PMT18-04033 City of Menifee Permit No.: PMT18-04033
® 29714 HAUN RD.
S ® MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE MENIFEE Date Issued: 08/15/2018
PERMIT
Site Address: 28355 BAVARIA DR, MENIFEE, CA 92585 Parcel Number: 336-273-024
Construction Cost:. $8,000.00
Existing Use: Proposed Use:
Description of REPLACE 2.5 TON COIL AND CONDENSER ONLY, SAME LOCATION
Work:
Owner Contractor
HOWARD MARSHALL LUCKY AIR INC
28355 BAVARIA DR 4049 BURGESS WAY
MENIFEE, CA 92585 RIVERSIDE, CA 92501
Applicant Phone:9516828573
NATHAN WALTERS License Number:836498
LUCKY AIR INC
4049 BURGESS WAY
RIVERSIDE, CA 92501
Fee Description aty Amount IS)
Air Handling/Condensing Units SFR 1 133.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.0o
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 effors 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_Pennit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjurythat I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect the fallowing reason:
License Class. CMG License No. By my signature below I acknowledge that,except for my personal residence
Expires ?✓/ Signature in which I must have resided for at least one year prierto completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
o I hereby affirm under penalty of perjury one of the following 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 for workers 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 37DO of the Labor Code,for the performance of work for which www-leginfo.ca.gov/calaw.htmi.permit is issued.
Polity p Date
❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 37DO of the Labor Code,for the performance of the work for which o By my signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and polity owner or authorized to act on the property owners behalf.I have read this
number are: /' l/ . ' ,(`- application and the information I have provided is correct.I agree to comply
Carrier� (_O_ -Tl'�— W W 7� with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy ff6ZA"Iellyy Sot] Expires enter the above identified property for inspection purposes.
(This section need notto be completed is the permit is or one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT I
❑I certify that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If V (�
workers compensation laws of California,and agree that if_-I �.-s-hci come. HAZARDOUS MATERIAL DECLARATION
subject to the worker r J s compens sie ectionsOf"5 n3700 of the Labor
Code,I shall forthwith w .wi ose provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant -- -- D to � /,S 8 mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes KNo
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($100,0D0),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SC construction
or See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Airlines
Qua
CONSTRUCTION LENDING AGENCY o Yes 4.
1 hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 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) ❑Yes L�44o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjurythat I am exempt from the permitting checklist.I understand my requirements underthe State of
Contractors License Law for the reason(s)indicated below by the Califor�aN�
Health&Safety Code Section 25505 a 5534 concerning
checkmark(s)I have placed next to the applicable items)(Section 7031.5 hazarde ing.
Business and Professions Code).Any city or county that requires a permit to �1'es
construct,alter,improve,demolish or repair any structure,prior to its Date Y7
PROP TY OWNER OR AUTHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRPI
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 licensure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 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 than($500). q P p p rty owners and property
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(5323).
Code,The Contractors 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. ❑No EPA Lead-Safe Certified Firm is required for this project because:
D I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a • If your project does not comply with EPA RRP rule please fill out the RRP
Nt r,o , „ ryaj_� ee C_ �aJ�,Acknowledgement.
A ,Menifee
DATE: PERMIT/PLAN CHECK NUMBER
TYPE: COMMERCIAL RESIDENTIAL -- MULTI-FAMILY MOBILE HOME POOL/SPA SIGN
SUBTYPE: '- ADDITION XALTERATION DEMOLITION ELECTRICAL MECHANICAL
NEW -- PLUMBING RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK _
L l�
PROJECTADDRESS3�� c ��1��Q � ZIP
ASSESSOR'S PARCEL NUMBER J:J1O 3'03 LOT Ian TRACT
OWNER NAME C.�.
t
ADDRESS �j'
PHONE v 1 Y — EMAIL
APPLICANT NAME
ADDRESS mw
ey�� �7�7 , / s-
PHONE �i,�(-,5'6 -- / fQ,5 EMAIL
CONTRACTOR'S NAME it f /`_ OWNER BUILDER? YES Y NO
BUSINESS NAME
ADDRESS //'``
PHONE �C&2 _ s'73 EMAIL
CONTRACTOR'S STATE LIC NUMBER r fly LICENSE CLA551FICATION GgCD
VALUATION S 91k SO FT L SQ FT
APPLICANT'S SIGNATURE DATE
aTYSTAFF USE ONLY ,
DEPARTMENT DISTRIBUTION CITY 11F�'6I�I� VjeSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED -�J .7U11
PERMIT FEE 1� �b� SMIP GREEN
PLAN CHECK FEE INVOICE TOTAL
OWNER BUILDER VERIFIED -YES NO DRIVERS LICENSE# NOTARIZED LETTER YES - NO
City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.Lis
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ASSESSORS PARCEL NUMBER
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