PMT14-02381 City of Menifee Permit No.: PMT14-02381
29714 HAUN RD. Type: Residential Mechanical
� L `' MENIFEE, CA92586
MENIFEE Date Issued: 09/05/2014
PERMIT
Site Address: 27873 HILLPOINT DR, MENIFEE, CA Parcel Number: 333-241-008
92585 Construction Cost: $13,563.00
Existing Use: Proposed Use:
Description of REPLACE 3 TON A/C, COIL 7 90,000 BTU FURNACE
Work:
Owner Contractor
SHELBY HOLLADAY W C HEATING&AIR CONDITIONING INC
27873 HILLPOINT DR 41357 DATE ST
MENIFEE, CA 92585 MURRIETA, CA 92562
Applicant Phone: 9516000700
STEVEN SCHNIERER License Number: 779604
W C HEATING &AIR CONDITIONING INC
41357 DATE ST
MURRIETA, CA 92562
Fee Description Q_yt Amount
Air Handling/Condensing Units SFR 1 133.00
GREEN FEE 1 1.00
$310.00
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_Permit_Template.rpt Page 1 of 1
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City Of Menifee
LICENSED DECLARATION
I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions
Professions Code and my license Is in full force and effect: Code:The Contractor's License Law does not a to an owner of a property
License Cass C'.2'.X7 License No. '??�7�,0�-I apply
who builds or Improves thereon, and who contracts for the projects with a
Expires-d.3011t, Signature ,-> licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ 1 am exempt from licensure under the Contractors'State License Law for the
❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason:
I have and will maintain a certificate of consent of self-insure for workers' By my signature below I acknowled a that, except for m
compensation,Issued by the Director of Industrial Relations as provided for by 9 P y personal residence in
Section 3700 of the Labor Code, for the performance of work for which this which I must have resided for at least one year prior to completion of
permit is issued. improvements covered by this permit, I cannot legally sell a structure that I have
Policy# built as an owner-building if it has not been constructed in its entirety by licensed
/� contractors. I understand that a copy of the applicable law, Section 7044 of the
V511 have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this.application is
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:bUQ:/www lepinfo ca gov/calaw himl.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier-, b)-�- Property wneror Authonzed gent Date
r
Expires i)� � 1.5 Policy# /S"StJt�'�3"DLI4C'ti"a
Name of Agent Phone# �My my Signature below, I certify to each of the following: I am the property
owner or authorized to act on the property owner's behalf. I have read this
(This section need not be completed if the permit is for application and the information I have provided Is correct. I agree to comply
_ one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building
construction. I authorize representatives of this city or county to enter the above-
0 1 certify that in the performance of the work for which this permit is issued,I identified property for the Inspection purposes.
shall not employ any persons in any manner so as to become subject to the
workers'compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. - Property Owner or Authorized Agent - Date
Date; 1 S 1`4 Applicant; � i -"'z-- City Business License# 63J20z
WARNING: FAILURE TO SECURE WORKERS'
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL HAZARDOUS MATERIAL DECLARATION
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000), IN ADDITION TO THE COST OF COMPENSATION, [DYES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING AHAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES NQ_ EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS. MATERIALS
I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE?
agency for the performance of the work which this permit is issued (Section
3097 Civil Code) WILL THE INTENDED USE OF THE BUILDING BY THE
APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
v&O DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME �-w.vrh �,„Y'er-2+^
License Law for the reasons)indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s)(Section 7031.5, Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, 0 SCHOOL?
or repair any structure, prior to its 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 License Law (Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or ES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any 10 CHECKLIST. I UNDERSTAND MY REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than ($500).) CODE, SECTION 25505, 25533,AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation, will do ( ) all of or( ) porting of the work, and the structure is - PROPERTY OWNER OR AUTHORIZED AGENT
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 X ,, ;f-g,� -.�_��_-_
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
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
purpose of sale).
CITY OF lylEl®Yll'll E PLCK No: P i
29714 Haun Road Date: Date:/ , I
Menifee, CA 92586 City of Menifee
Phone: (951)672-6777 Building & safety D unt: mount: 00D
Fax:(951)679-3843 $EP 0 5 201 Ck#: Ck#:
Building Combination PermNeceived
To Be Completed By Applicant
Legal Description: Planning Case: F:
Property Address: Assessor's Parcel Number.
27873 Hillpoint Drive 333 241 008
Project/Tenant Name: Unit#: Floor#:
Name. Shelby Holladay one No. Fax No,
Property Address: Unit Number Zip Code
Owner 27873 Hillpoint Drive 92585
Email Address:
Name: Steven SChnierer Phone No. Fax No.
951-241-6876
Applicant Address: Unit Number Zip Code
25251 Alessandro Blvd, Moreno Valley, CA 92553
Email Address:
Name: Phone No. Fax No.
WC Heating & A/C 91- 7
Contractor Address: City S�teA Zip 92562
41357 Date Street Murrieta lG.
Contractor'MA
firess /License o. Contractor's�,j 4
`10 pf California License No. Classification: C,20
Number of Squares: bO
Square Footage
Description of Work: Replace 3ton A/C, Coil, & 90,000 BTU Furnace cost of work:$ 13,563.00
Applicant's Signature e Date:September 4, 2014
70'Be Completed By City Staff Only.
Indicate As R-Received or N/A-Not Applicable
5 Completes sets of fully dimensioned,drawn to sale plans which include: 1 set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on&'/:x 11)
El Structural Calculations
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan I ❑ bound Report-Residential
Class Code: Indicate New Construction Alteration• Addition' Means/Methads
Work Type: Repair" - Retrofit' Revision to Existing Pennir Required? YES NO
Proposed Building Use(s): Existing Building Use(s):
#Buildings: #Units: #Stories: Will the Building Have a Basement?
Y of N
Bldg.Code Occupancy Group Indicate Indicate if YES or NO Indicate all Geo-tech.Haz.Zone
At Project Spnnklered that a 1
Completion: Construction pp y: Coastal Zone
Type(s): C of O YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. Planning Comm.Zoning Administrator
Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit speaal Case:Bldg_
OfficialApprowl
Expedite Project(s): Child, City Project Green Building Landmark Affordable Housing
For Staff Use Only
Building/Safely I Permit Specialist City Planning Civil Engineering EPWM-Admin I Transportation Mgmt Renl Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
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