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PMT14-03355 City of Menifee Permit No.: PMT14-03355 29714 HAUN RD. 4WGCF.i..h> MENIFEE, CA 92586 Type: Residential Mechanical MENIFEE Date Issued: 1 211 9/2 01 4 PERMIT Site Address: 28848 DEL MONTE DR, MENIFEE, CA Parcel Number: 337-214-002 92586 Construction Cost: $5,179.80 Existing Use: Proposed Use: Description of HVAC CHANGE OUT HT 45K BTU, COOL 24K BTU,2 TON Work: Owner Contractor MONTE PIERSON MONKS AIR CONDITIONING 28260 WESTOVER WAY P O 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 ,Qty Amount 1$1 Forced A t or Gtavl NNEumace oume 5, 1 ? s149 Oil Air Handling/Condensing Units SFR 1 133.00 .U..Ilding Peftt($SlIar1C9 ,..s..�z..s,..-,. '.� 4,s27 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 slated, 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_Permil_Template.rpt Page 1 of 1 CITY OF MENIFEE PLCK No: 29714 Haun Road Date: Date: Menifee, CA 92586 tq iy Phone: (951)672-6777 Amount: Amount aoly Fax:(951)679-3843 Ck#: Ck#: Building Combination Permit To Be Completed By Applicant Legal Description: l.o'r 2\ b Planning Case. F: L: Rt: R pg3Address. IV I once. D r• .I �. q�g Assessor's Parcel Number. 2 -3 7 Z 1%.-N O o Z ProjectfTenant Name: V17c-visoV1 Unil#: Floor#: Namely /1 �,^ L� 17• F let 7q /( f p Faz No. Property r s:Mon he-,i `I� Unit Number T KJO Zip Cod Owner W� Od FX lA M'e Email Address: Name: CrckTq ^ ^ /,� No. '"L LJ -ZOIZ Applicant Address:3O5 UY.r Unit Number Zip Code 6rlail Address;rrv-1�O ACV S/�G ✓I'Y�1t�r� ma�f CcQm / /} '�(/ -7�I Name: M O/ L K7 S A i 1 �1 ( f , • (,`7�� f�7%��5�2 PY (�72-2D12- Contractor Addres3�-3O Ix A 1 , r ri Q� 1n Cit}v A p In I c Statrf ytodf'� � ontractor t usmes dense o. 1. Contrraactor's 2, $j y 4alif ;ia/(Licee-nos le No`L.� Classification: /n n`( Number or Squares: Square Foolage G\tk Z Description of Work: VkV•A Ci1�-Ji+/�61�- ova N� Z'`-� �4;k Cost of Work:gC EO Applicant's Signatu[@- -�/ Date: J To'Be Completed By,Clty Staff Only Indicate As R-Received or N/A-Not Applicable 5 Completes sets of fully dimensioned,drawn to sale plans which include: 1 set of documents whicn include ❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Soils Report(on cd only) ❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on B '/x 11) - ❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Structural Calculations ❑ Single Line diagram for sled.services over 400 AMP ❑ Floor Plan ❑ Structural Framing Plan 8 Details ❑ Shoring Plan ❑ Sound Report•Residential Class Code: Indicate New Construction Alteration. Addition' Means/Melhods Work Type: Repair' Retrofit' Revision to Existing Permit' Required? YES NO Proposed Building Use(s): Existing Building Use(s): #Buildings: #Units: 0 Stories: Will the Building Have a Basement? Y of N Bldg. Code Occupancy Group Indicate Indicate it YES or NO Indicate all Geo-tech.Haz.Zone At Project Sprinklered that apply: Coastal Zone Completion: Construction pP y: Type($): C Of O YES or NO Noise Zane Requiretl7 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 Retrofit Ispaaa,case.Bldg Official Aoomval Expedite Project(s). Child Care City Project Green Building I Landmark Affordable Housing For Staff Use Only Building/Safely Permil Specialist Ciry Planning Civtl Engineering' EPWM-Admin Transportation blgmt. I Rerl Control THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY Zov�-VV ld City Of Menifee LICENSED DECLARATION I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ 1, 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 Class. �License N . .. who builds or Improves thereon, and who contracts for the projects with Expire3 Signature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ 1 am exempt from[!censure under the Contractors'State License Law for it ❑ I 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 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 I he permit is issued. built as an owner-building If it has not been constructed in its entirety by Iicens, Policy# _ contractors. I understand that a copy of the applicable law, Section 7044 of t Business and Professions Code,is available upon request when this application ❑ 1 have and will maintain workers' compensation insurance, as required by submitted or at the following Web site:http•//www lealnfo ca oovlcalaw htrH. section 3700 of the Labor Code, for the performance of the work for which this s g permit is issued.My workers compensation Insurance carrier and policy number are: roperty caner or u ooze Agent ,Date Comer P011cy ib�'Expire # I w I I�� ❑ By my Signature below, 1 certify to each of the following: I am the prope Name of Agent Phone# owner or authorized to act on the property owner's behalf. 1 have read t (This section need not be completed'rf the permit is for application and the info 'on I have provided Is correct. I agree to com one dollars($b00)or less) with all BPI ble dry a unty ordinances and state laws relating to build constructo . odz r 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 any f t inspection purposes. shall not employ 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 provislo 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; Applic t 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 BUILDING ($100,000), IN ADDITION TO THE COST OF.COMPENSATION, AYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES DNO GREATEREQUAL TO OR OUNTS SPEC FIED ON THE HAZARDOUS MATIERIALE CONSTRUCTION LENDING AGENCY 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 GUIDE LINES OWNER BUILDER DECLARATIONS PRINT NAME: 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 AYES 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) Any city or county that requires a permit to construct, alter, improve, demolish, D 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 DYES Section 7000)of Division 3 of the Business and Professions Code)or that he or INFORMATION GUIDE AND THE SCAQMD PERMITTIN she Is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENT 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).) CODE SECTION S MAT 25505RIALF'tE5533PWf AND 25534 CONCERNIP ❑ 1, 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). n w m V v°i w O T D T D m W IT ut H n F+ � O ry A Z M. 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