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PMT14-02790 City of Menifee Permit No.: PMT14-02790 29714 HAUN RD. Type: Residential Mechanical MENIFEE, CA 92586 MENIFEE Date Issued: 1 0121/2 01 4 PERMIT Site Address: 26661 CALLE EMILIANO, MENIFEE, CA Parcel Number: 330-280-072 92586 Construction Cost: $4,991.40 Existing Use: Proposed Use: Description of HVAC CHANGE OUT COOL:36,000 BTU HEAT:70,000 BTU Work; Owner Contractor ADDIE PARK MONK'S AIR CONDITIONING 26661 CALLE EMILIANO P O BOX 128 MENIFEE, CA 92586 SUN CITY, CA 92586 Applicant Phone: 9516794502 GARY MONK License Number: 912194 MONKS AIR CONDITIONING P 0 BOX 128 SUN CITY, CA 92586 Fee Description Oty Amount l$1 Air Handling/Condensing Units SFR 1 133.00 BI GREEN FEE 1 1.00 $310.00 The issuance of this pormit 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 Men ifee LICENSED DECLARATION I hereby affirm under penalty or perjury that 1 am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licen: Chapter 9(commencing with sectlon 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Profess! Professions C d my license is in full me nd effe Code:The Contractor's License Law does not apply to an owner of a prop assIt License Cl License N _ who builds or Improves thereon, and who contracts for the projects wit ExpireZ_aLL6 Signature licensed contractors)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION" ❑ 1 am exempt from Iicansure under the Contractors 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 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 I must have resided .for at least one year, prior to comple0oi Section 3700.(:f the Labor Code,for the performance of work for which this improvements covered by this permit,I cannot legally sell a strature that I I permit is issued. built as an owner-building if it has not been constructed In Its entirety by Iloei 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 applicatn section 3700 of the Labor Code, for the performance of the work for which this submitted or at the idlowing Web site:httn•Nwww Ieminfo oa aovlcalaw html. permit is Issued.My workers'compensation insurance carder and policy number are: I^+ Property Owner or. onze Agent Ca ,Date rtier T- Expires Policy# 12� W i 2� �i p By my Signature below, I certify to each of the following: I am the prod Name of Agent Phone# owner or ardhorized to act on the property owner's behalf. I have read (This section need Opt be completed if the permit Is for application and the into 'on I have provided is correct. I agree to co one-hundred dollars($100)or less) - with all appli ble dty a unty ordinances and state laws relating to bul consWctio o' presentativas of this city or county to enter the at ❑ 1 car*that in the performance of the work for which this,permit is issued,I identified erty f t ins action purposes. shall O t4�&loy any persons in any manner so as to become subject to the workers'compensation laws of California,and agree IF I should become subject to the workers'compensation provisionsof Se n 3700 of the Labor p mart Authorized Date Code,I shall forthwith comply with those p ons. 3 City Business License# Date; ApPii WARNING, FAILURE TO SECURE WORKERS' AZARDOUS 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 SRICTION'3700 OF THE MIXTURE CONTAINING A HAZARDOUS MATERII LABOR CODE,INTEREST,AND ATTORNEYS FEES ❑NO EQUAL TO OR GREATER THAN THE AMOUN1 rnNSTRUCTION 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 TF 3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIF Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATIC FROM THE SOUTH COAST AIR QUALITY MANAGEMEI Lender's Address El NO DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST R 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 OYES WILL THE PROPOSED BUILDING OR MODIFIED FACILI' next to the applicable ftem(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, ONO 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 OYES INFORMATION GUIDE AND THE SCAQMD PERMITT'. she Is exempt from licensure 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($500).) CODE SECTOUS ION 255501.6 25533 AND 25534 CONCERN ❑ I, as owner of the property, or my employees with wages as their sole compensation,will do( )all of or( )porting of the work,and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the properly, provided that the Improvements are not intended or offered for sale.If,however, the building or Improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved.for the purpose of sale). CITY OF lW l Eil'1IF E PLCK No: P 't 29714 Haun Road Date: Dale: l Menifee, CA 92586 Phone: (951)672-6777 Amount: aunt Fax:(951)679-3843 Ckif: Ck#: Building Combination Permit ' To Be Com leted By Applicant Legal Descripion:�� Z(� , i��Z ( � Planning Case: F: L: Rt R Property Address: i r Assessor's Parcel Number. (o �P C I Vl-0 1�eni 330 7-PO 01-2 ProJecVTenant Name: GJZS� Unit it Floor#: Name: A, j t� JP _iW4 Fax Na. OwneProper Address' I 1 i Unit Number C-L_f Zip Code Email Address: "7 Name: —1^�1.,� , ,t /^ _ o Applicant Address:3O5 Uri Unit Number Zip Code9�8 EmailLI Address:M D r).K S C( I r16D v-� h`l corn n I 1 'mil/ �7�1 Name: MO{ LK7.J AirCoI 1 I I • l`�/J� �77'75D, W/G'ZDI� Contractor Addresr��-3O x A i 1 Y.�f-� 'r, _I C; At6 pp State] y1 Zip Cad9259f J ontra�`callor(�J Il us-7 tense o. Contractor's C,;ry$�te�rDalif liaV(Licenset No. L' Classl6olalliore /� n D -7 Number of Squares: l�L Square Footage 12 1'4— Description of Work: 4 G: 3 lam- n Cost of Work:$ /� D L DU14 . N ��r . YKfig / Applkant's Signatu Date: -- :To'$e Completed By,Clty'Staff Only::, Indicate As R-Received or NIA-Not Applicable 5 Completes sets of fully dimensioned.drawn to sale plans which include: 1 set of documenls 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 V,x 11) Foundation Plan ❑ Structural Calculations ❑ ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP ❑ Floor Plan ❑ Structural Framing Plan 6 Details ❑ Shoring Plan ❑ Sound Report-Residential Class Code: Indloate New Construction Alteration• Addition• ississ Work Ty MeanslMethods pe: Repair' Retrofit' YES NO Proposed Building Use(s): Existing Building Use(s): #Buildings: #Units: #Stories: III the Building Have a Basement? Y of N Bldg. Code Occupancy Group Indicate Indicate if YES or NO Indicate all Goo-tech.Haz.Zone At Project Construction Sprinklered that apply: Coastal Zone Completion: 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. Planning Comm. Zoning Administrator Fee Exempt: City Projec! Elec.Vehicle Charger Landmark Seismic Retrofit pet at ass: ag 01(dal Aoamval Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing For Staff Use Only Boildinq/SolelyI Permit Specialist City Planning I Can Erginee(Mg I EPWM-Admin I Transportalion Nigmt I Nent Control THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY zuv�V�b n a w o 0 0 0 o c n D v D m w 0° X .Or V to w � N r a N 7 m O N X O (D edi o 9 3 0 O N N 3 < O CO p d In UO , m d O O r ^ m o n c D d m .Or p. ° m a o N > 3 . > 3 o * u v 0 0 O N A S i^ O 3 N fl d 2 0 3 N W d oCD of N n a m .e p ry O y 3 C a < 3 7 "a A � a•�G � O d 0 �'T. N 3 C cm D p o n � q c 3 •--c 3 z .u'r ^ C� p � rpp m � N j > > 00 3' �• CZ CD < < d -• J K F. ti O 10 01 O ` C O m m C d C d � � S ci w T 3 F+ N w V1 N d O N < O W W d C K 6 DJ p o o � N a 3 m w O � N N p C O t/i O eNT 2 D S < n b 3 N N C N O T " T n o r mIM Il T' x C N N p�j N n N m IS v p D M. T .� _n '.� T p .T A .r A �. 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