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PMT18-02899
City of Menifee Permit No.: PMT18-02899 MENIFEE, EE,C 92 Type: Residential Mechanical MENIFEE,CA 92586 MENIFEE MENIFEE Date Issued: 0 611 4/2 01 8 PERMIT Site Address: 27182 AMBER ROCK DR, MENIFEE, CA Parcel Number: 335-481-005 92585 Construction Cost: $7,927.00 Existing Use: Proposed Use: Description of 5 TON CONDENSER & COIL REPLACEMENT Work: Owner Contractor GUADALUPE OCEGUERA A R S AMERICAN RESIDENTIAL SERVICES OF 27182 AMBER ROCK DR CALIFORNIA INC MENIFEE,CA 92585 965 RIDGE LAKE BLVD.#201 Applicant Phone: 9512769744 CHRISTINA CALHOUN License Number:765074 A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNU 965 RIDGE LAKE BLVD.#201 MEMPHIS, CA 38120 Fee Description OQt rr Amount ISI 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_Templale.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who conbach for the projects I hereby affirm under penalty of perjury that l am under provisions of with a licensed contractors)pursuant to the Contractors Slate License taw). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑l am exempt from licensure under the Contractors State license taw for Professions Code and my license is in full force and eff e ct �- l/ the following reason: License t7as•C(Q�C20/C3( License No._ CIOcJ�7y' By mysignature below I acknowledge that,except for my personal residence Expires — LSr�:r&Eignature in which l must have resided for a[least one year prior to completion of WORKERS COMPENSATION DECLARATION improvements covered by this permiL 1 cannot legally sell a structure that 1 have built as an owner-builder if it has not been constructed in its entirety by X/I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that copy of the appliable law,section have and will maintain a certificate of consent of self-insure for worker's compensation,issued by the Director of Industrial Bela tions as provided for 7044Oftheeosis su and Professions folioCode,ing webhle upon requestsvhen by Section 3700 of the labor Code,for the performance of work for which this application is submitted Drat the following websi[e: this permit is issued. wvAv.leeinfo.ca.eov/alaw.html. Policy It Date ❑l have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which InBy my signature below l certify to each of the following:I am the property this permit is issued.My workers compensation insurance arner and polio/ owner or authorized to act on the property owners behalf.I have read this numberare: / application and the information l have provided is correct l agree to comply Carver. L(&PT, with all applicable city and county ordinances and state lays relating to building construction.I authorize representatives of this city or county to Policy H 7�a3/CjnQ�/ /a(� Expi - �© 1103 enter the above identified property for inspection purposes. (This section need not to be completed 1,the permit rs for one-hundrer dollars($100)or lessr Date. PROPERTY OWNER OR AUTHORIZED AGENT Ol certify that in the performance of the work for which this permit is issued, 0. �C (t, 1� I shall not employ any persons in any mannerso as to becomesubject to the CITY BUSINESS UCENSE# J f r workers compensation laws of California,and agree that if I should become subject tothe worker's compensation provisionsof5ection 3700ofthe Tabor RDOUS MATERIAL DECLARATION Code,I shall fbrtbwth comply with those provisions. AVIII the applicant or future building occupant handle hazardous material or Applicant Date it containing a hazardous material equal to or greater the the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO REWORK 5 COMPENSATION COVERAGE IS oYes .