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PMT16-03203 City of Menifee Permit No.: PMT16-03203 29714 HAUN RD. Type: Residential Mechanical <A- CCELA> MENIFEE, CA 92586 MENIFEE Date Issued: 09/2812016 P E R M I T Site Address: 28398 INVERNESS CT, MENIFEE, CA Parcel Number: 340-110-020 92584 Construction Cost: $13,030.69 Existing Use: Proposed Use: Description of REPLACE 80,000 BTU FURNACE,4 TON(16 SEER)A/C UNIT, COIL&DUCT WORK,(10 SUPPLIES. Work: 3 RETURNS) Owner Contractor CLAUDE LEVVIS PEACH HOME SERVICES INC 28398 INVERNESS CT 532 MALLOY COURT MENIFEE, CA 92584 CORONA,CA 92880 Applicant Phone:7144628174 JANE RECKTENWALD License Number;989511 PEACH HOME SERVICES INC 532 MALLOY COURT CORONA,CA 92880 Fee Description Qtv Amount 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 1.00 General Plan Maintenance Fee-Mechanical 14.10 $324.10 The issuance of this permit shall not prevent the building offidal from thereafter requiring the correction of errors in the plans and specifications or Rom 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. Page I of 1 iii—Permit Template.rpt 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 ccintractor(s)pursuant to the Contractors State License Law). Chaptergi(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure u rider the Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: License Clam CoLD License No. By my signature below I acknowledge that,except for my personal residence Expires Signature in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION U improvements covered by this permit.I cannot legally sell a structure that I 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 713"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.Ieginfio.ca.gov/caIaw.htmL PoRcy# Date a I have and will maintain workees compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which o 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 an the property owner's behalf.I have read this number are; application and the information I have provided Is correct.I agree to comply Carrier Awaw'�- UA with ail applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy#I I dt%qwl�q Expires enter the above identified erty for inspection purposes. (This section need not to be completed is the permit is for one-hundred Dater,-'-a4 1P dollars($100)or less PROPERTY OWNER OR A)Q�IZED AGENT a I certify that in the performance of the work for which this permit is issued, I shall not em ploy any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 4-2,6 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 370D of the Labor Code,I shall forthWith comply 5itIrSpFe provisions. Will the applicant or future building occupant handle hazardous material or a mixture containing a hazardous material equal to or greater that the Appliosnt<:�� Dateci-pz-1(0 amounts specified on the Hazardous Materials Information Guide? RETOSE6E ORKERS COMPENSATION COVERAGE IS 0 Yes 0 WARNING:FAILU ;7 "!F-m UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA LTIES Will the intended use of the building by the applicant or future building AND CIVIL FINES UP TO ON E H U NDRED THOUSAND DOLLARS($101),01)(3),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South IN SECTION 3706 OF THE LA13OR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist for guidelines CONSTRUCrION LENDING AGENCY ci Yes %60 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) 0 Yes %00 OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code, ion 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ciYes Wo Business and Professions Code).Any city or county that requires a permit to !!5 Date construct,a Iter,improve,demolish or repair any structure,prior to its PROPERTY OWN ER OR AUTHbWAD AGENT issuance,also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI 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 7D31.5 by residence or childcare facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil Pena ItV of not more required practices.This includes renta I property owners a nd property than($500). managers who do the paint-disturb!ng 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( )portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-900-424-LEAD(5323). Code,The Contractor's State License Law does not apply to an owner of a ci 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 burden of proving that it was not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because: ci 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contnctor's State Uicense 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 13LU I L:DI7NC, & SAFETY PERMIT/PLAN CHECK APPLICATION 7 Menifee DATE 9-28-16 PERMIT/PL.AN CHECK NUMBER TYPE: OCOMMERCIAL IVRESIDENTIAL OMULTI-FAMILY 0MOBILEHOME r) POOL/SPA OSIGN SUBTYPE: OADDITION OALTERATION CIDEMOUTION C) ELEcTRICAL VMECHANICAL 0 CIMPW leDilIkAft.. Npw f"111RAft"'IS C)RE-ROOF-NUMBEROFSQUARE5 DESCRIPTION OF WORK -Replace 80,000 btu furnace, 4 ton (16 seer) A/C unit, & duct work (10 supplies, 3 returns) PROJECTADDREss 28398 Inverness Ct Menifee, CA 92584 ASSESSOR'S PARCEL NUMBER 340-110-020 LOT TRACT OWNER NAME Claude Lewis ADDRESS 28398 Inverness Ct Menifee, CA 92584 PHONE . 310-951-0422 EMAIL APPLICANTNAM -Jane Recktenwald ADDRESS PHONE 114-336-6159 EMAIL -janereckgDaft.net CONTRACroWs NAME -Ibe Prompt Plumber 2W-NERBUILDEQ? 0YESVNO BUSINESS NAME ADDRESS -&32 Malloy Qrt Corona, CA 92880 PHONE 714-462-8174 EMAIL CONTRACTOR'S STATE LIC NUMBER 98951 LICENSE CLASSIFICATION C36 VALUATION$ - 13 Q30.69 — SQF LSQFT APPLICANT'S�IGNMP; -27-16 DATE. CITYSTAFF USE ONLY OF IyE$AFjE7USINES$LICENSE NUMBER BUILDI14G PLANNING ENGINEERING FIRE GREEN SMIP INVO C' AMOUNT PAIDAMOUNT CASH 0 CHECK# 0 CREDIT CARD VISIVNIC PLAN CHECK FEES PAIDAMOUNT CASH G CHECK 0 OC DITCARD ViSA/MC EDIT RE OWNER BUILDER VERIFIED 0 YES C, NO OIL NUMBER NOTARIZED LETTER � YES NO S No City Of Mfflll�e BiJildh-,g Safely Depoi tnjeoi .1971 f Rd. C.L 92.5 9S.i-;1;12-6?7-1 11)5p.calon Line 95, 246 6233 Et ct 0 0 0 ct 0 m 0 < 0 42 > 0 m m < , = 0 0 Aw Z a CD 0- 0 o m 'A z m cy m 0 C::) CD mx- �urz, (D m ur rx;, !E m "11-sS -wo ml fp�'. rl ,7) z m a c m cr m rt Fat 54 ot no 27 =w 3 Tt m w r) _6 ED Er z SL R, § 5 I . co Ml w Fla -.1, a,7=511 ,z er 9 61 All 71 m a L4 wy— vr ;6- n G 18 2 0 S o ur 99 0 w ivi f� 9 i�o+:i, 5L iE n n 0 m > , n � > )> C) W 0 a q R R . - - a ' 0 q 06. R E K <. OWL Z, Ei RL zz 71 m1, 11 . l-.. 0 �V-,.I n 0 749 6 �g 1p Er 1 0 17 6 R L6