PMT18-01369 City of Menifee Permit No.: PMT18-01369
29714 HAUN RD. Type: Residential Mechanical
ACCEL/7 MENIFEE, CA 92586
MENIFEE Date Issued: 0 312 8/2 01 8
PERMIT
Site Address: 26543 SUN CITY BLVD,MENIFEE, CA Parcel Number: 337-223-003
92586 Construction Cost: $6,694.31
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, CARRIER 3.0 TON, 14.0 SEER, 80%AFUE, R410A SINGLE STAGE SPLIT A/C,
Work: 70K BTU FURNACE
Owner Contractor
ALAN GINGHER MONK'S AIR CONDITIONING
26543 SUN CITY BLVD P O BOX 128
MENIFEE, CA 92586 SUN CITY, CA 92586
Applicant Phone: 9516794502
GARY MONK License Number:912194
MONK'S AIR CONDITIONING
P O BOX 128
SUN CITY, CA 92586
Fee Description Qtv 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 ❑ lam exempt from Ilcensure under the Contractors'State License Lew 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 license is in full force and all which I must have resided for at least one year prior to completion
License Class _Licens No. 2- improvementscovered by this permit,1 cannot legally sell a structure that 1 he
Expires_3-3�--L R_ Signatu built as an owner-building If it has not been consWcted In Its entirety by Iicens,
cenbactors. 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 fallowing Web she:
❑ I hereby affirm under penalty of perjury one the following declarations: hryol/wwiv.leeinfo.n.aovlcalaw.html.I 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 Dale
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 prope.
r.� I have and will maintain workers' compensation Insurance, as required by owner or authorized to act on the property owner's behalf. I have read if
sedan 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 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 buildi
C� construction.I authorize representatives of this city or county to enter the aboo
Comer ��1 identified property for the inspection purposes.
Policy#12- 7 00— /2- Expires O'— — l O Dale
Property Owner or Authorized Agent /,.., (�(This section need not be completed•d the permit is for C" Business License# 0 J ✓V/7 6 one-hundred dollars($100)or less) dY
4 1 certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION
shall not employ any persons 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'compensaticn provisions of Section 3700 of the Labor amounts pacified on the Hazardous Materials Information Guide?
Code,I shall f wi imply with those provisions.�7 DYES A NO
Appli nt• Date; '.C-[l—� b 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 Dlstridt(SCAOMD)?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 bewithin 1000 feet of the out-
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF.THE bounder of school?
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES NO
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�fje,Section 25505 and 25534 concerning
3057 Civil Code) hazardous mate Ire Ai
OWNER BUILDER DECLARATIONS DYES NO ����nX�
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 PRART44NAaP4 AUTHORIZED AGENT
next to the applicable flem(s)(Section 7031.5.Business and Professions Code:
Any city or county that requires a permit to contact,alter,Improve,demolish, EPA RENOVATION,REPAIR AND PAINTING(RRPI
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•Busingss and Professions Code)or that he or residence or childcare facility to be RRP-certified firths and comply with
she is exempt from.Iicensure,and the basis fdr the alleged exemption. Any required practices.This Includes rental property owners and property
violation of Section 703'1.5 by any Applicant for,a pencil subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500.)' employees.For more information about EPA's Renovation Program Visit:
❑ I, as owner of the property, or my employees with wages as their sole www•epa.govAead or contact the National Lead Information Center at
1-300-424-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 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). 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 Contractors License Law does not apply td an owner of a property _
who builds or improves thereon,and who contracts for the projects with a
WIN
Nenifee
DATE 3 PERMIT/PLAN CHECK NUMBER pw '
TYPE: O COIAMERCIAL }(RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION C ALTERATION O DEMOLITION C ELECTRICAL IKMECHANICAL
O NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK PcC- non 3-0 fz-y-) 14 0
pP-/_ 1 Q0 SIl^l1 LP I�_5'4'n 1! S. t�/,�' NL ��hnG I� KU k)rjv
PROJEcTADDRESS 06Z �I� trn I L tj J I • Meriifee cA 13 L
ASSESSOR'S PARCEL NUMBER �JC)-k� 0 t 1 LOT �� - TRACT 3 G'A
OWNER NAME C�Ou d,-)dl o
ADDRESSI I �C�.!'7'� F I�j�l S. O�-Y-9Li V
PHONE(L44D`f Z'z-7-7-I/`( &j EMAIL -�
APPLICANT NAME _u Y
ADDRESS /3�C0/ 530/� M� U rr Nltri i ee CA q2sR
PHONE (•?JI ) P�/!�- SO2 �E/MAILfYIOYIKSaLr� IY1Gt L� • GDYYI
CONTRACTOR'S NAME 1.�1 A-I_y M Q /�-`t�, OWNER BUILDER? O YES NO
BUSINESS NAME J i t CDnd io n L
ADDRESS n 5 I GA r G•S
ff
PHONE N5D 6;-7qr 4502- +/� EMAIL man Ksdlr a? wtC6-L • Gorr
CONTRACTOR'S STATE LICyNUMBER 'mil i 2 / q LICENSE CLASSIFICATION CZ0
VALUATION$ 71/-35 O G SQ FT L SQ FT
APPUCANrS SIGNATURE DATE
CITYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINE55 LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE AMOUNTID AMOU
AMOUNT OCASH CCHECK# OCREDR CARD VISA/MC
PLAN CHECK FEEF PAID AMOUNT OCASH CCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menefee Building&Safety Department29714 Noun Rd. Menifee, CA 92586951-672.6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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