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PMT18-04267 City of Menifee Permit No.: PMT18-04267 29714 HAUN RD.ZA MENIFEE, CA 92586 Type: Residential Mechanical MENIFEE MENIFEE Date Issued: 08/29/2018 PERMIT site Address: 26860 AUGUSTA DR, MENIFEE,CA Parcel Number: 337-331-002 92586 Construction Cost: $7,472.00 Existing Use: Proposed Use: Description of HVAC CHANGE OUT, INSTALL NEW CARRIER 2.5 TON, 14 SEER, SIDE BY SIDE PACKAGE, Work: GAS/ELECTRIC Owner Contractor JEAN TANNER MONKS AIR CONDITIONING 1310 E OCEAN BEACH BLVD P O BOX 128 MENIFEE, CA 92586 SUN CITY, CA 92586 Applicant Phone:9516794502 GARY MONK License Number:912194 MONK'S AIR CONDITIONING P 0 BOX 128 SUN CITY, CA 92586 Fee Description DIV Amount(81 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 $324.1 D 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 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 ❑ lam exempt from licensure under the Contractors'State License Law for I 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 1 acknowledge that,except for my personal residence Professions Code license nse is In full force and which I must have resided for at least one year prior to completion License Class Wit/ Ucens No. eff Z Improvements covered by this permit,I cannot legally sell a structure that I he Expires-3-5)-20 Signatu built as an owner-building if it has not been constructed In its entirety by Iicens contractors.1 understand that a copy of the applicable law,Section 7044 of I WORKERS'COMPENSATION DECLARATION Business and Professions Code,Is available upon request when this applicator submitted or at the following Web sfte: ❑ I hereby affirm under penalty of perjury one the following declarations, httpJAvww.leoinfo.m covlmtaw.html. I have and will maintain a certificate of consentt for workers;of self-Insure for workers' compensebon,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 V. 1 have and YAM maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read t 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 com. permit is issued.My workers'compensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to buildi construction.I authorize representatives of this city or county to enter the abo, Cartier �7 identified property,for the inspection purposes. Policy#12 /b�� �Z Expires L� — � — 1 Date Property Owner orAuthorized Agent (This section need Lot be completed if the permit is for 0351079 one-hundred dollars($100)or less) City Business License# 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 eclfied on the Hazardous Materials Information Guide? Code,I shall wi mply with those provisions.J (�I DYES XNO Appli nt• Date; Nil the intended.use of the building by the applicant or future building occupant require a permit for the construction or modification from South WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See per mitring checkli COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES �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 boundarK of school? LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES A NO CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm that under the penalty 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 Safety C6ppgq,rrgd/e,Section 25505 and 25534 concerning 3097 Civil Code) hazardous mate) Ire orhr v OWNER BUILDER DECLARATIONS DYES NOl Dater I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the resson(s)indicated below by the checkmark(s)I have placed PRO 04NAU4 AUTHORIZED AGENT next to the applicable Item(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 fRRPI or repair any structure, prior to its issuance,also requires the apptimnt for the permit to file a signed statement that he or she is licensed pursuant to the The EPA Renovation,Repair and Painting(RAP)Rule requires contractors provisions of the Contractor's State Ucense Law(Chapter 9(commencing with receiving compensation for most work that disturbs paint In a pre-1978 Section 7000)of Division 3 of the-Businlass and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with she is exempt from Jimnsure.and the basis fdr the alleged exemption. Any required practices.This includes rental property owners and property violation of Section 703.1.5 by any Applicant for.a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their a civil penalty of not more than($504) employees.For more Information about EPA's Renovation Program visit: ❑ I, as owner of the roe or www.epa.govAead or contact the National Lead Information Center al property rty, my employees with wages as their sole 1-800424-LEAD(5323). compensation,will do( )all of or( )porting of the work, and the structure is 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 not built or Improved for the Firm Certification No.: purpose of sale). ❑ 1, as owner of the property-s.i exclusively contracting with licensed No EPA Lead-Safe Certified Firm Is required for this project bemuse: contactors to construct the projeot'(Section 7044,Business and Professions Code:The Contractor's License Law does not apply td an owner of a property who builds or Improves thereon, and who contracts for the projects with a PERMIT/PLANFETY APPLICATION '-Menifee DATEF) PERMIT,/PLAN CHECK NUMBER TYPE: O COMMERCIAL j4 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOUSPA O SIGN SUBTYPE: O ADDITION C ALTERATION C DEMOLITION C ELECTRICAL MECHANICAL C NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK PrC D ,i 11/l U ' (/� j r© PROJECT ADDRESS 2 C [-' I �, C '- ASSESSOR'S PARCEL NUMBER 33G LOT J -` TRACT z 3J--1 OWNER NAME ADDRESS PHONE (oiSl J —,�� I C EMAIL .APPLICANTNAME ADDRESS /3� �/ 53o M U�.Fr M en i key. CA i5l �W PHONE (` 51 ) 4f ;7n�--1 I502 /� � �/EMAILn-10nKSO4-tD CY1r�.1.I • cbrn CONTRACTOR'S NAME C C-r 1 VI DF/x OWNER BUILDER? OYES NO BUSINESS NAME C / w CDndi ion ADDRESS /� 15 //�� � I r ( GA /ZS PHONE (RQ1 6p7q-- 4502- EMAIL m�nIGSGilra'7 rn�-c.L • corm CONTRACTOR'S STATE LIC NUMBER Q12113LI LICENSE CLASSIFICATION C20 VALUATION$67 C . SO FT L SO FT G APPLICANT'S SIGNATURE ✓ DATE CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS UCENSE NUMBER BUILDING PAWNING ENGINEERING FIRE GREEN f SMIP INVOICE -((� PAIDAMOUNT AMOUNT OCASH OCHECK# OCREDIi CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# OCREDITCARD VISAIMC OWNER BUILDER VER;FIED OYES O NO DLNUMBER NOTARIZEDLETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 n m n a ?� o 0 0 0 o n n D T D n o _ m D D O n ti 3 w N N d n d W r^f J 6 O A VI j. 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