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PMT18-02926
City of Menifee Permit No.: PMT18-02926 29714 HAUN RD. jL cu` MENIFEE,CA 92586 Type: Residential Mechanical MENIFEE MENIFEE Date Issued: 06/19/2018 PERMIT Site Address: 28269 CHULA VISTA DR, MENIFEE,CA Parcel Number: 336-212-010 92586 Construction Cost: $6,782.00 Existing Use: Proposed Use: Description of REMOVE AND REPLACE 2.5 TON 14 SEER AC UNIT&COIL Work: Owner Contractor THOMAS CAMPANILE PEACH HOME SERVICES INC 28269 CHULA VISTA DRIVE 532 MALLOY COURT MENIFEE, CA 92586 CORONA,CA 92880 Applicant Phone:7144628174 PEACH HOME SERVICES INC License Number: 1023790 532 MALLOY COURT CORONA,CA 92880 Phone: 7144628174 Fee Description Oft rr Amount fE) 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 $324.10 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing builiding operations being carried on thereunder when In violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise staled,a permit for construction under which no work is commenced within six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA_Bldg_Permil_Templatesirt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractors)pursuant to the Contractors State Ucense Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for Professions Cade and my license is in full force and effect ''••``p the following reason: License ClassC C�License No. XD�$:A9 oo�r� By my signature below I acknowledge that,except formy personal residence Expires q-�JD Signature in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION 117— improvements covered by this permit.I cannot legally sell a structure that I have built as an owner-builder If it has not been constructed in its entirety by o I hereby affirm under penalty of perjury one of the following declaration:) 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 this permit is issued. www.leeinfo.ca ht.eov/calaw. ml. Policy It Date o I 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 ❑By 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 number are�: application and the information I have provided is correct.I agree to comply (/ Carrier 11Y40Y\Ols Nl\fj,\TJQ_Gt with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy q��q'7$S� t�! 'Expires La--1- S7 enter the above Identified property for inspection purposes. �I(This section need not to be completed is the permit is for one-hundred Date - -� I dollars($100)or less PROPERTY OWNER 0 A117H AGENT o l certify that in the performance of the work for which this permit is issued, shallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE H b-io?-OS worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensatio visions of Section 3700 of the Labor Code,I shall forthwith comply i" ose provisia S. �7 Will the applicant or future building occupant handle hazardous material or a Applicant Date mixture containing a hazardous material equal to or greater that the amounts s ecified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SE SURE WO KER'S COMPENSATION COVERAGE IS ❑Yes No UNLAWFUL,AND SHALL S JBJ N 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 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY o Yes S ,No 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) o Yes �i4o OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.l understand my requirements under the State of 1 hereby affirm under penalty perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for thea mason(s)indicated below by the hazardous material repo"-9-2. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ayes *No Business and Professions Code).Any city or county that requires a permit to construct,alter,Improve,demolish or repair any structure,prior to Its Date—__ issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWN ER ORA SH 11ZED AGENT 07 that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI 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 70315 by residence or childcare facility to be RRP-certified firms and complywith 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($500). managers who do the paint-disturbing work themselves or through their h� o I,as owner of the property,or my employee with wages as their sole employees.For more Information about EPA's Renovation Program visit: V compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at not Intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a oAn EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or Improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm Is required for this project because: a I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's State Ucense Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement I 7l.1.1-M r. tC /DD . -f J111m„ A • -SAFETY • .LAN CHECK APPLICATION DATE 6-14-1$ PERMIT/PLAN CHECK NUMBER 1' N�1 I�OCL TYPE: • � COMMERCIAL PRESIDENTIAL � MULTI-FAMILY MOBILE HOME P /SPA ISIGN SUBTYPE: ADDITION ALTERATION DEMOLITION ELECTRICAL MECHANICAL NEW -� PLUMBING ; RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK ce 21�2 toll (14 seer) A/C unit & coil PROIECTADDRE55 28269 Chula Vista Dr ASSESSOR'S PARCEL NUMBER 336- 1 -010 LOT 34 TRACT OWNER NAME Thomas m am e ADDRESS 8269 Chula Vista Dr Sun City, CA 92586 City ofMenife PHONE 951-679-4248 EMAIL UI Ing ep APPLICANTNAME RecktenWald JUN 1 7w ADDRESS _532 Ma �,`ft Corona CA 92880 PHONE 714-336-6159 � ,Fs EMAIL j,anereck@att net CONTRACTOR'S NAME OWNER BUILDER? YES VNO BUSINESS NAME Peach Home Servics DBA Goettl Air Conditioning ADDRESS _ 532 Mallo Crt Corona CA 92880 PHONE 951-737-4141 EMAIL CONTRACTOR'S STATE LIC NUMBER 1 0237-90 LICENSE CLASSIFICATION _C20, C36 VALUATIONS 6 78 00 SQ FT L SQ FT 3,920 APPLICANT'S SIGNATURE f n: DATE_6-14-18 DEPARTMENT DISTRIBUTION '�-�- , - � � V✓ CITY OF MENIFEE BUSINESS LICENSE NUMBER ,BUIL0INO PLANNING ENGINEERING :IRE GREEN •' f ✓�; SMIP INVOIC `+ AMOUNT 5eQ4 PAID AMOUNT D -.' CASHCHECKR CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT _ ''CASH CHECKp - CREDITCARD VISA/MC OWNER BUILDER VERIFIED YES NO DL NUMBER NOTARIZED LETTER YES C- NO Gfyopo iPntiNP bKf;f,r. 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