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PMT18-01587 City of Menifee Permit No.: PMT18-01587 29714 HAUN RD. Type: Residential Mechanical SACCEI /�R MENIFEE,CA 92586 MENIFEE Date Issued: 04/06/2018 PERMIT Site Address: 29234 MURRIETA RD,MENIFEE,CA Parcel Number: 338-092-002 92586 Construction Cost: $16,500.00 Existing Use: Proposed Use: Description of 3 TON COMPLETE SPLIT SYSTEM REPLACEMENT W/DUCT REPLACEMENT Work: Owner Contractor GREGORY FRENCH A R S AMERICAN.RESIDENTIAL SERVICES OF 29234 MURRIETA RD CALIFORNIA INC MENIFEE,CA 92586 965 RIDGE LAKE BLVD#201 Applicant Phone:9512769744 KENNY PEERY License Number:765074 A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNb 965 RIDGE LAKE BLVD#201 MEMPHIS,CA 38120 Fee Description Gil( 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 officlal 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_Pernit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects hereby affirm under penalty of perjury that l am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). ChapteM(commencing with section 700D)of Division 3 of the Business and a l am exempt from licensure under the Contractor's State License Law for ProFessions Code and my license is In full force and effect the following reason: License❑as<C(O?C70/G 3j45—License No. l C6(:)74 By my signature below I acknowledge that,except for my personal residence Expires - :5y1Tigna[ure in which l must have resided for at least one year prior to completion of WORKER'S COMPENSATION DE[IARAT[ON improvements covered by this permit I cannot legallysell a shvcture that I have built as an owner-builder if it has not been constructed in its entirety by �1 hereby affirm under penaltyoF perjury one of the following declarations:I licensed contractors.I understand that a copy of the amlfrable late,Section have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Pmfessions Code,Is available upon request when compensation,issued by the Director of Industrial Relations as provided for by section 3700 of the Labor Cade,for the performance of work For which this application is submitted ora[thefollowing website this permit is issued. vA-Av.leeinfo.ca.eov/calaw.hrml. Policy# Date al have and will maintain workees compensation insurance,asrequiredby PROPERTY OWNER ORAUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work forwhich O By mysignature below l certify to each of the following:I am the pmperty this permit is issued.My worker's compensation insurance carrierand policy owner or authorized to act on the propertyovmers behalf.I have read this numberare: application and the information 1 have provided Is correct I agree to comply Cary /L.ier with all applicabledryand county ordinances andstate lammiatingto • -/.-. // building construction.I authorize representatives ofthis dtyorcountyto Policy 9 M315LIS/S& Expi —54 enter the above identified property For inspection purposes. (This section need not to be completed B the permit is for one-hundml dollars($300)or less Date. PROPERTY OWNER OR AUTHORIZED AGENT ❑I mrdfythat in the performance of the work for which this permit isIssued, rshall not emolov any personsin anymannerso asto become subject to the CITY BUSINESS UCENSE# J I workers compensation taws of California,and agree that III should become subjectto theworkers compensation provisions of5ection 3700 of the Labor RODUS MATERIAL DECLARATION Code,I shall forrt/tth//w} comply wit thoseprovaium. J Q ill the aoalfcant or future building occupant handle hazardous material or Applicant Date I /� /J -iie containing a hazardous material equal to or greater that the --{ + , amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO REWORK S COMPENSATION COVERAGE iS - OYes '200 UNLAWFUL,AND SHALL SOBIECr AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the intended useaf the building by the applicant or future building ADDITION TO THE COST OF COMPENSATION,DAMAGES As PROVIDED FOR occupant require a permit for the construction or modification from South IN SECTION 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SC4QMD)?See permitting checklist forguideftnes CONSTRUCTION LENDING AGENCY aYes /No herebyaffirm that under the penaltyof perjury there is aconstruction Wll 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 Cade) DYes 0lw1 - OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and theSCA0,MD I herebyaffirn under penalty ofperjury that l am exempt from the permitting checklist l understand my requirements under theState of Contractor's License Law for the reason(s)Indicated below by