PMT17-02361 City of Menifee Permit No.: PMT17-02361
29714 HAUN RD. Type: Residential Mechanical
<ACCELX> MENIFEE,CA92586
MENIFEE Date Issued:
o7/to/eon
PERMIT
Site Address: 28082 BAVARIA DR, MENIFEE,CA 92585 Parcel Number: 336-304-011
Construction Cost: $10,900.00
Existing Use: Proposed Use:
Description of REPLACE HVAC SYSTEM
Work:
Owner Contractor
JOHN TUCKE PRIORITY ONE INC
28082 BAVARIA DR 28669 PATTI LANE
MENIFEE,CA 92585 SUN CITY,CA 92585
Applicant Phone:9519285667
STEVE RUDAS,JR License Number:753163
PRIORITY ONE INC
28669 PATTI LANE
SUN CITY, CA 92585
Fee Description Qtv Amount lEl
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 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_PermiLTemplate.rpt Page 1 of 1
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
Chapter9(commencing with section 70D0)of Division 3 of the Business and o 1 am exempt from licensure under the Contractor's State License Law for
Professions Code and m/yJJ,icense is in full force and effe 1✓ / the following reason:
License Class - //Li U s o. ✓ tr/ By my signature below I acknowledge that,except far my personal residence
xpires Signature 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
WO ER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
o I ereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
h e and will maintain a certificate of consent of self-insure for workers 7044 of the Business and Professions Code,is available upon request when
mpensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website:
y Section 3700 of the Labor Code,for the performance of work for which wwwleainfo.ca.eov/calaw.html.
thispermit:j�ued.
j Policy ff 1�1v� Date
PROPERTY OWNER OR AUTHORIZED AGENT
D I have and will maintain wof kers compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which o By my signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.1 have read this
J number are: application and the information I have provided is correct 1 agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier �yJ/y �/,�, V /� building construction.I authorize representatives of this city or county to
Polity;112 X f-- /--&pires W-9(24) :2 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,
1 shall not employ any persons in any manner so as to become subjectto the CI BUSINESS LICENSE q
workers compensation laws of California,and agree that if I should become AZARDOUS MATERIAL DECLARATION
subjectto the worker ompe lion provisions ofSection 3700 ofthe La or
Code,I shall fort
�, comp ith those provisions. mi11 the applicant or future building occupant handle hazardous material or a
�licant Date mixture containing a hazardous material equal to or Information
that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURETO CURE WORKER'S COMPENSATION COVE GE IS o Yes [dNo
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)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES_ for guideli es
CONSTRUCTION LENDING AGENCY o Yes )No
1 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) o Yes �40
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
i hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
California Health&Safety Code 'on 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the rdous a r repo in
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oY o 0
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,Improve,demolish or repair any structure,prior to its ROPER OWNER ORAUT ZED 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.REPAI AND PAINTING(RRP)
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
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.epa.eov/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 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
not built or Improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required forthis project because:
o I,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.
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
Menifee
DATE PERMIT/PLAN CHECK NUMBER �Oa
TYPE: [--]COMMERCIAL RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑A DITION []ALTERATION ❑DEMOLITION ❑ELECTRICAL MECHANICAL
[—]NEW ❑PLUMBBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK /� c— �/ ✓ �
PROJECTADDRESS og�_ /J Y� l r �$5
ASSESSOR'S PARCEL NUMBER 3� Sy 7-20"1% LOT fv TRACT I53s3
PROPERTY OWNER'S NAME
ADDRESS
PHONE EMAIL <
APPLICANT NAME //(% �.J
ADDRESS '
PHONE 2 EMAIL ^ ,,/
CONTRACTOR'S NA ME J�t0/ J1/� I/JY WNERBUILDER? ❑YES NO
BUSINESS NAME
ADDRESS ? 2/ / I "
PHONE � 3 /-� ./ EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ /�i'1 SO.FT L SQ FT
APPLICANT'S SIGNATURE DATE
qw
DEPARTMENT
t CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PINEERING FIRE GREEN `' SMIP
INVOICEro PAID AMOUNT O
AMOUNT CASH O CHECK It O CREDIT CARD V15A/MC
PLAN CHECK FEES PAIDAMOUNT pCASS OCHECK It 0CREDIT 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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