PMT18-02654 City of Menefee Permit No.: PMT18-02654
29714 HAUN RD.
/ MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE MENIFEE Date Issued: 05/31/2018
PERMIT
Site Address: 30060 THORNHILL DR, MENIFEE, CA Parcel Number: 336-142-0135
92586 Construction Cost: $5,747.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, NEW CARRIER 3.0 TON, 14 SEER, R410a SINGLE STAGE SPLIT A/C TO
Work: EXISTING FURNACE
Owner Contractor
SAM FEDELE MONKS AIR CONDITIONING
30060 THORNHILL DRIVE P 0 BOX 128
MENIFEE, CA 92586 SUN CITY,CA 92586
Applicant Phone:9516794502
TIFFANI SELLERS License Number:912194
MONKS AIR CONDITIONING
P O BOX 128
SUN CITY, CA 92586
Fee Description Qy Amount f$1
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 6.65
$167.65
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 O I am exempt from licensure under the Contractors'State License Law for
I hereby affirm under penalty or pejury that 1 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 Cote yy'license is in full force and a which I must have resided for at least one year pdor to completion
License Class_C7 ucens No. Z Qq improvements covered by this permit,I cannot legally sell a structure that I hi
Explres3-5 -0 Signatul built as an owner-bulding if it has not been constructed in its entirety by licen:
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 WebsHe:
❑ 1 hereby affirm under penalty of perjury one of the following declarations: htto://www leginfo.o.aov/ralaw.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 Date
Section 3700 of the Labor Code, for the performance of work for which this
permit is issued. Property Owner orAuthor¢ed Agent
Policy# ❑.By my Signature below, I certify to each of the following: I am the prop(
1( 1 have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I 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 1s correct I agree to com
permit is issued.My wodrers'compensation Insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to build
C -� 1 construction.I authorize representatives of this city or county to enter the abo
Cartier c.� � ) Q� identified property for the inspection purposes.
Policy#I G--/00— I Z Expiresj�— — 1 v Date
Property Owner or Authorized Agent ('
(This section need not be completed if the permit is for City Business License# 07640-7 6
one-hundred dollars($100)or less)
I certify that in the performance of the work for which this permitis issued,I HAZARDOUS MATERIAL DECLARATION
shall not emolov any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material o
workers'compensation laws of Ca;llomla,and agree that if I 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 an the Hazardous Materials Information Guide?
Code,I shall mply with those provisions. DYES 7NO
Appli n• Date; y 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(SCAOMD)?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
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 10D0 feet of the ou
DAMAGES AS PROVIDED FOR iN SECTION 3706 OF THE bounds ofa school?
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES NO .
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 California Health Safety e,Section 25505 and 25534 concerning
3097 Civil Code) hazardous mate I re orti�OWNER BUILDER DECLARATIONS ❑YES NO DateU Q
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the reason(s)indicated below by the chedanark(s)I have placed PRO O N AUTHORIZED AGENT
next to the applicable Item(s)(Section 7031.6.Business and Professions Code:
Any city or county that requires a permit to construct, after,Improve, demolish, EPA RENOVATION.REPAIR AND PAINTING fRRP1
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.liceased pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contracton
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•BusinPss and Professions Code)or that he or residence or childcare facility to be RRP-certified firms 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 7031.5 by any Applicant for a 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, www.epa.gov/lead or contact the National Lead Information Center al
p perty, 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 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 ficensed 0 No EPA Lead-Safe Certified Firm is required for this project because:
contactors to construct the project(Section 7044, Business and Professions
C)de: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
BUILDING • • • aCHECKAPPLIcATioN
�Menifee City of Menifee
Building Dept.
DATE PERMIT/PLAN CHECK NUMBER 2018
TYPE: O COMMERCIAL RESIDENnAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: 0 ADDITION O ALTERATION O DEMOLITION 0 ELECTRICAL vl�rMECHANI ece ved
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK jkC Q Ne_L � 3 •O
14-0 kLl I ocl 4o j2,y IsfTn -fu
PROJECT ADDRESS 5coGo Thbrn hl ! I Or. M,ertii Pee 0 ?25S-/
ASSESSOR'S PARCEL NUMBER E-5 io 2 o \3 .S LOT 2- TRACT 3
OWNERNAAME �j �1
ADDRESS--B 8 1 CQ� 25��ppS O r', r- 9
PHONE(/1-/ )JIU - 38SO EMAIL
APPUCANT NAME�2
ADDRESS 30 ^ ^ U v M p! /A Q
5 9
PHONE (951) 4;-7I- l5M EMAIL►Y OnKSO J r eD 9 rno.La . cbm
CONACTORS NAME / x AA /'`,, ,..f OWNERBUILDER? OYES NO
BUSINESS NAME CM On J (r Cond( 'o n
ADDRESS S ( GA c?ZS
PHONE (qM 6-n- 4,":PZ�1 f/� EMAIL mon lcsalr ct0 L _X4 C.L - Gam
n
CONTRACTOR'S STATE LIC NUMBER `mil/G-1—/� C LICENSE CLASSIFICATION CZo
VALUATION$ 5 _242
00 SQ F r ' 3 CI Q/ L SO FT q p
APPUCANT'S SIGNATURE DATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN — SMIP X
INVOICE 11 �/ PAID AMOUNT
AMOUNT I u - O CASH O CHECK Il O CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0 CASH 0 CHECK B O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee. CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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