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PMT18-03965 City of Menifee Permit No.: PMT18-03965 29714 HAUN RD. MENIFEE, CA 92586 Type: Residential Mechanical PL/1 E N I F E E MENIFEE Date Issued: 0811012018 PERMIT Site Address: 29154 DESERT HILLS RD,MENIFEE,CA Parcel Number: 338-052-002 92586 Construction Cost: $7,513.00 Existing Use: Proposed Use: Description of HVAC CHANGE OUT, NEW CARRIER 3.0 TON, 14 SEER 80%AFUE, R410a SINGLE STAGE A/C, Work: 70,000 BTU FURNACE Owner Contractor JOHN ATEN MONKS AIR CONDITIONING 29154 DESERT HILLS ROAD P O BOX 128 MENIFEE,CA 92586 SUN CITY,CA 92586 Applicant Phone:9516794502 TIFFANI SELLERS License Number:912194 MONKS AIR CONDITIONING P O BOX 128 SUN CITY, CA 92586 Fee Description QtV Amount ISl 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_Perrnit_Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ lam exempt from licensors under the Contractors'State License Law fort 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 'Q/{y/l'i�cense is In full force and eff which I must have resided for at least one year prior to completion License Class t/2l _Licens No. 2�q� improvements covered by this permit,I cannot legally sell a structure that 1 he Expires a_ _ - Signatu built as an owner-building if it has not been constructed in its entirety by licens contractors.I understand that a copy of the applicable law.Section 7044 of t WORKERS'COMPENSATION DECLARATION Business and Professions Code,Is available upon request when this application submitted or at the following Web site: ❑ 1 hereby affirm under penalty of perjury one of the following declarations: httoJAvww.lecinfo.ca.covlcalaw.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 Owner orAuthodzed Agent Policy# ❑ By my Signature below, I certify to each of the following: I am the prone '&_ I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read t1 section 3700 of the Labor Code, for the performance of the work for which this applimbm and the information I have provided Is correct. I agree to coml permit is issued.My workers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to buildi construction.I authorize representatives of this city or county to enter the abot Cartier c- r identified property for the inspection purposes. Policy#I L^ /b�� I Z Expires _Date Property Owner or Authorized Agent (This section need not be completed if the permit is for 03�78 one-hundred dollars($100)or less) City Business License# HAZARDOUS MATERIAL DECLARATION till that in the performance of the work for which this permit is issued,I ts all not employ any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or workers'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'compensaton provisions of Section 3700 of the tabor amounts s ecified on the Hazardous Materials Information Guide? Code,I shall hwi mpiy with those provisions. ❑YES VNO Appli amt Date; 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 checkli 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, WIII the proposed building or modified facility be within 1000 feet of the out DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE bounder of school? LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES NO CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I understand my requirements under the State of agency for the performance of the work which this permit is issued (Section California Health$$Safety C e,Section 25505 and 25534 concerning 3097 Civil Code) hazardous maul re ord OWNER BUILDER DECLARATIONS ❑YES NO I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date I 0 License Law for the reasons)indicated below by the checkmark(s)I have placed PRO OAAaP4 AUTHORIZED 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(RRPI 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 contractors 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 7000)of Division 3 of the-Busintess and Professions Cade)or that he or residence or childcare facility to be RRP-certified firms and comply with she Is exempt from.licensure and the basis fdr the alleged exemption. Any required practices.This includes rental property owners and property violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their a civil penalty of not more than($500).) employees.For more information about EPA's Renovation Program visit: 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.(Sechon 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 projec 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.: ❑ 1, as owner of the property on exclusively contracting with licensed ❑No EPA Lead-Safe Certified Finn is required for this project because: contactors to construct the prgject%Sectron 7044, Business and Professions Code:The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who contracts for the projects with a :4_____1_____________....._..__.—I,- ______,:_____, _..a u......... moo SAFETYBUILD PERM ITIPLANAPPLICATION Menifee DATE ��� PERMIT/PLAN CHECK NUMBER 015PW5 TYPE: O COMMERCIAL 34 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYP_: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL <MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES D/E'SCRIPTION OF WORRK��-,,o� PrC IV + PROJECT ADDRESS ASSESSOR'S PARCEL NUMBER 33frO5'2-002- LOT TRACT Z�� City of Meni- OWNERNAME J-oh1 AtPa'-) RIIilding nppt ADDRESS / C1�rzYYr?n. /i('Sp. �iL--7���{'; .sir 4 112M PHONE ��/S� J /✓�C'�'/ "1 /I3G C/��y'� /EMAIL Received APPLICANT NAME (..� rV (J( 1 eceiyed ADDRESS 3053 rilf- P-d , M !6Eet, CA c25W c�.-�II / /� 'L �y� PHONE (`�...JI ) (r-;7L `�I 5` L,✓Lys ,� �/EMAII.rnonKSQ1Y"i� CY1Q,L. - czrn . CONTRACTOR'S NAME ��-tf y ! y1 D /y`t�, OWNER BUILDER? O YES NO BUSINESSNAME I IY Condl �on ADDRESS 7 •1 I (.6 -25 T PHONE (`n W Cp� 4 [)' 2— EMAIL monk-SjaIr Z GtmC6-L • Gom CONTRACTOR'S STATE LIC NUMBER C//Z jq q LICENSE CLASSIFICATION C2-0 C-Q C/ VALUATION$ r 3 r SO FT ( 3Q Q L SQ FT APPLICANT'S SIGNATURE DATE CITYSTAFFUSEOWY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINES i LICENSE NUMBER BURRING PLANNING ENGINEERING FIRE GREEN I SMIP X INVOICE �J, PAIDAMOUNT AMOUNT �/GIAI'IO '\O OCASH O CHECK# OCRED!TCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK If OCREDITCARO MSA/MC OWNER BUILDER VERIFIED OYES O No DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Deportment 29714 Houn Rd, Menifee, CA 92586951-672.6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 w m E N U U Q Q v w ~ a m u y j V W 'a)_ L N S a N � E 0 ma3i n w m -O Ual C 41 y H � m — E o E n- COo y v c c y ym o L v o o Y a N Z m c ry in Q .i N y � G = C V y v � N O N• < m c E m Q i6 Y Y Q L6 y r 6" 7 E w O d 000 6 G C � Uf 0p 00 V N o o _ ti v v O m O LL Z u « t ' v O O O O �•1 y Y a o. o v ELO ❑ YO A � A N ry Y m y a y EO 4 L H L N c v0 E L O u L — V ° y U y jJ N V O! 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