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PMT17-03232 City of Menifee Permit No.: PMT17-03232 29714 HAUN RD. �ACCELA? MENIFEE, CA 92586 Type: Residential Mechanical MENIFEE Date Issued: 09/14/2017 PERMIT Site Address: 28573 MURRIETA RD, MENIFEE, CA Parcel Number: 339-111-006 92586 Construction Cost: $7,053.63 Existing Use: Proposed Use: Description of HVAC REPLACEMENT,3 TON A/C, 14 SEER, SINGLE STAGE SPLIT A/C,70,000 BTU FURNACE Work: Owner Contractor SHAWN MORGAN MONKS AIR CONDITIONING 28573 MURRIETA ROAD P O BOX 128 MENIFEE,CA 92586 SUN CITY, CA 92586 Applicant Phone: 9516794502 TIFFANI SELLERS License Number: 912194 MONKS AIR CONDITIONING P0 BOX 128 SUN CITY, CA 92586 Fee Description City Amount ISI Forced-Air or Gravity-Type Furnace or Burner 1 149.00 Air Handling/Condensing Units SFR 1 133.00 Building Pennit 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 building operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Men'dee.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_Permil_Ternplatexpt 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 of 1 which I must have resided for at least one year prior to completion License Class��Licens N 12-1044 improvements covered by this permit, I cannot legally sell a structure that I he Expires 3-31-% R' Signatu built as an owner-building If it has not been constructed in its entirety by linens 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 will under penalty of perjury one of the following declarations: httoJ/www.leainfo.ca.00vlcalaw.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 b Section 3700 of the Labor Code, for the performance of work for which this Date permit is issued. Property Owner or Authorized Agent Policy# ❑ By my Signature below, I certify to each of the following: I am the prope V I have and will maintain workers' co owner or authorized to act on the property owner's behalf. I have read ti ny compensation insurance, as required is application and the information I have provided is correct. I agree to coml section 3700 of the Labor Code, for the performance of the work for which this permit is Issued.My workers'compensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to buildi C construction.I authorize representatives of this city or county to enter the abo% Carrier �.�[ !� Q `Q' identified property for the inspection purposes. Policy#12'76�- I Z Expires U — ' '— ( O Date Property Owner or Authorized Agent (This section need not be completed If the permit is for 0: 5l,�79 one-hundred dollars($100)or less) City Business License# 4 1 certify that in the performance of the work for which this HAZARDOUS MATERIAL DECLARATION pe permit is issued,I 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 ecified on the Hazardous Materials Information Guide? Code,I shall t rthwi mply with those provisions. ❑YES NO Appl, nY 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 checkfl COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES <NO CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, WIII the proposed building or modified facility be within 1000 feet of the out DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE bounds ofa school? LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES RNO CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm that under the penaly 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 Cpqe,Section 25505 and 25534 concerning 3097 Civil Code) hazardous mateliol re orti OWNER BUILDER DECLARATIONS ❑YES NO I hereby affirm under penalty of penury that I am exempt from the Contractor's Date License Law for the reasons)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 IRRPI 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-Businass and Professions Code)or that he or residence or childcare facility to be RRP-certified firths and comply with she is exempt from.licensure.and the basis for the alleged exemption. Any required practices.This includes rental property owners and property violation of Section 7031.5 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: rue www.epa.gov/lead or contact the National Lead Information Center at ❑ I, as owner of the p p rty, or my employees with wages as their sole 1-800424-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 property, provided that the improvements are not intended or offered for sale.If,however, Certified Finn 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 purpose of sale). Finn Certification No.: ❑ I, as owner of the property an exclusively contracting with licensed 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 License Law does not apply td an owner of a property _ who builds or Improves thereon, ai,d who contracts for the projects with a BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE 2 PERMIT/PLAN CHECK NUMBER — TYPE: O COMMERCIAL X RESIDENTIAL C MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION C ELECTRICAL XMECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK A-C- Q (� PROIECTADDRESS 2 Z� ASSESSOR'S PARCEL NUMBER 1 '0 0 (o LOT TRACT Cit Ztsi&F<<44 ,� A BuI Ing a ep . OWNER NAM I�/t ADDRESS //'� ` 2017 PHONE (l,5/) 6�2- 43551 EMAIL APPLICANT NAME Q,rV ADDRESS 3 5W M U�yr� Moen l ate CA q25R PHONErqc 01) (r-;7q-Lf 502 p EMAILn-j0nK50irtV IYIG !A . com CONTRACTOR'S NAME U �I� / vl Q OWNER BUILDER? OYES 40 BUSINESS NAME Ml)nVl� Ir Cbndi on _ ADDRESS /� ( L32S PHONE (R S 5/ J �0��/� 45Q�2 /] EMAIL m onl-gc�Ir Z "%66- . • Gam / CONTRACTOR'S STATE LIC NUMBER `�!/2 /C/� / LICENSE CLASSIFICATION CZ VALUATION$ SO FT Q 6 a L SO FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION k CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT AMOUNT IO '1D OCASH CCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDA MOUNT 0CASH 0CHECK# 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. ,venifee, CA 92586 951-671-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 % \ / — . } ' 0 _ \ § § \ § \ { $ \ § - \ gym / \ / $f C.Q. \ \ } \\ \ a : - - � � ( R 0 \ ( !E >S ! \ k m / 1p \ t 7 Jj } ! R > � 9D. ~ � � / } } / E ^ � ` r n n n A n T m N x On N i:+ d NO Nf° O. 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