PMT17-03481 City of Menifee Permit No.: PMT17-03481
29714 HAUN RD.
�A_ I_A-? MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE - Date Issued: 10/02/2017
PERMIT
Site Address: 29298 MURRIETA RD, MENIFEE,CA Parcel Number: 338-091-074
92584 Construction Cost: $5,557.31
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, CARRIER 2.5 TON, 14 SEER R410A SINGLE STAGE SPLIT A/C,70K BTU
Work: FURNACE
Owner Contractor
ELIDA M FRANCO MONKS AIR CONDITIONING
64168 EAGLE MOUNTAIN AVE P 0 BOX 128
DESERT HOT SPRINGS, CA 92240 SUN CITY, CA 92586
Applicant Phone: 9516794502
GARY MONK License Number:912194
MONKS AIR CONDITIONING
P0 BOX 128
SUN CITY, CA 92586
Fee Description Oft Amount lSl
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_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 eff which I must have resided for at least one year prior to completion
License Class C�Ltcens No. Z improvements covered by this permit,1 cannot legally sell a structure that I he%
Expires 3^3 —[ go Signatu built as an owner-buflding if it has not been constructed In its entirety by license
contractors. I understand that a copy of the applimble law, Section 7044 of 0
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 of perjury one the following declarations: hgD:/hxww.leoinfo.cagov/calaw.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 by Date
Section 3700 of the Labor Code,for the performance of work for which this
permit is issued. Property Owner or Authorized Agent
Policy# ❑ By my Signature below,I certify to each of the following: I am the propeh
ui I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read If
section 3700 of the Labor Code, for the performance of the work for which this application and the Information I have provided is conect. I agree to comp
permit is Issued.My workers'compensagon Insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to buildir
CC�^. • _ construction.I authorize representatives of this city or county to enter the abov
Carder c. 1-2—
identified property for the inspection purposes.
Policy#12-_ !l I Z Expires U — ' — l O Date
Property Owner or Authorized Agent �j/� (�
(This section need pot be completed if the permit is for City Business License# 07 J ✓w-7 a
one-hundred dollars($100)or less)
Asall
I certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION
not emolov 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 amount�s,.s{p ecified on the Hazardous Materials Information Guide?
Code,I shalt f wi mply with those provisions. ❑YES A NO
Z
Appli nt' Date; WIII the intended use of the building by the applicant or future building
I
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checkik
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 be within 1000 feet of the out(
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE bounda of a school?
LABOR CODE,INTEREST,AND ATTORNEYS FEES ❑YES of
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 Safety C e,Section 25505 and 25534 conceming
3097 Civil Code) hazardous mete Ire orti
OWNER BUILDER DECLARATIONS DYE S NO
I hereby affirm under penalty of perj'rry that I am exempt from the Contractor's Date 1
License Law for the reason(s)indlcateJ below by the checkmark(s)I have placed PRO OVYNIIR QK AUTHORIZED AGENT
next to the applimble gems)(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(RRP)
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-Business and Professions Code)or that he or residence or childcare facility to be RRPcertified firths and comply with
she Is exempt from.licensure.and the basis for the alleged exemption. Arry required practices.This Includes rental property owners and property
violation of Section 703:1.5 by any Applicant for a 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:
❑ I, as owner of the roe www.epa.govAead or contact the National Lead Information Center at
property,of 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 sWcture 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 project
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 Firm 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). Firm Certification No.:
❑ I, as owner of the property an exclusively contracting with licensed 0 No EPA Lead-Safe Certified Firm 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, and who contracts for the projects with a
BUILDING & SAFETY P�RIVIIT/PLAN CHECK APPLICATION
Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: C COMMERCIAL )(RESIDENTIAL C MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: C ADDITION C ALTERATION O DEMOLITION C ELECTRICAL 9MECHANICAL
O NEW O PLUMBING C RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK A" n C QY I"LQ-j
Gip ?0K-
L
PROJECTADDRESS .y ') f" '" GI l.' ^ 0 (A C/
ASSESSOR'S PARCEL NUMBER LOT '10
TRACT I�OI
OWNER NAME "L- I CC GI
ADDRESS I j n A-V'C, 5A
PHONE ( I �� `1�-L( � (j G;�S EMAIL --� Li22*L,
APPLICANT NAME L{ rbjD( (�/� /'� �f �j
ADDRESS /3� �5:6n /jM U�y►'7 I " ��er i fee `^ ' q`^,��
PHONE (51 �P�L7-L15Q2 � �/JL EMAII-rnonKSal✓-� JYa1A • cbrn
CONTRACTOR'S NAME l�1 �-I� M Q/ (, OWNER BUILDER? C YES I JNO
BUSINESS NAME MOnVC / it COndi ,ohs ��+ ��1 Gj `'
ADDRESS 5 I'e cA `2S T
PHONE (95l� (f,-7q,- 4nnl /] EMAIL rnonKsc)rZ G1ma.:LL . Gam
CONTRACTOR'S STATE LIC NUMBER qI2 �—1 LI LICENSE CLASSIFICATION CZ0
VALUATION$ ) `7 , � I SQ FT + O O Z L SO FT
APPLICANT'S SIGNATURE DATE
r
DEPARTMENT DISTRIBUTION I CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN • SMIP
INVOICE -f PAIDAMOUNT n
AMOUNT „JP OCASH CHECK# 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0 CASH 0 CHECK# O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenrfee.us Inspection Request Line 951-246-6213
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