PMT18-00936 City of Menifee Permit No.: PMT18-00936
29714 HAUN RD.
<A-CCEL/-> MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE Date Issued:
03/02/2018
PERMIT
Site Address: 28210 HARMONY LN, MENIFEE, CA Parcel Number: 340-273-016
92584 Construction Cost: $9,000.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT,4-TON A/C(BACKYARD)100K BTU FURNACE(ATTIC)
Work:
Owner Contractor
PATRICIA HOWERTON A S I HASTINGS INC
28210 HARMONY LANE 4870 VIEWRIDGE AVENUE 9200
MENIFEE, CA 92584 SAN DIEGO, CA 92123
Applicant Phone:6195909300
JILL WESTON License Number:513115
A S I HASTINGS INC
4870 VIEWRIDGE AVENUE#200
SAN DIEGO, CA 92123
Fee Description gyt Amount W
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_Pennk Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts far the projects
With a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter9(commencing with section 700D)of Division 3 of the Business and o I am exempt from Rcensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class CZ-O License No. -7-79X�0� By my signature below l acknowledge that,except for my personal residence
Expires tb Signature in which lmost have resided for at least one yearpdarto completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
have built as an owner-builder if it has not been constructed In Its entirety by
o 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 worker's 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.leRInfo.ca.goy/caIaw.html.permit is Issued.
Policy# Date
Ihave and will maintain worker's 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 1 certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carder and policy owner or authorized to act on the property owner's behalf.I have read this
numberar/e-: application and the information 1 have provided is correct 1 agree to comply
Carrier Gtnrr_v with all applicable city and county ordinances and state laws relating to
�. building construction.I authorize representatives of this city or county to
Policy# A0CL,JCR0.9�LJx Expires 111)1A: enter the above identified property for inspection purposes.
(This section need not to he completed is the permit Is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
o I 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# naS2.02—
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
�— mixture containing a hazardous material equal to or greater that the
Applicant � Bate / -7 n amounts sp Wed on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes��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($100,000),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(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguideli es
CONSTRUCTION LENDING AGENCY 0Yes
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility he within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer bound'ry ofaschool?
(Section 3097 Civil Code) o Yes
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjurythat I am exempt from the
Call
Contractor's License Law for the reason d
s)indicated below by the arou atch&Safety Code,Section 25505 and 25534 concerning
material material reporting.
checkmark(s)I have placed next to the applicable items)(Section 7031.5 %
Business and Professions Code).Any city or county that requires a permit to Ye oNo
yC2 I2. 7 "1
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 Contractor's 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 licensure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 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
a 1,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 www.epa.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800.424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will he 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. D No EPA Lead-Safe Certified Firm is required for this project because:
o I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractoes 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.
11-1vlenifee
DATE nj U PERMIT/PLAN CHECK NUMBER -619
TYPE: ❑COMMERCIAL ❑RESIDENTIAL ❑MULTI•FAMILY ❑MOBILEHOME POOL/SPA ❑SIGN
SUBTYPE: []ADDITION []ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL
[]NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK r\
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