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pmt18-04922 City of Menifee Permit No.: PMT18-04922 29714 HAUN RD. MENIFEE, CA 92586 Type: Residential Mechanical MENIFEE MENIFEE Date Issued: 10/09/2018 PERMIT Site Address: 29554 WINDING BROOK, MENIFEE, CA Parcel Number: 340-250-033 92584 Construction Cost: $10,000.00 Existing Use: Proposed Use: Description of HVAC CHANGE OUT COOLING BTU 60,000 HEATING BTU 100,000 5 TONS HEATER IN ATTIC Work: Owner Contractor JOY PERKINS RIZZO HEATING&AIR CONDITIONING 29554 WINDING BROOK 32823 TIZNOW MENIFEE,CA 92584 MENIFEE, CA 92584 Applicant Phone:9516720397 ROXANNE EASLEY License Number: 349958 RIZZO HEATING &AIR CONDITIONING 32823 TIZNOW MENIFEE,CA 92584 Fee Description ON Amount IEl 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 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. 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 ❑1 am exempt from Iicensure under the Contractors State License Law for Professions Code' and^mmy license is in full force and of art ^�y,�,I.�s-� the following reason: License Class (Jl-IJ li ens 0. /mil ( c ` By my signature below I acknowledge that,except for my personal residence Expires 3 NJ _Signature' in which I 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 .9 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 is submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which ww%v.leginfo.ca.gov/calaw.htnil.permit is issued. Policy R Date have and will maintain worker PROPERTY OWNER OR AUTHORIZED AGENT s compensation insurance,as required by I section 3700 of the Labor Code,for the performance of the work for which 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 aGe:�,L� C;\,ry application and the information I have provided d correct.I agree to comply Carrier T/� l/�f )', with all applicable city and county ordinances and state laws relating to Policy � a _E>!p k building construction.I authorize representatives P this city or county to Poll �I i n r t t above ide tified ra ert dr section ur os s. (This section need not to be completed is the permit is for one-hundred I Date �� dollars($300)or less PROPERTY OWNER OR AUTHORIZED AGENT hh�� ❑I certify that in the performance of the work for which this permit is issued, �11 �f 7 I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE g 0\`� ��I w workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subjec[tot arkersco ensa[ion provisions of5ection 3700 of the Labor Code; shall f rthwi[h corn I ith those visions. Will the applicant or future building occupant handle hazardous material or a p i31n on 8 p Applicant Date mixture containing a hazardous material equal to or greater that the amounts 5%cified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes 0 , 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($10D,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 gui1`lfi as CONSTRUCTION LENDING AGENCY 0 Yes t�,o I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility he 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) 0 Yes �Jo 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&Safe Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the s maze a re orting. checkmark(s)I have placed next to the applicable item a ardou s)(Section 7031.5 0 0 0 Business and Professions Code).Any city or county that requires a permit to l7 ate .J construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWI OR AUTHORIZED A ENT 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING FIRM 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 forthe alleged exemption.Any violation of5ection 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 than($500). 4 P P p he owners and property managers who do the paint-disturbing work themselves or through their a 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.epa.govllead 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 ❑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. in No EPA Lead-Safe Certified Firm is required for this project because: 01,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 rill out the RRP ('t Acknowledgement. /10 BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE -1fl DATE: nv vt PERMIT/PLAN CHECK NUMBER "'—Q Z2 PLANNING CASE NUMBER TYPE: 0 COMMERCIAL XAESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O-M-ECHANICAL O NEW O PLUMBING O RE-ROOF NUMBER OF SQUAREESS DESCRIPTION OF WORK tpmwal PROJECTADD SS 2�`-I WW 1CII ICA jc—y� ZIP 612 ASSESSOR'S PARM R LOT TRACT OWNER NAME ADDRESS ZG155�'I W 1V-(,A PHONE ����-�1Se� I 0 EMAIL APPLICANT NAMZ \E ' V n ADDRESS \ �1 1 PHONE CA 1 (O(n 5�3� EMAIL CONTRACTOR'S NAME OWNER BUILDER. O YES XO BUSINESS NAM l ADDRESS (`'�,�� 1 PHONE \ �� � .ol /A�l EMAIL /� CONTRACTOR'S STATE LIC NUMBER �f",���" 1 L k..�� LICENSE CLASSIFICATION v VALUATION$ Q) V SOFT 2-�,Q 0C) L SO FT APPLICANT'S SIGNATURE DATE tug I V CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICETOTAL I GREEN SMIP OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZEDLETTER O YES O NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityof m en ifee.us ENIFE y !� a ?� 0 0 0 0 0 T T D v D n m w m m N w V w w c n X to n p_ .ldr Z N Ol n N n T S D D O O 7 N d •^dr N FOB O 9 D O O -ri 1 I Z O n m =Z O F+ N O N O O .0 .� n N N � < Q •0-N �" G O d 0 m '! 7 N c Z y n X O m �. 3 n O N N r 7 O fD n y N .. o > > .o. v = nan v O 3 o p •^dY m 4 o n m o • a Z o_ W N D 3 o- w D m y N !D •� N O f7 - N •N_, O o 3 H 3 p tN0 N d m N O- O d O 3 S 1yD w 3 fD £ ^ ? 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