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PMT16-00716 City of Menifee Permit No.: PMT16-00716 29714 HAUN RD. Type: Residential Mechanical '5A—CCEL/-> MENIFEE, CA 92586 MENIFEE Date Issued: 03/17/2016 PERMIT Site Address: 29728 DESERT JEWEL DR, MENIFEE, Parcel Number: 340-180-006 CA 92584 Construction Cost: $9,000.00 Existing Use: Proposed Use: Description of REPLACE EXISTING A/C, FURNACE&COIL Work: Owner Contractor ELIZABETH SKAGGS W C HEATING&AIR CONDITIONING INC 29728 DESERT JEWEL DRIVE 41085 GOLDEN GATE CIR MENIFEE, CA 92584 MURRIETA, CA 92562 Applicant Phone:9516000700 JILL WESTON License Number.779604 WC HEATING&AIR CONDITIONING INC 41085 GOLDEN GATE CIR MURRIETA, CA 92562 Fee Description Qttv Amount I$1 Forced-Air or Gravity-Type Furnace or Bumer 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_81dg_Pennit_Template.rpt Page 1 of 1 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 contractors)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑1 am exempt from licensure under the Contractor's State License Law for Professions Code azyndrmly license is in full force and effect. the following reason: License Class ` I License No. —17101, 60L( By my signature below l acknowledge that,except for my personal residence Expires 61'Wlit Signature kAP -293=7 in which l 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 Of hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that copy of the applicable law,Section have and will maintain a certificate of consent of self-insure for worker's 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 websfte: by Section 3700 of the Labor Code,for the performance of work for which w,Lv�y,leeinfo.ca.eov/calaw.html. this permit is issued. Policy# Date y0cave and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT Section 3700 of the Labor Code,for the performance of the work for which O By my signature below I certify to each of the follov ing:I am the property this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number are: ` \ application and the information I have provided is correct.I agree to comply Carrier QAnICShsr� �1an.c�.w QU��. with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy#1rJGWC-l.01b\'1q Expires X l \ I 1-1 enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or Applicant N_Qyo Date b mixture containing a hazardous material equal to orgreater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes ❑No 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($100,000),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 c construction Seeodi permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airllnes Qua CONSTRUCTION LENDING AGENCY O Yes O No 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) O Yes O No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I herebyaffirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements underthe State of Contractor's License Law for the reason(s)indicated below by the California Health&Safety Cade,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting. Business and Professions Code).Any city or county that requires a permit to oyes ❑No construct,alter,improve,demolish or repair any structure,prior to its Date PROPERTY OWNER OR AUTHORIZED AGENTissuance,also requires the applicant for the permitto file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRPI 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 exemptfrom licensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to he 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 owners and property than($500). managers who do the paint-disturbing work themselves or through their O I,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.euamov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800424-LEAD(5323). Code,The Contractor's 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. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. ABUILDING & SAFETY PERMIT/PLAN CHECK PPLICATION Menifee DATE 03/07/2016 PERMIT/PLAN CHECK NUMBER TYPE: ❑COMMERCIAL H RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN SUBTYPE: []ADDITION ❑ALTERATION []DEMOLITION ❑ELECTRICAL ❑MECHANICAL ❑NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK REPLACING AC, FURNACE,COIL PROJECTADDRESS 29728 DESERT JEWEL AQ16a(A ASSESSOR'S PARCEL NUMBER ' .�. • D LOT TRACT PROPERTY OWNER'S NAME ELIZABETH SKAGGS City of Menifee ADDRESS 29728 DESERT JEWEL, MENIFEE, CA 92585 g liept PHONE (951)679-5932 EMAIL MAR 15 2016 APPLICANTNAME JILLWESTON ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA 92123 PHONE (619)384-6622 EMAIL J CONTRACTOR'S NAME RUSSELL COCHRAN OWNER BUILDER? ❑YES❑✓NO 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$ $9,000.00 SQ FT 1784 L SO FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN �� SMIP ? INVOICE PAID AMOUNT AMOUNT ?94.10 •1 b O CASH O CHECKM O CREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. 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