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PMT16-01468 City of Menifee Permit No.: PMT16-01468 _ 29714 HAUN RD. Type: Residential Mechanical <ACCEUA—> MENIFEE, CA 92586 MENIFEE Date Issued: 05/11/2016 PERMIT Site Address: 29030 CROHAM HURST CT, MENIFEE, Parcel Number: 338-024-008 CA 92586 Construction Cost: $9,000.00 Existing Use: Proposed Use: Description of REPLACING 4-TON A/C,90,000 BTU FURNACE AND COIL Work: Owner Contractor JEANNE KEEFER W C HEATING&AIR CONDITIONING INC 29030 CROHAM HURST COURT 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 ON Amount 15) 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. M_Bldg_Perrrit_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 ❑1 am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and effect the following reason: License Class CA13 License No.1—IQ (,6H By mysignature below l acknowledge that,except for my personal residence Expires Signature rNvya 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 WORKER'S COMPENSATION DECLARATIO have built as an owner-builder if it has not been constructed in its entirety by o I 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 website: by Section 3700 of the Labor Code,for the performance of work forwhich v�,�,�w,ieeinfo.ca.eov/calaw.html. this permit is issued. Policy# Date Y,11 have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT 4ection 3700 of the Labor Code,for the performance of the work for which o 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 owner's behalf.l have read this number are: - application and the information I have provided is correct I agree to comply Cartier►]OY'IC.SI'1LCeJ N( t'y1C�L.b-t/1 with all applicable city and county ordinances and state laws relating to v building construction.I authorize representatives of this city or county to Policy# 0C.WC.10myi Expires �� L:7 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 o 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# O--3`J oC0 a worker's compensation laws of California,and agree that if l 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. I Will the applicant or future building occupant handle hazardous material or Applicant W Date t7 $' k mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FA URE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes "D 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(SCACUND)?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 10DO 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) ❑Yes 9410 OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCACIMD 1 hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist.I understand my requirements under the State of California Health al Safety Code,Section ZSSOS 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 ftem(s)(Section 7031.5 Business and Professions Code).Any city or county that requires a permit to oYes` ¢704 � construct,alter,improve,demolish or repair any structure,prior to its \\`` L L Date issuance,also requires the applicant for the permit to file a signed statement PROPEPQ OWN ER OR AUTHORIZED AGENT that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING fRRP) 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 or 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($500). managers who do the paint-disturbing work themselves orthrough their ❑1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Programvfsit: compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsiblefor this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because: o I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. SAFETYBUILDING & . • APPLICATION Menifee DATE 0 5/0 912 0 1 6 PERMIT/PLAN CHECK NUMBER 9mv - C*4 us TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION []ALTERATION []DEMOLITION ❑ELECTRICAL ❑MECHANICAL ❑NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK REPLACING 4 TON A/C;90,000 BTU FURNACE AND COIL PROJECTADDRESS 29030 CROHAM HURST CT 53Qi5910 ASSESSOR'S PARCEL NUMBER lb'! -n;PL4- dd$ LOT TRACT PROPERTY OWNER'S NAME JEANNE KEEFER r.0tV Of Menifee ADDRESS 29030 CROHAM HURST CT, MEN IFEE,CA 92586 Building Dept PHONE (951)310-8037 EMAIL MAY 10 2013 APPLICANT NAME JILL WESTON ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA 92123 e c e i r PHONE (619)384-6622 EMAIL J CONTRACTOR'S NAME RUSSELLCOCHRAN OWNERBUILDER? ❑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 $ $9,000.00 SO FT 1784 L SO FT APPLICANT'S SIGNATURE DATE i DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE AMOUNT O PAIDAMOUNT 159 -- CASH O CHECK# O CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. 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