PMT18-04225 City of Menifee Permit No.: PMT18-04225
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE MENIFEE Date Issued: 08/28/2018
PERMIT
Site Address: 30646 SONORA ST, MENIFEE, CA 92584 Parcel Number: 360-491-009
Construction Cost: $9,200.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, 14 SEER 5 TON A/C, COIL, 100,000 BTU FURNACE, NO DUCT WORK
Work:
Owner Contractor
GREG TETZLAFF CONSTANT COMFORT HEATING&COOLING INC
30646 SONORA STREET 27679 AVENIDA HALAGO
MENIFEE, CA 92584 SUN CITY, CA 92585
Applicant Phone:7608846273
LORI WOODWARD License Number: 1028866
CONSTANT COMFORT HEATING&COOLING INC
27679 AVENIDA HALAGO
SUN CITY, CA 92585
Fee Description OQrt Amount f5l
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 far 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_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 penalty of 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 l am exempt from licensure under the Contractors State License Law for
Professions Code
11 and my license is in full force and effect. pp// the following reason:
License Class 2QL-l�1�1/ jacense No.la x o`^cl By my signature below I acknowledge that,except for my personal residence
Expires � J I I Slgnatu U J/ ,�(60,�, in which 1 must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legallysell a structure that I
WORKER'S COMPENSATION DECLARATION
have built as an owner-builder if It has not been constructed in its entirety by
0 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 1s submitted or at the fallowing webske:
by Section 3700 of the Labor Code,for the performance of work for which �ytyw.leeinFo.ca.eov/calaw.html.
this permit is issued.
Policy It Date
D I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which D 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 policy owner or authorized to act on the property owners behalf.I have read this
number are: application and the information I have provided Is correct.I agree to comply
Carrier
with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy R Expires eja he above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred �C�&L1/:LZU—
dollars($100)or less Oate
PROPERTY OWNER OR AUTHORIZED AGENT
At 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 R
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the arkers compensation provisions of Section 3700 of the Labor
Code,I sh drthwith comply with those revisions. Will the applicant or future building occupant handle hazardous material Ora
I �, `—�_,7JU�S/ mixture containing a hazardous material equal to or greater that the
Applica Date amounts ecified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS oYes RNo
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
ADDITIONSECTION
3760FTHHE COST LABOR CODE,INTEREST,
ADATTOGES AS REYSFEOVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SERION 37060E THE LABOR CORE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY oYes KNo
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 bou dary of a school?
(Section 3097 Civil Code) ❑Yes 1yo
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 understand my requirements under the State of
Contractors License Law for the reason(s)indicated below by the California Health'&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applcahie item(s)(Section 7031.5 hazardou_s,mate ial reporting.
Business and Professions Code).Any city or county that requires a permit to °Yes 7 J J)�_
construct,alter,improve,demolish or repair any structure,prior to its Date
issuance,also requires the applicant for the permit to file a signed statement PROPERTYO NER OR AUTHORIZED AGENT
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 contactors
Business and Professions Code)or that he or she is exempt from Iicensum 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 he 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
o I,as owner of the property,or my employee with wages as their sale 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.eoa.eoy/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 0 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. 0 No EPA Lead-Safe Certified Finn Is required for this project because:
a 1,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
Acknowledgement Lob woo ���W d d- Go
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: PERMIT/PLAN CHECK NUMBER
GRADING/ PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLU jM�BING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK �J
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS O YES NO
PROJECTADDRESS �pC/6 ZIP ! f
ASSESSOR'S PARCEL NUMBER ��� ' �-[' LOT TRACT Building Dept.
OWNER NAME &1( AUG 2 7 2018
ADDRESS
PHONE &).��30U y
u+ y�' ^ j��) EMAIL
APPLICANT NAME
ADDRESS 16/ h
PHONE ��f)-- C�^�y a-7 2j EMAIL
CONTRACTOR'S NAME (/6 OWNER BUILDER? ::YES ONO
BUSINESS NAME
ADDRESS
PHONE ^ yy1L_ EMAIL CONTRACTOR'S STATE LIC NUMBER f Qa��fG(� LICENSE CLASSIFICATION �D
VALUATION$ SO FT L SO FT
APPLICANT'S SIGNATUR �DATE �
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL O GREEN SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofmenifee.us
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