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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. 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