PMT18-04435 City of Menifee Permit No. PMT18-04435
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Mechanical
A&
MENIFEE MENIFEE Date Issued: 09/11/2018
PERMIT
Site Address: 27958 MOONRIDGE DR, MENIFEE, CA Parcel Number: 333-261-009
92585 Construction Cost: $6,200.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, 2 TON A/C, COIL&40,000 BTU FURNACE, NO DUCT WORK
Work:
Owner Contractor
SARA GERARD] CONSTANT COMFORT HEATING&COOLING INC
27958 MOONRIDGE DRIVE 27679 AVENIDA HALAGO
MENIFEE, CA 92585 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 Oft r Amount(S)
Forced-Air or Gravity-Type Furnace or Bumer 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_Bldg_Permk_Templale.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION properly who builds cr improves thereon,and who contracts far the projects
i herebyaffirm under penalty of perjury that I am under provisions of with a licensed contractors)pursuant to the Contractors State License Law).
Chapter9(commencing with section 70001 of Division 3 of the Business and D I am exempt from licensure under the Contractors State License Law for
Professions Code and
and my license is in full force and effect. p the following reason:
License Class qq0 ato/� Ucense No. Ica'?ef& By my signature below I acknowledge that,except formy personal residence
Expires.-7-1 I-I"L Signatur LJ 77 'yw,C in which 1 must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION Improvements covered by this permit.I cannot legally sell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
- o l hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a ropy 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 websile:
by Section 3700 of the Labor Code,for the performance of work for which www.leginfo.ca.gov/`calaw.htmi.permit is issued.
Policy N Date
❑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:1 am the property
this permit is issued.My workers compensation insurance carder and policy owner or authorized to act on the property owners behalf.I have read this
number are: application and the information 1 have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Cartier building construction.1 authorize representatives of this city or county to
Policy N Expires t he abgve identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred �L7UtJGL2(,� Date ` ✓"-)
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
kI certify that in the performance of the work for which this permit is issued,
1 shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE g
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the*orkers compensation provisions of Section 3700 of the Labor
Code,I sh drthwith Fom ly w��ii/t�h�,those revisions. Will the applicant or future building occupant handle hazardous material or
Applica L 1..1J�' Date-1-3o-iS ' mixture containing a hazardous material equal to or greater that the
amounts ecified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes 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
ADDITION TO THE COST 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 KIND
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) Dyes ;0
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 applicable item(s)(Section 7031.5 hazardou_s,mate'aI reporting.
Business and Professions Code).Any city or county that requires a permit to oyes 7a/`u.
construct,alter,improve,demolish or repair any structure,prior to its Date
issuance,also requires the applicant for the permit to Tile a signed statement PROPERTYO NER ORAIIfHORiZED 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 contractors
Business and Professions Code)or that he or she is exempt from ficensure receiving compensation for most work that disturbs paint inapre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving orchildcarenfor to be rkthat distufied ris alnico pre-19ply th
than
Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($5l)0). managers who do the paint-disturbing work themselves or through their
D 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.eoa.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 D 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
Acknowledgement. rt+ ■
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
��� �ULLDING}&YSAFFaT�YJiY
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 X MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK 4 o dt' Ka(u d h r)
OCCUPANCY GROUP 1 O CONSTRUCTION TYPE SPRINKLERS OYES INO
PROJECT ADDRESS CP-716 D nywyn l[u' e_ V--4r . ZIP 2l�
ASSESSOR'S PARCEL NUMBER 3j- Q W - 00C� LOT TRACT
OWNER NAME
VA, 01f O�Y City of Menifee
ADDRESS a���22�p( huvr\ '� � b c • O
PHONE -1'J�� tJ"J� ��� 2018
n/��,�. EMAIL
APPLICANT NAME W ti6 `\-
Recea
ADDRESS ��L.0 1 Q
PHONE �J��-�`�Q " �� �� EMAIL ,O
CONTRACTOR'S NAME OWNER BUILDER? OYES A NO
BUSINESS NAME
ADDRESS 5r1JY1ti-Q.+
PHONE 4-> EMAIL
CONTRACTOR'S STATE LIC NUMBER 1 U &n L(e LICENSE CLASSIFICATION � aU
trb
VALUATION$ K t SQ FT L SO FT
APPLICANT'S SIGNATU 09J81-U A)\_ DATE l
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL lO GREEN SMIP
OWNER BUILDER VERIFIED 0 YES 01 No DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
G,rr o>
www.cityofinenifee.us
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