PMT16-03665 City of Menifee Permit No.: PMT16-03665
29714 HAUN RD. Type: Residential Mechanical
<A—CCF-LA—> MENIFEE, CA 92586
MENIFEE Date Issued, 11/1012016
P E R M I T
Site Address: 27938 RED DAWN DR, MENIFEE, CA Parcel Number: 333-263-021
92585 Construction Cost: $3,500.00
Existing Use; Proposed Use:
Description of HVAC REPLACEMENT, REPLACE FAU, COIL AND CONDENSER, 60,000 BTU,3-TON
Work:
Owrter Contractor
LUIS CERDA TRUTEAM OF CALIFORNIA INC
27938 RED DAWN DRIVE 260 JIMMY ANN DRIVE
MENIFEE, CA 92585 DAYTONA BEACH, FL 32114
Applicant Phone:3863042222
JESSE ARREDONDO License Number.221517
TRUTEAM OF CALIFORNIA INC
475 RIVERA ST, UNIT D
RIVERSIDE,CA 92501
Phone:9516834429
Fee Description Qtv Amount($
Forced-Air or Gravity-Type Furnace or Bumer 1 149.00
Air Handling/Condensing Units SFIR 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 bulliding 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 BidgPemit-Template.rPt Page 1 of I
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of c;I a m exempt from licensu re under the Contractor's State License Law for
Chapter9(commencing with section 7000)of Division 3 of the Business and
Professions Code and my license is in full force and effect. the following reason:
License Class—Ko License No. By my signa.ture below I acknowledge that,except for my personal residence
Explresq/31;�1-7 Signature_ in which I must have resided for at least one year prior to completion of
V 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-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 Labor Code,for the performance of work for which wvvvv.Ieginfo.ca.govLMIaw.htmI.
this permit is Issued. Date
Policy# PROPERTY OW N ER OR AUTHORIZED AGENT
o I have and will maintain worker's compensation Insurance,as required by o By my signature below I certify to each of the following:I am the property
section 3700 of the Labor Code,forthe performance of the work forwhich owner's behalf.I have read this
this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property
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
Carrier building construction.I authorize representatives of this city or county to
Policy#WVAD419110 Igo Expires—w3$eon enter the above identified property for Inspection purposes.
(This section need not to be completed Is the permit is for one-hundred Date—
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
o 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 worker's compensation provisions of Section 3700 of the Labor
Will the applicant or future building occupant handle hazardous material or a
Code,I shall forthwith comply with those provisions. mixtu re containing a haza rdous material eq ua I to or greater that the
Applicant_ ��O&, _Date A i" amounts specified on the Hazardous Materials Information Guide?
1ALARNING:FAILURE TIP SECURE WORKER'S COMPENSATION COVERAGE IS ci Yes a 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 ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permitfor the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAOMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY o Yes o No
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) ci Yes ci No
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 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.
checkmark(s)I have placed next to the a ppilcable item(s)(Section 703 1.5 ciYes a No
Business and Professions Code).Any city or countythat requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to Its PROPERTY OWNER OR AUTHORIZED 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 REN ON,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
a nd the basis for the alleged exemption.Any violation of Section 703 1.5 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 Ity of not more required practices.This includes rental property owners and property
than[$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 I I all of or I )portion of the work,and the structure is wvvw.epa. /lead or contact the National Lead Information Center at
not Intended or offered for sale.(Section 7044,Business and Professions 2-800-424-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 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 ci No EPA Lead-Saft Certified Firm is required for this project because:
not built or improved for the purpose of sale.
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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Men if e e
DATE 11/10/2016 PERMIT/PLAN CHECK NUMBER
TYPE: [:1 COMMERCIAL [E RESIDENTIAL []MULTI-FAMILY F]MOBILE HOME E]POOVSPA F]SIGN
SUBTYPE: F]ADDITION []ALTERATION E]DEMOUTION []ELECTRICAL [EMECHANICAL
E]NEWEIPLUMBING F1 RE-ROOF-NUMBER OF SQUARES
I DESCRIPTION OF WORK Replace FAU,coil and condenser.(6OKBTU/3TON)
PROJECTADDRESS 27938RedDawnDr 6195?>15
ASSESSOR'S PARCEL NUMBER 333-263-021 LOT 21 TRACT TR 17730
PROPERTY OWNER'S NAME LuisCerda city 01 ent "
Builallly P.G&Iie" oept.
ADDRESS 27938 Red Dawn Dr, Rornoland,CA 92585
PHONE (951)238-4757 EMAIL
APPLICANITINAME JesseArredondo
ADDRESS 475 Rivera St, Unit:D, Riverside,CA 92501
PHONE (951)505-5017 EMAIL jesse.arredondo@truteam.com
CONTRACTOR'S NAME TrutearnofCAInc OWNERBUILDER? [-]YES�&NO
BUSINESS NAME
ADDRESS 475 Rivera St, UnitD, Riverside,CA 92501
PHONE (951)683-4429 EMAIL
CONTRACTOR'S STATE LIC NUMBER 221517 LICENSE CLASSIFICATION C20
VALUATION$ $3,500.00 SOFT 1139 LSQFT
APPLICANIrs SIGNATURE NV—�44�;tt-�J—Z5—�l DATE 11/10/2016
CITY STAFF USE ONLY
DEPARTMENT DISrRIBUT]ON SMIP [)-C-7 CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I I—
INVOICE -- PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
LANTMOU
P LAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDERVERIFIED OYES 0 NO DLNUMBER NOTARIZEDLE17ER 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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