PMT17-02876 City of Menifee Permit No.: PMT17-02876
r 29714 HAUN RD. Type: Residential Mechanical
A. CCELA-3' MENIFEE,CA 92586
MENIFEE Date Issued: 08/15/2017
PERMIT
Site Address: 29282 KNOLL CT, MENIFEE,CA 92586 Parcel Number: 338-203-011
Construction Cost: $8,000.00
Existing Use: Proposed Use:
Description of REPLACE 88,000 BTU FUNRACE&4 TON, 18 SEER,A/C UNIT
Work:
Owner Contractor
CAROLE BAUMAN COOL AIR SOLUTIONS INC
29282 KNOLL COURT 41162 SANDALWOOD CIR STE 101
MENIFEE, CA 92586 MURRIETA, CA 92562
Applicant Phone: 9516762665
JANE RECKTENWALD License Number:874502
COOL AIR SOLUTIONS INC
41162 SANDALWOOD CIR STE 101
MURRIETA, CA 92562
Fee Description QtV Amount 15)
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 Permit_Terrplate.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class Ca-V License No. 19-1A6 oa By my signature below I acknowledge that,except for my personal residence
Expires a"�-fl Signature fcE� in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
in I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have andwill maintain a certificate of consent of self-insure for worker's 7044 of the Business and.Professions Code,is available upon request when
compensation,Issued by the Director of Industrial Relations as provided for this application is submitted or at the following website:
by Section 3700 of the Labor Code,for the performance of work for which
this permit is Issued. www.leginfo.ca.gov/calaw.html.
Policy# Date
❑I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which ❑By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
number are; '' f,`,ry�O 1/�a� application and the information I have provided is correct.I agree to comply
cyP 1�A1 with all applicable city and county ordinances and state laws relating to
Carrier C p building construction.I authorize representatives of this city or county to
Policy# '1/aop o egr7 Expires J— "1 O enter the abc�op identified p erty for inspection purposes.
(This section need not to be completed is the permit is for one-hundred CX�1S�,�
dollars($100)or less Date
PROPERTY OWNER OR ORIZED AGENT
❑I certify that in the performance of the work for which this permit is issued,
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compe3s2tt7 provisions of Section 3700 of the Labor
Code,I shall forthwith com hose ovisions. �I Will the applicant or future building occupant handle hazardous material or a
Applicant Date SAS-1 mixture containing a hazardous material equal to or greater that the
amoun specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SE ORKER'S COMPENSATION COVERAGE IS ❑YesM0
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 forthe 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 guidelines
CONSTRUCTION LENDING AGENCY ❑Yes krNo
I 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) ❑Yes 64io
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
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 oyes 0100
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 PROPERTY OWNER OR AUTHORIZED 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRPI
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 Arms and comply with
an Applicant far a permit subjects the applicant to a civil penaity 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
❑I,as owner of the property,or my employee with wages astheir 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.gov/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 Contractor's State License Law does not apply to an owner of a ❑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. o No EPA Lead-Safe Certified Firm is required for this project because:
❑1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's 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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
DATE _ _17 PERMIT/PLAN CHECK NUMBER
TYPE: ,COMMERCIAL VRESIDENTIAL C: MULTI-FAMILY 0 MOBILE HOME POOL/SPA SIGN
SUBTYPE: ADDITION ALTERATION DEMOLITION ELECTRICAL V!MECHANICAL
NEW .) PLUMBING i RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace 88,000 btu fumace & 4 ton 18 seer) A/C unit
PROJECTADDRESS 29282 Knoll Ct ga9�p
ASSESSOR'S PARCEL NUMBER J'j8_?n3-011 LOT TRACT
OWNER NAME a Bauman City of Menifee
Building & Safety Dept.
ADDRESS 29282 Knoll.-Qt Sun City, CA 92586
PHONE 951-672-4106 EMAIL
APPLICANT NAME ,lane Recktenwald Received
ADDRESS
PHONE 714-336-6159 EMAIL
CONTRACTOR'S NAME Gool Air Solutions Inc OWNER BUILDER? YES V'NO
BUSINESS NAME
ADDRESS 41162 Sandalwood Cir Ste 101 Murrieta, CA 92562
PHONE 951-676-2665 EMAIL
CONTRACTOR'S STATE LIC NUMBER 874502 LICENSE CLASSIFICATION
VALUATION$ 8,000.00 SQ F L SQ FT
APPLICANT'S SIGNATURE DATE 8-15-17
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP x
INVOICE
AMOUNT PAIDAMOUNT -
• l • 10 - CASH CHECK If (,CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT C'CASH CHECK# O CREDITCARD VISA/MC
OWNER BUILDER VERIFIED ;.)YES ) NO DI.NUMBER NOTARIZED LETTER 0 YES i, NO
City of Menifee Suildinq& SafM Deportment 29714 Houn Rd Menifee. C4 92586 951-672-6777
WWW cityofiner,ifee us In3Pecllun Requ,st tme951-246-5113
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