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
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