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PMT18-02494 City of Menifee Permit No.: PMT18-02494 29714 HAUN RD. Type: Residential Mechanical CCEL/4 MENIFEE, CA 92586 MENIFEE Date Issued: 05/22/2018 PERMIT Site Address: 27075 PETUNIA CT, MENIFEE, CA 92586 Parcel Number: 335-362-022 Construction Cost: $6,759.56 Existing Use: Proposed Use: Description of HVAC CHANGE OUT, NEW CARRIER 3.5 TON 14.0 SEER R410a SINGLE STAGE SPLIT A/C WITH Work: 90,000 BTU FURNACE Owner Contractor DON SLATER MONK'S AIR CONDITIONING 27075 PETUNIA COURT P 0 BOX 128 MENIFEE,CA 92586 SUN CITY, CA 92586 Applicant Phone: 9516794502 TIFFANI SELLERS License Number: 912194 MONK'S AIR CONDITIONING P O BOX 128 SUN CITY, CA 92586 Fee Description ,O�t Amount 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_Templatexpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ lam exempt from leensure under the Contractors'State License Law for 1 hereby affirmunder penalty or perjurythat 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 rjo{i h��rise Is In full force and eff which I must have resided for at least one year prior to complellon License Class_(� Ucens No. 2 improvements covered by this permit,I cannot legally sell a structure that I N Expires 3_3 i_ R� Signatu built as an owner-building If it has not been constructed in its entirety by licem 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 site: ❑ 1 hereby affirm under penalty of perjury one of the following declarations, hao•JAvvnv.leainfo.ca.govlcalaw.html. I have and will maintain 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 P0IIcyW ❑.By my Signature below, I certify to each of the following: I am the propr V_ I have and will maintain workers' compensation insurance, as required by per or authorized to act on the property owner's behalf. I have read I section 3700 of the Labor Code,for the perfomrance of the work for which this application and the Information I have provided is correct I agree to corn permit is issued.My workers'compensation insurance carder and polity 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 abo Carder identified property for the Inspection purposes. Policy#1 L— /b0— /Z Expires �— f —� DateProperty Owner or Authorized Agent ' (This section need Cot be completed If the permit is for 035l�79 one-hundred dollars($100)or less) City Business License# 1 certify that in the performance of the work for which this pemdt is iswied,I HAZARDOUS MATERIAL DECLARATION shall not emofov any parsons in any manner so as to became subject to the Wig the applicant or future building occupant handle hazardous material o workers'compensation laws of California,and agree that if I shouttl become mixture containing a hazardous material equal to or greater that the subject to the workers'compensation provisions of Section 3700 at the Labor amounts s cified on the Hazardous Materials Information Guide? Code,4 shall mply with those provisions. ❑YES�O Appll nt• Date; 10 o WIII 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 Dlsbddt(SCAQMD)?See permitting 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 ($900,000),IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the ou DAMAGES AS PROVIDED FOR AN SECTION 3706 OF THE bound of a school? LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES E"O . CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm that under the penalty of perjury thsre 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 C e,Section 25505 and 265M concerning 3097 Civil Code) hazardous mate Ire orti OWNER BUILDER DECLARATIONS DYES NO I hereby affirm under penally 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 O N AUTHORIZED AGENT next to the applicable ilem(s)(Section 70315.Business and Professions Code: Any city or county that requires a permit to construct after,improve, demolish, EPA RENOVATION.REPAIR AND PAINTING(RRP1 or repair any structure,prior to 16 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 License Law(Chapter 9(commencing with receiving compensation for most work that disturbs paint in a pre-1978 Section 70D0)of Division 3 of the-86stripss and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with she is exempt from Jicensure.and the basis fdr 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 palnt-disturbing 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.govBead 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 Professlons Code; The Contractor's Stale License Law does not apply to an owner of a property ❑An EPA Lead-Ssfe 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). Firm Certification No.: O 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 ] PERMIT/PLAN CHECK NUMBER TYP : O OMMERCIAL X RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOLISPA 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 f(C Cba= (' f-e ,T C ``-��� ftoC MG Gt L Lw q8 k- I i ,, w v PROJECTADDRESS Qy7_S 7,1 C" Cf, l ` .}�( C" '2� " ASSESSOR'S PARCEL NUMBER 3 -2 n -L Z 6 LOT � LA^-r TRACT Bu Ids OWNER NAME S a —c C ADDRESS _ ,� n , ' C-t be v-J PHONE V70 • I-3(,n] EMAIL Received APPLICANTIN2NA/^MMl.�E aj r i_J ADDRESS 5W M VM I' ^ / I d lf �>p� eY " 1 l PHONE (q5 ) IP (/L?lf502 A EMAILrnonKjQ1r� ►Y�;La - �.om CONTRACTOR'S NAME l..( LY- ' V I Q L`�� OWNER BUILDER? OYES NO BUSINESS NAME C MWIC5' (r Chod I Qn I ADDRESS //� J/ C� ( GA q-25 PHONE l '�1SI) Ld 1`�f � C/�J/Z �]� /EMAIL mbnlcS60r r� Gi�"na:�L - GOm CONTRACTOR'S STATC LIC NUMBER/ "I 12 1-J`y LICENSE CLASSIFICATION CZ0 VALUATION$ ve , S� SQ FT LSO FT APPLICANT'S SIGNATURE DATE /t7II DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING cNGINEERING FIRE I GREEN SMIP INVOICE AMOUNT PAID AMOUNT O CASH O CHECK# O CREDIT CARD VISAIMC 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 Menifee Building&Safety Department 29714 Houn Rd. 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