PMT17-03116 City of Menifee Permit No.: PMT17-03116
29714 HAUN RD.
�ACCELA7. MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE Date Issued:
09/01/2017
PERMIT
Site Address: 26310 RIDGEMOOR, MENIFEE,CA Parcel Number: 337-211-009
92586 Construction Cost: $6,532.89
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, NEW CARRIER 3.0 TON, 14.0 SEER SINGLE STAGE A/C,70K BTU FURNACE
Work:
Owner Contractor
CONSTANCE KENNEDY MONK'S AIR CONDITIONING
26310 RIDGEMOOR RD P 0 BOX 128
MENIFEE, CA 92586 SUN CITY, CA 92586
Applicant Phone: 9516794502
GARY MONK License Number:912194
MONKS AIR CONDITIONING
P O BOX 128
SUN CITY, CA 92586
Fee Description Qtv Amount($
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_Pernit_Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ lam exempt from licensure under the Contractors'State License Law fort
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 eft t which I must have resided for at least one year prior to completion
License Class C, Ucenspl No. improvements covered by this permit,I cannot legally sell a structure that I he
6rpires3-31-!R' Signatu built as an owner-building if it has not been constructed in its entirety by licens
contractors. I understand that a copy of the applicable law,Section 7044 of t
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application
submitted or at the following Web site:
❑ I hereby affirm under penalty is perjury one t the following dor workers; httollwww.leginfo.m.gov/mlaw.htmi
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
peril is issued. Property Owner or Authorized Agent
Policy# ❑ By my Signature below, I certify to each of the following: I am the props
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 9
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 coml
permit is issued.Myworkers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to build!
CC�� , ram• construction.I authorize representatives of this city or county to enter the aboi
Carrier e. r identified property for the Inspection purposes.
Policy#1 2-760— I Z Expires V — I C O - Dale
Property Owner crAuthorized Agent
(This section need Dot be completed If the permit is for 035
City Business License
one-hundred dollars($100)or less)
I certifythat in the performance of the work for which this peril is issued,I HAZARDOUS MATERIAL DECLARATION
shall not employ 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 III don the Hazardous Materials Information Guide?
Code,I shall f vA mply with those provisions. DYES
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 District(SCAQMD)?See permitting checkli
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 bewithin 1000 feet of the out
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF. THE bounds ofaschool?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES VNO
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.I understand my requirements under the State of
agency for the performance of the work which this permit is issued(Section California Health A Safety Cy e,Section 25505 and 25534 concerning
3097 Civil Code) hazardous mate Ire orti 0•
OWNER BUILDER DECLARATIONS ❑YES NO
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date
License Law for the reason(s)indicated below by the checkmark(s)I have placed PRO O N 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 fRRPI
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 Renovatiorf,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.licensure.and the basis fdr the alleged exemption. Any required practices.This includes rental property owners and properly
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 4 employees.For more information about EPA's Renovation Program visit:
❑ www.epa.gov/lead or contact the National Lead Information Center at
I, as owner of the ro p pe rty, 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 projec
who, through employees' or personal effort; builds or improves the properly,
provided that the improvements are not intended or offered for sale.If,however, Certified Fir 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 Fir Certification No.:
purpose of sale).
❑ I, as owner of the property an exclusively contracting with licensed No EPA Lead-Safe Certified Fir is required for this project because:
contactors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply td an owner of a property who builds or improves thereon, and who contracts for the oroiects with a
Menifee
DATE PERMIT/PLAN CHECK NUMBER 11� O ✓ I ' CA
TYPE: O COMMERCIAL )4 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA 0 SIGN
SUBTYPE: O ADDITION O ALTERATION 0 DEMOLITION O ELECTRICAL XMECHANICAL
O NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK P-C CbQnCf Q lo
P
14-O -i-t��? Si � 9- A/C_ 070
PROJECTADDRESS 2- 6 �,;;'S � r F `-
ASSESSOR'S PARCEL NUMBER 37-4- ZA JOB LOT 2b'1 TRACT Z
OWNER NAME nc cn
ADDRESS 5 C ' i z�, a 1� ICJ
PHONE ( ) ZTy J� EMAIL
APPLICANT NAME U r /�p �p D �+,� /��/ p� p
ADDRESS n3C�' Sl!3o M vMr I" I l..r I ( T et CA '�1 5 `1'
PHONE (`�JI ) �P7q� JD�L EMAIL monKSAlr0 9 rrlo-;t_( - Corn
CONTRACTOR'S NAME CT Ar M QI .L.K OWNER BUILDER? O YES NO
BUSINESS NAME C MonVl� Ir Condl on I
ADDRESS /� S ( GA q2594
PHONE (RM 6;-7q— 45n2 EMAIL rr)on ksa*i r aD ►Y-LC -L . GO vvl
CONTRACTOR'S STATE LIC NUMBER
C IZ 1 LI LICENSE CLASSIFICATION C2-0
VALUATION$ �,5,✓2, C 1"'/ SO.FT 9- L SQ FT
APPLICANT'SSIGNATURE DATE
CfTYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BuILDING PLANNING NGINEERwG FIRE GREEN II SMIP
INVOICE (O PAID AMOUNT
AMOUNT OCASH OCHECKR OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDA MOUNT GASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 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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