PMT16-02745 C4 of Menifee Permit No.: PMT1 6-02745
29714 HAUN RD. Type: Residential Mechanical
<A-cCF-CA-> MENIFEE, CA92586
�A�— MENIFEE Date Issued: 08/2212016
P E R M I T
Site Address: 25730 TYLER CT, MENIFEE, CA 92586 Parcel Number: 335-403-010
Construction Cost: $13,019.00
Existing Use: Proposed Use:
Description of REPLACE 3 TON COMPLETE SPLIT SYSTEM
Work:
Owner Contractor
JENNIFER NUGENT A R S AMERICAN RESIDENTIAL SERVICES OF
25730 TYLER CT CALIFORNIA INC
MENIFEE, CA 92586 965 RIDGE LAKE BLVD SUITE 201
Applicant Phone:9512769744
CHRISTINA CALHOUN License Number:765074
A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNU
965 RIDGE LAKE BLVD SUITE 201
MEMPHIS. CA 38120
Fee Description Amount($1
Forced-Air or Gravity-Type Furnace or Bumer 149.00
Air Handling/Condensing Units SFR 133.00
Building Permit Issuance 27.00
GREEN FEE 1.00
General Plan Maintenance Fee-Mechanical 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.131dg_Perrnit Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and a I am exempt from licensure underthe Contractor's State License Lawfor
Professions Code and my license Is in full force and effect. the following reason:
License Class C-10 C-20 C-3 Lipinise 0 By my signature below I acknowledge that,except for my personal residence
Expires �QjAob 1 Signature( I.which I must have resided for at least one year prior to completion of
J I ::, improvements covered bythispermit.I cannot legally sell a structurethatl
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if It has not been constructed in its entirety by
ci I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this application Is submitted or at the following website:
by Section 3700 of the La bar Code,for the performance of work for wh ich
this permit is issued. www.Ieginfo.ca.RQyAaIaw.htmI.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
in I have and will maintain worker's compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which ci By my signature below I certify to each of the following:I am the property
this permit Is Issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Carrier L,
Policy# IIA Jq 6A(P�b J 01qExpires 1124-Ml ri enter the above Identified property for inspection purposes.
(This section need not to be completed is the permit is Ifor one 1,hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
ci I certify that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the work r' ompe It. f f h
e sc on P 41ons a ection 3700 a t e La or
ovi��n Will the applicant or future building occupant handle hazardous material ora
mixture containing a hazardous material equal to or greater that the
Code,I shall with a, Ilan I amounts specified on the Hazardous Materials Information Guide?
Applicant�%4/ Aff S 17�� Date P-1
WARNIIVG'fA^1L�URETOSFr11RI�M 1115RKER'S COMPENSATION COVERAGE IS o Yes 0440
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AN D CIVI L FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant req uIre a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY o Yes Dho
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) o Yes b0o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exem pt from the California Health&SafetyCode,S * 25505 2SS34 concerning
Contractor's License Law for the reason(s)indicated below by the hazapdpus terial re .19. ��n
checkmark(s)I have placed 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 or repair any structure,prior to its
issuance,also requires the applicant for the permit to file a signed statement e"W-OWNER OR AWORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not mom required practices.This includes rental property owners and property
then($500). managers who do the paint-disturbing work themselves or through their
o 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gay/lead or contact the National Lead Information Center at
not intended or offered for sole.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or persona I effort,builds or Improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of so le. o No EPA Lead-Safe Certified Firm Is required for this project became:
0 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
DOC # 2014-0365771
PH10HI TY TITLE 09125/2014 03:27 PM Fees. $21.00
Page 1 of 3 Doc T Tax Paid
Recorded in official Records
j1j%CoRnING REQUZE1 Us 11V7 County of Riverside
Chardonnay Ficrow. Inc Larry W.Ward
order No.62823 Assessor,County Clerk&Recorder
Esclow No. 19420-I-L
AND WHYN itEyiumn mA.Iil.TO; —This document was electronically submitted
-rd"r. � ft�V-�% * 1,the County of.Riverside for recording"
JARED C. NUGENT Recelpted by SMEZA
25730 TYLER COURT
MENIFEE.CA 92586
Ell's
(T'C'Trl" 111
SPACE A30VT IS Cl�
11,reel No 335-403,01 fl-I TRA 9:026-042
GRANT DEED W
1 t1l;UND—�Rt�JUNEJ)GRAN rolk(S)DECLARE�S)MAT DO"Mr-NTARy-1 R,-,NSrER TAX IS$iqW and CITY S
X ,,jnpu;ed on full value orproperry conveyed,or . mg at the lime orsuic.
F1 compt!tcdotiftilivalacicssliclsore,icuinbrancesmmain
[] unincorpnratedarc3: X I,the city of Mcnifec,and
FOR A VAIM ABLE CONSIDERATION,receipt of which is hereby acknowledged,
Carmen Dclatorre.an unmarried woman
hcrcbyGRANI(.S)to Jared C.Nugent and JetiniferNI,Nurcnt,husband wid wife 25 30intTcomnts
the following described real properly in lite Coun;y of Riverside,State of California
Lot 73 or Tract No. Imt)41-1 in the City of Mcnifle, County of Riverside State of C11fifDrnia,as per map
recorded In Book 143 Prige(s) 66, 67 And 08 of Map$, In the Ofrlct of th� County Recorder of Rivenide
ColintV. (,—t-c -j— ;411,7 of MenHeo
3uilding & Sai0ty DWI.
AUG 2 2 2016
Received
�z
Kol TIM si.torient to.SAME AS ABOVIF or Address Noted 13cl"
BUILDING & SAFETY PERMiT/PLAN CHECK APPLICATION
Menifee
DATE AM Lf PERMIT/PLAN CHECK NUMBERFM-f Kv, 0 M5
TYPE: 1-: COMMERCIAL '04ESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: 0 ADDITION 0 ALTERATION 0 DEMOLITION 0 ELECTRICAL '�KJVIECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES—
DESCRIPTION OF WORK '&_r0r%
PROJEcTADDRESS ZS'_75b
ASSESSOR'S PARCEL NUMBER �Y�_ q()"l LOT TRACT
OWNER NA�ME nn, ?e/v-
ADDRESS CA,%
PHONE (9 ;'k� -49(a'- A4Y(n-.?— EMAIL
APPLICANT NAME
ADDRESS t)CV^,-Q� C&.-S
PHONE 800 (.too EMAIL
CONTRAcrows NAME OWNER BUILDER? 0 YESz�W
BUSINESS NAME = C/
ADDRESS 3-C)-to "4w-s
PHONE 800 (A(arj 0 Lo-1 is— EMAIL
CONTRACTOR'S STATE LIC NUMBER -7&5-0 -7 (f LICENSE CLASSIFICATION 74 C jr4p
VALUATION$ SQ07 L SO FT
DATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION 7�_�MIEIINIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE 1 10 PAIDAMOUNT
AMOUNT I I 1 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
PLAN CHECK FEES I PAIDAMOUNT I 1 0 CASH Q CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 No DLNUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
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