PMT16-02176 City of Menifee Permit No.: PMT16-02176
29714 HAUN RD. Type: Residential Mechanical
-K;kCCEL/? MENIFEE, CA 92586
MENIFEE Date Issued: 07/12/2016
PERMIT
Site Address: 28811 BRIDGE WATER LN, MENIFEE, Parcel Number: 364-152-012
CA 92584 Construction Cost: $6,000.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT 4-TON, 15 SEER,SINGLE STAGE SPLIT A/C, 110,000 BTU FURNACE
Work:
Owner Contractor
PAUL CRAFTS MONKS AIR CONDITIONING
28811 BRIDGE WATER LANE P 0 BOX 128
MENIFEE, CA 92584 SUN CITY, CA 92586
Applicant Phone:9516794502
TIFFANI SELLERS License Number: 912194
MONKS AIR CONDITIONING
P O BOX 128
SUN CITY, CA 92586
Fee Description ON Amount(SI
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_Templare.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ 1 am exempt from licenpure under the Contractors'State License Law forth
following reason:
I hereby affirm under penalty or perjury that I am licens d 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
Professions Code and,19yZCense is in full force and eft which I must have resided for at least one year prior to completion c
License Class ) LlcensA No. Zt' improvements covered by this permit,I cannot legally sell a structure that I hav,
Expires Signal built as an owner-building If it has not been constructed in its entirety by licensee
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 is
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one the of u g declarations: httoJAvww.ieeinfo.p eov%platy htmi.
I have and will maintain a certificate of consentt of s If-insinsure for workers'
compensation,issued by the Director of Industrial Retail ns as provided for by Date
Section 3700 of the Labor Code, for the performance f work for which this
permit is issued. Property Owner orAuthodied Agent
Paltry# ❑ By my Signature belowi I certify to each of the following: I am the propeM
I have and wIl maintain workers' compensation Insurance, as required by owner or authorized to act on the property owner's behalf. I have read the!
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 oomph
permit is issued.My workers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to buildinc
C� construction.I authorize representatives of this city or county to enter the above
Carrier cam/ / J identified property for the ir)spection purposes.
I Policy#12--700— Z Expires �— — I i Date
Property Owner or Authorized Agent
(This section need not be completed if the permit is for CI Business License# r� 22.one-hundred dollars($100)or less) City
I certifythat 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 ecome subject to the Will the applicant or futureibullding occupant handle hazardous material or a
workers'compensation laws of California, and agree that if I should become mixture containing a hazarbous 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,1 shall f mply with tho;,e provisions. OYES
, ry0
Appli ant, 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 SECUI1 E 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 �es
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 bounds ofa school? '
LABOR CODE,INTEREST,AND ATTORNEY' FEES ❑YES XNO
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 unde)tand my requirements under the State of
agency for the performance of the work which this permit is Issued(Section California Health Safety Oyy e,Section 25505 and 25534 concerning
3097 Civil Code) hazardous mate Ire orti`•g.
OWNER BUILDER DECLARATIJNS ❑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(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 licer{sed pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's State License Law (Chapterig(commencing with receiving compensation for oat 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 facile to be RRP-certified fines and comply with
she is exempt from licensure and the basis for the alle' ed 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:
❑ I, as owner of the roe www.epa.govilead or contact the National Lead Information Center at
property,rty, or my employees with ages as their sole 1-800-424-LEAD(5323).
compensation,will do( )all of or( )porting of the workand the structure is
not intended or offered for sale.(Section 7044,Business an tl Professions Code;
The Contractor's State License Law dots not apply to an Pwner 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- rm ,
Builder will have the burden of proving that it was not built or improved for the Firm Certification No.:
purpose of sale).
❑ 1, 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 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 contractors)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
"Menifee
DATE —7 — G— PERMIT/PLAN CHECK NUMBER ? � zO 2
TYPE: O COMMERCIAL )(RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL ir.MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES F -
DESCRIPTION OF WORK fYC - n ��
"li 6(2 0
p Aln f 1110
PROJECTADDRESS �_ O 13rid tQ c M en t
ASSESSOR'S PARCEL NUMBER �A k J-L c> LOT _ TRACT
OWNERNAME ^
ADDRESS 2 C 11 13 r( 'Llld '�T L
_
PHONE nnSl )5,5J - 3 - ,5EMAIL JUL
12 2016
APPLICANT NNA/M�EG�& "-
ADDRESS `nn)IJJ//��OM GUMM1
PHONE (`7 � (C;7q-I1 S` 02-�I/I EMAIL mDtlKSOir� YL TY .Lj • CbYYI
CONTRACTOR'S NAME L-..{ A-ry I O OWNERBUILDER? OYES NO
BUSINESS NAME �Y L�LJI1d� �OYI I
34
ADDRESS S/�//� I' G�r� GA Morrf1121A Rd IF 92S
PHONE ("!S'� Lp f"f� `T� 02- /�� /EMAIL manl-Sair a'7 Prna-/�-`l-�/- Cam
CONTRACTOR'S STATF LIC NUMBER '�l'2 1c1`1 LICENSE CLASSIFICATION C -O
VALUATION$ LMJ SQ FT 7- __ L SO FT
APPLICANT r_
'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
771
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE 77--�� PAIDAMOUNT ' 1
AMOUNT 3d U' ID �ry-1O 0C,AS `J CHECK# OCREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 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.ciiyofinenifee.us Inspection Request Line 951-246-6213
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