PMT18-00009 City of Menifee Permit No.: PMT18-00009
29714 HAUN RD. Type: Residential Mechanical
<ACCEL/? MENIFEE, CA 92586
MENIFEE Date Issued: 01/03/2018
PERMIT
Site Address: 30263 CALLE POMPEII, MENIFEE, CA Parcel Number: 364-121-016
92584 Construction Cost: $8,256.06
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, CARRIER 5.0 TON, 14 SEER R410a, 1 STAGE COOL,2 STAGE HEAT,SPLIT
Work: A/C, 110K BTU FURNACE
Owner Contractor
GUNDA HUEHNKEN MONKS AIR CONDITIONING
30263 CALLE POMPEII P O BOX 128
MENIFEE, CA 92584 SUN CITY,CA 92586
Applicant Phone:9516794502
TIFFANI SELLERS License Number: 912194
MONWS AIR CONDITIONING
P O BOX 128
SUN CITY, CA 92586
Fee Description QQt rr Amount($1
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 carved 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 ❑ 1 am exempt from Ilcensure 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 gaFi license Is in full force and eB which I must have resided for at least one year prior to completion
License Class (� _Licens No. ZI Improvements covered by this permit I banmot legally sell a structure that 1 he
Expires 3- I-! 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
❑ I hereby afire under penalty of perjury one of the fallowing declarations: submitted or at the following Web site.
I have and will maintain a certificate of consent of seffminsure for workers' hmo•Jlw .leglrrf6.c:a.Qov1nalsw.htmil.
compensation,issued by the Director of Industrial Relations as provided for by
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
I have and w0l 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 anti the Information I have provided is correct I agree to coml
permit Is Issued.My workers'compensation Insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to buildl
Carrier
—SC-1 F construction.I authorize representatives of this city or county to enter the Am
p r p� Identified property for the Inspection purposes.
Policy# 2— /b�� I Z Expires O'— � — ! O Date
Property Owner arAuthorized Agent
(This section need pot be completed If the permit is for O one-hundred dollars($100)or less) City Business License# 3 ✓YJ7 b
4 1 certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION
shall not employ any parsons 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 Code,I shall f mply with those provisions. amounts edged on the Hazardous Materials Information Guide?
DYES amounts
Appli ant Dcte; /a - o� I Will the intended,use of the building by the applicant or future building
WARNING: FAILURE TO SECURE WORKERS' occupant require a permit for the construction or modification from South
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Coast Alr Quality Management Distddt(SCAQMD)?See permitting checkli:
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND for guidelines
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS DYES <NO
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outi
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF. THE bounds ofa school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES XNO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAOMD
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 e,Section 25505 and 25534 conoeming
3097 Civil Code) hazardous mate re orti
OWNER BUILDER DECLARATION DYES NO �� y
I hereby affirn 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 fRRPJ
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 Contractors State License Law(Chapter 9(commencing with receiving compensation for most work that disturbs paint In a pre-1978
Secgon 7000)of Division 3 of the•Businaas and Professions Code)or that he or residence or childcare facility to be RRP-certI ied firms 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 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 mom than($500).) employees.For more Information about EPA's Renovation Program visit
❑ 1, as owner of the property, or my employees with wages as their sole www.epa.gowlead or contact the National Lead Information Center at
compensation,will do( )all of or( )porting of the work,and the structure is 1-800.424-LEAD(5323).
not Intended or offered for sale.(SBCti3n 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,
the building or improvement Is sold within one year of completion,the Owner- Certified Fro Name:
Builder will have the burden of proving that it was not built or Improved for the
purpose of sale). Firm Cerlificalkin No.:
❑ 1, as owner of the property an exclusively contacting with licensed 0 No EPA Lead-Safe Certified Firm Is required for this project beausa:
contactors to construct the project(Section 7044,Business and Professions
Code:The Contactors License Law does not apply tdan owner of a property _
who builds or improves thereon, and who contracts for the projects with a
C •FETY • • IT/PLAN CHECK APPLICATION
Menifee
DATE I�'Z-�p-� PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL )(RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: C ADDITION C ALTERATION O DEMOLITION C ELECTRICAL MECHANICAL
O NEW C PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK n -6,Ln' .r- s• S
Lj I C,6 ,1 5&(c 2. IUrn �o •+ �> :, AIL III
PROJECTADDRESS �026 5' CCU U-- 17N1vrJ 1 0 � C,-�), �iZ2-
ASSESSOR'S PARCEL NUMBER /�3LPLA- % LOT TRACT City
OWNER NAME (�� �•1( I( � �I(,1 (J �'I !'1 k ('_ -) Building Dept.
ADDRESS c)— ; ,C// ` . G� L�GV`( JAN 0 2 20irl
PHONE �J(9 /j�y� /EMAIL Receive
APPLICANTNAME ry 11f
ADDRESS 3�530 M u rr Mtri l ref Cry Q25R
Y)
PHONE rg5lI /) IP !�7/n-Lf 502- EMAII.rnonKSA I y-9D 9 rrvW . Clem
CONTRACTOR'S NAME LCL.0 ' V I O OWNER BUILDER? C YES IhO
BUSINESS NAME C / i COn�� C�YII
ADDRESS
//� / J// nn 'rC50
� I CA _125
PHONE (q51� LO�'''1' `f 'nq J], /ENTAIL mon lcsci l r a"� Gt rna:�•1-�7• Ga+�'�
CONTRACTOR'S STATE LLIIC NUMBER 'mil I Z 1'/`Y LICENSE CLASSIFICATION cL
VALUATION$�i L_,5L SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE lO 10 PAIDAMOUNT
AMOUNT OCASH O CHECK N OCREDIT CARD VISA/MC
PLAN CHECK FFEF PAID AMOUNT 0CASH 0CHECK# 0CREDIT CARD VIWMC
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 92586951-672-6777
www.cityofinenifee.us inspection Request Line 951-246-6213
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