PMT17-02446 City of Menifee Permit No.: PMT17-02446
29714 HAUN RD.A. CCELA— MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE Date Issued:
07/13/2017
PERMIT
Site Address: 29710 CALLE GREGORIO, MENIFEE, CA Parcel Number: 330-291-004
92586 Construction Cost $5,943.63
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, CARRIER 3.0 TON, 14 SEER, 80%AFUE, R4109 SINGLESTAGE HEAT&4/C,
Work: 70K BTU FURNACE
Owner Contractor
WILLIAM WRIGHT MONKS AIR CONDITIONING
26710 CALLE GREGORIO P O 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 O-tt Amount lSl
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_Templatespt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ 1 am exempt from licensure under the Contractors'State License Law for it
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 1 acimawledge 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 Ucens No. 2I QL1 improvements covered by this permit,I cannot legally sell a structure that 1 W
Expires 3-31-! R' Signatu built as an owner-building If it has not been constructed In its entirety by[loans(
contractors. I understand that a copy of the applicable law,Section 7044 of it
WORKERS'COMPENSATION DECLARATION Business and Professions Code,Is available upon request when this appllrabon
submitted or at the following Web site:
❑ 1 hereby affirm under penalty of perjury one of the following declarations: htto•JAvww.leointo.ra.aov/nlaw.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 Agent
Policy# O By my Signature below, I certify to each of the fallowing: I am the proper
)i( I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's 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 ;lave provided is correct. I agree to comp
permit is issued.Myworkers'compensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to buildir
C� . construction.I authorize represent.utives of this city or county to enter the abov
Cartier I I ) identified property for the inspection purposes.
Policy#12-7b0- /Z Expires �"— 1 l Date
Property Owner or Authorized Agent
(This section need not be completed If the permit is for 0356079
one-hundred dollars($100)or less) City Business License If
I certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION
shall not employany 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 eciff don the Hazardous Materials Information Guide?
Code,I shall cad mply with those provisions. zz DYES
NO
Appli nt, Date; it J� I 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 District(SCAQMD)?See permitting checklis
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES J<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 cute
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE bounda of a school?
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES ZNO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.1 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,„ection 25505 and 25534 concerning
3097 Civil Code) hazardous mate Ire orti
❑YES NO Date
OWNER BUILDER DECLARATIONS �
1 hereby affirm under pen silty of perjury that I am exempt from the Contractor's
License Law for the reason(s)Indicated below by the checkmark(s)I have placed PRO6RT<04NAtPK 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 1RRP1
or repair any structure,prior to its issuance,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•Businpss and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with
she is exempt from.Ilcensure 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($500.) employees.For more information about EPA's Renovation Program visit:
www.epa.govllead or contact the National Lead Information Center at
❑ 1, as owner of the property, or my employees with wages as their sole 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 0 No EPA Lead-Safe Certified Finn is required for this project because:
contactors to construct the project(Section 7044,Business and Professions
Code:The Contractor's Ucense Law does not apply td an owner of a property
who builds or improves thereon, and who contracts for the projects with a
rt,.e......a-.............dam,..,,...,..a,..n.e ef.,,e I I.e. r-A If,—,,r nrn,ert droe not mmnhr,Wth SPA RRP n,ln nleaco fill cad thn RRP
& SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE �— /� PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL X RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION C DEMOLITION- O ELECTRICAL XIVECHANICAL
O'NEE/W OPLUMBING ORE-ROOF-NUMBER OF SQUARES
7T V DESCRIPTION OF WORK /O-C O CA-rv-le r5. O ' n Vj 5a�P,
ems& FITuL ey IOct S,Y. le I Cc _ �a I ' ; 70 < 87li Forh-a LP
PROJECTADDRESS S7l r Lr- �R fv2P_ CR Z
ASSESSOR'S PARCEL NUMBER 33O2q\ b0K lLOT K TRACT Z
OWNER NAME
Cky of Menl '
ADDRESS� C- _`�. C.�-�D BO t,
PHONE 6 /�}CQ- &4:1- 0511 I May,
'-----
APPLICANT NAME (� r ay,
ADDRESS /3�c S-51 /� M U-y►'�r M en i fe e c�F
PHONE (q51) I >-7q-g6` 0Lys � ,^ VEMAILrnonKSwv-Ltd ►Y-a:LA , (_brn
CONTRACTOR'S NAME l..ICUr-Y I1/IO///L-``��� ,,..JJ OWNERBUILDER? OYES NO
BUSINESS NAME I �f' �.Undi 'oYl
ADDRESS n i I
PHONE (951� 6rvinn-- 4 xIZ EMAIL mon ksc-tr a'7 rrlQ6-L - CAm
CONTRACTOR'S STATE LIC NUMBER 9121gy LICENSE CLASSIFICATION CZQ
VALUATION SO FT ,2 13 14- L SO FT
APPLICANT'S SIGNATURE • DATE
CITYSTAFFUSE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN --- SMIP
INVOICE /I .--� PAID AMOUNT
AMOUNT � � � OCASH OCHECK# JCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH OCHECK# 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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