PMT15-01088 City Of Menifee Permit No.: PMT1 S-01088
29714 Type: Residential Mechanical
'��'1CCE1../'1�.` MENIFEEEE,, C CA 92 92586
e°""""ASAI�, MENIFEE Date Issued: 0412 8/2 01 6 '..
PERM IT
Site Address: 29178 PARADISE CANYON DR, Parcel Number: 340-200-026
MENIFEE, CA 92584 Construction Cost: $9,575.00
Existing Use: Proposed Use:
Description of REPLACE 4TON A/C, COIL, &90,000 BTU FURNACE
Work:
Owner Contractor
ROXANNE ELSEA W C HEATING&AIR CONDITIONING INC
29178 PARADISE CANYON DRIVE 41357 DATE ST
MENIFEE, CA 92584 MURRIETA, CA 92562
Applicant Phone: 9516000700
STEVEN SCHNIERER License Number: 779604
W C HEATING &AIR CONDITIONING INC
41357 DATE ST
MURRI ETA, CA 92562
Fee Description q�t Amount
1orobdAirorGravl 'Type Fume arBurger_ .. :1 Oq.
..z...,....rv__�.5 zrru.eawv�xve�su.,y.E a5m�,.az�.;E
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
°Air H n l gCon easing Uni 'SF t F vk �" �33 g4 v„�s ...w..,..s.._,.EMI +tc 2:,... .
Air Handling/Condensing Units SFR 1 133.00
g Bwld�n erml iSS v Ta J 5 g k; "
9.P_,.-. ;.«... .,.:.4..r.�TFw `s .`:�. :' `�e �is2 2 .6
GREEN FEE 1 1.00
$692.00
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 slated,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
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 apply to an owner of a property
License Class.C-Z-o License No.-779 - who builds or improves thereon, and who contracts for the projects with a
Expiresb 36 to Signature Sl_ - licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I 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 acknowledge that, except for my personal residence in
compensation,issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of
Section 3700 of the Labor Code, for the performance of work for which this improvements covered by this permit, I cannot legally sell a structure that I have
permit is issued. built as an owner-building if it has not been constructed in its entirety by licensed
Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the
� 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:htto'/Iwww leoinfo ca aov/calaw html,
permit is issued.My workers'compensation insurance carrier and policy number are:
Property Owner or Authorized Agent Date
Carrier )rers
Expires Policy#ATWCO]Y'7L o1
XBy my Signature below, I certify to each of the following: I am the property
Name of Agent Phone# owner or authorized to act on the property owner's behalf. I have read this
be completed if the permit is for application and the information I have provided is correct. I agree to comply
(This section need not
one-hundred dollars($be 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-
El I certify that in the performance of the work for which this permit is issued,I identified property for the inspection purposes.
shall not emulov 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 Property Owner or Authorized Agent Date
Code,I shall forthwith comply with those provisions.
City Business License
Date; 3 IS Applicant; c
_ WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
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, ❑YES OCCUPANT HANDLE AHAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES NO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY !— SPECIFIED ON THE HAZARDOUS MATERIALS
INFORMATION GUIDE?
I hereby affirm that under the penalty of perjury there is a construction lending
agency for the performance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name ❑YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
�nI FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address dNO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME: �cwSereY"
License Law for the reason(s)indicated below by the checkmark(s)I have placed ❑YES 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 SCHOOL7
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 INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any 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($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole
HAZARDOUS MATERIAL REPORTING.
compensation,will do ( )all of or ( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X '�
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
A M e n i f e e
DATE 4 Zy- 16 PERMIT/PLAN CHECK NUMBER
TYPE: C COMMERCIAL CkRESIDENTIAL 'J MULTI-FAMILY " MOBILE HOME 0 POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION ?DEMOLITION C> ELECTRICAL O MECHANICAL
." NEW " PLUMBING C1 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Pe ZAAT� /aL C " G 90 C�j eyu ur
p)cPROJECT ADDRESS 2.rI 17H ?Rrv.AiZc Ca 0,-. )'+Ye. V
ASSESSOR'S PARCEL NUMBER 3go- ZOO-OZ(o LOT Z(0 TRACT Z5 -Z
OWNER NAME jZanarra �1sea nlfe0
ADDRESS 2.9178 ?Rrccl,st Cc>, � ai Building & Safety Dept.
o�, �, ee CA 925
PHONE q5j-(,72- CIOy\ EMAIL APR 2 8 2015
APPLICANT NAME S}e'C_N :&c r�ietw Received
ADDRESS 3\7_Z.5 L0.9 0.0r Vt'l\Z We-salcke \M: aSe CA 6i12�.Z
PHONE El --)3.5- 7871- EMAIL
CONTRACTOR'S NAME L )C_ A OWNER BUILDER? C)YE0O
BUSINESS NAME
ADDRESS q1025 C>nlckh cC� Mrr-%AC CA c12562-
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER 'T79(oc4 LICENSE CLASSIFICATION G2c3
VALUATION$ c'J,57S.� SOFT LSO FT
Ii
APPLICANT'S SIGNATURE ?e �TL— DATE 44 Z� 1
CITYSTAFF USE ONLY i�Nli
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
462 G PLANNING ENGINEERING FIRE I GREEN I SMIP p
INVOICE PAID AMOUNT
AMOUNT �5_qpp(� S Z C+CASH 0 CHECK# 7L/ {o;%CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT CASH %CHECK# CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES C% NO DL NUMBER NOTARIZED LETTER v YES C NO
City of Menifee Building &Safety Department 29714 Haan Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.Lis Inspection Request Line 951-245-6213
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