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PMT16-01080 City of Menifee Permit No.: PMT16-01080 29714 HAUN RD. Type: Residential Mechanical <XCCELA? MENIFEE, CA 92586 MENIFEE Date Issued: 04/11/2016 PERMIT Site Address: 26309 SPANIEL LN, MENIFEE,CA 92586 Parcel Number: 335-392-002 Construction Cost: $9,000.00 Existing Use: Proposed Use: Description of REPLACE EXISTING 5-TON A/C,90,000 BTU FURNACE AND COIL Work: Owner Contractor NANCY RUDOLPH W C HEATING&AIR CONDITIONING INC 26309 SPANIEL LANE 41085 GOLDEN GATE CIR MENIFEE, CA 92586 MURRIETA,CA 92562 Applicant Phone:9516000700 JILL WESTON License Number:779604 W C HEATING&AIR CONDITIONING INC 41085 GOLDEN GATE CIR MURRIETA, CA 92562 Fee Description Qy Amount ISI 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_eldg_Permk_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). 1 hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and O I am exempt from licensure under the Contractor's Stale License law for Professions Code and my license is in full force and effect. the following reason: License Class ('nt5 License No. :I74 ('idy By my signature below l acknowledge that,except for my personal residence Expires Q`5611L Signature YJ in which I 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 DE[LARATIO J have built as an owner-builder if it has not been constructed in its entirety by D 1 hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a 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 websim: by Section 370D of the Labor Code,for the performance of work for which www.leeinfo.ca.eov/calaw.html. this permit is issued. Date Policy# PROPERTY OWNER OR AUTHORIZED AGENT Yhave and will maintain worker's compensation Insurance,as required by 4ection 3700 of the Labor Code,for the performance of the work forwhich ❑By my signature below l certify to each of the following:I am the property this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this number are: 1 application and the information I have provided is correct.I agree to comply hires iGr1ltiL,n with all applicable city and county ordinances and state laws relating to Carriers building construction.I authorize representatives of this city or county to Policy# OU6Q.,'1.0313at Expires,T�L!7 enterthe above identified property for inspection purposes. (This section need not to be completed Is the permit is for one-hundred Date dollars($30D)or less PROPERTY OWNER OR AUTHORIZED AGENT o I certify that in the performance of the work for which this permit is issued,Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# O--35 a©a worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers 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 1 mixture containing a hazardous material equal to or greater that the Applicant Date r7 �' (� amounts specified on the Hazardous Materials Information Guide? WARNING:FA .I RE TO SECURE WORKER'S COMPENSATION COVERAGE IS Dyes UNLAWFUL,AND SHALL SUBJECTAN EMPLOYERTO 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(SCAQMD)7 See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY O Yes "o I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be 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) Oyu yd(o OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements underthe State of I hereby affirm under penalty of perjury that l am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes [Mo ..tt 11 II Business and Professions Code).Any city or county that requires a permit to Date J" 2 —l3 construct,alter,improve,demolish or repair any structure,priorto its PROPEFQ OWNER OR AUTHORIZED AGENT issuance,also requires the applicant forthe permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors 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 exempt from 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 be 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 wthrough their o1,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.epa.aov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-80D-424-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 factors to construct the project(Section 7044,Business and Professions The Contractors 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. BUILDINGPERMIT/.PERMIT/PLAN CHECK APPLICATION s � Menifee DATE 04/07/2016 PERMIT/PLAN CHECK NUMBER Q1?D TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION []ALTERATION ❑DEMOLITION [-]ELECTRICAL ❑MECHANICAL ❑NEW [-]PLUMBING [-IRE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK REPLACING 5 TON A/C;90,000 BTU FURNACE AND COIL PROJECT ADDRESS 26309 SPANIEL LANE AaSSP ASSESSOR'S PARCEL NUMBER 3 _ fAQ . Qpa LOT TRACT PROPERTY OWNER'S NAME NANCY RUDOLPH City of IB ADDRESS 26309 SPANIEL LANE,MENIFEE, CA 92586 Building Dept PHONE (251)424-5143 EMAIL APPLICANTNAME JILLWESTON ADDRESS 3645 RUFFIN RD#330-335 SAN DIEGO, CA 92123 e c e s ve PHONE (619)384-6622 EMAIL J CONTRACTOR'S NAME RUSSELLCOCHRAN OWNERBUILDER? ❑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 SO FT 1784 L SO FT APPLICANT'S SIGNATURE DATE �CITY STAFF USE ONLY _ DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIFE I GREEN 1 SMIP INVOICE PAID AMOUNT AMOUNT •l OCASH OCHECKN CCREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER C YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. 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