PMT18-00136 City of Menifee Permit No.: PMT18-00136
29714 HAUN RD. Type: Residential Mechanical
'(�kCCELA> MENIFEE, CA 92586
MENIFEE Date Issued:
01/1012018
PERMIT
Site Address: 26515 ALTA AVE, MENIFEE, CA 92585 Parcel Number: 331-462-001
Construction Cost: $5,000.00
Existing Use: Proposed Use:
Description of REMOVE AND REPLACE HVAC-3 TON 16 SEER FURNACE-70K BTUS
Work: SAME SIZE AND LOCATION
Owner Contractor
ALEXANDER STEWART KMA HVAC INC
26515 ALTA AVE 25920 IRIS AVE 13A-400
MENIFEE, CA 92585 MORENO VALLEY,CA 92551
Applicant Phone:8777178732
KMA HVAC INC License Number: 1023799
25920IRIS AVE 13A-400
MORENO VALLEY, CA 92551
Phone:8777178732
Fee Description Div Amount 151
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 staled,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 property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractOT(a)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and a 1 am exempt from Iicensure under the Contractors State License Law for
Professions Code and my license is In full force and effect. the following reason:
License Class VLO License No. �u 2s1
By my signature below I acknowledge that,except for my personal residence
Expires Z Signature A in which l must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.1 cannot legally sell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
❑I hereby affirm under Penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for workers 7044 of the Business and Professions Code,is available upon request when
compensation,Issued by the Director of Industrial Relations as provided for this application is submitted or at the Following website:
by Section 3700 of the Labor Code,for the performance of work for which www.leginfin.m.90Y/calaw.1affll.permit is issued.
Policy# Date
O I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which o By my signature below I certify to each of the following:I am the property
this permit Is Issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
number are: I`1 application and the information I have provided is correct.I agree to comply
Carrier N 0< (A with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# 'kM Wtd �12_ 1�j�Expires 11601-1 enter the above identified property for inspection purposes.
(This section need not to be completed is the permit A for one-hundred Date
dollars($100)or less PROPERLY OWNER OR AUTHORIZED AGENT—
❑1 certify that In the performance of the work for which this permit is issued,
Ishallnotemolov any persons In any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall f4rt((zwi h comp) with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant_ Date f(7 I mixture containing a hazardous material equal to or greater that the
sl amounts speufed on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ayes a No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($1D0,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District cons(SCtionor odi permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airines
CONSTRUCTION LENDING AGENCY o Yes o No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) ❑Yes o No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD
I hereby affirm under penalty of perjury that I am exempt from the Permitting checklist.I understand my requirements under the State of
Contactors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.ayes ❑No
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRPI
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from Iicensure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 70315 by residence or childcare facility to be RRP-certified firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
o I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is wwrmeoa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-80D-424-LEAD(5323).
Code;The Contactors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.if,however,the building or Improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or Improved for the purpose of sale. ❑No EPA LeadSafe Certified Firm Is required for this project because:
o I,as owner of the property am exclusively contacting with licensed
contactors to construct the project(Section 7044,Business and Professions
Code:The Contactors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
IL
Menifee
DATE: PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL CILMECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK (,WA-0 0i1 - Tg foN lip 5 ' F-
PROJECT ADDRESS tiU' 1 q PVT 4 PNt ZIP
ASSESSOR'S PARCEL NUMBER 3?j 1• (.(03, '00 I LOT TRACT
OWNER NAME Rv 01yelL 5ti rw
ADDRESS 1/v 5 pri/14 Av'
PHONE "Is EMAIL
APPLICANTNAME NA14wS Lotle
ADDRESS 1/ 017,0 5 fW' oo N`� -,00UA-
��AA °1'L
PHONE '16t 4jbUI 0&4,1 EMAIL
CONTRACTOR'S NAME t'-M A 1�V" OWNER BUILDER? OYES ONO
BUSINESS NAME ktA lk
ADDRESS 1,5h 4L6 �(GIS A%1F, Af 13 A Da
PHONE W51 411(o 0511 EMAIL hw4 A) N'0'�t►1AtI,,
CONTRACTOR'S STATE LIIC NUMBER 10151E4 a1 LICENSE CLASSIFICATION
VALUATION$ ` (J SQ FT L SQ FT
APPLICANT'S SIGNATURE / DATE I (^
CITY STAFF USE ONLY-
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENG ERING FIRE ACCEPTED BY:
PERMIT FEE ,. , SMIP GREEN
PLAN CHECK FEE INVOICE TOTAL
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of Menifee
Building Dept.
