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PMT16-02429 City of Menifee Permit No.: PMT16-02429 29714 HAUN RD. Type: Residential Mechanical <ACCEUA ' MENIFEE, CA 92586 MENIFEE Date Issued: 07/29/2016 PERMIT Site Address: 30097 SHORELINE DR, MENIFEE,CA Parcel Number: 364-022-012 92586 Construction Cost: $6,249.80 Existing Use: Proposed Use: Description of HVAC CHANGE OUT, CARRIER 4.0 TON, SINGLE STAGE A/C,90,000 BTU FURNACE Work: Owner Contractor SAHIL DESAI MONKS AIR CONDITIONING 30097 SHORELINE DR P 0 BOX 128 MENIFEE, CA 92586 SUN CITY, CA 92586 Applicant Phone:9516794502 GARY MONK License Number:912194 MONKS AIR CONDITIONING P0 BOX 128 SUN CITY, CA 92586 Fee Description Oft t Amount I$1 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 carded 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_Permil_Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ ]am exempt from licensure under the Contrac!ars'State License Law forth I hereby affirm under penalty or pedi try that I am likens d under provisions of following reason: Chapter 9(commencing with section 7000)of Division of the Business and By my signature below I acknowledge that,except for my personal residence ii Professions Code �^license is in full force and eff which I must have resided for at least one year prior to completion c License Class C2 Licens No. 2—1 Improvements covered by}his permit,I cannot legally sell a structure that I haw Expires3_ I-I R Signalu built as an owner-building'd it has not been constructed 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 is submitted or at the following Web site: ❑ 1 hereby affirm under penalty of perjury one of the ollowing declarations: httnl/www leeinfo ca eov%calaw html, 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 Code, for the performance f work for which this permit is Issued. Property Owner orAuthoriied Agent Policy# ❑ By my Signature belowi I certify to each of the following: I am the propeM 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 thit section 3700 of the Labor Code, for the performance of a work for which this application and the information I have provided is correct. I agree to oomph permit is issued.My workers'compensation insurance cardej and policy number are: with all applicable city andicounty ordinances and slate laws relating to buildinc construction.I authorize re resentatives of this city or county to enter the above Carrier ���7[ !� ) identified property for the iris pection purposes. Policy#I Expires__ — — I Date Property Owner or Authorized Agent (This section need not be completed if the permit is for /,. -7 one-hundred dollars($100)or less) City Business License# `1��Jy/C�J 1 certify that in the performance of the work for which I is 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 futury building occupant handle hazardous material or a workers'compensation laws of Calffcmia, and agree that if I should become mixture containing a hazallous material equal to or greater that the subject to the workers'compensation provisions of Section 3700 of the Labor amounts s ecified on the Hazardous Materials Information that Guide? Code,I shZ1vArmpiywfth those provisions. DYES NO Appli an, 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 SECUf2E 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 KIND FINES UP TO ONE HUNDRED THOURAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be vAthin 1 DOD feet of the outer DAMAGES AS PROVIDED FOR IN SECTICiN 3706 OF THE bounda ofaschooI? LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES rXNC 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 undersfand my requirements under the State of agency for the performance of the work which this perr it is issued (Section California Health Safety e,Section 25505 and 25534 concerning 3097 Civil Code) hazardous mate If re orti: OWNER BUILDER DECLARATIONS DYES NO I hereby affirm under penalty of perjury that I am exempt from theContractor's I Date, License Law for the reason(s)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, alte% 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 licersed 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 frost 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 facillto be RRP-certified firths and comply with she is exempt from licensure and the basis for the alleged exemption. Any required practices.This includes rental property ovmers and property violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint:c isturbing work themselves or through their a civil penalty of not more than($500).) employees.For more infornlation about EPA's Renovation Program visit: ❑ I, as owner of the property, or my employees with 'ages as their sole �•epa.govAead or contact the National Lead Information Center at 1-800.424-LEAD(5323). compensation,will do( )all of or( )porting of the work,and the structure is not intended or offered for sale.(Section 7044,Business antl Professions Code; The Contractor's State License Law dots not apply to an TO of a property O An EPA Lead-Safe Certified Renovator will be responsible for this project who, through employees' or personal effort; builds or improves the property, provided that the improvements are not Intended or offered for sale.If,however, Certified Firm Name: the building or improvement is sold within one year of completion,the Owner- a, Builder will have the burden of proving that it was not built o�improved for the Firm Certification' o.purpose of sale). N ❑ I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firm is required for this project because: contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP Menifee 7- l — ( DATE PERMIT/PLAN CHECK NUMBER f 1 "" I • �e� ! TYPE: O COMMERCIAL }$RESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O AUDITION O ALTERATION O DEMOLITION O ELECTRICAL MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK /'K D l 0 vv-,I/- �L� �G (lO PROJECTADDRESS ASSESSOR'S PARCEL NUMBER ��o� �pp�LZ-�`'Z LOT �`f TRACT OWNER NAME r I L e I . C , � ADDRESS' /� � r�p l� PHONE (ggg `r4f - 2�(-��3/� EMAIL APPLICANT NAME ADDRESS 305__ )o M� *U rr* M� i � CA Cl �N PHONE (q�) ' ;7 L?—LT 502 EMAIL YY WIKSAIY'9D g► a:0 COWL CONTRACTOR'S NAME U aX� I L/i O I= OWNER BUILDER? O YES iNO BUSINESS NAME l l ��r UI1d/ 'br) ADDRESS /; 530 � C��-{ � � ��� PHONE (q51' LO 1`�1- 4 n2- /�' IEMAIL ►nonle-SG.�r A7 G{��/�- �m CONTRACTOR'S STATE LI,C/NUMBER ( C 121L "7 LICENSE CLASSIFICATION C12-0 VALUATION$ Z`f�7 a b Q SO FT ' � b L SO FT APPUCANT'SSIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION �,vj CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN - SMIP INVOICE - t PAID AMOUNT AMOUNT OC -SH O CHECK# OCREDR CARD MSA/MC PLAN CHECK FEES PAID AMOUNT 0CASH O CHECK# OCREDITCARD %AWMC OWNER BUILDER VERIFIED 0 YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Meni,ee Building&Safety Department 29714 Haun Rd. 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