PMT16-03189 City of Menifee Permit No.: PMT16-03189
29714 HAUN RD. Type: Residential Mechanical
<A=ELA—> MENIFEE, CA 92586
MENIFEE Date Issued: 09/2712016
P E R M I T
Site Address: 26204 BIRKDALE RD, MENIFEE, CA Parcel Number: 337-410-086
92586 Construction Cost: $1,90000
Existing Use: Proposed Use:
Description of REPLACE 60,000 BTU FAU ONLY IN GARAGE
Work:
Owner Contractor
JOHN VASQUEZ TRUTEAM OF CALIFORNIA INC
26204 BIRKDALE ROAD 260 JIMMY ANN DRIVE
MENIFEE,CA 92586 DAYTONA BEACH, FL 32114
Applicant Phone:3863042222
ED PONCE License Number: 221517
TRUTEAM OF CALIFORNIA INC
260 JIMMY ANN DRIVE
DAYTONA BEACH, CA 32114
Fee Description city Amount($)
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Mechanical 1 7.45
$184.45
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 canstruction 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 BidgPemil—Template.ript Page 1 of I
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 u I am exempt from licensure underthe ContractoesState ricense Law for
Professions Code and my license is in full force and effect. the following reason:
License Class C—Ze License�yo. i22 1 7 By my signature below I acknowledge that,except for my personal residence
Expires �15o)i,7 signature in which I must have resided for at least one year prior to completion of
Improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in Its entirety by
o 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-Insum 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 Labor Code,for the performance of work for which
this permit is issued. www.le_ginfo.ca.aov/calaw.html.
Policy# Date
*have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the La bor Code,for the performance of the work for which Y y signature below I certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance ca rrier and policy ewimmr 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
Carrier4i�� with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# f-P UT-79-4 6 1 kt) Expires r- 1301 -7-7 enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date 717-6//:Z
dollars($100)or less 40rERTY 6WNER OR AUTHORIZED AGENT
ct 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 becomesubject to the CITY BUSINESS LICENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthw- comp e provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applicant Datle6� amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes ci No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ON E H LIN DRED THOUSAND DOLLARS($100,000b IN occupant require 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 oYes oft
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) uYes nNo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCACBVID
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)Indicated below by the hazardous material reporting.
checkmarks)I have placed next to the applicable item(s)(Section 7031.5 oYes u No
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,Improve,demolish or repair any structure,prior to its PROPERTY OWN ER OR AUTHORIZED AGENT
Issuance,also requires the applicant for the permit to file a signed statement
that he or she is licensed pursua nt to the provisions of the Contra ctor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI
License Law(Chapter 9(commeneing 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
a nd 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
a n Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes renta I property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
a 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 I )all of or I )portion of the work,and the structure is www.epa.goy/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractoes State License Law does not apply to an owner of a u An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal 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 bu rden of proving that it was
not built or improved for the purpose of sale. a No EPA Lea cl-Safe Certified Firm is required for this project because:
a 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 EVA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
9�-Emil k�-!I'll,
DATE 09/27/2016 PERIVIIT/PLAN CHECK NUMBER pjl"�O -
TYPE: F—ICOMMERCIAL R]RESIDENTIAL [-]MULTI-FAMILY []MOBILEHOME F]POOL/SPA F]SIGN
SUBTYPE: F]ADDITION F]ALTERATION ODEMOUTION []ELECTRICAL RfMECHANICAL
F]NEW F]PLUMBING [:1 RE-ROOF-NUMBER OF SQUARES—
DESCRIPTION OF WORK Replace FAU only in same location.(60KBTU)(6ACAS--<) city 01 me Dept.
S
PROJEcTADDRESS 26204Birkda[eRd str
ASSESSOR'S PARCEL NUMBER 337-410-086 LOT 86 TRACT 026020 RE)CE) Ved
PROPERTY OWNER'S NAME JohnVasquez
ADDRESS 26204BirkdaIeRd,MenIfee,CA92586
PHONE (323)350-7408 EMAIL
APPLICANT NAME Edward Ponce
ADDRESS 475 Rivera St,Unit:D,Riverside, CA 92501
PHONE (951)722-6905 EMAIL edward.ponce@truteam.com
CONTRACTOR'S NAME Truteam of CA Inc OWNERBUILDERI [-]YES&O
BUSINESS NAME
ADDRESS 475 Rivera St,Unit:D,Riverside,CA92501
PHONE (951)683-4429 EMAIL
CONTRACTOR'S STATE LIC NUMBER 221517 LICENSE CLASSIFICATION C20
VALUATION$ $1,900-00 SO FT 1285 L SQ FT
I APPLI ANT'S SIGNATURE DATE 09/27/2016
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAIDAMOUNT
AMOUNT � 19LA - W5 I I 1 0 C4LSH 0 CHECK9 OCREDITCARD VISA/MC
PLAN CHECK FEES I PAIDAMOUNT I 1 0 CASH 0 CHECK# OCREDITCARD ASAIMC
OWNER BUILDER VERIFIED 0 YES 0 NO DLNUMBER NOTARIZED LEITER 0 YES 0 NO
City of Menifee Building&Safety Department29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
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