PMT15-02755 i
P
City of Menifee Permit No.: PMT15-02755
MENIFEE,
EE, C 92 Type: Residential Mechanical j
MENIFEE, CA 92586 I!
MENIFEE Date Issued: 09/0412016
J
PERMIT
Site Address: 28825 SUNNY VIEW DR, MENIFEE, CA Parcel Number: 372-250-023
92584
Construction Cost: $9,000.00
Existing Use: Proposed Use: g
Description of HVAC CHANGE OUT COOLING 60,000 BTU HEATING 100,000 BTU HEATER IN ATTIC
Work:
i
Owner Contractor
BOB COMWELL RIZZO HEATING&AIR CONDITIONING
28825 SUNNY VIEW DR 29092 RAMBLING BROOKS CT
MENIFEE, CA 92584 MENIFEE, CA 92585
Applicant Phone: 9516720397
ROXANNE EASLEY License Number: 349958
RIZZO HEATING&AIR CONDITIONING
29092 RAMBLING BROOKS CT
MENIFEE, CA 92585
Fee Description Oq Amount f$1
I
Air Handling/Condensing Units SFR 1 133.00
I s ce
GREEN FEE 1 1.00
e.
$324.10
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_Bldg_Permit Templatarpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ I am exempt from licensure under the Contractors'State License Law for the
following reason:
I hereby affirm under penalty or perjury that I am licensed under provisions of
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence in
Professions Code n v license is in full force and et. ��J which must have resided for at least one year prior to completion of
License Class Liens �"'1"1°" improvements covered by this permit, I cannot legally sell a structure that I have
Expires 10 Signature built as an owner-building if it has not been constructed in Its entirety by licensed
contractors. I understand that a copy of the applicable law, Section 7044 of the
WORKERS'COMPENSATION DECLARA ION Business and Professions Code,is available upon request when this application is
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one of the following declarations: httn'I/www leoinfo ca oovlcalaw html.
I have and will maintain a certificate of consent of self-insure for workers'
compensation,issued by the Director of Industrial Relations as provided for by Date
Section 3700 of the Labor Code, for the performance of work for which this
permit is issued. Property Owner or Authorized Agent
Policy# f/n-By my Signature below, I certify to each of the following: I am the property
I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read this
zseclion 3700 of the Labor Cade, for the performance of the work for which this application and the information I have provided is correct. I agree to comply
permit is issue . y workers'compensa ion insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to building
constru . I authorize representatives of this city or county to enter the above-
Carrier " d propyrty for the inspection purposes. y
/' r D
Policy# ti ��\ I�Expires )I�0 ate
Property Owner orALthArized Agent
y
(This section need not be completed if the permit is for City Business License# 0 l.✓ \�--/�✓'
one-hundred dollars($100)or less)
HAZARDOUS MATERIAL DECLARATION
certify that in the performance of the work for which this permit Is issued, I
sh I not employ any persons In any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a
workers' compensation laws of California, and agree that if I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor amounts ecified on the Hazardous Materials Information Guide?
Cod , sha I to
ith com Iy with those pro/Wyygs�ions. El YES [ 10
Applicant; Data
i Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARM
FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL forguidel' as
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND El YES .p0
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundaryr9f a school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES EYES 'l] 0
CONSTRUCTION LENDING AGENCY I have nAaad the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist. I understand my requirements under the State of
agency for the performance of the work which this permit is Issued (Section California Health&Safety Code,Section 25505 and 25534 concerning
s me
OW Civil R Code) azaSou l"9 ortin� Date
OWNER BUILDER DECLARATIONS �
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 PROPERTY OWNER OR AUTH AGENT
next to the applicable item(s)(Section 7031.5. Business and Professions Code:
Any city or county that requires a permit to construct, alter, improve, demolish, EPA RENOVATION REPAIR AND PAINTING(RRP)
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 The EPA Renovation, Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's State License Law (Chapter 9 (commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with
she is exempt from Iicensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than ($500).) employees.For more information about EPA's Renovation Program visit:
www.epa.gov/lead or contact the National Lead Information Center at
❑ I, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323).
compensation, will do( )all of or( ) porting of the work, and the structure is
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 ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however, Certified Firm Name:
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 Firm Certification No.:
purpose of sale).
❑ I, as owner of the property an exclusively contracting with licensed El No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044, Business and Professions
Code:The Contractor's License Law does not apply to an owner of a property
who builds or improves thereon, and who contracts for the projects with a
licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
III
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
,&Menifee
DATE"1 ,y•J o PERMIT/PLAN CHECK NUMBER S-QX755
TYPE: O COMMERCIAL RESIDENTIAL C; MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL MECHANICAL
U NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK M CM O \Yj(j ?kUU0,000
' eC c
PROJECTADDRESS 2g�Z�5 11n V1 Vv
ASSESSOR'S PARCEL NUMBER LOT 20 TRACT _Jq
OWNER NAME �� l
ADDRESS Z%t2_'5 -e
PHONE ��10 /��' y,p ram, �pEMAIL
APPLICANTNA(MMEEE n0 / "nt W�4+S�/��l/i�/
ADDRESS :C \"V v-00 U` OY bNJ If, li p
PHONE v�Iu wSZSY EMAIL C)
CONTRACTOR'S NAME 1 1,�/ OWNER BUILDER? OYES YNQ
BUSINESS NA//M''��E -tZ- ��-A �/�� y �f
ADDRESS—"III.P2- �T,�V(I��,��-�11( kt ��DrS
PHONE 3rD� U12— 09 I EMAIL /+
CONTRACTOR'S
/STATE LIC NUMBER &:101a LICENSE CLASSIFICATION GZ
VALUATION $ v` SQ FT ��„Q V V L SQ FT
�
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION p CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN I SMIP
INVOICE O PAIDAMOUNT
AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED C YES 0 NO DL NUMBER NOTARIZED LETTER () YES () NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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