO _I
BUSINESS NAME All Star Water Heaters
iADDRESS 30300 Puerta Vallarta Way
NI PHONE 951-301-0067 EMAIL allstarsierra@gmail.com
CONTRACTOR'S STATE LIC NUMBER 812894 - LICENSE CLASSIFICATION C36 —
VALUATIONS 800.00 SQ FT L SQ FT /��—
APPLICANT'S SIGNATURE _— _ - —._ E_—_ /-� -/ ---
.._.-�- ..__— _.".._ ..—__ __ _. DATE JQI C@._1�= ,
----
DEPARTMENT DISTRIBUTION
— ---- -- --
I UT'OF MENIFEE BUSINESS LICENSE NUMBER
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BUILDING PLANNING ENGINEERING FIRE GREEN ` SMIP Ix --
INVOICE -- PAID AN90UMT
AMDUN'i_1 ,1 • ,�•` CASH '-'-NECKK __%CREDIT CARP VISA/MC
I PLAN CHECK FEES VAID AMOUNT O CASH G CMECK# -.-_ O CREDITCARD VISA/MC
OWNER BUILDER VERIFIED DYES `7 NO DL NUMBER_ 111 NOTARIZED LETTER O YES U NO yp1
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