PMT18-03966 City of Menifee Permit No.: PMT18-03966
AR AR MENIFEE,
HAUN RD.
MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE MENIFEE Date Issued: 0 811 012 01 8
PERMIT
Site Address: 29792 PEBBLE BEACH DR, MENIFEE, Parcel Number: 336-122-021
CA 92586 Construction Cost: $5,943.25
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, NEW CARRIER 2.5 TON, 14 SEER R410a SINGLE STAGE A/C,70,000 BTU
Work: FURNACE
Owner Contractor
HELEN COOPER MONKS AIR CONDITIONING
29792 PEBBLE BEACH DRIVE P 0 BOX 128
MENIFEE,CA 92586 SUN CITY, CA 92586
Applicant Phone:9516794502
TIFFANI SELLERS License Number:912194
MONKS AIR CONDITIONING
P0 BOX 128
SUN CITY, CA 92586
Fee Description QQt r Amount f$1
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 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_61dg_Permit Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ lam exempt from licensure under the Contractors State License Law fort
I hereby affirmunder 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 Ilcy}y�nse is in full force and which I must have resided for at least one year prior to completion
License Class Licens No. eff 2_ improvements covered by this permit,I cannot legally sell a structure that I ha
Expires3_3 J-LLl_ Signatu built as an owner-building if It has not been constructed in its entirety by licens
contrctors. 1 understand that a copy of the applicable law. Section 70"of t
WORKERS'COMPENSATION DECLARATION Business and Professions Cade,is available upon request when this application
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one of the following declarations: http:/A w leginfo m.goy/rmlaw.htmi.
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 or Authorized Agent
Policy# ❑ By my Signature below, I certify to each of the following: I am the prope
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 tl
section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to coml
permit is Issued.Myworkers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to build!
construction.I authorize representatives of this city or county to eater the abok
Cartier / Q identified property for the inspection purposes.
Policy# �7 G� /b�� 12- Expires t� — ' '— f Date
Property Owner or Authorized Agent
(This section need not be completed if the permit is for City Business License# O J ✓���
one-hundred dollars($100)or less)
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 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'compensation provisions of Section 3700 of the Labor amounts s ecited on the Hazardous Materials Information Guide?
Code,I shall wi mply with those provisions. / ❑YES amounts
NO
Appli an• Date; Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modlication 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, Will the proposed building or modified facility be within 1000 feet of the out
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE bounds faschool?
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES N0
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the pena'.y 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 A Safety C e,Section 25505 and 25534 conceming
3097 Civil Code) hazardous mate I re,
e orti
OWNER BUILDER DECLARATIONS DYES NO
I hereby affirm under penelty of perjury that I am exempt from the Contractor's Date
License Law for the reason(s)indicated below by the checkmark(s)I have placed PRO6WK0441111P4 AUTHORIZED AGENT
next to the applicable Rem(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-Businpss and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with
she is exempt from-licensure 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 fora permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500).) - employees.For more information about EPNs Renovation Program visit:
❑ I, as owner of theproperty, or m employees with wages as (heir sole www.epa.gov8ead or contact the National Lead Information Center at
compensation,will do ( ) ll o or( )porting of the work,and the structure is 1-800�24-LEAD(5323).
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this projec
who, through employees' or personal effort; builds or improves the property,
provided that the Improvements are not intended or offered for sale.If,however, Certified Firm Name:
the building or Improvement Is sold within one year of completion,the Owner-
Builder will have the burden of proving that It was of built or Improved for the Firm Certificetion No.:
purpose of sale).
❑ I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firm Is required for this project because:
contactors to construct the prgjectlSection 7044. Business and Professions
Code:The Contractor's License Law does not apply td an owner of a property
who builds or improves thereon, ai.d who contracts for the projects with a
.........._.._ ,.,_._ „_____,_..., ,1 .---.-....e ,h..opo
BUILDING & SAFETY PERMIT/PLAN APPLICATION
"Menifee
DATE ��� PERMIT/PLAN CHECK NUMBER PIMIR 0aguto
TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: O ADDITION O ALTERATION 0 DEMOLITION O ELECTRICAL XMECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
5
DESCRIPTION OF WORK +I hC- Chap a fI N42 ( i
111-St✓� 2 l S ' z s-I 2 c 70 BTUnn,AI ,n�-v
PROIECTADDRESS Z� -Lv JLQ "TP Imo. 'V� �Z--V -
ASSESSOR'S PARCEL NUMBER LOT tAIA _ TRACT ZZLi,
OWNER NAME ICIr CitV Of IVIPnifep
n / Building Dept.
