PMT14-02787 City of Menifee Permit No.: PMT14-02787
29714 Type: Residential Mechanical
'WGl.l�. MENIFEEEE,, C CA 92 92586
MENIFEE Date Issued: 1 012112 01 4
PERMIT
Site Address: 27121 EL RANCHO DR, MENIFEE, CA Parcel Number: 336-112-006
92586 Construction Cost: $5,227.60
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT HEAT:70,000 BTU COOL:30,000 BTU
Work:
Owner Contractor
GEORGIA RATLIFF MONKS AIR CONDITIONING
27121 EL RANCHO 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 Amount($1
Air Handling/Condensing Units SFR 1 133.00
e.
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 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 Bidg_Permit_Template.rpt Page 1 of 1
City Of Menifee
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 gcen
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044,Business and Professi
Professions Ctppd my license Is in full force and effect. Code:The Contractors License Law does not apply to an owner of a prop
License Class. License N { � who builds or improves thereon, and who contracts for the projects wit
ExpireJ--3 Signatu .licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS,COMPENSATION DECLARATION"
❑ 1 am exempt from licensure under the Contractors'State License Law for
❑ 1 hereby affirm under penalty of perjury one of the foilrnMng declarations: following reason:
I have and will maintain a certificate of consent of set-insure for workers' By my signature below I acknowledge that,except for my personal residenc
compensation,issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year, prior to completlol
Section 3700.of the Labor Code,for the performance of work for which this Improvements covered by this perm I cannot:legally sell a structure that I I
permit is issued. built as an owner-bullding If it has not been constructed in its entirety by lioei
Policy# contractors. 1 understand that a copy of the applicable law,Section 7D44 0
❑ I 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 she:hth326M .leainfo.ca govkala%lbrml,
permit is issued.My workers'compensation insurance canter and policy number are:
Canter P Property Owneror Authorized Agent Date
Expires Policy# I Z-J DD i 2-
❑ By my Signature below, I certify to each of the following: I am the prod
Name of Agent Phone# owner or authorized to act on the property owners behalf. I have read
(This section need=be completed If the permit Is for application and the Info 'on I have provided is correct. I agree to co
ona-hundred dollars($100)or less) with all appli ble city a unty ordinances and state laws relating to bui
oonstmctio o' presentatives of this city or county to enter the at
❑ 1 certify that in the performance of the work for which this,permit is issued,I identified any ins ction purposes.
shall not employ any persons in any manner so as to become subject to the
workers'compensation laws of California,and agree th 'rf I should become
subject to the workers'compensation provisio of Se n 3700 of the Labor P ner Authorized ent Date
Code,I shall forthwith comply with those p ons. 3
Date; Appl) City Business License#
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, ❑YES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR
DAMA43ES AS PROVIDED FOR IN SECTiON 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERV
LABOR CODE,INTEREST,AND ATTORNEYS FEES ❑NO EQUAL TO OR GREATER THAN THE AMOUNT
CONSTRUCTION LENDING AGENCY SPECIFIED ON .THE HAZARDOUS MATERIAL
I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE?
agency for the performance of the.work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY Ti
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIF
Lender's Name ❑YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATIC
Lender's Address [I NO FROM THE SOUTH COAST AIR QUALI T Y MANAGEMEI
DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST R
OWNER BUILDER DECLARATIONS GUIDE LINES
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reason(s)indicated below by the checkmark(s)I have placed ❑YES WILL THE PROPOSED BUILDING OR MODIFIED FACILI'
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 after, 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
provisions of the Contractor's State License Law(Chapter 9 (commencing with I HAVE READ THE HAZARDOUS M AT E R I
Section 7000)of Division 3 of the Business and Professions Code)or that he or ❑YES INFORMATION GUIDE AND THE SCAQMD PERMITT.
she is exempt from licensure and the basis for She alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMEf
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ONO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFI
a civil penalty of not more than($500).) CODE SECTION
25505
550 26533'IAND 25534 CONCERN
❑ I, as owner of the property, or my employees with wages as their sole
compensation,will do( )all of or( )porting of the work,and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the Improvements are not intended or offered for sale.If,however,
the building or Improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENIFEE PLCK No: Pe ,oa
29714 Haun Road Date: Dat : V1
Menifee, CA 92586 1D ?A
Phone: (951)672-6777Amount: ount:
Fax:(951)679-3843 Ck#: Ck#:
Building Combination Permit
To Be Completed By Applicant
Legal Description: 712- 1-kJ 3 ki Pianning Case: F: L Rt: R:
Property Address: Assessor's Parcel Number.
2112j Ej I�cxnC�10 DY' iVi�iFee C+4 336 tiv-7-0 o (�
Projec enant Name: /' Unit#: Floor#:
Prope
Name r - i ' P Mo Fax N
a o.
Owner Address _ y_�/`.i � r C, LUnit Nu/mber Zip Code`"Z -
Email Address:
Name: !J A !!^^
, M V
Applicant Address:305 U r r d Uum nit Nb —er Zip Code
7ffmall Address:r-nQ SC, l COrYI
Name: MOnK75 Air" Dr'1 I � ' �� 679-45M / �72-Zalz
Contractor Address(^S-3O Iv ^ I , rvit� e City Apal t- Stater yt Zip Codpf].Z94
ontraato7r,J ,t usines cense o. Contractor's CsRy$fit kalif liaa ILi\ce-n�s le NO. lJ Classl`fic-la-111�on: ^ �_1O4J
Number of squares: `�/L. `7 l�
Square Factage 0�0`Z
Description of Work: e i� �lo ._L-.� ^l, ) F�@(ate '. -}o gTv Cost of Work:$
Tl f ILA/ l lJ tiT i 0 52.7. - O
Applicant's Signal
Date:
Tq''Be Completed By.Ctty'Staff Only:,.:-
Indicate As R-Received or WA-NOI Applicable
5 Completes sets of fully dimensioned.drawn to sale plans which include: -i at of documents which include
❑ Title Sheet ❑ Elevations ❑ Electricaf Plan
❑ Gea Tech/Soils Report(on cd only)
❑ Plot I Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on B'6 x Jl)
❑ Foundation Plan ❑ Cross Section ❑ Structural Calculations
❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan d Details ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alterafion• Addition' MeanslMethods
Work Type: Repair' Retrofit' Revision to Existing 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 it Indicate all Geo-tech.Haz.Zone
At Project Sphnklered YES or NO
Completion: Construction that apply: Coastal Zone
Type(s): C Of 0 YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. I lPlanning Comm.Zoning Administrator
Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit Ospecialfidall Aoerova ass lidg
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Building/Safety Permit Specialist City Planning I Civil Engineerng I EPWM-Admin I Transportation Mgm-t I Rert Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
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