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PMT18-04446 City of Menifee Permit No.: PMT18-04446 Ar. An 29714 HAUN RD. Type: Residential Mechanical ,A r MENIFEE, CA92586 MENIFEE MENIFEE Date Issued: 09/12/2018 PERMIT Site Address: 29893 CAMINO CRISTAL, MENIFEE,CA Parcel Number: 340-090-002 92584 Construction Cost: $3,000.00 Existing Use: Proposed Use: Description of REPLACE 60,000 BTU/3 TON FAU FURNACE ONLY, SAME LOCATION Work: Owner Contractor CARMEN GARCIA BUILDER SERVICES GROUP INC 29893 CAMINO CRISTAL 475 N WILLIAMSON BLVD MENIFEE, CA 92584 DAYTONA BEACH, FL 32114 Applicant Phone:3863042222 EDWARD PONCE License Number: 1034361 BUILDER SERVICES GROUP INC 475 N WILLIAMSON BLVD DAYTONA BEACH, CA 32114 Fee Description Q1t r Amount ISI Forced-Air or Gravity-Type Furnace or Burner 1 149.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Mechanical 1 7.45 $184.45 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_Permit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is In full force and effect. the following reason: h License Class I� —�!� Ucense o. //,'3 L/-�6. // By my signature below 1 acknowledge that,except for my personal residence Expires 3OJI C/ Signature �'�-�.�"y`� 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 DECLARATION have built as an owner-builder if it has not been constructed in its entirety by ❑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-leginfo.ca.gov/calaw.htmi. this permit is issued. Policy 4 Date �I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT 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 carder and policy owner or authorized to act on the property owner's behalf.I have read this numberare: 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 4C6-S 1.7qq,N P F_rLr J= / building construction.I authorize representatives of this cityor county to Policy# O d-4�C`/5'3yr'Y%Expires enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑I cerufy that in the performance of the work for which this permit is issued, �Q I shall not em ilov any persons in any manner so as to become subject to the CITY BUSINESS UCENSE k L. worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall forthwtg/complywith hos provisions. / Will the applicant or future building occupant handle hazardous material or G - � o-�F/� mixture containing a hazardous material equal to or greater that the Applicant ✓ -L-^ Date amounts specified an the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 O Yes @ No 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 370G OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES rorguidelines CONSTRUCTION LENDING AGENCY oYes ffN0 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) ❑Yes 40 OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes VNa a Business and Professions Code).Any city or county that requires a permit to � /',_ Date PAV/"F construct,alter,improve,demolish or repair any structure,prior to its PROPERTY 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 Contractor's State EPA RENOVATION-REPAIR AND PAINTING fRRPI 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 Iicensure 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 owners and property than($500). managers who do the paint-disturbing work themselves or through their ❑1,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.eov/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 Contractor's State License Law does not apply to an owner of a ❑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. D No EPA Lead-Safe Certified Firm is required for this project bemuse: In I,as owner of the property am exclusively contracting with licensed contactors 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 RAP EA Pon ^ O _7R Te"v1 Acknowledgement. BUILDING i SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE PERMIT/PLAN CHECK NUMBER I�;—O TYPE: [-]COMMERCIAL ❑✓ RESIDENTIAL MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION ❑ALTERATION []DEMOLITION []ELECTRICAL ❑✓ MECHANICAL ❑NEW ❑PLUMBING [-IRE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK REPLACING FAU FURNACE ONLY SAME LOCATION 3 p,J PROJECTADDRESS 29893 CAMINO CRISTAL ASSESSOR'S PARCEL NUMBER 340-090-002 LOT 9 TRACT 22128 PROPERTY OWNER'S NAME r4 V) lhoa;GC--� ADDRESS p( �- %J Ajj(a; Ltcf 5 �rxl o I = a PHONE -1- a G S - 3 rro EMAIL APPLICANT NAME ) el - ADDRESS 475 Rivera St, Unit:D, Riverside, CA 92501 PHONE (951)722-0905 EMAIL CONTRACTOR'S NAME Truteam of CA Inc OWNER BUILDER? ❑YES❑✓NO BUSINESS NAME TruTeam of CA ADDRESS 475 Rivera St, Unit:D, Riverside, CA 92501 PHONE (951)683-0429 EMAIL CONTRACTOR'S STATE LIC NUMBER 1034361 LICENSE CLASSIFICATION C20 VALUATION$ $3,000.00 SQ FT L SQ FT APPLICANT'S SIGNATURE DATE R/f i hS- CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITYOFMFNIFFF ISjN�NIICENSENUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE I PAID AMOUNT AMOUNT O CASH 0CHECK# OCREDITCARD VISA/MC. PLAN CHECK FEES PAIDAMOUNT OCASH OCHECKII OCREDITCARD VISA/MC OWNER.BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 c X yO. fy'f •p z z m m 2 ry Z y: y d n N n 9 O D D 7 n .d. T 0 3 m p1 'n'< o 3 v' D o o G 1 z o �. f1 d n n N 10 O O d d N 1 m o °. O o y ° d p y n m d 3 O d x o m ^. m 3 . 3 n o N 3 O m n y m n0 N r) OC O r Do y 0 n d � < O V N O w Z cr vi N 3 ° nni < m Q O d O 3 lD W N W q, •• j O O w n 3 o o vi z p d w o F, Q y C ° m ?. w ° tG N N 3 'om rri =.,Z- c o S m ; n m z o c o v v m fD CD •O CD jco (�r O VI W A m m �. n �. 3. � d C C < d K •2 0 o a � 01 0o n > > �mJ Ll ". y a a v (C tOe 3 N OOp C 3 2 $ � p O y � JL n ?1 T N D m K tt O. J (l l Z N G Iy xo o ,C gU wwm w .. o of m 2 N N o ri+ 3 O N m o z m N w m nnv n 'm �n � O 7 O p 9 C S O. J r 0 2 o FF m ° m ? 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