PMT17-02323 City of Menifee Permit No.: PMT17-02323
29714 HAUN RD. Type: Residential Mechanical
�ACCELA? MENIFEE, CA 92586
MENIFEE Date Issued:
07106/2017
PERMIT
Site Address: 29381 THORNHILL DR, MENIFEE, CA Parcel Number: 338-062-004
92586 Construction Cost: $6,805.19
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, CARRIER 2.5 TON, 14 SEER, 92%AFUE, R410A SINGLE STAGE, SPLIT 4/C
Work: 60K BTU FURNACE
Owner Contractor
NANCY MALONEY MONKS AIR CONDITIONING
29381 THORNHILL DR P 0 BOX 128
MENIFEE, CA 92586 SUN CITY, CA 92586
Applicant Phone:9516794502
GARY MONK License Number.912194
MONKS AIR CONDITIONING
P0 BOX 128
SUN CITY, CA 92586
Fee Description QtV Amount(SI
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
spedfiicalions 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 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.
M_61dg Permit_Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ 1 am exempt from licensure under the Contractors State License Law for ti
I hereby affirm under penalty or perjury 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 that,except for my personal residence
Professions Code license is in full force and eff t}} which I must have resided for at least one year prior to completion
License Class_ Li No. !Z� improvements covered by this permit,I cannot legally sell a structure that I he,
ExpiresJ"3 Signatu built as an owner-building if it has not been constructed in its entirety by Iicensl
contractors. I understand that a copy of the applicable law,Section 7044 of 0
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application
submitted or at the following Web site:
❑ 1 hereby affirm under penalty of perjury one of the following declarations: htio:Ilwww.leeinfo.ce.eovicelaw.html.
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 work for which this
permit Is issued. Property Owner or Authorized Agert
Policy# ❑ By my Signature below, I certify to each of the following: I am the proper
1 have and will maintain workers compensation insurance, as required by owner or authorized to act on the property owners behalf. I have read th
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 comp
permit is issued.My workers'compensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to buildir
construction.I authorize representatives of this city or county to enter the abov
Cartier (c.�7�.�1 � Identified property for the inspection purposes.
Policy#I L-2b0— I Z Expires 6.— — f< Date
Property Owner or Authorized Agent
(This section need not be completed if the permit is for ol� 7g
one-hundred dollars($100)or less) City Business License#_
I certifythat in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION
shall not emolov 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 amounts vecified on the Hazardous Materials Information Guide?
Code,I shall t wi mply with those provisions. I DYES A NO
Appli nt• Date; ` 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 SECURE WORKERS' Coast Air Quality Management Diairict(SCAQMD)?See permitting checkliE
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 outE
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundar
ofaschool?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES f 0
CONSTRUCTION LENDING AGENCY I have read the Hazardous Materal Information Guide and the SCAQMD
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 C e,Section 25505 and 25534 cenceming
3097 Civil Code) hazardous matey( Ire oorti
OWNER BUILDER DECLARATIONS DYES NO Date
I hereby affirm under penalty of perjury filet I am exempt from the Contractor's
License Law for the resson(s)indicated below by the checkmark(s)I have placed PRO O41NAtO4 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(RRPI
or repair any structure, prior to its issuatice, 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-1978
Section 7000)of Division 3 of the-Business 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 fora permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($5000 employees.For more information about EPA's Renovation Program visit:
❑ I, as owner of the roe or m employees with wa es as their sole www.epa.gov/lead or contact the National Lead Information Center at
property,rtY, Y9 1-800-424-LEAD(5323).
compensation,will do( )all of or( ;porting of the work,and the structure is
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 ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees' or personal effort; builds or improves the property,
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 or improved for the Firm Certification No.:
purpose of sale). "
❑ I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firrm Is required for this project because:
contactors to construct the project(Section 7044, Business and Professions
Code:The Contractor's License Law does not apply td an owner of a property
who builds or Improves thereon, and who contracts for the projects with a
I;--- A ...,. .,-IN. et.,ta 11---—l...n lf,,nur nrroart An.�not mmnlw udth PPA RRP nda nIm<o fill not tha RRP
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION.
Menifee
DATE 1-7 PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL )4 RESIDENTIAL 0— MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION b DEMOLITION- O ELECTRICAL MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES I�
DESCRIPTION OF WORK hC Z •S I Ol l I S
Z%) 19-FoL �-4wq SI 5426 t A/C, 04 INN F\)Ma P-
PROJECTADDRESS �r� IVIrX�I C� IZStJ�o
ASSESSOR'S PARCEL NUMBER :SS y�1 06 Z Ot7K LOT 3(er TRACT FI It t enifee
OWNER NAME
I
ADDRESS 2 LEI,
PHONE Il�l I�C�`I' / 2- 4e EMAIL —J It'30C vC- fit!
APPLICANT NAME &Jary /� (,� p
ADDRESS /3�c�I 5/30/� M U rr I" I' I I �-"L. cA "I�0 `C
PHONE rq ) (P�1?-L[50�y-� ^ EMAILmonKsoIreD n-vw • am
CONTRACTOR'S NAME U CA !�l I yl Q L , OWNER BUILDER? OYES NO
BUSINESSNAME J II- CDod Ibn I
ADDRESS I GA /7S
PHONE ("/
//
S SI� ( �;7C�- q5Q�2 /] EMAIL mon l�sa'tr a7 rn L G rr,a L • o
CONTRACTOR'S STATE LIC NUMBER `/mil/Z j-1 y LICENSE CLASSIFICATION CZ0
VALUATION$ NU`J c I q SQ FT Z L SO FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY 0
DEPARTME11 D6TRIBU1ION I J CITY OF MENIFEE BUSINESS UCENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE 39 PAIDAMOUNT
AMOUNT OCaSH OCHECK# OCREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMDUNT 0CASH 0CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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