Loading...
PMT16-02094 City of Menifee Permit No.: PMT16-02094 29714 HAUN RD. Type: Residential Mechanical 4ACCELA.. MENIFEE, CA 92586 MENIFEE Date Issued: 07/05/2016 PERMIT Site Address: 29460 PEBBLE BEACH DR, MENIFEE, Parcel Number: 338-072-017 CA 92586 Construction Cost: $6,480.00 Existing Use: Proposed Use: Description of HVAC CHANGE OUT,3-TON 14-SEER SINGLE STAGE SPLIT A/C,70,000 BTU FURNACE Work: Owner Contractor NANCY GRUBER MONK'S AIR CONDITIONING 29460 PEBBLE BEACH DRIVE P O BOX 128 MENIFEE, CA 92586 SUN CITY, CA 92586 Applicant Phone: 9516794502 TIFFANI SELLERS License Number:912194 P0 BOX 128 SUN CITY, CA 92586 Fee Description ON Amount ISI 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_Bidg_Permtt_Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ I am exempt from licensure under the Contractors'Stale License Law for th I hereby affirm under penalty or perjury that I am livens d 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 I Professions Code license is in full force and off which I must have resided for at least one year prior to completion c License Class t�Licens No. Z improvements covered by this permit, I cannot legally sell a structure that I ham Expires 3"3I_ Signatu built as an owner-building if it has not been constricted in its entirety by license contractors. I understand that a copy of the applicable law,Section 7044 of th WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application i. submitted or at the following Web site: ❑ I hereby affirm under penalty is perjury one t the If-insure g declarations: hlto://www.leoinfo.ca cov/calaw htm1. I have and will maintain a certificate of consent of s If-Insure for workers' compensation,issued by the Director of Industrial Relati ns as provided for by Date Section 3700 of the Labor Cade, for the performance f 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 propert, N( 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 thi: section 3700 of the Labor Code, for the performance of the work for which this application and the information 1 have provided is correct. I agree to compl, permit is issued.My workers'compensation insurance carrier and policy number are: with all applicable city andlcounty ordinances and state laws relating to buildint C,� construction.I authorize representatives of this city or county to enter the above Carrier rc.�7<_7 identified property for the inspection purposes. Policy#1 G— /rJD� I Z Expires �— — I Date Property Owner or AuthorizedrAgent �X/ l^ 2 5 �7 4J--- (This section need not be completed If the permit is for City Business License t / n J one-hundred dollars($100)or less) ty �. 4 1 certify that in the performance of the work for which this permit Is issued,I HAZARDOUS MATERIAL DECLARATION shall not employ any persons in any manner so as to become subject to the Willworkers compensation laws of California,and agree that if I should become mix the applicant or fhazardouture s m occupant handle hazardous material or a 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? Code,I shall f ant• hwi mply with those provisions. DYES NO Appli Date; 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 checklist COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES )(NO 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 bounds of a school? LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES ,B 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.I understand my requirements under the State of agency for the performance of the work which this permit is issued (Section California Health Safety Cp e,Section 25505 and 25534 concerning 3097 Civil Code) hazardous mate I re orti g. OWNER BUILDER DECLARATIONS DYES NO I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date License Law for the reason(s)indicated below by the checkmark(s)I have placed PRO 0N 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 fRRP) or repair any structure, prior to its issuLnce, also requires llhe 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 licensure 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 applicont 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 EPKs 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 purpose of sale). Firm Certification No.: ❑ I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Finn 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 BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE _ I J I PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL )(RESIDENTIAL O MULTI-FAMILY O MOBILE HOME 0 POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL MECHANICAL O NEW C PLUMBING C RE-ROOF-NUMBER OF SQUARES - _ O DESCRIPTION OF WORK h b 3 ' G I -O L)I hC� h- `/ S l PROJECTADDRESS i a CZ ASSESSOR'S PARCEL NUMBER 0-�-2- 0 LOT TRACT 7�`�O� OWNER NAME I I G BUilding & Safety Dept. ADDRESS S I —7 PHONE ��/�� Zy 1/� - / !