PMT17-02632 City of Menifee Permit No.: PMT17-02632
29714 HAUN RD. Type: Residential Mechanical
{ACCELA? MENIFEE,CA 92586
MENIFEE Date Issued: 07/27/2017
PERMIT
Site Address: 27270 DEL MONTE LN, MENIFEE, CA Parcel Number: 336-230-013
92585 Construction Cost: $5,774.38
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, CARRIER 2.5 TON 14.OSEER, R410A, SINGLE STAGE SPLIT A/C,70K BTU
Work: FURNACE
Owner Contractor
JIM &DIANE LEVANOFF MONKS AIR CONDITIONING
27270 DEL MONTE LN P O BOX 128
MENIFEE, CA 92585 SUN CITY, CA 92586
Applicant Phone:9516794502
GARY MONK License Number:912194
MONKS AIR CONDITIONING
PO BOX12B
SUN CITY,CA 92586
Fee Description City 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 slated,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 Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ lam exempt from fimMure under the Contractors'State License Law forth
herebyaffirm under penalty perjury following reason:
penal orthat I am Itcens d under provisions of
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 ti
Professions Code deli license is in full force and eft which I must have resided for at least one year prior to completion c
Ucense Class Ucens No. Z� Improvements covered by�is permit,I cannot legally sell a structure that I haw
Expires. - I- f R Signat.r built as an owner-building it has not been constructed in its entirety by ficenset
contractors.I understand _ et a copy of the applicable law,Section 7044 of thi
WORKERS'COMPENSATION DECLARATION Business and Professions Code,Is available upon request when this application f:
❑ 1 hereby affirm under penalty of perjury one of the ollowing declarations: submitted or at the following Web site:
I have and will maintain a certificate of consent of s If-In ure for workers' hdolAvwmleolnfocaeovlcalawhtml.
compensation,issued by the Director of Industrial Relati ns as provided for by Section 3700 of the Labor Code,for the performance A work for which this Dale
permit is issued. Property Owner orAuthorfzed Agent
Policy#
'.../ ❑ By my Signature below I certify to each of the following:I am the propert±
cri 1 have and will maintain workers' compensation Insurance, as required by owner or authorized to act on the property owner's behalf. I have read thf!
section 3700 of the Labor Code, for the performance of he work for which this application and the Informatiion I have provided is correct I agree to compy
permit is Issued.Myworkers'compensation Insurance came and policy number are: with all applicable city andicounly ordinances and stale laws relating to buildinc
construction.Iauthorize representatives of this city or countyto enter the above
Cartier «��7rs, Identified property for the igspec0on purposes.
Policy#�Z- /rJ�� IZ Expires_ f Date
Property Owner or Authorized Agent
(This section need not be completed i°the permit is for (2 2�/_ -]
one•hundred dollars($100)or less) City Business Ucense# ! LL,�)� (✓J
t
1 certify that In the performance of the work for which his permit Is Issued,I HAZARDOUS MATERIAL DECLARATION
shall not emotov any persons In any manner so as to It ecome subject to the Will the applicant or future building occupant handle hazardous material or a
workers'compensation laws of California,and agree th t'd I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 370D of the Labor amounts s ecified on the razardous Materials Information Guide?
