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PMT18-02748 City of Menifee Permit No.: PMT18-02748 29714 HAUN RD. MENIFEE, CA 92586 Type: Residential Mechanical MENIFEE MENIFEE Date Issued: 06/06/2018 PERMIT Site Address: 29554 WINDING BROOK DR, MENIFEE, Parcel Number: 340-250-033 CA 92584 Construction Cost: $10,000.00 Existing Use: Proposed Use: Description of HVAC CHANGE OUT, HEATER IN ATTIC,COOLING BTU 60,000, HEATING BRU 100,000 Work: Owner Contractor JOHN PERKINS RIZZO HEATING&AIR CONDITIONING 29554 WINDING BROOK DR 32823 TIZNOW MENIFEE,CA 92584 MENIFEE,CA 92584 Applicant Phone:9516720397 ROXANNE EASLEY License Number. 349958 RIZZO HEATING&AIR CONDITIONING 32823 TIZNOW MENIFEE,CA 92584 Fee Description Qty Amount(81 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_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and of � C the following reason: License Class Clmil/ 1i ens o. J By my signature below I acknowledge that,except for my personal residence Expires 1- / _Signature in which I must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon request when compensation,Issued by the Director of Industrial Relations as provided for this application is submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which snvw.leeinfo.ca.eov/calaw.html. this permit is issued. Policy 0 Date PROPERTY OWNER OR AUTHORIZED AGENT have and will maintain worker's compensation Insurance,as required by s I section 3700 of the Labor Code,for the performance of the work for which AIBy my signature below I certify to each of the following:I am the property this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this numberar t: ' � �;`�,r� application and the information I have pmvfded is correct.I agree to comply Carrier TI l7z O Ij'"J _ with all applicable city and county ordinances and state laws relating to { _//�� building construction.I authorize representatives of this city or county to Polity 1, 5lprre� / ,an r above ide tified property 6�rinspection purposes. (This section need not to be completed is the permit is for one-hundred Date I dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT a I certify that in the performance of the work for which this permit is issued, O�\`� I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE q V worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subjer Code, hwlth camp) i[h those visions. Will the applicant or future building occupant handle hazardous material or a Applic Date �I�I� mixture containing a hazardous material equal to or greater that the amounts sified on the Hazardous Materials Information Guide. WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes IT UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguid�elip as CONSTRUCnON LENDING AGENCY ❑Yes d(�o I hereby affirm that under the penalty of perjury there is a construction Will 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 Code) 0 Yes lo TN OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements underthe State of California Health a Safe Cade,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)indicated below by the a ardous m�tena re oiling. 11� n checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ❑ ❑ o Business and Professions Code).Any city or county that requires a permit to ate construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWI OR AUTHORIZED A ENT issuance,also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRP) License law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their u I,as owner of the properly,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.I:ov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a 0 An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not Intended or offered for Certified Firm Name: sale.If,however,the building or Improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because: o 1,as owner of the property am exclusively contracting with licensed contractors to constract the project(Section 7044,Business and Professions Code:The Contracto/s State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP jAcknowledgement. fl .�✓/11, J n ��/A�i�ODA _ ads 7l r1.ti BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: U1U PERMIT/PLAN CHECK NUMBER HT1 S -oa PLANNING CASE NUMBER TYPE: O COMMERCIAL , ESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL MECHANICAL N,E/W� O PLUMBING 0 RE-ROOF NUMBER OF SQUARES �/� DESCRIPTION OF WORK V e, ci ivr r f 1 %mm �V PROJECTADDRESS \AAY B/IFI ZIP Z ASSESSOR'S PARCEL NUMBER 3 -P IJb LOT TRACT OWNERNAME n \� ADDRESS q5 1 PHONE QN D . Jul-, J- 1 J EMAIL APPLICANT NAME Yu no rw ?Mi ADDRESS 1O (�/} VU� PHONE EMAIL{ L I/I� CONTRACTOR'S NA E OWNER BUILDER? O YES O BUSINESS NAME 2-7 ADDRESS ry�^- ` (� //� ! /� PHONE v 1, �Jf�2 � ("'pE'MAIL VA6 A YM CONTRACTOR'S STATE LIC NUMBER 3kAq( I g LICENSE CLASSIFICATION C VALUATION$ SQ FT L SQ FFT (�11 j1 APPLICANT'S SIG NAf DATE 'V/1\Q 1 1 OTY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUJWS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICETOTAL a a � I V GREEN f� SMIP OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 G\TY OR www.cityofmenifee.us ENIFE ^D po m C X In n a A A m N m 1 -,ri Z o n 'Z O fD o 0 01 0 n n o o m 3 N m c 3 3 3 m ry < a vi 3 !D O Q o' M O G G O y Ci 1/� T n C 9 x N x D F. 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