PMT15-03987 City of Menifee Permit No.: PMT15-03987
29714 HAUN RD. Type: Residential Mechanical
�ACCELAA MENIFEE,CA 92586
MENIFEE Date Issued:
01105/2016
PERMIT
Site Address: 26162 BIRKDALE RD, MENIFEE, CA Parcel Number: 337-410-081
92586 Construction Cost: $11,000.00
Existing Use: Proposed Use:
Description of REPLACE 3-TON HEAT PUMP
Work:
Owner Contractor
RODNEY LIGGET W C HEATING&AIR CONDITIONING INC
26162 BIRKDALE ROAD 41085 GOLDEN GATE CIR
MENIFEE, CA 92586 MURRIETA,CA 92562
Applicant Phone:9516000700
RUSSELL COCHRAN License Number:779604
WC HEATING&AIR CONDITIONING INC
41085 GOLDEN GATE CIR
MURRIETA, CA 92562
Fee Description OQt Amount($1
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
$184A5
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 ❑ lam exempt from licensure under the Contractors State License Law for the
I hereby affirm under penalty or perjury that I am licensed under provisions of following reason:
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence in
Professions Code m license is in full force and effectp �/ which I must have resided for at least one year prior to completion of
License Class C Licenseo. // r 60l improvements covered by this permit, I cannot legally sell a structure that I have
Expires 6170 /d Signature C. built as an owner-building if it has not been constructed in Its entirely by licensed
contractors. I understand that a copy of the applicable law, Section 7044 of the
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is
submitted or at the following Web site:
❑ 1 hereby affirm under penalty of perjury one of the following declarations: htto://www.leciinfo.ca.gov/calaw.htmi.
I have and will maintain a certificate of consent of self-insure for workers'
compensation,issued by the Director of Industrial Relations as provided for by Date
Section 3700 of the Labor Code, for the performance of work for which this
permit is issued. Property Owner or Authorized Agent
Policy# ❑ By my Signature below, I certify to each of the following: I am the property
901111 have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read this
section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to comply
permit is issued.My workers compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to building
�I construction.I authorize representatives of this city or county to enter the above-
Carder �E�v?LfL identified property for the inspection purposes.
Policy# *fWN9771VCI Expires 111117 Date
Property Owner or Authorized Agent
(This section need not be completed if the permit is for City Business License#
one-hundred dollars($100)or less)
❑ 1 certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION
shall not emolov any persons in any manner so as to become subject to the WIII the applicant or future building occupant handle hazardous material or a
workers'compensation laws of California,and agree that If I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor amounts spef'fled on the Hazardous Materials Information Guide?
Code,I shall forthwith comply with those provisions. DYES 5wo
Applicant; Date; 4/i /74c Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guideline
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES ZO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary off school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES LIYNO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health R Safety Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous�yaterial reporting.
OWNER BUILDER DECLARATIONS ❑YES PlNO /
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date s�D
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT
next to the applicable item(s)(Section 7031.5.Business and Professions Code:
Any city or county that requires a permit to construct,alter, improve, demolish, EPA RENOVATION,REPAIR AND PAINTING(RRP)
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 The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
provisions of the Contractors State License Law(Chapter 9 (commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with
she is exempt from licensure and the basis for the alleged exemption. Any required practices.This includes rental property ovmem and property
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500).) employees.For more information about EPA's Renovation Program visit:
www.epa.govAead or contact the National Lead Information Center at
❑ I, as owner of the property, or my employees with wages as their sole 1-800424-LEAD(5323).
compensation,will do( )all of or( )porting of the work,and the structure is
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 ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees'or personal effort, builds or improves the property,
provided that the improvements are not Intended or offered for sale.If,however, Certified Finn Name:
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 Firm Certification No.:
purpose of sale).
❑ I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply to an owner of a property
who builds or improves thereon, and who contracts for the projects with a
licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
BUILDING & SAFETY PERMIT/.PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 12/28/2015 PERMIT/PLAN CHECK NUMBER Pmns- Caen
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION [-]ELECTRICAL []MECHANICAL,
❑NEW [-]PLUMBING [-IRE-ROOF-NUMBEROF SQUARES Clty Of 'yi Dee"
DESCRIPTION OF WORK INSTALL 3 TON HEAT PUMP DEC
PROJECT ADDRESS 26162 BIRKDALE RD
ASSESSOR'S PARCEL NUMBER LOT TRACT
PROPERTY OWNER'S NAME RODNEY LIGGET
ADDRESS 26162 BIRKDALE RD
PHONE (714)469-6494 EMAIL
APPLICANT NAME WE GREEN INC.
ADDRESS 4540 KEARNY VILLA RD#213
PHONE (951)600-0700 EMAIL ERIC@WEGREENINC.COM
CONTRACTOR'S NAME RUSSELL COCHRAN OWNER BUILDER? ❑YES❑✓ NO
BUSINESS NAME WE CARE PLUMING
ADDRESS 41085 GOLDEN GATE CIR.
PHONE (951)600-0700 EMAIL CATWOOD@WECARETEAM.COM
CONTRACTOR'S STATE LIC NUMBER 779604 LICENSE CLASSIFICATION C20
VALUATION$ $ 11,000.00 SQ FT 1256 L SO FT
APPLICANT'S SIGNATURE DATE
�PaSTA15EUSE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN 1 SMIP
INVOICE 0. PAID AMOUNT r,
AMOUNT \V S 1� •�S 0 CASH OCHECKit CREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO OIL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building& Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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