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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 D m m A A m m. '° 1 p_ .ldr ry z y. 01 n N n 9 9 D D n w T < v M O. O O O y On d 0 V� m m m ': N eds 3 C a a n n N N' O O m ry c p K m o d W c m O N N n m d n 0 o. o m �^ s c � m D n N O m d O O N 7 O VI m W pp d m A O h oo m w 0 n o T 3 0 Z. 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