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PMT16-03337 City of Menifee Permit No.: PMT16-03337 29714 HAUN RD. <A-CCEL:A. MENIFEE,CA 92586 Type: Residential Mechanical MENIFEE Date Issued: 10/11/2016 P E R M I T Site Address: 26660 RIDGEMOOR RD, MENIFEE, CA Parcel Number: 337-203-002 92586 Construction Cost: $5,400.00 Existing Use: Proposed Use: Description of HVAC CHANGE OUT,3.0 TON, 14 SEER, SINGLE STAGE A/C,70,000 BTU FURNACE,3.0 COIL Work: Owner Contractor LOUIS RATLIFF MONK'S AIR CONDITIONING 26660 RIDGEMOOR ROAD P 0 BOX 128 MENIFEE,CA 92586 SUN CITY. CA 92586 Applicant Phone:9516794502 TIFFANI SELLERS License Number:912194 MONWS AIR CONDITIONING P 0 BOX 128 SUN CITY, CA 92586 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 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 builicling 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_Permit Terriplate.ript Page 1 of 1 City Of Menifee LICENSED DECLARATION 0 lam exempt from licensure under the Contractors'State License Law for I I hereby affirm under penalty or pedury that I am licensed under provisions of following reason: Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge thal� except for my personal residence Professions Code and pyL. . "in full force icense is a which I must have resided for at least one year prior to completion License Clai LI N improvements covered by this permit,I cannot legally sell a structure that I he built as an owner-building I it has not been constructed in its entirety by licens Expires.:�_ Signatua contractors. I understand that a copy of the applicable law, Section 7044 of I WORKER&COMPENSATION DECLARATION Business and Professions Code,is available upon request when this applicatior submitted or at the following We"Ite: 0 1 hereby affirm under penalty of pedury one of the following declarations: htutcr,,/Avww.leainfa.m.aov/c�law.htmi. I have and will maintain a certificate of consent of self-insure for workers' compensation,issued by the Director of Industrial Relations as provided for by Date Section 3700 of the Labor Code, for the performance of w6rk for which this permit is issued. Property Owner orAuthortzed Agent Policy# 13 By my Signature below, I certify to each of the following: I am the prope V_ I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read t section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct I agree to com permit is Issued.My workers'compensaton insurance camer and policy number am: with all applicable city and county ordinances and state laws relating to build la_ _� F_ construction,I authorize representatives of this city or county to enter the abo, Carrier I identified property for the inspection purposes. Poficy#/2--7nO- /2— Expires Property Owner or Authorized Agent—Date Cl-his section need not be completed if the permit is for City Business License# 0;�1154P_7?k one-hundred dollars($100)or less) 4 1 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 become subject to the Will the applicant or future-building occupant handle hazardous material or 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 arrlount�s Feciffed an the Hazardous Materials Information Guide? Code,I shall fcrhW&#mply with those provisions. Q YES A NO , //J _ Appli4nrD��� Data; Will the intended use of the building by the applicant or future building occupant require a permit for the construction or modification from South tNING_ FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checkil COMPENSATION COVERAGE is UNLAWFUL, AND SHALL for guidelines SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES )(NO 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 oul DAMAGES AS PROVIDED IFOW IN SECTION 3706 OF THE bounder of school? LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES KNO CONSTRUCTION LENDING AGEN I have read the Hazardous Material Information Guide and the SCAQMD I hereby affimn that under the penalty of perjury there is a construction lending permitting checidist.I understand my requirements under the State of agency for the performance of the work which this permit is issued (Section California Health fi Safety C9qe.Section 25505 and 25534 concerning 3097 Civil Code) hazardous mate'AA OWNER BUILDER DECLARATIONS DYES I hereby affirm under penalty of pequry that I am exempt from the Contractor's —plv —Date License Law for the rearon�s)indicated below by the checkmark(s)I have placed PRO�E�C\WNAE,04 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, alter, improve, demolish, EPA RENOVATION,REPAIR AND PAINTING(RRPJ or repair any structure, prior to its issualince, also requires the 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-1 978 Section 70001 of Division 3 of the-Businjass 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 property owners and property violation of Section 703.1.5 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: www.epa.gov/lead or contact the National Lead Information Center at 1, as owner of the property or my employees With wages as their sole 1-800-424-LEAD(5323). compensation,will do( )all of or( 1,porting of the work, and the structure is not intended or offered for sale.(SecCon 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property E)An EPA Lead-Safe Certified Renovator will be responsible for this projec who, through employees� or personal effort; builds or improves the property, provided that the improvements am not intended or offered for safe.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 purpose of sale). Firm Certification No.: 0 1, as owner of the property an exclusively contracting with licensed 0 No EPA Lead-Safe Certified Firm 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 tcr an owner of a property who builds or improves thereon, and who contracts for the projects with a BUILDING SAFETY PE.RMIT/PLAN CHECK APPLICATION �Menifee DATE PERMIT/PLAN CHECK NUMBERP rMs - (-)33?7-1 TYPE: OCOMMERCIAL )(RESIDENTIAL omuLn-FAMILY CIVIOBILEHOME OPOOL/SPA CSIGN SUBTYPE: OADDITION OALTERATION ODEMOLMON OELECTRICAL I(MECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK �;,.o Coo \Ij PROJECTADDRESS ASSESSOR'S PARCEL NJMBER 3 3 Za 3 co 2- LOT 7,9-11 TRACT 2��tv�nf�nifee OWNER NAME D) I lr� a+� ') F-( Building & Satety Dep ADDRESS Jj OCT 11 2016 PHONE EMAIL (9-a) F- - —11 FUVMXT �, AERLICANTRAME r rLy, ADDRESS kgdf Lq25R4— PHONE (1?5/ EMAiLrnorl K50.1 r eD ffw.�A - com CONTRACrOR'S NAME OWNERBUILDER? OYES iNO BU -�;b r) i,kAO ADDRESS MS30 rVil4n Rd CA q25 3 q PHONE 6-L czrr-� EMAIL rY -S e�l r CONTRACTOR'S STATE LIC NUMBER IqL1 LICENSE CLASSIFICATION C2-0 VALUATION$,5,1 LICID sQFT A 14--1 L SO FT I-MUCANT'S SIGNATURE —�E�—�- DATE crrysTAFFUSEONL� DEPARTMENT DISTRIBUTION MENIFEE BUSINESS UCENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GRE N SMIP X INVOICE -2 PAIDAMOUNT 0 CASH 0 CHECK 0 CREDrr CARD \nsA/mc AMOUNT I _,�LA. I PLAN CH ECK FEES PAIDAMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES 0 No OIL NUMBER — NOTARIZED LETTER 0 YES 0 NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityof,menifee.us Inspection Request Line 951-246-6213 w w m GI 0 z m Ui' FD m m ID CL n m w 0 0 cr m 0 0 a Ln 0 m m M" w C c FDh 6 t m CD m cr m CD > CE) aq m CP 0 0 1 m SL 6 w w H I I I I I 1--� 6 > rn > m 0 M m z =g rb 3 0 g k , �i - ET 0 m z 2, 9 9, m m . . 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