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PMT14-02070 I i I City of Menifee Permit No.: PMT14-02070 MENIFEE, EE, C 92 Type: Residential Mechanical MENIFEE, CA 92586 MENIFEE Date Issued: 08/08/2014 PERMIT e I Site Address: 28128 NORTHWOOD DR, MENIFEE, CA Parcel Number: 337-161-008 92586 Construction Cost: $8,152,80 �i Existing Use: Proposed Use: Description of HVAC CHANGE OUT, PACKAGE UNIT, 2.5-TON A/C, 40,000 BTU FURNACE Work: Owner Contractor SUZANNE SMITH MONKS AIR CONDITIONING 28128 NORTHWOOD DRIVE P O BOX 128 MENIFEE, CA 92586 SUN CITY, CA 92586 Applicant Phone: 9516794502 GARY MONK License Number: 912194 MONKS AIR CONDITIONING P0 BOX 128 SUN CITY, CA 92586 Fee Description Qty Amount d - r�GrarVit�jype�F�rn2�'�"ceoc erne 1' d 00' Air Handling/Condensing Units SFR 1 133.00 ul ng-Pe Is uahre. - q- =«00- GREEN FEE 1 1.00 $310.00 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 buillding 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.rpl Page 1 of 1 3 City Of Menifee I LICENSED DECLARATION I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an -:exclusively contracting with licans i Chapter 9(commencing withsection 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professlo 1 Professions Co d my license is in rce and effe Code:The Contractor's License Law does not apply to an owner of a props 9i License Cla! _License N Tuli C, - _ who builds or Improves thereon, and who contracts for the projects with y Expire3 a F I6 -Signatue licensed oontractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ I am exempt from Iicenaure under the Contractors'State License Law for I '. ❑ I hereby aifittn under penalty of perjury one of the following declarations: following reason: I have and will maintain a certificate of consent of se -Insure for workers' By my:signature below I acknowledge that, except,for my personal residence compensation;Issued by the Director of Industrial Relations as provided for by which I must. have resided ;for. at. least one year prior to completion Section 3700`of the Labor Code, for the.performance of work for which this -'improvements covered by this permit,I cannot legally sell a structure that I N permit Is issued. built as an owner-building If it has not been constructed In its entirety by Iicem Policy# contractors. I understand that a copy of the applicable law, Section 7044 of ❑ 1 have and will maintain workers' compensation insurance, as required by Business and,Professions Code,is available upon request when this applicatloi section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site: ttttg'/!¢atw leeinfo ca aovlcalaw html. permit Is Issued,My workers'compensation insurance carrier and policy number are: /^+ , rope wneror. ut ooze gent � � ,.Date Carrier - C' ����//�� �I . Expires �� Policy# Z� W �� Z Cl By my Signature below, I certify to each of the following: I am the props Name of Agent Phone# owner or authorized to act on the property owner's behalf. 1 have read (This section need not be completed If the permit]a for application and the Info"on I have providedis correct. I agree to oon one-hundred dollars($100)or less) with all app11 ble city a ounty ordinances and state laws relating to bulk constructio or z r presentatives of this city or county to enter the abr ❑ I certify that In the.performance of the work for which this,permit is Issued,I Identified erty f ins edon purposes. shall not employ any persons In any manner so as to become subject to the workers'compensation laws of Califomia, and agree th if I should become subject to the workers'compensation provisio of Se n 3700 of the Labor Pro ner Authorized Agent Date Cod:,;I shall forthwith comply with those proN ors. _ // City Business License# J / Date; Appliedt; � . WARNING: FAILURE- TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDINC ($100,000), IN ADDITION TO THE COST OF-:COMPENSATION, OYES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORy DAMAGES AS PROVIDED FOR IN SECTION"3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAI LABOR CODE, INTEREST,AND ATTORNEYSFEES - ❑NO EQUAL TO OR GREATER THAN THE AMOUNT: CONSTRUCTION LENDING AGENCY SPECIFIED ON .THE HAZARDOUS MATERIAL: INFORMATION GUIDE? I hereby affirm that under the penalty