PMT18-02485 City of Menifee Permit No.: PMT18-02485
29714 HAUN RD.
'�CCEL/F� MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 05/22/2018
PERMIT
Site Address: 30011 CARMEL RD, MENIFEE,CA 92586 Parcel Number: 336-133-002
Construction Cost: $6,723.88
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, NEW CARRIER 2.5 TON,4 SEER, R410A SINGLE STAGE SPLIT A/C W/70K
Work: BTU FURNACE
Owner Contractor
EVERLEE DAVIS-KELLY MONK'S AIR CONDITIONING
30011 CARMEL RD 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 ON Amount f$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_Pennit Templale.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ 1 am exempt from(censure under the Conaactors'State License Law for
I hereby affirm under penalty or perjury that I am licensed under provisions of fallowing 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 eft which I must have resided for at least one year prior to completion
Ucense Class �- Ucens No. )2-IQLI improvements covered by this permit,I cannot legally sell a structure that I h:
Expires 3—'� —! Signatu built as an owner-building If it has not been constructed In its entirety by licens
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 applicetior
submitted or at the following Web4de:
❑ I hereby ail( under a cerfi of perjury one t the following declarations: httpJMvnvleainfo.ca nov/plew.html.
1 have and will malntaln a certificate of consent of seH-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
.Poolicy# ❑.By my Signature below, I certify to each.of the following:I am the prop(
n( I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's 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 coned I agree to Corr
permit is Issued.My workers'compensation Insurance carder and policy number are: with all applicable city and county ordinances and state-laws relating to build
construction.I authorize representatives of this city or county to enter the alto
Cartier Q identified property for the Inspection purposes.
Policy#12— 00— /2 Expires �— 1 —1 p Dom•
Property Owner or Authorized Agent
(This secton need p_ot be completed H the permit is for oi5�7g
City Business License#
one-hundred dollars($100)or less)
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 VA the applicant or future building occupant handle hazardous material o
workers'compensation laws of California,and agree that H I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'oompensadon provisions of Section 3700 of the Labor amounts eoified on the Hazardous Materials Information Guide?
Code,I shall imply with those provisions. DYES amounts
Appli on- Date; 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 pernitfing check(
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 fadiify,be within 1000 feet of the ou
DAMAGES AS PROVIDED FOR IIN SECTION 3706 OF THE bounds of a school?
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES�JO
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 Celffomia Health 1 Safety e,Section 25505 and 25534 concerning
3097 Civil Code) hazardous mate d re orti
OWNER BUILDER DECLARATIONS DYES NO
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 PRO OAlkagA AUTHORIZED AGENT
next to the applicable items)(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 IRRP)
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 contractor
provisions of the Contractor's State Ucense Law(Chapter 9(commencing with receiving compensation for most work that disturbs paint in a pre-1978
Seetion 7900).of Division 3 of the-B6aM)3ss and Professions Code)or that he or residence or childcare facility to be RRP-certified firths and comply with
she is exempt from Jioensure.and the basis far the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 by any Applicant fora permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than(3500.1 employees.For more Information about EPA's Renovation Program visit:
ro www.epa.govAead or contact the National Lead Information Center at
D 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 projei
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 proviig that it was not bulk 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
• APPLICATION
Menifee
DATE 1 PERMIT/PLAN CHECK NUMBER 1 -0
TYPE: O MMERCIAL )(RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOUTION O ELECTRICAL MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK hC Q -e{ t) 2 .5
>
Y ' ^ c A
O c i 1X� �
PROJECTADDRESS ( GiZ
ASSESSOR'S PARCEL NUMBER LOT Tt)g • 0 3
OWNERNAME �J ( — Building Dept.
ADDRESS//��,�----//
PHONE " 6/ � J�[}�' j53 EMAIL
APPUcANTIMME D l,/ (deceive
ADDRESS 305W r Pd., Mitn ( �e-e CA 025R4
PHONE RJ! ( 7q—g5C(2 �/EMAILInonK-50ir� IY7Gw - cben
`
CONTRACTOR'S NAME C-T�y' 1 V I o j x OWNER BUILDER? OYES iNO
BUSINESS NAME 1 (r d( -O rl -
ADDRESS /� 5 ( GA -'1 ZS
PHONE Cg51� Cp-7q-- 4,502. EMAIL rnbn V-SQIr Z 9 k-na--.L - C-0
CONTRACTOR'S STATE LIC NUMBER ppQI Z IIN LICENSE CLASSIFICATION CZQ
VALUATIONS 4a,7z.5, OCR SQFT 2 LSQFT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESSLICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREENF-I SMIP
INVOICE PAID AMOUNT
AMOUNT O CASH O CHECK# O CREDIT CARD VISr�/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDIT CARD VISAIMC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO
City of Men fee Building&Safety Department 29714 Noun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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