PMT16-01093 City of Menifee Permit No.: PMT16-01093
29714 HAUN RD.' Type: Residential Mechanical
IACCELA? MENIFEE, CA 92586
MENIFEE Date Issued: 04/11/2016
PERMIT
Site Address: 30647 SHORERIDGE DR, MENIFEE, CA Parcel Number: 364-172-025
92584 Construction Cost: $16,990.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT 3.0&4.0, 16 SEER 2 STAGE,A/C 90 K FURNACE &70K BUT FURNACE 2
Work: UNITS
Owner Contractor
MICHAEL PERRY MONK'S AIR CONDITIONING
30647 SHORERIDGE DR P O BOX 128
.MENIFEE, CA 92584 SUN CITY, CA 92586
Applicant Phone:9516794502
GARY MONK License Number:912194
MONKS AIR CONDITIONING
P0 BOX 128
SUN CITY, CA 92586
Fee Description Dot Amount t51
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
Air Handling/Condensing Units SFR 1 133.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Mechanical 1 14.10
$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 ❑ lam exempt from licensure under the Contractors'State License Law for it
I hereby affirm under penalty or perjury that I am licensed under provisions of following reason:
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
Professions Code p-I�license Is in full force and e which I must have resided for at least one year prior to completion
License Class Licens No. ffZ1 improvements covered by this permit I cannot legally sell a structure that I har
Expires3-31-,I p _ Signatu built as an owner-building if it has not been constructed in its entirety by licemu
contractors. I understand that a copy of the applicable law, Section 7044 of ti
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one the following declarations: htto•/Avww.leginfo.ca.goy/olaw.htmi.
I have and will maintain a certificate of consentt 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# ❑ By my Signature below, I certify to each of the following: I am the proper
VL I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owners behalf. 1 have read th
section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to comp
permit is issued.My workers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and stale laws relating to buildir
C� r construction.I authorize representatives of this city or county to enter the abov
Carrier r r identified property for the inspection purposes.
Policy#_I 2— )00— I Z Expires 6— I — I C� Date
Property Owner or Authorized/Agent
(This section need not be completed If the permit is for City Business License#one-hundred dollars($100)or less) h'
I certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION
shall not emolov any persons in any manner so as to become subject to the Will the applicant or future-building occupant handle hazardous material or,
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 specified on the Hazardous Materials Information Guide?
Code,I shall f vA mply with those provisions. ❑YES NO
Appli nt• Date; - I Ir I L— Will the intended.use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklis
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES XNO
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 oute
DAMAGES AS PROVIDED FOR 1IN SECTION 3706 OF THE bounds of school?
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES NO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.1 understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health A Safely C e,Section 25505 and 25534 conceming
3097 Civil Code) hazardous matte I re orb
OWNER BUILDER DECLARATIONS ❑YES NO
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date
License Law for the reasons)indicated below by the checkmark(s)I have placed PRO O N AUTHORIZED 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 fRRP1
or repair any structure,prior to its issuance, also requires the applicant for the
permit to rile 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-Businpss and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with
she is exempt from Jicensure.and the basis fdr the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 703'.1.5 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:
❑ 1, as owner of the property, or my employees with wages as their sole www.epa.govAead or contact the National Lead Information Center at
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 Stale 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 purpose of sale). Finn Certification No.:
❑ I, as owner of the property an exclusively contracting with licensed No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply td an owner of a property
who builds or improves thereon, and who contracts for the projects with a
BUILDING
PERMITIPL4N CH ECK APPLICATION
g�Menifee
DATE PERMIT/PLAN CHECK NUMBER O O
TYPE: O COMMERCIAL -4 RESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: 0 ADDITION 0 ALTERATION O DEMOLITION O ELECTRICAL MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES C
DESCRIPTION OF WORK 'I'N fC- D(a 3 O �� 4,� '�S� � ��� �/G
Q 0 7 D K T v 60Yv�c-a- 2 Jl
PROJECTADDRESS -,) ce/ Igor r0
ASSESSOR'S PARCEL NUMBER �`t ' I 2,- 025-`4 LOT S_ TRAM
OWNERNAME
ADDRESS (2q--7 buff r I qZ
PHONE ( 15 - Z EMAIL
APPLICANTNAME U Ir
ADDRESS //30/ 5-;6M, u rr M � CA `���`�
PHONE (l51) �P�/I�� 1 S�Z N EMAIL I'1"onKSAI►^
CONTRACTOR'S NAME U �-r M�/ }i/x OWNER BUILDER? O YES NO
BUSINESS NAME IY (...undi ,On I
ADDRESS
///� �S/ /7 G n 25
PHONE (q J Lp��f 4502- /�, IEMAIL ry')bn�C.SzX I r- � ►r%a� ' �m
CONTRACTOR'S STATE LIC NUMBER `mil jZ jc/`Y LICENSE CLASSIFICATION C,ZO
VALUATION$ C)( SQFT SO LSQFT
APPLICANT'S SIGNATURE DATE
C17Y STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE 'O PAID AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
AMOUNT
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department29714 Haun Rd. Menifee, CA 92586 951-671-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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