of perjury there Is a construction lending agency for the performance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY THI 3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRI Lender's Name - OYES A PERMIT FOR THE CONSTRUCTION ORMODIFICATIOI FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address ❑NO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOI GUIDE LINES OWNER BUILDER DECLARATIONS I hereby affirm under penalty of perjury that I am exempt from the Contractor's , PRINT NAME: License Law for the resson(s)Indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILIT' next to the applicable Item(s)(Section 7031.5.Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF, Any city or county that requires a permit to construct, alter, improve, demolish, ❑NO SCHOOL? or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the I HAVE READ THE HAZARDOUS MATERN provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or DYES INFORMATION GUIDE AND THE SCAQMD PERMITTIP she Is exempt from licensure and the basis for-the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMEN' violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFE' a civil penalty of not more than($500).) - CODE S U TIONMAT 5505RIAL E 5533,AND 25534 CONCERNIt HAZAR❑ 11 as owner of the property, or my employees with wages as their sole compensation,will do ( )all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, ` provided that the Improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or Improved for the purpose of sale). CITY O _•`ENIFEE PLCK No: Permit No: City of Menifee Mt"e 0 29714 Haun Road Building & Safety Depi. Date: Date: Menifee, CA 92586 8 Phone: (951)672-6777 AUG 0 8 2014 A nount: Amount:OCV Fax:(951)679-3843 Ck#: Ck#: .T9 e,c.eived Building Combination Permit To Be Completed By Applicant Legal Description: . 2�� b lAT 3�V 1- 3 � I Planning Case: F: L: Rt: R: Property Address: Assessor's Parcel Number. Z�12S1 v\ovt.-TtA�nn7oO 'PAIL 6 I oo 8- Project/Tenant Name: Unit#: Floor#: Svv�n�1� Name: z Phone o. Fax No. �s3S`�Jv`I Property Address: Unit Number Zip Code 'Z !�T 6 Owner 'Lb-\ T ', V\0 9^-\1 V. J o 9 OY2- �l Email Address: Name: hone No. ax N (7�� VY1o✓\1c qs� 61%�`�Sb2 qsl 6'72_7-012 Applicant Address: Unit Number Zip Code q,Z,S� 30>3O 'Mv�'s1s�'rA 2'fl t-( Email Address: V*r�� C�ivNv�l.{.ovh Name: ee,, lMoV1�S `C k�1 61°1-�tSb2 �°IN1� 1�72 -Ztol2 Contractor Address: City State Zip Code 305-3-0 VV^vaN&Ve1-fa Y1L0 M\FY 'VF\,M CAA 1 01z!"( ontractor 3 uvness icense o. Contractor's State of Calitomia License No. Classification: �z V Number of Squares: Square Footage 1.0(o Description of Work: N V 1),C_ Ch�JND 1 ur wT — '�" -• Z-C"7ti H Cost of Work:$ plob Gf�s ��t,�t.r �,n.r: HVKtSr� �I.SZ-$o Applicant's Signature Date: -. Tq.Be Completed By.City Staff Only "-- - Indicete As R-Received or N/A-Not Applicable 5 Completes sets of fully dimensioned,drawn to sale plans which include: 1 set of documents which include ❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Soils Report(on cd only) ❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8%x 11) ❑ Structural Calculations ❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP ❑ Floor Plan ❑ Structural Framing Plan 8 Details ❑ Shoring Plan ❑ Sound Report-Residential Class Code: Indicate New Construction Alteration' Addition' Means/Methods Work Type: Repair' Retrofit' Reuislon to Epsting Permit' Required? YES NO Proposed Building Use(s): Existing Building Use(s): #Buildings: #Units: #Stories: Will the Building Have a Basement? Y of N Bldg.Code Occupancy Group Indicate Indicate if YES or NO Indtcate all Geo-tech.Haz.Zone At Project Construction Sprinklered that apply: Coastal Zone Completion: Type(s): C Of o Noise Zone Required? YES or NO Listed on Historic Resources Inventory CITY PLANNING STAFF ONLY APPROVALS: Costal Commiss JArch.Review Board Landmark Comm. Planning Comm.Zoning Administrator Fee Exempt: City Pmject Elec.Vehide Charger Landmark Seismic Retrofit Spatial Case:Bldg. ofgdal Approval Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing For Staff Use Only Building/Safety Permit Specialist City Planning Civil Engineering EPWM-Admin Transportation Mgmt. 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