PMT18-04037 City of Menifee Permit No.: PMT18-04037
S'" 29714 HAUN RD.
�' A' i MENIFEE, CA 92586 Type: Residential Plumbing
MENIFEE MENIFEE Date Issued: 0811512018
PERMIT
Site Address: 27360 HACIENDA DR,MENIFEE, CA Parcel Number: 336-232-012
92584 Construction Cost: $12,959.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT,3 TON COMPLETE SPLIT SYSTEM
Work:
Owner Contractor
ALICE CURRIER A R S AMERICAN RESIDENTIAL SERVICES OF
27360 HACIENDA DRIVE CALIFORNIA INC
MENIFEE, CA 92584 965 RIDGE LAKE BLVD.#201
Applicant Phone: 9512769744
CHRISTINA CALHOUN License Number:765074
A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIi
965 RIDGE LAKE BLVD.#201
MEMPHIS, CA38120
Phone: 9512769744
Fee Description DQt Amount
Foroed-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 thereunderwhen 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_BIdg Permit_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 penaltyof perjury that 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 o I am exempt from Iicensure under the Contractor's State License Law for
Professions Code and my license is in full force a ffect. he following reason:
License Class ( �Cl L3� Lic s o.1t0 By my signature below l acknowledge that,except for my personal residence
Expires Signature in which l must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLA TI0 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 worker's 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 3700 of the Labor Code,for the performance of work for which www.leeinfo.m.aov/calaw.htrnL
this permit is issued.
Policy a Date
PROPERTY OWNER OR AUTHORIZED AGENT
m I , ve and will maintain worker's compensation insurance,as required by
section 3700 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 worker's compensation Insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier L.l building construction.I authorize representatives of this city or county to
Policy It 1611'S' 1(ayoI]Expires enter the above identified property for inspection purposes.
(This section need not to be completed Is the permit is or one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit is issued, Orl.G.7's�l LA
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE k ��J/���f�J /�
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the war scompe �eaFlDn plaai Icyns ofS 3700 of the Labor
Code,I shall f w"th co I ose visi Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applican Date d amounts specified on the Hazardous Materials Information Guide?
WAR N - ILURE TO SEC WORKER'S[OMPENSATI COVE GE IS oyes Qlflo
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($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THECOST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY Oyes DAD
I 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) oyes 421*40
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I undeffndeqre under the State of
I hereb afi Ucense Law for the reasons)indicated below by[he Califom" Ith&Safe nd 25534 concer ing
hero tins atelist.checkmark(s)I have placed next to the applicable items)(Section 7031.5s y p
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its PROP N ORIZED 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 Contractor's State RRENOVATION,REPAIR AND PAINTING(RRPI
License Law(Chapter9(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 70315 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 owners and property
than($500). managers who do the paint-disturbing work themselves or through their
o1,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( I portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-80OA24-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a aAn 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 offeredfor 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:
❑1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's 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
Acknowledgement.
-LI Jlli\I GII ILIi/ay`r'.v.l al ��11 I _`°It.' IC�r•. 'il 1"..ilil�il.i(fl�lj! <<
DATE: �' 18 PERMIT/PLAN CHECK NUMBER
TYPE: I COMMERCIAL ?'RESIDENTIAL '` MULTI-FAMILY D MOBILE HOME POOL/SPA SIGN
SUBTYPE: 'ADDITION : ALTERATION DEMOLITION ELECTRICAL CKMECHANICAL
NEW . PLUMBING RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK 11S TLC.-, ep,•h„�l,,,Q}y.Q, 'lv� .�..
PROJECTADDRESS Z-13(ao ql„'\rna�. '�T- _ ZIP `7258y
ASSESSOR'S PARCEL NUMBER �Q' �,-,�- LOT TRACT C1tY Of Meni e
OWNER NAME UcY'je_�<- C,2 Def I.
ADDRESS SAME AS JOBSITE FUG 15 201
PHONE EMAIL
APPLICANT NAME ' ��
ADDRESS
PHONEC 2,0 y"3/-Z9 EMAIL
CONTRACTOR'S NAME RIGH T IME HOME SERVICES OWNER BUILDER? YES VLNO
BUSINESS NAME ARS
ADDRESS 3030 MYERS ST RIVERSIDE CA 92503
PHONE 800 660 0675 EMAIL CCALHOUN@ARS.COM
CONTRACTOR'S STATE LIC NUMBER 765074 LICENSE CLASSIFICATION C10 C20 C36
VALUATIONS LSQFT
APPLICANT'S SIGNATURE DATE 8 /b d$
CIFYS'TAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENFEE BUSINESS UCENSE NUMBER
BBI;OhVG PLANNING nYG/NEE61NG FIRE ACCEPTED 87:
PERMIT FEE SMIP GREEN
PLAN CHECK FEE I I INVOICE TOTAL
OWNER BUILDER VERIFIED -YES NO DRIVERS LICENSE 0 NOTARIZED LETTER YES NO
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