Code,I shall vd mply with tho:.e provisions. I
❑YES, ' NO
Appli n Datt:. �— � Will the intended.use of thE building by the applicant or future building
WARNING: FAILURE TO SEC E WORKERS' occupant require a permit for the construction or modification from South
COMPENSATION COVERAGE IS UNLAWFIL, AND SHALL Coast Air Quality Management District(SCAOMO)?See permitting checklist
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND for guidelines
OYES XNO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($1 MOOD),IN ADDITION TO THE COST OF�OMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTI N 3706 OF THE bounds of school? '
LABOR CODE,INTEREST,AND ATTORNEYS FEES ❑YESNC
CONSTRUCTION LENDING AGENCY I have read the HazerdousiMaterial Information Guide and the SCAOMD
I hereby affirm that under the penalty of perjury there is construction tending permitting checklist.I undelstand my requirements under the State of
agency for the performance of the work which this pewit is Issued (Section tDYES
ornia Heelth Safety e,Section 25505 and 25534 concerning
3097 Civil Code) rdous mate I re oril
OWNER BUILDER DECLARATIONS : NO
I hereby affirm under penally of perjury that I am exempt on the Contractor's j Date_
Ucense Law for the reason(s)indicated below by the che ark(s)I have placed PROk-RTV10ViNkpA AUTHORIZED AGENT
next to the applicable Item(s)(Section 7031I.5.Business ar♦d Professions Code:
Any city or manly that requires a permit to construct,afte,Improve, demolish, EPA RENOVATION.REPAIR AND PAINTING(RRPi
or repair any structure,prior to its Issuance,also requires the applicant for the i
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 Ucense 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 c10dcare facility to be RRP-cerlified firms and comply with
she is exempt from licensure and the basis for the alle6ed exemption. Any required practices.This includes rental properly owners and property
violation of Section 7031.5 by any Applicant for a permit subiecis the applicant to managers who do the paint3disturbfng work themselves or through their
a civil penalty of not more than($500).) employees.For more infemjation about EPA's Renovation Program visit:
❑ I, as owner of the property, or my employees with ' www.epe.govilead or mntagt the National Lead Information Center at
compensation,w will do ages as their sole 1-800.424-LEAD(5323).
( )all of or( )porting of the work,and the structure Is
not intended or offered for sale.(Section 7044.Business an I Professions Code;
The Contractor's State Ucense Law does not apply to an owner of a property ❑An EPA Lead-Salle Certified Renovator will be responsible for this project
Who, through employees'or personal effort;builds or Im roves the property, ,
provided that the Improvements are not Intended or offered or sale.If,however,the building or Improvement Is sold within one year of completion, Certified the Owner- d Firm Name:,
Builder will have the burden of proving that it was not built of improved for the
purpose of sale). Firm Certification No.:
❑ 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,Busfne�s and Professions
Code:The Contractors Ucense Law does not apply to an pwner of a property
who builds or Improves thereon, and who contracts fqr 4he projects with a
licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE Z-S—1 PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL )4 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL XMECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK ACC- C0-4'11-P 2 . 5 -tt-y-% ,
l .a Si Izcr � WOK Tv
PROJECTADDRESS -7 Z O D-cl m -11 Ca 22585
ASSESSOR'S PARCEL NUMBER 3 S(^^Z'' 3'O o l 3 LOT � I�) TRACT
OWNERNAME Cil iru I I ,�,,�ti/ PT
ADDRESS /_/ F ;( S � t. '�J
PHONE �1�'1-�- T cS JcIS��! EMAIL
APPLICANT NAME Y
ADDRESS / JI 3�c0' 5/- -)DM uMrr �M l ftf � F O2-5R
%PHONE :::;7 1?-Lf 502 /, /^ fEEMAIL/nonKS0ir9D rra!�I • Cbyn
CONTRACTOR'S NAME U Cj,!y >' y I DI/L.`�, �.( OWNER BUILDER? O YES iNO
BUSINESS NAME I_ I�' I�UI�Id I ,o n I
ADDRESS
5 � )rritin
kd I ^..n q2 5 q
L PHONE (?51 � / q- 402- EMAIL monV-Sa*lr
rr�a�-!. • C.Dm
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ j T7 J SO FT L SQ FT
APPLICANT'S SIGNATURE DATE ✓I Z q—1CrrYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION I CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING _ENGINEERING FIRE GREEN F SMIP
INVOICE l'�' PAID AMOUNT
AMOUNT CASH O CHECK k O CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0 CASH O CHECK a O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586951-672-6777
www.cityof,nenifee.us Inspection Request Line 951-246-6213
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