PMT16-00384 City of Menifee Permit No.: PMT16-00384
29714 HAUN RD.
4F'CCEL/-17. MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 02/1712016
PERMIT
Site Address: 30189 VIA PALERMO, MENIFEE,CA Parcel Number: 364-096-001
92584 Construction Cost: $12,000.00
Existing Use: Proposed Use:
Description of REPLACE 4-TON A/C, COIL, FAU AND ALL DUCT WORK
Work:
Owner Contractor
DAVE LYONS W C HEATING&AIR CONDITIONING INC
30189 VIA PALERMO 41085 GOLDEN GATE CIR
MENIFEE, CA 92584 MURRI ETA,CA 92562
Applicant Phone:9516000700
ERIC BARNETT License Number.779604
W C HEATING&AIR CONDITIONING INC
41085 GOLDEN GATE CIR
MURRIETA, CA 92562
Fee Description Qtv Amount[El
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.
AA_Bldg Permt_Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ lam exempt from licensure under the Contractors'State License Law forth
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 ii
Professions Code an license is in full force and effert�., which I must have resided for at least one year prior to completion c
License Class � License t`�o. 7 / 60y improvements covered by this permit,I cannot legally sell a structure that I hav,
Expires tS s6 1d Signature t` - built as an owner-building if it has not been constructed in its entirety by license,
contractors. I understand that a copy of the applicable law,Section 7044 of th,
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application 1
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one t the following for workers. httpJ/www.leginfo.ca.gov/calaw.html.
I have and will maintain a certificate of consent of self-insure for workers'
compensation,issued by the Director of Industrial Relations as provided far 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 proper,
19' 1 have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read thi:
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 compl;
permit Is issued.My workers'compensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to buildini
9 construction.I authorize representatives of this city or county to enter the above
Carrier .9C&1rSf 1XC_ yr4Tf�,q.L✓,Q.� identified property for the inspection purposes.
Policy# W-114 Expires �/�/� 7 Date
y"
Property Owner or Authorized Agent
�
(This section need not be completed if the permit is for City Business License# ¢✓✓9 "�(�
?
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 amid any persons in any manner so as to become subject to the Will 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 specified on the Hazardous Materials Information Guide?
Code,I shall forthwith comply with those provisions. DYES fyrv0
Applicant; G► Date; ZL/7I 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 guidelinj�
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES Z NO
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 boundaryy of�'school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES ISNO
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&Safety Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous ryEferial reporting.
OWNER BUILDER DECLARATIONS DYES EYNO
I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's Date /7 (6
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 IRRP)
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 Contractor's 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 owners and properly
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:
❑ I, as owner of theproperty, or m employees with wa es as their sole www.epa.gov/lead or contact the National Lead Information Center at
y9 1-800-424-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).
❑ 1, 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 Contractor's 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
y,r
C& SAFETY PERM IT/PLAN CHECK APPLICATION
® .Meni ee
DATE 02/12/2016 PERMIT/PLAN CHECK NUMBER -CX> ✓'EH
TYPE: [-]COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION [-]DEMOLITION ❑ELECTRICAL ❑MECHANICAL
[-]NEW [-]PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK REPLACE 4 TON AC, COIL, FAU AND ALL DUCT WORK
PROIECTADDRESS 30189 VIA PALERMO GJ
en
ASSESSOR'S PARCEL NUMBER 2foU- (y-��y - �� LOT TRACT City Ot Dept
PROPERTY OWNER'S NAME DAVE LYONS
G
ADDRESS 30189 VIA PALERMO `►pp
PHONE (951)526-3856 EMAIL
APPLICANT NAME ERIC BARNETT
ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA 92123
PHONE (619)384-6622 EMAIL ERIC@WEGREENINC.COM
CONTRACTOR'S NAME RUSSELLCOCHRAN OWNERBUILDER7 ❑YESQNO
BUSINESS NAME WC PLUMBING, HEATING&AIR
ADDRESS 41085 GOLDEN GATE CIR MURRIETA, CA 92562
PHONE (951)600-0700 EMAIL
CONTRACTOR'S STATE LIC NUMBER 779604 LICENSE CLASSIFICATION C20
VALUATION$ $12,000.00 SO FT 2140 L SO FT
APPLICANT'S SIGNATURE DATE 02/12/2016
CITYSTAFFUSE ONLY
DEPARTMENT DISTRIBUTION CITY OF 1MENIFEE BU51�NSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN I SMIP 'v
INVOICE '��y ` PAID AMOUNT
AMOUNT t,/b�-�'tO 0CASH 0CHECK It OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0 CASH 0 CHECKR O CREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER 0'' YES 0 NO
City of wlenifee Building& Safety Department29714 Houn Rd. Menifee, CA 92586951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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