PMT14-02789 City of Menifee Permit No.: PMT14-02789
29714 HAUN RD.
' ICCELA- MENIFEE, CA 92586 Type: Residential Mechanical
&v .ome eNnso MENIFEE Date Issued: 1 012112 01 4
PERMIT
Site Address: 25821 MORGANTOWN WAY, MENIFEE, Parcel Number: 339-133-026
CA 92586 Construction Cost: $2,329.20
Existing Use: Proposed Use:
Description of FURNACE CHANGE OUT ONLY HEAT:70,000 BTU
Work:
Owner Contractor
ROBERT&HELEN LACAYO MONKS AIR CONDITIONING
25821 MORGANTOWN WAY 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
Q-yl, Amount
Building Permit Issuance 1 27,00
E.
$177.00
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 building operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menlfee.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
I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, 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 7D44,Business and Professl
Professions Co my license Is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a prop
License Claes. License N C7`Y who builds or Improves thereon, and who contracts for the projects wil
Expirez3-" :Signatu licensed oontractor(s)pursuant to the Contractors State License Law). ..,
WORKERS'COMPENSATION DECLARATION'
❑ I am exempt from Iicensure ender the Contracture'State License Law for
❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason:
I have and will maintain a certificate of consent of wilt-insure for workers' By my signature below I acknowledge Burt 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 compeetooi
Section 3700.of the Labor Code,for the performance of work fbr which this improvements covered by this permit I cannot legally sell a structure that I I
permit Is issued. built as an awner-building If it has not been constructed in Its entirety by Iicei
Policy# contractors. I understand that a copy of the applicable law,Section 7044 0
❑ 1 have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this applicaO
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web she:01#p•IAvww Ieginfb ca covlcelew.html.
permit is Issued.My workers'compensation Insurance carder and policy number are:
r'_^ � Property Owner or. o e Agent ,Date
Caller f'� -
Expires — —'_ Policy f
❑ By my Signature below, I certify to each of the following: I am the pro,
Name of Agent Phone# owner or aidhorized to act on the property owner's behalf. I have read
(This section need 114E be completed if the permit Is for application and the info on I have provided is correct. I agree to cc
one hundred dollars($100)or less) with all appii ble city a unty ordinances and state laws relating to bui
wnatructio presentadves of this dry or county to enter the at
❑ I certify that In the performance of the work for which this,permit is issued,I identified arty f t ine ection purposes,
shall notjiof emolov any persons in any manner so as to become subject to the
workers'compensation laws of Calffomia,and agree thg ff I should become _
subject to the workers'compensation provisio rof Se n 3700 of the Labor Pr er W Authorized Agent Date
Code,I shall forthwith comply with those p c ns.
CiN Business License#�
Date; .kppll
WARNING: FAILURE TO SECURE WORKERS' HAzAgDOUS 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, DYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR
DAMAGES AS PROVIDED FOR IN SECTIOIM -3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIF
LABOR CODE,INTEREST,AND ATTORNEYS FEES ❑NO EQUAL TO OR GREATER THAN THE AMOUNI
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 OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATIC
FROM THE SOUTH COAST AIR QUALITY MANAGEMEI
Lender's Address ❑NO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST F(
GUIDE LINES
OWNER BUILDER DECLARATIONS
1 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 chedkmark(s)I have placed OYES WILL THE PROPOSED BUILDING OR MODIFIED FACILI'
next to the applicable items)(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 MATERI
Section 7000)of Division 3 of the Business and Professions Code)or that he or DYES INFORMATION GUIDE AND THE SCAQMD PERMITT'.
she is exempt from Iicensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMEP
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFI
a civil penalty of not more than($500).) CODE, SECTION 25505 25533 AND 25534 CONCERN
❑ 1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL I}EPOWING.
compensation,will do( )all of or( )porting of the work,and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or Improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF LV'lENIFEE PLCK No: P it ATI
,r
29714 Haun Road Date: Date:
Menifee, CA 92586
Phone: (951)672-6777 Amount: ount: GG
Fax:(951)679-3843 Ck S: Ck IF:
177
Building Combination Permit j
To Be Completed Lap
Legal Description: z5 Z La,f LEI Piannin Case:
9 F: L: Rt: R:
Property Address:n� � I �r zS&�„ Assessor's Parcel Number
GG� I�Ii VI W I' 1 -33OL 1 3 3 o z b
ProjecVTenant Name:
Name: Vim r I �F Fax No.
Property Address: L Unitl Number
Owner t'_ Zip Code
Email Address: rl.�.0� rtC)I • C, G'ZL'
Name: Ci—a ,. / D F
Applicant Address:3OS u _ U
Z,ujl-
Number Zip Code - �
EmailAddress: n0 LKSC4 .1 " ol rr-) CC Corm
Name: Mon K's Air on I � T M? 67q-- 45D2_ / (P72-2a12_
Contractor Addres5^C3O ^ A 0 r6 ,^d Cit�t /t pint CC Wal yy Zip Cadpf].rj59`4
Contractor stjl ;t usmes kVdense o. Contractor's Cvity$�fa�(Deli( IiavLl toe—nisei No, `1't C�`(4J j5
`J/L, o Classification: O
Number of Squares:
Square Footage i tv Io
Description of work: �, C4-04N 6 Js_ off' lia�Y>T'•'�Kt?�Go.�•� y"I t, Cost of work:s2 3 ZUr
Applicant's Signatu
Date:
._Tq'Be Completed By.Clry,Staff Only',, 71 ' ,, c
Indicate As R-Received or N/A-Not Applicable
5 Complates sets of fully dimensioned,drawn to sale plans which include: 1 set of documen is which Ind uoa
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Gad Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on B Y x 11)
Foundation Plan ❑ Structural Calculations
❑ ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration• Addition' Maans/Melhods
Work Typo: Repair• Retrofit' Revision to Existing Petrrut'lRequini YES NO
Proposed Building Use(s): Existing Building Use(s):
It Buildings: k Units: k Stories: Will the Building Have a Basement?
V of N
Bldg. Code Occupancy Group Indicate Indicate it Indicate all Geo-tech.Haz.Zone
At Project Sprinklered YES Or NO
Completion: Construction that apply: Coastal Zone
Type(s): Coto YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. Planning Comm.Zoning Administrator
Fee Exempt: City Project I JElec.Vehicle Charger Landmark Seismic Retrofit Paoal aee: mg
Offidai Aocmval
Expedite Project(s). Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Budding/Safely Permit Specialist City Planning qml Engineer•ng- EPWM-Admin Transporla lion Mgmt I Reri control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
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