PMT17-00110 City of Menifee Permit No.. PMT17-00110
29714 HAUN RD. Type: Residential Mechanical
"7%CCEL/_> MENIFEE, CA 92586
MENIFEE Date Issued: 01/18/2017
PERMIT
Site Address: 26805 HULL ST, MENIFEE, CA 92585 Parcel Number: 331-443-016
Construction Cost: $7,767.00
Existing Use: Proposed Use:
Description of REPLACE 4 TON A/C IN BACK YARD&70,000 BTU FURNACE
Work:
Owner Contractor
JANICE MCCLUNG LUCKY AIR INC
26805 HULL ST 4049 BURGESS WAY
MENIFEE,CA 92585 RIVERSIDE,CA 92501
Applicant Phone:9516828573
STEVEN SCHNIERER License Number:836498
LUCKY AIR INC
4049 BURGESS WAY
RIVERSIDE, CA 92501
Fee Description 21 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 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 staled,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_Bidg_Permit_Template.rpl 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 ❑I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class GZO License No. $'$3 b By my signature below I acknowledge that,except for my personal residence
Expires � 7�1t 1 12- Signature . Ju�i.7�C�— in which l 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
.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 workers 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 370D of the Labor Code,for the performance of work for which wwvv.le-info.ca.eov/calaw.html.
this permit is issued.
Policy N
Date
PROPERTY OWNER OR AUTHORIZED AGENT
have and will maintain workers compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which �my signature below I certify to each of the fallowing:)am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners 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
Policy JJ Lis W C.7%-%-7'7z Expires �I s I\� enter the above Identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred CAL �1Z Date I 18 r-7
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
O I certify that in the performance of the work for which this permit is issued,
1 shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If C313S L+($
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall f��orth,�with comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
�3,MwTZi Date l \s 1-1 mixture containing a hazardous material equal to or greater that the
Applirant
~ amounts�sp�.fled on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS .Yes o704-
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 permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)7 See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forgutde�fi es
CONSTRUCTION LENDING AGENCY O Yes. ^
I herebyaffirm that underthe penaltyof perjurythere 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 v to
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
Contractors License Law for the reason(s)indicated below by the azardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 s ,
Business and Professions Code).Any city or county that requires a permit to Date I.
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 Contractors 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-7978
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 more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
o I,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.eoa.Ttoy/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 Contractors State License Law does not apply to an owner of a D 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. in No EPA Lead-Safe Certified Firm is required for this project because:
o 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors 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.
CUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
�Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL. RESIDENTIAL ❑MULTI-FAMILY [:]MOBILE HOME ❑POOL/SPA []SIGN
SUBTYPE: ❑ADDITION []ALTERATION ❑DEMOLITION ❑ELECTRICAL`MECHANICAL
[-]NEW [-]PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK J�e \o.cz +\-Oh A, c,
PROJECTADDRESS 2b€C S 64,11 St
ASSESSOR'S PARCEL NUMBER '5'51' LOT _ TRACT �,�/
PROPERTY OWNER'S NAME J o �=,rca I M c-C luyN •;
ADDRESS ZIc80S I,4Qi� s}. CA g2S85
PHONE 9S1-732- 97914 EMAIL
APPLICANTNAME ! < \r�,eccC
ADDRESS 31225 La. l�ct F -0c CA cvluz-
PHONE 2,18-735- 7a7L EMAIL
CONTRACTOR'S NAME OWNER BUILDER? ❑YE$ O
BUSINESS NAME
ADDRESS g099 3vr („)�, �:vccside CA 92s01
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER 'Z 3(o9`T Z LICENSE CLASSIFICATION GZv
VALUATION$ '17e7.ov SO FT L SO FT
APPLICANT'S SIGNATURE DATE ')' sk_
•
DEPARTMENT DISTRIBUTION CITYUMENIIFEE BU5�SSy4ENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP 33 55 vvOo
INVOICE PAID AMOUNT
AMOUNT I I I OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECKN OCREDITuwD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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