� UNLAWFUL,AND SHALL suhjECTAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLARS($100,0o0),IN Will the intended use of the building by the applicant or future building ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification From South IN SECTION 37060FTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality ManagementDistrict(SCAOJND)?See petmilting checklist forguiclai maz CONSTRUCTION LENDING AGENCY oyes �o,No I herebyaliirn that under the penalty cifperjury there is a construction Will the proposed building or madified facility be within 1000 feet ofthe lending agency for the performance of the work which this permitis issued outer boundary of a school? (Section 3097 Civil Code) 0 yes O OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and IheSCAQMD herebyaffirm under penalty of perjury that l am exempt from the permitting checklist l understand my requirements undertheSate of Contactols License law for the reason(s)indicated below by the California Health Code,Section 25505 and 25534 concerning rheckmark(s)I have placed next to the applicable Ttem(s)(Section 703LS hazardous material reporting. Business and Proressilons Code).Any city or county that requires_a permit to DY 13No mastruct,alter,improve,demorish or repair any structure,priorto its ��'A Date ssuance,also requires the applicant for the permitto File a signed statement PROPERTY OWNER OR ORI ED AGENT hatheorshe is licensecipursuant to theprovisions of the Contactors State EPA RENDVA710N.REPAIRAND PAINTING(RRP) 1cense law(Chapter9(commencing with Section 7000)of Division 3 ofthe Iminess and Professions Code)or that he arshe is exempt from ficensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Ind the basis for the alleged exemption.Any violation ofSemon 7031.5 by receiving compensation for most work that disturbs paint in a pre-1978 inApplicantforapermitsubjecstheapplicanttoacivilpehaltyoFnotmore FesfdenmorchildcarefldlitytoheRRP-certified firms and comply with ban($500). required practices.This includes rental property owners and property managers who do the paint-disturbing work themselves or through their ll,as owner of the property,or my employee with wages as theirsole employees.For more information about EPAs Renovation Program visit: ompensation,will do( )all oFor( )portion ofthe work,and the structure is wvAv.eoa.gov/lead or contact the National lead Information Centerat tot intended or offered forsale.(Section 7044,Business and Professions 1-800424-LEAD[5323). :Ode,The Contractors State License Law does not apply to an owner of a property,who,through employeeY or personal effort;builds or improves the aAn EPA Lead-Safe Certified Renovator will be responsible for this project ruperty provided that the improvements are not intended or offered for Certified Firm Name: ale.If,however,the building orimprovement is sold within one year of I ompletion,the Owner-Builderwi➢have the burden of provingthatit was Firm Certification No.: of built or improved for the purpose of sale- ❑No EPA Lead-Safe Certified Finn is required forthis project because: I,as ownerofthe property am exclusively contracting with licensed 3ntractors to construct the project(Section 7044,Business and professions ode:The Contractor's State License law does not apply to an owner of a ' Ifyourprojectdoes not comply with EPA RAP rude please rill out the RRP i Acknowledgement DATE: L� S PERMIT/PLAN CHECK NUMBER TYPE: COMMERCIAL DAESIDENTIAL MULTI-FAMILY MOBILE HOME POOL/SPA L'SIGN SUBTYPE: ADDITION ALTERATION DEN40LITION ELECTRICAL V-MECHANICAL NEW PLUMBING RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK, 5" Tp,rY s_o - PROJECT ADDRESS Z7�8� y[Yt1�q-,y �p�,k �.�'. ZIP ASSESSOR'S PARCEL NUMBER �j�jS -�S�J��S' LOT TRACT OWNER NAME OC. _esr0_ Uu U ADDRESS SAME AS SITE PHONE ��JSi) 9 7o - zz 19 EMAIL APPLICANTNAME-�p� -(� &,/`vw ADDRESS �/ pL/ .v✓5Q �L��V PHONE 2- EMAIL CONTRACTOR'S NAME RIGHTIME HOME SERVICES OWNER BUILDER? _'YESd•NO BUSINESS NAME ARS ADDRESS 3030 MYERS ST RIVERSIDE CA 92503 PHONE 800 660 0675 EMAIL CCALHOUN@ARS.COM CONTRACTOR'S STATE LIC NUMBER 765074 LICENSE CLASSIFICATION C10 C20 C36 VALUATION S 71 S 42 L SO FT APPLICANT'S SIGNATURE DATE !8 L CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF LVIENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIFE ACCEPTED PERMIT FEE . I o I SMIP I GREEN PLAN CHECK FEE INVOICETOTAL OWNER BUILDER VERIFIED :'YES :: NO DRIVERS LICENSE,# NOTARIZED LETTER YES NO a N• � � o' � m n y � 3 ° r .� � a=o N •�• n � o o , c 2 » •'� w n n 2 CL D ul, n w n n ^ n _ 0 < m d '•• � wD 0 ? � � '�6 a •� _ O W T A N � � f 9 6 (p ry ry C » = a - w c O n m m � n jp N m a o a 2 D D c V _ � r ys �gryp S y�yy, L ypy A'.• 8 S � }� 1'� �J�4'•�g S p i n ^ r n n a m m m �,. R1° mz °' z ,�, � O m m EL £ m h 'm wrri � o— m o n n a F A F m 3 O SO N N a a 2 A d g 0 M O m N SOXD O M. W. 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