/� � EMAIL JUL 0 5 201E APPLICANTNAME -L..�{ r - V -tv I'l, • ' ADDRESS 3 S )QM. U�y►%�r PHONE rg \51 / (,r-;7n-[1J 502 EMAILrf-10 nKSOIr9D rrala ^ CbYY'l l.�{ CONTRACTOR'S NAME Levy M D x^ OWNER BUILDER? O YES JNO BUSINESS NAME f r Wn� 'O n I +7 ADDRESS////�� lS C PHONE ( "J5I J (r,11 - 4501 EMAIL mOnKSGitr a"� P►yla--L • Ca m CONTRACTOR'S STATE LIC NUMBER C I Z I-/ 1( LICENSE CLASSIFICATION CZO ('�`� b' VALUATION$ ��/' n� SO FT L SQ FT APPLICANT'S SIGNATURE fi DATE CITY STAFF-u' • DEPARTMENT DISTRIBUTION CRY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP k INVOICE PAID AMOUNT AMOUNT �O ( OCASH OCHECKp OCREDRCARD MSA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECK It O CREDIT CARD MSA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O 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 w Q £ r a U � t1 C U N T N N N 0 o -- S r Y Y a O-6 2 a 70 o �' c � 3 r• j O H ti Z r m C N n w 3 m l7 m w E a o v > c c y a ON VI Z Oti n-I O N d N m c & 3 £ m y c a — M a p o 'O � �n O « Z � C C W Y m v O O J z Y L U� C � C. C •C � 6 U E u. U N O a o u N G F O O a O y V > O m z —eun m 3 3 po u = moil, C o m in 0 LL z .s 3 O O N N Q 1p 00 O i E 6 N 'N G Y C v m c v iv o z �n c c c CI a y p pay A O t!1 0 6 ei O C i u 0 O vuvi N U « u m S aYE H � V m n• « ¢, C uo c c £ U N O > m v t u — C C m C a N ~ m v 3 a m m w w m m o v„ a i a p c y m o y d a m c ono VO.• V T o m C w p v ar ut 0 0 � a y y N O ` E aci > y a c « m W CO O E V) N �n 0 v p U N Q a C O V a+ H O m o > w p O m co O « v f0 d O Ll. J v O E c « .� a T LL YO- Q Z ..Oa v N 'D O O £ ae E O LL u u « O O o O z w uc A i FL Gl a! V V E U rl «v�i 'N E E •N C a0 ¢ c a a V iv V '^ = Z N - v C u Q m Q u > o o O o o Cd "� CJ C u w frl u O C d 2 a O n u ti 0 o � c v a z roi � m w uj `p O v ei v c u d n a � f j O 9 O O N ' m E E m Na C. C 0 m U 0 •C o m � w n G c W d 3E Y d d o v tko m w t �V•I . mc E ti C C W e d O c 0 O O Q u E Q u E w N Q m C T N T o c C O O c12 V CL v Y c m > d O O d E a � O 01 d0 C C H O O V c E c U o' G o E o u h 0 o «_ a oC Q N U L T V O m E u o Y 00 N 2 Q O VI N = W v1 r E d 2 m `om y � � vo w `c 9 ^ � v3 0 = 3 o d L Q .O = � w u vu3g ,.. � E y' N L ac E -`v, x a m E v u O 0 N U 7• VI C C GI W y N C d t4 V U p O N 7 . o E u S � ~ Q c diet N c m � N o m w W yOpC c .. � m m L C duvdi U U O O C O ¢. Y g V m 6 d fp f0 a0 N O C O m Ln i w 6 - y n E r d N 3 `y c w K w C tl0 6 2 E Q L E •'d: m o a g A d C c O O = .m GG L'• w d -O 6 O C y d m a `d >> W N 10 c n Q U 4 V m E E W a m Ow c v v of E '.l n a 2 Z 3 v Q c T. oo ": ,emu >.. �' >• co m U O V E E d 2 E O O S O d N N E C a C f0 ad+ F ` Y O T •L' ` � C W Y d O LL O LL y LL u U 7 d d Q V Q U U U V w �. S w LLI li K U. a � 10 c u U a c a C U o a 6 W a s v y O m m a a c O c 5 w w n w o V E u E « c c Oa u a O v 9 ¢ n a O w m a v a w NL n o a v N A O y O c V N N e v s o c a 9 a v� N E c c O w w 0 N O N o O LO o °' a w io n E T l!1 o O o Y a It O a ¢ h o � p w N c 3 .. E o O 'c E min m n O 1� u Ch Gl c a0 ¢ « N N E O (O 2 'v 1? c m y a o in (O uwi .may ti w u A C O Q. u c u O j a n a N O N y O H O mO u tVl v waa � w A O U .y LN c y o GN u nOl y 'O q3 w ¢ O N 3Ol aOl W > O tf `o E 'O m O m 'oo a t E 3 m w o n a u > v w A v a a to w oQ o .- =o E c E � n- N = E Q Y V a y N O O a 0 a C C o O w v E c " o A u m A c E o E :Ea E U A a c OW ? O v Y u w E a u u U E a E Y C G 3 � � c � w3u `o m «w O '^ a m `a o c N G w o a in V1 O. y w u a v tf E v O ¢p m v '= E � O « m o 0 Y p E Y C t+ m E 6 U a O N Vl L f� ''J ✓ N ti O 6 V i O A E Q V U O 0 U O O a Q O N w v W s{ a w m A O of O o m p Z z K W a > d w " c O m E « y w r A L Q U = N 3 c w a — w 0° V y T 'a c E m c, Z '�' c l7 �,V1 w W CL„ a U` >,to v W m "a am 4w aE Z �^ r ry m a i on c En Oo EO mm yu�n :Eo2 u2 m 02 � cw .¢mw m¢� u