ADDRESS ',�}S/� 7, 1--�
PHONE C"(J� J 6'7�' Jf V% `�/ EMAIL "— AUG 1 G 20�$
APPLICANT NAME r
EdDRk
ADDRESS 33560
� 5 3 60/] M Q rr Men
PHONE (`/7Jt J (r-;7q--1502 EMAIL rnonKSQI✓ eD rnaG .I - COY1"l
l...l CONTRACTOR'S NAME 0l-r\/ M S/-x D OWNER BUILDER? O YES NO
BUSINESS NAME c it CDndi �Wn
ADDRESS .PcA `f�25
PHONE (C//151� 67q— 4,50Z EMAIL mon Ksa'Ir a".) rna-_L • C.om
CONTRACTOR'S STATE
LIC NUMBER 9121914 \^LICENSE CLASSIFICATION cL0
VALUATION$S -!q 3 F -Z SQ FT L SO FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBU LION CITY-OF MENIFEE BUSINESS UCENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN I I - SMIP X
INVOICE x
AMOUNT . 10 PAIDAMOUNT w�•�O 0CASH 0 CHECK OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECKn OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER O YES 0 NO
City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92585 951-6:1-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
00
w n'+ o O- `O E r v
NO O 00 'C ❑ N > y v « w v
m
m
N O
� S a
C W
N
E m a3i E v
J c c Y c
00 pf �' H O l7
a O « d N Z
d - C V O
T d C
3 m —
0
N O O N C L N
� C N V1 V rl e-I N
a
C
"p a n• v
❑ 6 O .d. C L j
zi
Z U
E w U N y� m
4i
m v v m w o E a ❑ °' E y « E � �
c
a N O a a
y O rl N py •n O. O � O
c G c L N O C K VI
w c u O O w
N
S u
U � .p n• Y
Y
L c o E
LL m U
v
w o .; °1 10 m ai E ry m oo v
o_ E o
E u J a m 'E m ,� u a a• � o �
Z ;a o N o a iO ❑ N
m o >
o p m c Q
O E V F m w o x N
A v
U ¢ y` Q u u o 0 0 0 o m l/ ¢ u
w O F p
M � p N w K
N do w V
N eNi ❑ p u U
Q 3 O ¢ U
m OU
Z
LL m
u s 'o
m 0
o v u`
o c 0 a o
a o in O n LL N
Z
in
La y
� C
a_ d
° ° N t
m a y o a
z s n C
F m
N
E > p
c = c v v
m - E_ v 2
0 0 u m
O G a N v
ill m
n N
° U N
O o,
m u Q r a m
C G N Y
= d a u
3 u c Ol 2 2 0
E
a m a, 3 m w A c m v L Y E W
E t L o v
Q u° E a E o v P d a o n `o_ °
_ m a - v a �n n c
u cc E
a o ° c d 6 D
a .. q .� c o c N E
c F>• a is
c d ps W v u ai w vs
O « c - E u O c c
_ E 1O 3 u
LL d C N c d O u t N N
C 6 U 01 0 6 D y V Q L 00 L
_ do ccA „ A o — 3
LL Ci m c c d > m m O o E o.
E
U O
GIQ
C V Y El
0 Cc
O W W d a D '�_, n 00 a
m h N a o ° $ y 3 d w o y
do 0
« a m u o
y m e c 'cy - N u 0
j b d E C m 5 c ° d v �0
do
do
c C
u " E v c y m N
Z « p c t J o A .v. ¢ = N o
-Q-+ c a E v my .° o ff '..^ � 3 i i d E E
U O o m �n o v ¢ .. Q 2 U O m u
U v > F- c Eu Es vsa 3c c ry
m N = p d N N N v `m ° O O y w
N
O p C. c vai P u a u u '" w v N y E
Ul Y fA C ` E 22 N N Z Z C
Q c y E m " 10 q E c T >' w
u Q G 'O LLc' w xo' xdw w u: c u
z u u u u w
s A il-
rn
a. ._ >p
A E n
V p
w 6 c
os
V`SY v p
m y
Y a
,Cis y N o E D ,CCU
SI_ 'p S2_0 os
O �
al°.
o N E
o M oA SuM
o O >
Y C O O C O^l V d N p
L9 p c p
C o m0 wU
U �n CA -u Ot w eao 5 O N E 01 a 01 a
Ou
L L L E
c
n
c
0 n a o A v i`
`o .E
u n N n =
E c
v
m ° 2 u c a
� c � � = Ea
�>
2 O `p o o m r v ry o
C V
Q Y U q a c p ° E ° y
LL ' v o E c
> c u u [ .N u u . U
O L A v o o y o
E n` c o c
£ N c 3 u a a
O t0
o @y o oN
a O O „O . o al ry
a 3
O
z O p `w
LL v♦ O Y L Z m W p m E a o ° o Z
w m
w am+ aL+ U v m W o
u
o .Fo 3n
"
.2�0F4 F4
a
E C Z Cp
O O EO
°p2Ym4 2 a cm• a_wmmG u � rc � `� u � am