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PMT18-03962 City of Menifee Permit No.: PMT18-03962 29714 HAUN RD. MENIFEE, CA 92586 Type: Residential Mechanical MENIFEE MENIFEE Date Issued: 08/10/2018 PERMIT Site Address: 27101 SUN CITY BLVD,MENIFEE, CA Parcel Number: 337-252-027 92586 Construction Cost: $2,903.31 Existing Use: Proposed Use: Description of HVAC CHANGE OUT, NEW CARRIER 2.0, 14 SEER R410a SINGLE STAGE CONDENSING UNIT,NO Work: FURNACE Owner Contractor TIM&KRISTINA MILLER MONKS AIR CONDITIONING 27101 SUN CITY BLVD P O BOX 128 MENIFEE,CA 92586 SUN CITY,CA 92586 Applicant Phone:9516794502 TIFFANI SELLERS License Number.912194 MONWS AIR CONDITIONING P0 BOX 128 SUN CITY, CA 92586 Fee Description gtv Amount I$ 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 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 ❑ lam exempt from licensure under the Contractors'State License Law for I hereby affirm under penalty or perjury that I 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 Code god�^license is in full force and efr f which I must have resided for at least one year prior to completion License Class No. Z improvements covered by this permit,I cannot legally sell a structure that I hi I-0 , SignatuLtcens Explres3-3 built as an owner-building if it has not been constructed in its entirety by licem 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 Website: ❑ 1 hereby affirm under penalty of perjury one of the following declarations: hltoJMuM1v.leainfo.w.gowcalaw.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 0wner or Authorized Agent Policy# ❑.By my Signature below, 1 certify to each of the following: I am the propt ( I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owners 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 is corect I agree to cor permit is issued.My workers'compensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to build C construction.I authorize representatives of this city or county to enter the abo Cartier a� J Q identified property for the Inspection purposes. Policy#12-7b0- !/Z Expires �— I —! / Date ' Properly Owner or Authorized Agent (This section need no be completed if the permit is for 03540 g one-hundred dollars($100)or less) City Business Ucense# 14 I certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION shall not employ any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material o wcrkers'compensation laws of California,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 eclfied on the Hazardous Materials Information Guide? Code,I shall f cooly with those provisyiyo�n�s. ❑YES 7 Appli n- Date; V WIII 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(SCAQMD)?See permitting checks COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES J<NO CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the ou DAMAGES AS PROVIDED FOR iN SECTION 3706 OF THE boundarK of school? LABOR CODE,INTEREST,AND ATTORNEYS FEES ❑YESNO CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirn that under the penalty of perjury there is a construction lending permitting ohecIdist.I understand my requirements under the State of agency for the performance of the work which this permit is issued(Section Califomia Health$ Safety C e,Section 25505 and 25534 concerning 3097 Ciw7 Code) hazardous mate) I re orti OWNER BUILDER DECLARATIONS ❑YES NO( DaA-2�1? I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the reason(s)indicated below by the checkmark(s)I have placed PROk-wrr0XVNAa,0AAUTHORIZED AGENT next to the applicable item(s)(Section 7031.5.Business and Professions Code: Any city or county that requires a permit to construct, alter,improve,demolish, EPA RENOVATION.REPAIR AND PAINTING(RRP) 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,licensed pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contractor 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 70D0)of Division 3 of the-136sinpss and Professions Code)or that he or residence or childcare facility to be RRP-certified firths and comply with she is exempt from.lcensure,and the basis for the alleged exemption.Any required practices.This includes rental property owners and property violation of Section 7031.5 by any Applicant for. permit subjects the applicant to managers who do the paint-disturbing work themselves or through their a civil penalty of not more than($500).y employees.For more information about EPA's Renovation Program visit: ro www.epa.gov/lead or contact the National Lead Information Center at ❑ I, as owner of the property 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 proje- 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 licensed No EPA Lead-Safe Certified Firm is required for this project because: contactors to construct the prq)eci(Section 7044,Business and Professions Code: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 IT/PLANFETY PERM APPLICATI ON Menifee DATE "2—I PERMIT/PLAN CHECK NUMBER1 117a I-ILY OT IvIeni ee TYPE: O COMMERCIAL 34 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA_ t, SUBTYPE: O ADDITION C ALTERATION O DEMOLITION O ELECTRICAL MECHANICAL;,, O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES %.JJ 7 U 20 8 � DESCRIPTION OF WORK ftc CbanQe i+] �� L u (Q i I roc U �c e -L - iv C `rm?c- n• r, !1 1 J PROJECTADDRESS 2-7 1 G Oa- (�j" 1 -1�-% %k o \ Coi' cru W fD ASSESSOR'S PARCEL NUMBERNUMBER 313?-Z 6 L OZ'3- f_ LOT t`k3 TRACT -6 OWNER NAMEE . I irn cI K . • ! )�� /le Al �P I^,, /' • �y, ADDRESS •TJ-'�Sl / ` /lf�i.0 f \l ,I:° 1 '-I V�+I 11f . �`7 I,r :Lf� "I.LS l-L PHONE �IlSI / ll� J- �3�1 EMAIL APPLICANT NAME � r ADDRESS 30// Mu--YYr'Tlri•e-Iz,_ d ! M•en fee, c� �25� PHONE rq�� ) I//P (( -q 502 EMAILYY'1onKSo trOD 9ma:o - Ctrn CONTRACTOR'S NAME CTarU M or' K OWNER BUILDER? C YES NO BUSINESS NAME o ! /L'` �r Condi or"I ADDRESS !/' ()5 > M0 r -i�,�r 2d , M-c-n CA PHONE [ ` ?51J COr7 4,5L 7 _JL EMAIL mon ksa i r c"� rna.�.L • Go m CONTRACTOR'S STATE LIC NUMBER g121gy LICENSE CLASSIFICATION C2,0 VALUATION$ ,2 , 0ID 5• 3 I SO,FT L SQ FT APPLICANT'S SIGNA TURE DATE IS 2— C17YSTAFFUSEOPAY DEPARTMENT DISTRIBUTION CRYOF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP X INVOICE ` � M PAIDAMOU AMOUNT I�+r '' � 1`..Q-j•kp5 OCASH OCHECK# OCREDi7 CARD VISA/MC PLAN CHECK FEES PAIDA MOUNT OCASH OCHECK# OCRED fCARD 'ASVMC OWNER BUILDERVERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O /ES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-6.72-6777 www.cityofmenifee.us Inspection Request Line 951-246-6213 E r N o w A a a « d n N Q � 9 f a y m ti Q m O O C N C U .a 'p 'E (D O a U 2 N c C CV N a E m m E a u p = c a y o co c > r, p z a Z a C a 9 0 V .st m Q O yc-,- « « fit: : °•,. c c � � ^7 )O i0 at. .6 Z N • C O O y U C ywy C O a .p Z U c E c c c Q a '= 3 �-"V -" d `O E - is SE14.=: c E w « E 6 > m 3 3 3 p m Om ! a c N ov 3 O m G O Y. 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