PMT14-02608 City of Menifee Permit No.: PMT14-02608
_ 29714 HAUN RD,
MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 0 9/2 612 01 4
PERMIT
Site Address: 26663 SAINTANDREWS DR, MENIFEE, Parcel Number: 337-363-006
CA 92586 Construction Cost: $5,500.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT SPLIT HEAT 70,000 BTU COOL 30,000 BTU
Work:
Owner Contractor
NANCY MALONEY MONKS AIR CONDITIONING
26663 SAINT ANDREWS DR P 0 BOX 128
MENIFEE, CA 92586 SUN CITY, CA 92586
Applicant Phone: 9516794502
GARY MONK License Number: 912194
MONKS AIR CONDITIONING
P0 BOX 128
SUN CITY, CA 92586
Fee Description GQyt Amount($)
Air Handling/Condensing Units SFR 1 133.00
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 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 staled, 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_Ndg_Permit_Template.rpt Page 1 of 1
i
City Of Menifee
LICENSE[) DECLARATION
I hereby affirm underPenalty or perjury that I am licensed under provisions of ❑ 1, as owner of the property an exclusively contracting with licen
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Profess!
Professions C my license is in full rce nd efflef. Code:The Contractor's License Law does not apply to an owner of a prop
License Oless,l� .Q_License N j `7 who builds or Improves thereon, and who contracts for the projects wit
Expires:3 L I SIgnatum licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION ❑ I am exempt from Ilcensure under the Contractors+State License Law foI
❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason: _
I have and will maintain a certificate of consent of self-Insure for workers' By my signature below I acknowledge that, except,for my personal resident
compensation;issued by the Director of Industrial Relations as provided for by which 1 must have resided .for at:.least one year prior to compeetiol
Section 37QO..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 I
permit is issued. built as an owner-building if it has not been constructed in Its entirety by Iicel
Policy# contractors. I understand that a copy of the applicable law, Section 7044 c
❑ 1 have and will maintain workers' compensation Insurance, as required by Business and.Professions Code,is available upon request when this applicati
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:htp,/Aywwlaainfo,ca,govtmiaw.html.
permit is issued.My workers'compensation Insurance carrier and policy number are:
^+ rope erorA onz ent ,Data
Carrier r P
Expires 1 _ Policy# 1 1
❑ By my Signature below, I certify to each of the following: I am the pro
Name of Agent Phone# owner or authorized to act on the property owner's behalf. I have real
(This section need nM be completed If the permit is for application and the Info"'on
nfo 'on I have provided is correct. I agree to cc
one-hundred dollars($100)or less) with all appli ble city unty ordinances and state laws relating to bu
construca,/A
sentatives of this city or county to enter the al
❑ 1 certify that in the.performance of the work for which this permit is issued,1 identifiedection purposes.
shall not employ any persons In any manner so as to become subject to the �Q�I !_l
workers'compensation laws of California, and agree th If I should become subject tothe workers'compensation provislo of Se n 3700 of the Labor Prod AgeeDate
Code,I shall forthwith comply with those p ' ons. 3
_ City Business License#
Date; .��9� � •�PPIi
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 BUILDIN
($100,000), IN ADDITION TO THE COST OF.COMPENSATION, OYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR
DAMAGES AS PROVIDED FOR IN sEC.TION'3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERb
LABOR CODE, INTEREST,AND ATTORNEYS FEES ONO EQUAL TO OR GREATER THAN THE AMOUN'
CONSTRUCTION LENDING AGENCY SPECIFIED ON .THE HAZARDOUS MATERIAI
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 TI
3D97 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQU0
Lender's Name pYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATIi
FROM THE SOUTH COAST AIR QUALITY MANAGEME
Lender's Address 0NO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST P
.GUIDELINES
OWNER BUILDER DECLsReTIONS PRINT NAME:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the reason(s)indicated below by the checkmark(s)I have placed OYES WILL THE PROPOSED BUILDING OR MODIFIED FACILI
next to the applicable ltem(s)(Section 7031.6.Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY 01
Any city or county that requires a permit to construct, after,improve, demolish, p 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 provisions of the Contractor's State License Law(Chapter 9(commencingI HAVE READ THE HAZARDOUS MATER
(commencing with OYES INFORMATION GUIDE AND THE SCAQMD MATE I
Section 7000)of Division 3 of the Business and Professions Code or that he or
she is exempt from ]!censure and the basis for.the alleged exemption. Any CHECKLIST, I UNDERSTAND MY REQUIREMEI
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAF
a civil penalty of not more than($500).) CODE SECTION 25505 25533 AND 25534 CONCERN
❑ I, HAZARDOUS MATERIAL f'tEPORtING.
as owner of the property, or my employees with wages as their sole
compensation,will do( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property
X
who, through employees' or personal effort, builds or Improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or Improvement is sold within one year of completion,the Owner- -
Builder will have the burden of proving that A was not built or improved for the
purpose of sale).
CITY OF MENIFEE PLCK No: PREft — N
29714 Haun Road Date: Date,
Menifee, CA 92586 ft Zb(l
Phone: (951)672-6777 )GO nt: Amou iCIO
Fax:(951)679-3843 Ck#: Ck#:
Building Combination Permit
To Be Completed By Applicant
Legal Description: 'T IZ23
`� tNT 3\Z Planning Case: F: L: Rt: R
Property Address: Assessor's Parcel Number.
Z L S�=.n� ta^n9Yl��✓Z D YL `3 3 3"—3
Project/Tenant Name: Unit#: Floor#:
1M�A Lo v�
Name: VN Vy, A, A h Pone Fax No.
Address: �S1 ..HZ3
Property
Owner 'Z�y`b D tFl. VY`�,nZ-�5 V y(, Unit Number Zip Code q ��
Email Address:
Name: hon No.
GAR. VY�o /t�C c 67% "t �2 tax
611-7-012
Applicant Address: Unit Number Zip Code Cl,25�30�3O ry�v�(Gy1,'st�`'h4 1%D 1.(
Email Address:
V}r�0.�Cavtnva+�l.{.ow�
Name: q, ,e
lMoo�C s � `C q 1}Nto'1°1'U5b2 `OL�,O 672-7,o1,2
Contractor Address: City State Zip Code
30S3� V CAA\nv�7i((�tnA Y1�0 mV�V �fLF A �lzs7r"(
on ractor s ty usrness tense o. Contractor's City State of California License No. Classification:
3S6 �tZtq 6,7-u
Number of Squares:
Square Footage
Description of Work: `SW IC -t)vT - 3PUT,,r--- (' �- Cost of Work:$
7ora� Govl,' 3o1�tiTv
Applicant's Signature Date:
<-To Be_Corripleted By:Giry Staff-Only -
Indicate 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 El Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Fraining Plan&Details ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate ' New Construction Alteration' AddiBon' Means/Methods
Work T� Repair* Retrofit' Revision toEAsfingPerrrX 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 H YES or NO Indicate all Geo-tech.Hez.Zone
At Project Construction Sprinklered that apply: Coastal Zone
Completion: Type(s): C ot O Noise Zone
Required? YES or NO
ri Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. I Planning Comm.Zoning Administrator
Fee Exempt: - City Project Elea Vehicle Charger Landmark Seismic Retrofit special Case:Bldg.
OFidal Approval
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
BuildinglSalety I Permit Specialist I City Planning I Civil Engineering EPWM-Admin I Transportation mgmt. I Rent Conaol
�z - \ THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
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