PMT16-02483 City of Menifee Permit No.: PMT16-02483
29714 HAUN RD. Type: Residential Mechanical
-(;KGCELA--�' MENIFEE,CA 92586
MENIFEE Date Issued: 0 810 312 01 6
PERMIT
Site Address: 29561 THORNHILL DR, MENIFEE, CA Parcel Number: 336-121-009
92586 Construction Cost: $6,250.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT 2.5 TON, 14.0 SEER,A/C 70,000 BTU FURNACE
Work:
Owner Contractor
ED&CINDY BENNETT MONKS AIR CONDITIONING
21025 PASEO MONTANA P 0 BOX 128
MURRIETA, CA 92562 SUN CITY, CA 92586
Applicant Phone:9516794502
GARY MONK License Number.912194
MONKS AIR CONDITIONING
P0 BOX 128
SUN CITY, CA 92586
Fee Description Qty Amount I51
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_Perrru Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ 1 am exempt from licensure under the Contracitors'State License Law for th
I hereby affirm under penalty or pedi Try that I am licens 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 eff which I must have resided for at least one year prior to completion c
License Class tz allo. 2� Improvements covered by this permit, I cannot legally sell a structure that I hair
Licens
Expires 3- - R Signal built as an owner-building if 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:
❑ I hereby affirm under penalty of perjury one t the self-insure
ngdeclarations:forworkers'
r htto;//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 3ns as provided for by Date
Section 3700 of the Labor Code,for the performance f work for which this
permit is Issued. Pro perry Owner orAuthoriied Agent
Policy# ❑ By my Signature below, I certify to each of the following: I am the propeM
1 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 he work for which this application and the information I have provided is correct. I agree to compll
permit is issued.My workers'compensation Insurance carrier and policy number are: with all applicable city and;county ordinances and state laws relating to buildini
C� construction.I authorize representatives of this city or county to enter the above
Carrier , identified property for the inspection purposes.
Policy# L- Z Expires 1'— — Date
Property Owner or Authorized Agent / may/
C W�
7 U
(This section need not be completed if the permit is for CI Business License#_ /. -!one-hundred dollars($100)or less) City
I certify that in the performance of the work for which HAZARDOUS MATE
Is permit is Issued,I ;i21AL DECLARATION
shall not emolov any persons in any manner so as to ecome subject to the YVIII the applicant or futurebuilding occupant handle hazardous material or a
workers'compensation laws of Caldcmia, and agree th t if I should become mixture containing a hazarldous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor amounts vecified on the Hazardous Materials Information Guide?
Code,I shall wi mply with tho a provisions. DYES X NO
Appli n' Datt; WIII 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 SECUt E WORKERS' Coast Air Quality Management District(SCAOMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWF�PL, AND SHALL for guidelines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND ❑YES �NO
CIVIL FINES UP TO ONE HUNDRED THOUOAND 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 school?
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES
X0
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� e,Section 25505 and 25534 concerning
3097 Civil Code) hazardous mate
R I re orti .
OWNER BUILDE DECLARATIONS ❑YES NO
1 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 O41N!kpg A(1THORIZED 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 requiresjthe 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 (Chapter19(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 faciliVto be RRP-certified firms and comply with
she is exempt from licensure and the basis for the site ed 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-listurbing work themselves or through their
a civil penalty of not more than(S500).) employees.For more information about EPA's Renovation Program visit:
❑ 1, as owner of the property, or my employees with wages as their sole wwvv.epa.govAead or contact the National Lead Information Center at
1-800-424-LEAD(5323).
compensation,will do( )all of or( j porting of the work,land the structure is
not intended or offered for sale.(Section 7044,Business amp Professions Code;
The Contractor's State License Law does not apply to an Towner of a property O An EPA Lead-Safe Certifged Renovator will be responsible for this protect
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- ;
purpose of sale).
Builder will have the burden of proving that it was not built eir improved for the 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 oontrector(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 �j -� PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL X.MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES.
DESCRIPTION OF WORK K_ D 2, 5 5 i� 1 -D JEDZ N/G
-7 o K, Q`I U n/-\
PROJECTADDRESS _2_ I Th.brn InLLI F "
ASSESSOR'S PARCEL NUMBER 33 b ,?, t 00'1 LOT Z TRACT
1
OWNERNAME Ed ( 1_ { n n nn
ADDRESS �Z7ID2E? P� 5C / I�/ Lbn-f-a IVIo g25b
PHONE [� t(J�/T�D' EMAIL
APPLICANT NAME -u r
ADDRESS UM I " ' 1 "� CA C) "Q
`�
PHONESVLy� p EMAlLYY1pt1KSGl lY CYIGI La G�YYI
CONTRACTOR'S NAME �� 1 V I //�`�, OWNER BUILDER? OYES NO
BUSINESS NAME J II- l-..1�n& OYl {
ADDRESS 5 >0 G^r�V ( GA C125
PHONE ( `////��M 6; Iq 4 • n9- /], /EMAIL mn Okc S -Ir Z Prr_LCL -L - C-0
CONTRACTOR'S STATE LIC NUMBER gl2IL31 LICENSE CLASSIFICATION C2,0
O
VALUATION$ /J, SOFT LSQFT
APPUCANT'SSIGNATURE DATE
CITY STAFF USE•
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I f�'�, SMIP
INVOICE
AMOUNT -T!� PAID AMOUNT OCASH 0 CHECK# 0CREDIT CARD vISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDITCARD 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.cityofinenifee.us Inspection Request Line 951-246-6213
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