PMT16-02595 City of Menifee Permit No.: PMT16-02595
29714 HAUN RD.
'CXCCELX'? MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 0 811 012 01 6
PERMIT
Site Address: 27585 BOSTON DR, MENIFEE, CA 92586 Parcel Number: 335-273-033
Construction Cost: $7,000.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT-PACKAGE HEAT PUMP 2.5 TON
Work:
Owner Contractor
CARLOS&JUDY ANTONY MONKS AIR CONDITIONING
27585 BOSTON DR P O BOX 128
MENIFEE,CA 92586 SUN CITY,CA 92586
Applicant Phone: 9516794502
GARY MONK License Number.912194
MONKS AIR CONDITIONING
P0 BOX 128
SUN CITY, CA 92586
Fee Description ON Amount 1$)
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 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_Bld9 Permit_Terrplate.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ [am exempt from licensure under the Contractors'State License Law forth,
I hereby affirm under penalty or perjury that I am titans hd under provisions of following reason:
Chapter 9(commencing with section 7000)of Division r 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 eft which I must have resided for at least one year prior to completion c
License Gass Licens No. 2I improvements covered by this permit,I cannot legally sell a structure that I have
Expirss3-51_ 1& Signatu built as an owner-bugel ng if it has not been constructed In its entirety by license[
contractors. 1 understand that a copy of the applicable law, Section 7044 of the
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application t:
submitted or at the following Web site:
D I hereby affirm under penalty of perjury one t the self-insure
declarations: httpNAv leginfo ce eovlcalaw htm1.
I have and will maintain a certificate of consent of s IFinsure for workers'
compensation,issued by the Director of Industrial Relati ns as provided for by Dale
Section 3700 of the Labor Code,for the performance af work for which this
permit is issued. Property Owner or Authorized Agent
Policy# I ❑ By my Signature below, I certify to each of the following: I am the propery
I have and will maintain workers' compensation ins6rance, as required by owner or authorized to act on the properly owner's behalf. I have read [hit
section 3700 of the Labor Code, for the performance of I he work for which this application and the information I have provided is correct. I agree to compil
permit is issued.My workers'compensation insurance caniei and policy number are: with all applicable city andi.counly ordinances and state laws relating to building
Cam- construction.I authorize representatives of this city or county to enter the above.
Caller �! ?� G Identified property for the Inspection purposes.
Policy#12-700— /2- Expires O'— 169 Date
Property Owner or Authorized Agent
(This section need not be completed if the permit Is for
one-hundred dollars($100)or less) City Business License#
I 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 hiecome subject to the Will the applicant or future+bullding occupant handle hazardous material or a
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 Face on the Hazardous Materials Information Guide?
Code,I shall f hwi mply with those provisions. ❑YES 0
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 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 KNO
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 SECT16N 3706 OF THE bounda ofa school?
rXZ
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES
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 wLrk which this permit is issued (Section California Health Safety Cy e,Section 25505 and 25534 concerning
3097 Civil Code) hazardous male I re orti §.
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 reason(s)indicated below by the checkmark(s)I have placed PROF�F�OVINEtR 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 fRRP1
or repair any slmclure, prior to its issuance,also requires ithe 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 properly 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:
O I, as owner of the property, or my employees with wages as their sole www.epa.govAead or contact the National Lead Information Center at
compensation,will do( )all of or( )porting of the work,and the structure is 1-800-024LEAD(5323).
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to anowner 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 properly,
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 Firm Certification No.:
purpose of sale). -
❑ 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 contact 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 contrectods)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 PERMIT/PLAN CHECK NUMBER Igo'
TYPE: O COMMERCIAL )(RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL JQMECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OFSQUARES.
DESCRIPTION OF WORK P(C I T�TL(�� (� U-S
PROJECTADDRESS _Z ��J� Srove Q Ir ` 1 CA yrLSS
ASSESSOR'S PARCEL NUMBER 3 TjS Z. --3 b 3 3 LOT ° v0 TRACT
OWNERNAME L -*-
ADDRESS 'K>YZ l CAM2-
PHONE
C�1J17�o I� S{C �I EMAIL
APPLICANT NAME
ADDRESS /3�C7�] MGU rr i
PHONE (7�t J `� (/I��502 EMAIL rnDnKSAIV'2t7 rria:d - Cbrn
CONTRACTOR'S NAME ULr� ! 1/I /`,, r OWNER BUILDER? OYES NO
BUSINESS NAME it C ondi on t G
ADDRESS
///� S// nn I ' G n Rd M-en e it C A �25
PHONE (ATM 6� 7'�f 4 09- �]' (EMAIL mOnlcsciir aD ►n��- • CZm
CONTRACTOR'S STATE LIC NUMBER "/IZ 1 `Y LICENSE CLASSIFICATION CZ-0
VALUATION$ -71`0 00 SQ FT a) q Y L SO FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS UCENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN - SMIP
INVOICE PAID AMOUNT
AMOUNT OCASH OCHECK# OCREDTT 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 Deportment 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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