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PMT18-03812 City of Menifee Permit No.: PMT18-03812 I, 29714 HAUN RD. ,F MENIFEE; CA 92586 Type: Residential Mechanical MENIFEE MENIFEE Date Issued: 08/02/2018 PERMIT Site Address: 28393 CRESTWOOD ST, MENIFEE,CA Parcel Number: 333-321-024 92585 Construction Cost: $10,000.00 Existing Use: Proposed Use: Description of HVAC CHANGE OUT,3 TON COMPLETE SPLIT SYSTEM REPLACEMENT Work: Owner Contractor DELORES THOMAS A R S AMERICAN RESIDENTIAL SERVICES OF 28393 CRESTWOOD STREET 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 CALIFORNI/ 965 RIDGE LAKE BLVD.#201 MEMPHIS,CA 38120 Phone: 9512769744 Fee Description 01t rr Amount 151 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 buitiding operations being carded 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 with a licensed contractols)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3of the Business and o I am exempt from lirensure under the Contractor's State License Law for Professions Code and my license is in full Wffe�ct. he following reason:UcenseClass ( 20 «� Uy my signature below l acknowledge that,except for my personal residence Expires r�� Signature which l must have resided for at least one year prior to completion of provements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLA 71ave built as an owner-builder if it has not been constructed In its entirety by o l hereby affirm under penalty of perury one of the fallowing 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 far 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 www.leglnfo-u.gov/mlaw.html. this permit is issued. Policy# Dare ca 10. ve and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,far the performance of the work for which ❑By my signature below I certify to each of the following:)am the property this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this number are: application and the Information 1 have provided is correct.I agree to comply Carrier�.-+l with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy It -i�n31568(03�01-Ixplms In 1, 11 enter the above identified property for inspection purposes. (This section need not to be completed is the permit is far one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT 01 certify that in the performance of the work for which this permit is issued, 0V�..c/ JJ�1 u I shall not employ any persons in any manner so as to became subject to the CITY BUSINESS LICENSE# worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the war e{s compe aaF7Dnyvisloins of swW370Dofthe Labor Code,eNILUREt�l h to i rose visi Willmix ure applcontaining nt oring a hazeruture building occoequaltpant or dle ousthat material or a mixture containing a hazardous material equal to or greater that the ApplicaDate L amounts specified on the Hazardous Materials Information Guide? WAROSEC WORKER'S COMPENSATI COVE GE 15 oYes yam, 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($100,00D),IN occupant require a permft for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SMMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidellnes CONSTRUCTION LENDING AGENCY oYes "o hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 10DO 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 `a4lo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD hereby affirm under penalty of perjury thatlam exempt from the Permitting checklist.I understand quire under the State of [alifomI Ith&Safe Section 2 nd 25534 cancer ing Contractor's License Law for the reasons)indicated below by the haze pus aterfal r checkmark(s)I have placed next to the applicable Items)(Section 7031.5 s .14 Business and Professions Code).Any city or county that requires a permitto construct,alter,improve,demolish or repair any structure,prior to Its PROP N ORIZED AGENT issuance,also requires the applicant far the permitto file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State A RENOVATION REPAIR AND PAINTING(RRPI 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 lirensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of Section 7031.S 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($500). managers who do the paint-disturbing work themselves or through their O I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD 15323). Code;The Contractor's State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. O No EPA Lead-Safe Certified Firm is required for this project because: D 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's State License taw does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. B DATE: 18 PERMIT/PLAN CHECK NUMBER02rol;)L TYPE: CIIMMERCIAL c, RESIDENTIAL MULTI-FAMILY 0 MOBILE HOME POOL/SPA SIGN SUBTYPE: ADDITION ALTERATION DEMOLITION ELECTRICAL MECHANICAL NEW PLUMBI/N�G� ' RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORX, PROJECTADDRESS Z ig� 1� Cf�`bTtk�00d Or_ ZIP 9Z.S8S ASSESSOR'S PARCEL NUMBER - .�'(�a� LOT TRACT OWNER NAMEV��n.3 �P�p�f S Building De t. ADDRESS SAME AS JOBSITE AUG p 2yplg PHONE / S l 7-3 ) I(,S EMAIL APPLICANTNAME +C'L$�'I /191, �IIn.Ov>�� Received ADDRESS SZX� PHONE(']a zD y- 3 9 EMAIL CONTRACTOR'S NAME RIGHTIME HOME SERVICES OWNERBUILDER7 ' YES/IZNO BUSINESS NAME ARS ADDRESS 3030 MYERS ST RIVERSIDE CA 92503 PHONE 800 660 0675 EMAIL CCALHOUN@ARS.COM CONTRACTOR'S STATE LLIIC NUMBER 765074 LICENSE CLASSIFICATION C10 C20 C36 VALUATION 5 10 FT L SQ FT APPLICANT'S SIGNATUR 8 DATE Z /B CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: � CITY OF IWENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE PERMIT FEE SMIP k I GREEN `- PLAN CHECK FEE I INVOICE TOTAL OWNER BUILDER VERIFIED `:YES ' NO DRIVERS LICENSE.". 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