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us JAN I U 20i01
Received
m w m a N i° u, w N N D o D m
n A Z �; Vni d n N fl D D a a 7 ,� o.di. �+
o o -ri -ri rf
m
Z
m
3 � m n < ''1 .^. Q N � o m
3 m r 3 p
a
m i
D v
M A X 3 N O N N n N 3
3 eNi
in N d N O
O O O Q i N S C m
n S m m J <
O O pl J
3 00 7 D w m
m J D
.Os d
J �
N
° < m
< N
�
o °
m
O O w O fD x
D
ae fU J Jn J D m
:*' d O.
O > O n g O CZi J A
O. ~
A p J J ID O -p Q
CD
= QCi Now o. a m
< -
\c N (D R.
O ry pJp N m o _
o a
CD Ei
J 3 d O
N �
d V E (C
� J
a �
N = n d
m
a a D c
A <
i5 COPY
rn
n z ;n m : M ^ ^ " o "
Dm w m m x x sc. v� O M G mm , CL
w' 3 N fD N m w nn9 ina = 3 9 O O
F d V m
(D
^_ £ n m < N d O
j w O O nT £ m� Own w = •O T
m N w a r
.�. N .O .O a vmAi d m o _,
w . m O
n A
= p •* of v y N 1"1 7 O m
° ° w "° O
m o ° o y m 3
0 0 dim 3yw� N0. R N
m 3 m - s 3 3
ry G (C C O O O
G 3
m m N A 7
m m
° O c m TzR w C vi A
93 p O < - > ; w o C r
0 7 (p m m 3 3 m y o o N 7C
3
30
N O 3nx u a_ Q 3 C. A
m m N n m m =
3 @ _ti O O
N
d m< O .� -i � I
3 y as m N o d F, d m � � m nN
a VI "O u0°
a < fJ a rt 3 D n D
CP
mm o 0 o O C' x a. Tn
m < O
N w 'm a m a fD � 000
tD C m T A A � f�1 00
A N H A V <
�y w A N x
/tiJ m o m a Gm3 �
' o
Z W �" o, •2 3 w is
CD
m
cs d a
v D� � c
O
m o m o =r0
0 a
N »
m O
_
m Tn a ^ o m Z
nT o m m m
p A m N ry 0
� ut N 0 0 � O.
a T n
O ° T
G
m n o w F e' m 7ri
2 N N
� m
P w - -
t V OID I 4:;� '
S 3 n N D a to n F+ D -I n p F+ O D n 1
O N n O n W N 6 S O n
W w tin N N D d N a U A w N F+ 'Z N N m L n = 1'1 fO1 N
J O N Vi D 0 0 m c
a J N Dp 'C D
w J of 9 D n o N f w T a v a z G a A c
' o y
m 5 £ n m J D S d m
3 O f"1 J n o A. o » 3. m >• — D m N = O O
m C�' D m m ? N am m c3 A i
w C m 3
< ] p O O
o ]ny o �w. ny c „ a03
< M a D
o O. n v c a w o n o y r1 A
2W o w m Da
D N In
N n N D N
O O A ^ O c 3 W Z M r1 e1
A o 6
71
o IQ�
o �a _ a 93 T
v o 'p » m Mm _. o ; a fl_ (D
0 o vm � n � a3. N N , W n
3 0 ? ,Z o a » w o m c A
0 0'�. 3 3 N _ a 3 ?�
a o ]b �v nw H
tpN o w o
a m N w o a
R 0 3
N ap 09 O N o F. T y' ir
3 » ,,,,'� o• g 3 R a
NN O n o' c n W n N w p O
' O O C V ON O m a n �. F o f° n 0 v c a
> > w G ✓ m w Oa v� n a a w O S w Ot m x c 3 fD
v f.9 m ? N O N 0
O n
� �m o .'. m 3 .o'. � �
0
on m o o w
m ]m > Q ^
A b
oa in c n < n 3i ^
o m — o m
3 n a
O.
w n n o a
u a � o N � _
n 0
a 3 O N v
N m m a
i E
r w w n = n
z as N Ino �
m _
10• C onm
n
O w m n
O ^ o 0 N
T o
C
� 3 v
N
m a O
W m O p y N
lOD V�i O A W T
PMT is • 00104�6