PMT18-02278 City of Menifee Permit No.: PMT18-02278
29714 HAUN RD.
4;N: /7►. MENIFEE, CA 92586 Type: Residential Mechanical
Gwrmmf OMlwae MENIFEE Date Issued: 05/10/2018
PERMIT
Site Address: 29486 CATANO RD, MENIFEE, CA 92584 Parcel Number: 339-222-005
Construction Cost: $6,416.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, CARRIER 3 TON 2 STAGE A/C, 80%AFUE, R410a, 70,000 BTU FURNACE
Work:
Owner Contractor
LINDA CONAWAY MONKS AIR CONDITIONING
29486 CATANO ROAD P O BOX 128
MENIFEE,CA 92584 SUN CITY,CA 92586
Applicant Phone:9516794502
TIFFANI MONKS License Number.912194
MONK'S AIR CONDITIONING
PO BOX128
SUN CITY,CA 92586
Fee Description 21y Amount($1
Forced-Air or Gravity-Type Furnace or Bumer 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 licensure under the Contractors'State Ucense Law for
following reason:
I hereby affirm under penalty or perjury that I am licensed under provisions of
Chapter 9(commencing with sectloh 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 eft t n which I must have resided for at least one year prior to completion
License Class_ _Ucens No. 2- "ZY improvements covered by this permit I cannot.legally sell a structure that I hr
Expires 3-31-/R' Slgnatu built as an owner-building If it has not been constructed In Its entirety by Iicen;
contractors.I understand that a copy of the applicable law,Section 7044 of
WORKERS'COMPENSATION DECLARATION __ Business and Professions Code,is available upon request when this application
submitted or at the following Web-she:
❑ I hereby affirm under penalty of perjury one of the following declarations: httoJAvww.leginfo.ca.gov/calew.hbnl.
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 Date
Section 3700 of the Labor Code,for the performance of work for which this
permit Is Issued. Property Owner or Authorized Agent
Policy# D.By my Signature below, I certify to each of the following:I am the propt
4 1 have and wll maintain workers compensation insurance, as required by per or authorized to act on the property owners behalf. 1 have read I
section 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 con,
permit is issued.My workers'compensation Insurance carder and policy number are: with all applicable city and county ordinances andstate-laws relating to build
concoction.I authorize representatives of this city or county to enter the abo
Carder c. �7 Q, identified property for the Inspection purposes.
Policy#12— /b0� I L— Expires 6— —I V Date
Property Owner or Authorized Agent
(This section need pot be completed If the permit is for City Business License# O J.✓Vf�
one-hundred dollars($100)or less)
14 1 certify that in the performance of the work for which this pemnit is issued,I HAZARDOUS MATERIAL DECLARATION
shall not enrol any persons in any manner so as to beootae subject to the Will the applicant or future building occupant handle hazardous material o
workers'compensation laws of California,and agree that if 1 should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor amounts s ecified on the Hazardous Materials Information Guide?
Code,I shall mply with those provisions. ❑YES VNO
Appg nt• Date; 5 —7 ' Will the intended.use of the building by the applicant or fubrre building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO EC E WORKERS' Coast Air Quality Management District(SCAOMD)?See permitting checkl
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 be within 1000 feet of the ou
DAMAGES AS PROVIDED FOKIIN SECTION 3706 OF THE bounds ofa school?
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES
J0
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAOMD
I hereby affrn 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 Cyy e,Section 25505 and 255M concerning
3097 Civil Code) hazardous mate I re orti g.
OWNER BUILDER DECLARATIONS DYES NO
I hereby affirm under penally of perjury that I am exempt from the Contractor's �\ Date
ON License Law for the reasan(s)Indicated below by the checkmark(s)I have placed PRO AUTHORIZED AGENT
next to the applicable hem(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 IRRPf
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,Ilcaased pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contractor.
provisions of the Contractor's State License Law(Chapter 9(commenting with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Divislon 3 of the•B,.slrmpsa end Professions Code)or that he or residence or childcare facility to be RRP-certified firths and comply with
she is exempt from licensure.and the basis fdr ftme alleged exemption. Any required practoes.This includes rental property owners and property
violation of Section 703).5 by any Applicant for. permit 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 m employees with wages as their sole www.epa.gov/lead or contact the National Lead Information Center at
pe ( )all of or( )poring of the work,and the structure la 1-800.124LEAD(5323).
compensation,will do
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 O An EPA Lead-Safe Certified Renovator will be responsible for this proje,
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). Finn Certification No.:
❑ I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Finn Is required for this project because:
contactors to construct the prgjecl(Setition 7044,Business and Professions -
Code:The Contractor's License Law does not apply tdan owner of a property
who builds or improves thereon,and who contracts for the projects with a
SAFETY •LAN (HECK APPLICATION
Menifee
DATE Z�J�' PERMIT/PLAN CHECK NUMBER _I
TYPE: O COMMERCIAL )(RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL XMECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK ntLfL(.L..t - C)
sfr,II.Ae A7C " I ' awl ;
PROJECTADDRESS C 2LX�itv of
�Q
ASSESSOR'S PARCEL NUMBER LOT TRACT y)""Vpt•
OWNER NAME C, ' V ' MAY O
ADDRESS //�� 11 ti ��7U
PHONE(q.'5 ) 24 L5- �7G-7 EMAIL Receive
APPLICANT NAME & r
ADDRESS /3�c01 5260/] M QY M en l Rete CO- g25R4
PHONE (`7Ji ) (P r"?-L[5Q2 /� EMAILmonKSoIrtD rr)o,).� . Cbm
CONTRACTOR'S NAME U �•If ' V I Q /`,, r OWNER BUILDER? OYES NO
BUSINESS NAME C MnnV!,5i t Cbnd i 'o r)
ADDRESS nG J /� I r r7 GA q25
944
PHONE (IR51� �or7� '7�n/G_ /�, /EMAIL mOn k-S c i r a7 h'ZG2./_�.i. • GD rn
CONTRACTOR'S STATE LIC NUMBER `�1 I Z 1—/L1 LICENSE CLASSIFICATION C2_Q
VALUATION$ - -I CCU SO FT ?i 1 Sz'� L SQ FT
APPLICANT'S SIGNATURE DATE
CITYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS UCENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE SREEN SMIP
INVOICE '�" -�1111 2 PAIDAMOUNT
AMOUNT ✓�Y•�O C/ O CASH O CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 0CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586951-672-6777
www.cityofinenifee.us Inspection Request Line 951-245-5213
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