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PMT17-01708 City of Menifee Permit No.: PMT17-01708 29714 HAUN RD. Type: Residential Mechanical <A-CCEL/-> MENIFEE,CA 92586 MENIFEE Date Issued: 05/31/2017 PERMIT Site Address: 27192 CORONADO WAY, MENIFEE, CA Parcel Number: 336-210-005 92586 Construction Cost: $4,700.00 Existing Use: Proposed Use: Description of HVAC CHANGE OUT,CARRIER 2.5 TON, 14.0 SEER, 122 EER, R410A,SINGLE STAGE, SPLIT A/C Work: SYSTEM Owner Contractor JUNE RUBIN MONKS AIR CONDITIONING 27192 CORONADO WAY P 0 BOX 128 MENIFEE, CA 92586 SUN CITY, CA 92586 Applicant phone:9516794502 GARY MONK License Number:912194 MONKS AIR CONDITIONING P O BOX 128 SUN CITY, CA 92586 Fee Description Qty, Amount($1 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 carded 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_Templaterpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ lam exempt from licensure under the Contractom'State License Law forth I hereby affirm under penalty or perjury that I am Ilceris under provisions of following reason: Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence i• Professions Code license is in full force and eft which I must have resided for at least one year prior to completion c License Class. Ucens No. 2 improvements covered by this permit, I cannot legally sell a structure that 1 haw Expires3-3)-1 R Signalu built as an owner-building if it has not been constructed in Its entirety by license contractors. I understand that a copy of the applicable law, Section 7044 of thi WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is submitted or at the following Web site: ❑ I hereby affirm under penalty of perjury one the(allowing declarations: htto://www.leciinfo.ca.aovlcalawhtml. I have and will maintain a certificate of consentt of self-insure for workers' compensation,issued by the Director of Industrial Relati ns as provided for by Date Section 3700 of the Labor Code, for the performance f work for which this permit is issued. Property Owner orAuthoriied Agent s Policy# ❑ By my Signature below, I certify to each of the following: I am the propeM I have and will maintain workers' compensation Ins irance, as required by owner or authorized to act on the property owner's behalf. I have read thi: section 3700 of the Labor Code, for the performance of a work for which this application and the information I have provided is correct. I agree to compq permit is issued.My workers'compensation insurance cardei and policy number are: with all applicable city andcounty ordinances and state laws relating to bulldlnf C� construction.I authorize representatives of this city or county to enter the above Cartier �[ identified property for the 19'spection purposes. Policy 2. Expires I I Date Property Owner orAuthodzedd Agent /� may/ `2 56 —/ L� (This section need not be completed if the permit is for CI Business License# l one-hundred dollars($100)or less) City � Asall I certify that in the performance of the work for which is permit is issued,I HAZARDOUS MATE;RIAL DECLARATION not employ any persons in any manner so as tq ecome subject to the Will the applicant or future!building occupant handle hazardous material or a workers'compensation Taws of California, and agree th t if I should become mixture containing a hazardous material equal to or greater that the subject to the workers'compensation provisions of Sect on 3700 of the Labor amounts Fecified on the Hazardous Materials Information Guide? Code,I shall wit#mply with tho..e provisions. ❑YES NO Date;Appb n Will the Intended use of the building by the applicant or future building occupant require a permit for the construction or modification from South WARNING: FAILURE TO SECUI RE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines SUBJECT AN EMPLOYER Try CRIMINAL PENALTIES AND ❑YES <NO CIVIL FINES UP TO ONE HUNDRED THOUISANO DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE bounce ofaschool? LABOR CODE,INTEREST,AND ATTORNEYS FEES ❑YES ZNa. CONSTRUCTION LENDING AGENCY I have read the HazardousiMatedal Information Guide and the SCAQMD I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I understand my requirements under the State of agency for the performance of the work which this permit is issued (Section California Health Safety P e,Section 25505 and 25534 concerning 3097 Civil Code) I hazardous mate Ire orti• . OWNER BUILDER DECLARATIONS ❑YES NO I hereby affirm under penalty,of perjury that I am exempt from the Contractor's Data. License Law for the reason(s)indicated below by the checkmark(s)I have placed PROk-RT<0dNk94 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, a0el, improve, demolish, EPA RENOVATION REPAIR AND PAINTING(RRP, or repair any structure, prior to its issuance, also requiresthe 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 ost work that disturbs paint in a pre-1978 Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare faciliy to be RRP-certified firths 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 7031.5 by any Applicant for a permit spbleots 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: ❑ I, as owner of the property, or my employees with wages as their sole w rw.epa.govAead or contact the National Lead Information Center at compensation, will do( )all of or( )porting of the work„and the structure is 1-Bm0-424-LEAD(5323). not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property who, through employees' or personal effort,; builds or improves the property, An EPA Lead-Safe Certified Renovator will be responsible for this project provided that the improvements are not intended or offered for sale.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 of improved for the Finn Certification o.: purpose of sale). N ❑ I, as owner of the property an exclusively contracting with licensed 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 to an owner of a property who builds or Improves thereon, and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). If your project Goes not comply with EPA RRP rule please fill out the RRP B!jILDING & S���FC-:-IVPERI��-ITI/PL-ANC.HE--KAPPLI.CATION . Menifee DATE `JL�� I� PERMIT/PLANCHECKNUMBER TYPE: O COMMERCIAL )(RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLRION -O ELECTRICAL MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK ou4 (L h-L( L "5 4 L U, I -b S- LEL 12,2 e0, ELI1Cct S LICce S Lf /� PROJECTADDRESS 2 1 ASSESSOR'S PARCEL NUMBER 3'36 ZVO L�c�s'! LOT- TRACT `�3 3 OWNER NAME ( /'� , �-bi�1 A /� ADDRESS rr / 1( f c)(L 1 �a I� .y)l "(7 (zi PHONE (cl, L 1 2 EMAIL APPLICANT NAME I� r Ly l L Y, ADDRESS//��JIJ\J/�JCA Lq�Z5N -7O/� M UMI I� PHONE t ` 5l J (P ("q-L 502 EMAILrrU>tIKSA I r 0 @ rra:d • cbrn U CONTRACTOR'S NAME Q-r Y M OCv1 L O_WNER BUILDER? O YES NO BUSINESS NAME 1 I CDY�cfi or) n ADDRESS!/� /�//� rr PHONE ( IRM 6, !'mil- 4509- /]_� /EMAIL mcnl�sGtr � rna-+-�- �►n CONTRACTOR'S STATE LIC NUMBER c I Z I-/"Y LICENSE CLASSIFICATION zt��� VALUATION$ SQ FT r� L SQ FT rDEPEN A(UIU ��LMON 00 CRY OF MENIFEE BUSINESS UCENSE NUMBER ENGINEERING HRE GREEN • SMIP PAID AMOUNT O CASH O CHECK 6 O CREDR CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDIT CARD VIWMC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department29714 Houn Rd. Menifee, CA 92586 951-6 72-677 7 www.cityc finenifee.us Inspection Request Line 951-246-6213 % / > - \ 0 0 q q M : { \ \ 25 : _ e $ \ 2 _ ; _ § ; £ E ± /\ \ IF q - Ca cr k ® m § I ( 0M |, E-a0M\I \,- o { Pw} m \ K t \ \ J } } \ / \ � \ m 7 k POTr oncQ . r m m w m an d � n Ae FAV y _ V1 a D m a N 0 W 3 CO C� 3 10w SSa. 2a9 '^ � a O O m Q 0 N W N O to A O N 10 d n n+ i I N of Dxm x3 a ? 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