the California Health&Safety Cade,Section 25505 and 25534 concerning chedamrk(s)I have placed next to the applicable item(s)(Section 70315 hazardous material reporting. , Business and Professions Code).Any city or county that requiresa permit to DY ONo construct,alter,Improve,demolish or repair any structure,prior to itseejz�w12A44 Date CXl issue fte,also requires the applicant for the permit to file a signed statement PROPERTY OWNER OR�EDAGENr' that he orshe Is licensed pursuant to the provisions of the Contractors State EPA RENOVATION.REPAIR AND PAIGNTIING(RRP) License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair Painting RRP Business and Professions Cade)or that he arshe fs exempt from licensu2 - P g( J Rule requires contractors and the basis for the alleged exemption-Any violation ofsectioq 7031.5 by receiving compensation for most work that disturbs paint in a pre-7978 an Applicant for a permit iubjects the applicant to a civil peitaltyofnot more residence or childcare Facility to be RRP-certified firms and comply with than($500). iequired practices.This includes rental propertyawners and property managers who do the paint-disturbingwork themselves or through their al,as owner of the property,army employee with wages aitheirsole employees.For more information about EPA's Renovation Program visit compensation,will doO all oforO portion of the work,and the structure is www-eaa. ov�iead or contact the National Lead information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-IEAD(5323). Code,The Contractors State License Law does not apply to an owner ofa DM EPA Lead-Safe Certified Renovator will he responsible for this property who,through employees'or personal effort,builds or improves the P project Property provided that the improvements are not intended or offered for Certified Firm Name sale-If,however,the building orimprovement is sold within one year of Firm Certification No*: compeetion,the Owner-Builderwill have the burden of proving that It was not built orimproved forthe purpose of sale. D No EPA Lead-Safe Certified Finn is required forthis project became: D 1,as owner of the propertyam exclusively contracting with licensed contractors to construct the project(Secdon7044,Business and Professions Code:The Contractors State License taw does notappty to an owner of a IF our project does not Y P 1 comply with EPA RRP rule Please fill out the RRP � Acknowledgement j • ,Is DATE S S PERMIT/PLAN CHECK NUMBER T*mI b TYPE: -- COMMERCIAL O*SIDENTIAL C MULTI-FAMILY MOBILE HOME •-,)POOL/SPA '-'SIGN SUBTYPE: " ADDITION ALTERATION 0 DEMOLITION ELECTRICAL C MECHANICAL NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 3 To 3 tvi ( L PROJECT ADDRESS Z '� U' v" �O• ASSESSOR'S PARCEL NUMBER 1` ! LOT TRACT OWNER NAME IeYlJ,,` I ADDRESS PHONE I EMAIL APPLICANT NAMEVv�.U�" ' /' ADDRESS 3U (� S"'r . R1V FR&lQ z. Cam- PHONE (�00) �60-Q)6-7 1 r EMAIL CONTRACTOR'S NAME \ 11" nT�M1� TI�l�l' Sf�UI - OWNER BUILDER? C YES /NO BUSINESS NAME ADDRESS �J o 50 ��ryY S � 1"l�V�r��r( GR PHONE OUP �/l9V VC7 r EMAIL �/ CONTRACTOR'S STATE LIC NUMBER / S rrll V V I LICENSE CLASSIFICATION Lldf i.10�G VALUATION$ S"Od SQ L SQ FT APPLICANT'S SIGNATURE DATE DEPARTMENT PLANNING DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER ENGINEERING FIRE GREEN SMIP INVOICE PAIDAMOUNT AMOUNT • CASH CHECKR CREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT C CASH O CHECK N 'J CREDIT CARD VISA/MC OWNER BUILDER VERIFIED C YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO S m n EL 93 o 0 0 n o T T D m n n yp N tp V V• W Y m X p, a ry d y N n n N n 9 9 > > m z o n n n n m m o o d a n C FF a N o m n d 3 D A m m VI m O O jp Y O V1 7 N m 00 41 w � ^ n o p m O < 0 ^ v n 3 i Oo Cla 0 Q N a d ' � < � a •c � o w m A N £ � W m °° °' ? ° c o F F E. cz ^ c a m 3 = 3 m v 9. 3 o m m _n v c c)7 tp P c .• „ F F n N C C -c v 00 r. to Z � O d O „! •G a R C = O 6 0 V N n w a Z < = 0l O N O 7 O N a n 3 v Z < m v o 0 n m 3 m w c N � 6 ry N 2 n 2 o m ° N n o f0 w � 6 �• O. =� Y N � 09i F ut m m n ,G w •� o Y y w v� vA+ 3 N 41 m �I�rri� • a�� oFficE r r n r n n " m � � n, NA ,� � n O D n m w m m _ � 1p zaxs "c o M v� z 'Z C O N 'n r (1 u' T C 2 � D d _• (p H N T w 3 3 x x = x a a a Om m n' n N N (AO n 3 n o ri n a 3 m 3 m D 3 D 009 0=q a !i O13 oiu, . ? v u C V d A O a 0 3 3vo n bo 1 1 S 3 p 3 n 3 0 m C 3Dx � � '° a so n N m M p m o v tin a •• `c' `�" n - p j 3 np y_ 3 on D m a N O O S n n O' N O G A Ov N � w v m a N p m m < o w m > > > m < V1 N N p i+ In o m 3 F O ? 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