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PMT15-01760 City of Menifee Permit No.: PMT15-01760 ^ ''-��•-��. 29714 HAUN RD. ;ii C+�i�.t„A> MENIFEE, CA 92586 Type: Residential Mechanical rrc�mwxucrav a MENIFEE Date Issued: 06/2512015 PERMIT Site Address: 29289 CALGARY CT, MENIFEE, CA Parcel Number: 338-242-005 92586 Construction Cost: $6,200.00 Existing Use: Proposed Use: Description of HVAC CHANGE OUT-SPLIT SYSTEM A/C: 3 TON FAU: 70,000 BTU Work: Owner Contractor ART&NANCY STONE MONK'S AIR CONDITIONING 29289 CALGARY CT P 0 BOX 128 MENIFEE, CA 92586 SUN CITY, CA 92586 Applicant Phone: 9516794502 GARY MONK License Number:912194 MONK'S AIR CONDITIONING P 0 BOX 128 SUN CITY, CA 92586 Fee Description (3yt Amount($) �E. :orc d it o,� Cavity-Ty e��urna gID(� Um�`ri�,ctai t� ` 13' 'S'���E� d t' 14900' 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 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_81dg_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 ❑ 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 Professior Professions Cog my license is in full roe and etfe Code:The Contractors License Law does not apply to an owner of a proper License ClaSe License N j 4 _ who builds or improves thereon, and who contracts for the projects with Expire3 Signatu licensed contractors)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ 1 am exempt from Iicensure 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 1 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 ifs entirety by licens Policy# _ contractors. I understand that a copy of the applicable law, Section 7044 of 11 ❑ 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:hfto•/tw wv iminfo ca aov/alawhtml. permit is Issued.My workers'compensation insurance artier and policy number are: ror+ perry err or Authorize Agent ,pate Carrier f Expires —1 Policy# ❑ 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'rfthe permit is for application and the info 'on I have provided is correct. I agree to corn one-hundred dollars($100)or less) with all appli ble Gry a only ordinances and state laws relating to build' censtructio oft 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 inspection purposes. shall not employany persons in any manner so as to become subject to the workers' compensation laws of Cal'rfomla, and agree th ff I should become subject to the workers compensation provisio of Be n 3700 of the Labor Pro er Authorized Agent Date Code,1 shall forthwith comply with those p ons. rn City Business License# 3 � Date; �� •�PPIi 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 ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 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 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 THE 3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE Lender's Name OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION FROM THE SOUTH COAST AIR QUALITY MANAGEMENI 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 DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable ftem(s) (Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A 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 I HAVE READ THE HAZARDOUS MATERIA 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 OYES INFORMATION GUIDE AND THE SCAQMD PERMITTIN she is exempt from Iicensure 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 SAFET a civil penalty of not more than($500).) - CODE SECTION 25505RIAL 25533 55 3 WG D 25534 CONCERNIN ❑ I, as owner of the property, or my employees with wages as their sole compensation,will do( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; X The Contractor's State License Law does not apply to an owner of a property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). BUILDING • I SAFETYPERMIT/.PERMIT/PLAN CHECK APPLICATION Menifee DATE -Z — /S PERMIT/PLAN CHECK NUMBER 1 / 1Co TYPE: 0 COMMERCIAL XAESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: 0 ADDITION ()ALTERATION :)DEMOLITION O ELECTRICAL ;MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK UU. .A)L'. FNNV'. }010001kTV /� PROJECTADDRESS L 2 p,v,t1 e �/ ASSESSOR'S PARCEL NUMBER 3"3S-.Z 00-' - LOT JILA TRACT 00-1 OWNER NAME ADDRESS 2"���/1 L C�q `�//� 75-g PHONE ( -7) 34I-5I&5 EMAIL n e m J) Q rye/ APPLICANT NAME &CLrV -: 0 L� /�p p �+,� /��7 ADDRESS nSC 5";J: /DM� U I% I`� 11..E I l ftt 1.A `�I / 5F- PHONE (/Jl ) LP !L7- 502 p EMAILmonKSa1 r� 1'YIG A, Corn CONTRACTOR'S NAME l..I cur ► V I Q �^ ,.( OWNER BUILDER? O YES NO BUSINESS NAME 1 i t Cond l ior) Lna ADDRESS ""��S ( PHONE (C//?51 ) 6 — 4� 2_ �] EMAIL mon le-salr 4D 9 ry_LC6_L . Gom CONTRACTOR'S STATE LIC NUMBER `�//Z 1-/ L4 LICENSE CLASSIFICATION CZQ VALUATION$ GD SO FT Z SZ L SO FT APPLICANT'S SIGNATURE DATE �2— CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION __7UFdL NJ1Fft BUSINESS NSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN ` SMIP Ij✓�i✓•� L Q INVOICE � C1 W PAID AMOUNT ` AMOUNT >C Ibw ASH O CHECK N >CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECK It O CREDITCARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-572-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 y y / w ° / } 3 \ _ ( _ \ \ ($ 7 _ ) § \ ( ° 0 Z N 0 ) : - \ � � 0 *0 \ § m / J f > 3 § / \ , - § _ ° kk 7 ~ / ® � ; ƒ \ , ± \ 7 / I2 if t — \ CL�\� 4= \ \ 0� / } ; 7 � f{ c * ; ;vm , ƒ § ( ( ® k0 m w 3m : / I \ a \ ; \ \ \ \ , � 2 ® { « 2 Ei i I i 0 m w W % P P .1 (D � � V1� � v e� 3 e_f• T .'� 00 ° o D P ^ A .2 0 � F Q a P � O• �P � .2 0 < > > D rt ui w O 2. .01. 5. 'm s m F ,O N v O c y "• O w ° m = A O z o .3 a F N o. Q 7 3 N 3 O O m as i 7 o et n fD O •� w � 3 CL r oFm 3 0 o p = 3 7 Om < m :oa 3 H D T a n E,r3' �. „ 0 7 w C w < - v, L m 3 a 3 w !° x Ut 3 N O O t+ l° p H 1p > > n a n � m m S m m n � o a o n � O 0 Nv O' a Q. n,L., N 0 � r a m t ? 3 ^ o 0 01 w o 3 v � o A w ? a W r n 3 1