PMT14-03354 City of Menifee Permit No.: PMT14-03364
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 12/19/2014
PERMIT
Site Address: 26585 MC CALL BLVD, MENIFEE, CA Parcel Number: 337-292-007
92586 Construction Cost: $7,331.60
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT HT 60K BTU, COOL 36K BTU
Work:
Owner Contractor
NORMA HARRIS MONK'S AIR CONDITIONING
26585 MC CALL BLVD P 0 BOX 128
MENIFEE, CA 92586 SUN CITY, CA 92586
Applicant Phone: 9516794502
GARY MONK License Number: 912194
MONKS AIR CONDITIONING
PO BOX128
SUN CITY, CA 92586
Fee Description Q1tr Amount
ForcedAlror.GravltyTypeFurnaceorBurner ' =1` 1"' �- 149Ob:
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 Mantras. 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 license
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professlor
Professions Co �pd my license is in full rce and effe Code:The Contractor's License Law does not apply to an owner of a proper
License Classt. ', (�_License N _ who builds or Improves thereon, and who contracts for the projects with
Expire: _ J Signatu licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION ❑ I am exempt from licensure under the Contractors'State License Law for ti
❑ I hereby affirm under penalty of perjury one of the fallowing 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 residence
compensation,Issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion -
Section 3700 of the Labor Code, for the performance of work for which this improvements covered by this permit, I cannot legally sell a structure that 1 he
permit is Issued. built as an owner-building If It has not been constructed in Its entirety by licens
Policy# contractors. I understand that a copy of the applicable law, Section 7044 of t
❑ 1 have and will maintain workers' compensation Insurance, as required by Business and Professions Code,is available upon request when this application
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:httm,llwww leolnfo ce oovlcelaw himl.
permit Is Issued.My workers'compensation insurance carder and policy number are:
Property caner or Autho :edAgent ,Date
Carrier
Expires —1 Policy# �� w I
❑ By my Signature below, i certify to each of the following: I am the grope ,
Name of Agent Phone# owner or authorized to act on the property owner's behalf. I have read t
(This section need not be completed if the permit is for application and the info
on
I have provided is correct. i agree to cam
one dollars($100)or less) with all appl1 bla dty a ounty ordinances and state laws relating to build
construe om presentatives of this city or county to enter the abo
❑ 1 certify that In the performance of the work for which this,permit Is issued,I identified arty f t� ins ection purposes.
shall not ern any persons in any manner so as to become subject to the
workers'compensation laws of California, and agree th if I should become
subject to the workers'compensation provisio of Be n 3700 of the Labor Pro ner Authorized Agent Date
Code,I shall forthwith comply with those pro ' ons.
City Business License# � � �—
Date; Appiic
WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO.CRIMINIAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000), IN ADDITION TO THE COST OF,COMPENSATION, []YES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A
DAMAGES AS PROVIDED FOR IN SECTION3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑NO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON .THE HAZARDOUS MATERIALS
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 THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATIW
FROM THE SOUTH COAST AIR QUALITY MANAGEMEN-
Lender's Address ❑NO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOF
GUIDELINES
OWNER BUILDER DECLARATIONS PRINTNAME:
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 []YES WILL THE PROPOSED BUILDING OR MODIFIED FACILITI
next to the applicable item(s)(Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF f
Any city or county that requires a permit to construct, alter,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 I HAVE READ THE HAZARDOUS MATERIP
provisions of the Contractor's State License Law(Chapter 9(commencing with
Section 7000)of Division 3 of the Business and Professions Code)or that he or ❑YES INFORMATION GUIDE AND THE SCAQMD PERMITTIh
she Is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENI
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFE'
a civil penalty of not more than($500).) HAAZDARDOUS MATERIAL l4tEPORI'ING D 25534 CONCERNIP
❑ I, as owner of the property, or my employees with wages as their sole
compensation,will do( )all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code; X
The Contractor's State License Law does not apply to an owner of a property
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.if,however,
the building or Improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MIL' NYll'IL' ii PLCKNo: P ilt
29714 Haun Road Date: Dal : '
Menifee, CA 92586 1 (qtiq
Phone: (951)672-6777 Amount; Amoun: Op
Fax:(951)679-3843 Ck#: Ck#:
Building Combination Permit
To Be Completed By Applicant
Legal Description: ,r9- 3 Z LID T— S-R Planning Case: F: L Rt: R:
P�party Address: Assessor's Parcel Number.3 3 7 Z°�2 o O 7
M CaII bldd Men�Fee , cR q2
ProjecVTenant Name: L-k di,<L Unit#: Floor#:
Name: Orry) �}0..t'r-ts n 02 Fax No.
Property AQdr s 8 C ^„ I I I J � Unit Number Zip Code}
Owner L W.
Email Address:
Name: cm.r. A ^ ,^ N j
Applicant Address:3O S U r r 1 `�Unit Number Zip Code l].Z5.rrY
o
Emai Address:M 01 —K S ct I r-� /Y1 a-.-(� I
Name: MonK'S Air 2a12-
Contractor Addres3^C3O ry �r o r� t� Pd Cit1� C6 it Stater yt Zip Cod ��
onrractorCC..JJ�`L.tJ, usmes Icense o. Contractor's Cxity$jgte,kalif 7iaa Licen�sel No. lJ Classification: /n n O
Number or Squares: `'�/L• `'� l�L
Square Footage 'I
Description of Work: l�Vw Ui.A.AI NT (,01GB'ry CuJ L'-3 f. Cost of Work:Yr•1/ J 3 2 1_ (Q
Applicant's Signatu Date:
:;•7Q'Be Completed By.Clty'StaH Only
Indicate As R-Received or N/A-Not Applicable
5 Completes sets of fully dimensioned.drawn to sale plans which include: t set of documents whicn 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 S x it)
❑ Structural Calculations
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan (3 Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan 1 ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition' Means/Methods
Work Type: Repair' Retrofit' Revision to Eeisting Pennil' Required? YES NO
Proposed Building Use(s): Existing Building Use(s):
#Buildings: #Units: #Stories. Will the Building Have a Basement?
V of N
Bldg, Code Occupancy Group Indicate Indicate if YES or NO Indicate all Geo-tech.Haz.Zone
At Project Sprinklered thata
Completion: Construction 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. Planning Comm. Zoning Administrator
Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Rations Spacial Gasa.Bldg
Official Aooroval
Expedite Project(s), Child Care City Project Green Building Landmark I Affordable Housing
For Staff Use Only
Building/Safely Permit Specialist City Planning I Gml Engineer'.ng I EPwM-Admin Transportation Mgmt. Renl Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
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