PMT18-01368 City of Menifee Permit No.: PMT18-01368
29714 HAUN RD. Type: Residential Mechanical
�ACCEJ /� MENIFEE, CA 92586 9P
MENIFEE Date Issued: 03/28/2018
PERMIT
Site Address: 29063 THORNHILL DR, MENIFEE, CA Parcel Number: 338-044-011
92586 Construction Cost: $7,235.00
Existing Use: Proposed Use:
Description of HVAC CHANGE, NEW CARRIER 3.0 TON, 14.0 SEER, 92%AFUE, R41 OA SINGLE STAGE SPLIT A/C
Work: SYSTEM W/60K BTU FURNACE
Owner Contractor
JOSEPH BOUCHAYA MONKS AIR CONDITIONING
29063 THORNHILL DR P O BOX 128
MENIFEE,CA 92586 SUN CITY,CA 92586
Applicant Phone:9516794502
GARY MONK License Number:912194
MONKS AIR CONDITIONING
P0 BOX 128
SUN CITY, CA 92586
Fee Description OQt 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 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 ❑ tam exempt from ficensure 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 1 acknowledge that,except for my personal residence
Professions Code license is in full force and eff t which I must have melded for at least one year prior to completion
License Class_r Licens No. 2 improvements covered by this permit,I cannot legally sell a structure that I he
Expires3-5): I R' Signatu built as an owner-building If it has not been constructed In its entirety by ficens•
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 appllcetion
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one of the following declarations: httollwww.leginfo.ra iov/slaw html.
I have and will maintain a cartifcate 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 o1 the following: I am the prope.
Id I have and will maintain workers compensation insurance, as required by owner or authorized to act an the property owner's behalf. I have read it
section 3700 of the Labor Code, for the performance of the work for which this application and the Information I have provided is cored. 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
C construction.I authorize representatives of this city or county to enter the abov
Carder ��7lh� identified property for the inspection purposes.
Policy#1�]— /V0— I Z Expires U — / — { O Date
Property Owner or Authorized Agent
(This section need not be completed if the permit is for City Business License#__ 03 v72
one-hundred dollars($100)or less)
41 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 Wit 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'oompensaficn provisions of Section 3700 of the Labor amounts ecified on the Hazardous Materials Information Guide?
Code,I shall vA mply with those provisions. /^'� (�' ❑YES 7e
Appli nt• Date; J2CJ O Will the intended.use of the building by the applicant or future building
occupant require a permit for the construction.or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checkfi:
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines -
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND OYES <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 oub
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE bounds ofa school?
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES JNO
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 e,Section 25505 and 25534 concerning
3057 Civil Code) hazardous mate I re orti
OWNER BUILDER DECLARATIONS DYES NO
ma%
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's Date✓'t /lam;�I X
License Law for the reason(s)indicated below by the checcmark(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 fRRPI
or repair any structure,prior to its issuance, also requires the applicant for the
permit to fife 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-Businjess and Professions Cade)or that he or residence or childcare facility to be RRP-certfied firms and comply with
she is exempt from.Iicensure.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-0isturbing work themselves or through their
a civil penalty of not more than($500).) employees.For more information about EPA's Renovation Program visit
www.epa.govAead or contact the National Lead Information Center at
❑ I, as owner of the property, 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 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, Certified Finn 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 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
FETY TIERMIT/PLAN CHECK APPLICATION
'Menifee
DATE ,7}20 '15 PERMIT/PLAN CHECK NUMBER I J� 1lJL
TYPE: O COMMERCIAL X RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDffION C ALTERATION O DEMOLITION O ELECTRICAL KMECHANICAL
O NEW O PLUMBING O RE-ROOF-NUM�BER OF SQUARES. I
DESCRIPTION OF WORK PfC- (/a.,K I-,3 -D L O SI-T,,
LY
gFLE �?- ,fDr �- na `:SKr - `s (-v 70 8-n) /-
PROJECTADDRESS 2�S4 J cC (,Ln / C V , P�� S�w
.ASSESSOR'SPARCELNUMBER S3aZ-Z3 LOT TRACT
OWNER NAME L / CC
�q
ADDRESS L' �ll �Q
PHONE 6N ) 672 — 5 EMAIL
APPUCANT NAME U ar V.—M, D(lk
ADDRESS 305PO! O/� /M U 1 {rQd ,, I" I fr�( ' ` f CA 0 Z5 V .
PHONE (q!5 502�- p ,� �EEMAII-rnonKSA 1 P� "WAA • cbm
CONTRACTOR'S NAME aCJ r ! 1/I OF LV, �J OWNER BUILDER? O YES NO
BUSINESS NAME
�CCa�--� A( IIr Conde or) I
ADDRESS////�J 70 M I CA y25
PHONEN51� Cp1'�f 4 X/�9— J]' IEMAILngonkSalraGem .!- • GD+r,
CONTRACTOR'S STATE L�IC�}NUMZB�ER `mil P 2 I `7 LICENSE CLASSIFICATION CZ-0
VALUATION$to ,( l`t, �11 SQ FT �•C'� � LSQ FT
APPLICANT'S SIGNATURE DATE
CITYSTAFF USE ONLY
DEPARTMENT DISDYIBVPON CITY OF MENIFEE BUSINES-°LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT 0CASH OCHECK# OCREDITCARD VISAJMC
PLAN CHECK FEET PAID AMOUNT OCASH OCHECKR OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER 0 YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenlfee.us Inspection Request Line 951-246-6213
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