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PMT18-00008 City of Menifee Permit No. PMT18-00008 29714 HAUN RD. Type: Residential Mechanical -5A—CCELA? MENIFEE, CA 92586 MENIFEE Date Issued: 01/0 312 01 8 PERMIT Site Address: 27751 CALLE RABANO, MENIFEE, CA Parcel Number: 336-324-017 92585 Construction Cost: $6,513.94 Existing Use: Proposed Use: Description of HVAC CHANGE OUT, CARRIER 2.5 TON, SINGLE STAGE A/C, 14 SEER,60K BTU FURNACE Work: Owner Contractor KENNETH CLARKE MONKS AIR CONDITIONING 27751 CALLE RABANO P O BOX 128 MENIFEE, CA 92585 SUN CITY, CA 92586 Applicant Phone:9516794502 TIFFANI SELLERS License Number:912194 MONKS AIR CONDITIONING P0 BOX 128 SUN CITY,CA 92586 Fee Description 0tv 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 carded 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_Pennit_Templale.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ Jam exempt from licensure under the Contractors'State License Law fort 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 Licens No. 2 improvements covered by this permit,I cannot legally sell a structure that I ha Expires 3-31-!R' Signatu built as an owner-building if it has not been constructed In its entirety by Iicens. 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 of perjury one t the following for workers htt? leainfo.m.gov/calaw.html. 1 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 proper ,q I have and will maintain workers compensation insurance, as required by owner or authorized to act on the property owners behalf. 1 have read tt 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 com{ permit is issued.My workers compensation insurance carder and policy number are: with all applicable city,and county ordinances and state laws relating to buildT CC consWctlon.I authorize representatives of this city or county to enter the abov Cart �� .ier c-� F Identified property for the Inspection purposes. Policy#12— 700� /Z Expires y — ' — { U Date Property Owner orAuthorized Agent 2 (This section need Lot be completed If the permit is for City Business License# O'J ✓0779 one-hundred dollars($100)or less) I certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION shall not emolov any persons in any manner so as to become subject to the Will the applicant or fulure-building occupant handle hazardous material or workers'compensation laws of Caffomia,and agree that d 1 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? Cade,I shall f A mply with those provisions. DYES amounts Apple nY Date; Will the intended.use of the building by the applicant or future building occupant require a permit for the construction or modi0rabon 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 <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 bounds ofaschool? LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES NO 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 pennit is Issued (Section California Heal Safety C e,Section 25505 and 25534 concerning 3097 Civil Code) hazardous male I re orti OWNER BUILDER DECLARATIONS DYE S 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 OVYNAaSIK AUTHORIZED AGENT next to the applicable Hems)(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 IRRP1 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•Bubinpas 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 property violation of Section 7031.5 by any Applicant foCa permit subjects the applicant to managers who do the paint-disturbing work themselves or through their a civil penalty of not more than($504j.) employees.For more Information about EPA's Renovation Program visit: ❑ I, as owner of the roe or employees with wa es as their sole www.epa.govAead or contact the National Lead Information Center at properly,KY, my9 1-800-424-LEAD(5323). compensation,will do( )all of or( )porting of the work,and the structure Is not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this project who, through employees' or personal effort; builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, Cerlified Firm Name: the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or Improved for the purpose of sale). FirmCertification No.: ❑ I, as owner of the property an exclusively contracting with licensed No EPA Lead-Safe Certified Firm is required for this project bemuse: contactors to construct the project(Section 7044,Business and Professions - Code:The Contractor's License Law does not apply td an owner of a property who builds or Improves thereon, and who contracts for the projects with a FETY PERMIT/PLAN CHECK APPLICATION Meniree DATE I - PERMIT/PLAN CHECK NUMBER �$ TYPE: O COMMERCIAL )6 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION C ALTERATION •O DEMOLITION O ELECTRICAL XMECHANICAL O NEW O PLUMBING O RE-ROOF-N UMBER OF SQUARES DESCRIPTION OF WORK fYC LLX ru-r 2 -� rL%� JI f1f L S e A/c- i4-o 5 K 13TU F�) PROJECTADDRESS ` • ,� I ' 22nC e-N1l Pam- �� �2S8S" ASSESSOR'S PARCEL NUMBER 3'36 51,"k ��"� LOT '5--y - TRACT 1 "S 3 V 3 I i OWNER NAME jj 1 J City of Menifee K IBuilding Dept. ADDRESS /�m-j� PHONE (T�L WI 0a EMAIL - L APPLICANT NAME !,� r / L K ADDRESS I�l 3�5/30/� /M UMr PHONE (g51) �P ` ^7 I?- 50L„ EEMAILrnDtiKSOI Y•eD rY1Q,j - cbrn CONTRACTOR'S NAME l�l �-I- / v I D,^X OWNER BUILDER? OYES NO BUSINESS NAME L I r an&4-"onu34 • ADDRESS 5!! nn � G�r7 ''e. kd l� qZS 'f PHONE ('�151 LO�Vr X/�J L. /] IEMAIL man ksc i r Z) rna-/I-�l- • C-O rr, CONTRACTOR'S STATE LIC NUMBER `mil i 2 1 `-1 LICENSE CLASSIFICATION CZ0 VALUATION$ (f 5�3 � C�� SQ FT LSQFT APPLICANT'S SIGNATURE DATE CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER V BUILDING PL4NNING ENGINEERING FIRE GREEN SMIP I X INVOICE AMOUNT L. - io I PAIDAMOUNT a 1 0CASH OCHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEEF PAID AMOUNT OCASH OCHECK# OCREDITCARD VEiA/MC OWNER BUILDER VERIFIED O YES 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 951-246-6113 w m n E r o o y z O O N ¢ w W N F .-I TV o =O C W O a N a 0 N c y aC V W s a, E Z 3 M1 N E Q c c E c o In w > m ¢ E O E 3 m a E !' c_ a 3 E _w al E v ❑ a o m = c � = Y v o 0 m E E c v s = N O y U'c C ri m CI .O Z u ,j Q N V1 0 U ¢ L C C G E � N Y d ~ m m d O = 01 V] M1 O O •y bO O `o E 9 ❑ w E cc E .'°. > —y p fa ❑ ❑ LL Z U M O G N O } E N c ' E a w u = C L N O Ill W UI m = m E _ C = V u O W u N j m w O !a L S y IJ (p E c v E v a w g a Y O y « y Ol LL L u c m o 0 t u m w LL a > o E � u m m u I^W m o E o 0 n c > y a c s n w o E . 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