PMT16-01802 City of Menifee Permit No.: PMT16-01802
29714 HAUN RD. Type: Residential Mechanical
�CCEL/A. MENIFEE, CA 92586
`--" `"x" MENIFEE Date Issued: 06/10/2016
PER �lIi IT
Site Address: 27607 CHARLESTOWN DR, MENIFEE, Parcel Number: 335-241-021
CA 92586 Construction Cost: $0.00
Existing Use: Proposed Use:
Description of INSTALL 4-TON A/C, FURNACE PACKAGE UNIT
Work:
Owner Contractor
LEE MURPHY W C HEATING&AIR CONDITIONING INC
27607 CHARLESTOWN DRIVE 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 City Amount f51
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 0.00
General Plan Maintenance Fee-Mechanical 1 14.10
$323.10
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 building 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_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
1 hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the.Business and O l am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class /y 26 License No._:]`14 E6H By mysignature below l acknowledge that except for mypersonal residence
Expires %6 SignatureQk(SJ&AGYJ in which l must have resided for at least one year pdortocompletion 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
❑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 for which wvnv.leeinfo.ca.eov/calaw.htmi.
this permit is issued.
Policy# Date
YQII have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
§ectian 370D 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 carder and policy owner or authorized to act on the property owners behalf.I have read this
number are: l ' �p application and the information l have provided is correct l agree to comply
Carier�tO.Y'�.S�r'ILCG �V l'yiLt.ltil?tA with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives ofthis city or county to
Polity# Wc,WC,1O5tJCi Expires T� enterthe 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
a I certify that in the performance of the work for which this permit is issued, O�`J ao a
Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
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 370D of the Labor
Code,I shall forthwith comply with those provisions. 1 Will the applicant or future building occupant handle hazardous material or
Applicant Date r7� $' (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 15 OYes QAto
UNLAWFUL,AND SHALL SUBIECTAN 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(SrAOMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY DYes 00
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 100D 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) Oyes r/+Ho
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist l understand my requirements underthe State of
I hereby affirm under penalty of perjury that lam exempt from the
California
Contractor's License Law for the reason(s)indicated below by the hazardous
HealthalSafetyinode,Section 25505 and 25534 concerning
rdo
hus material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes t�10o 1(
Business and Professions Code).Any city or county that requires a permit to s�l� �e)_0 ( Ie Date J"LZ7 'l'l]
construct,alter,improve,demolish or repair any structure,prior to its pROPE OWNER OR AUTHORIZED AGENT
issuance,also requires the applicant for the 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(RRP)
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 orthrough their
❑1,as owner ofthe property,or my employee with wages as theirsole employees.For more information about EPA's Renovation Programvisit:
compensation,will do( )all of or( )portion afthe work,and the structure is www.eoa.eov/lead or contact the National Lead Information Centerat
not intended or offered forsale.(Section 7044,Business and Professions 1-BOD-424-LEAD(5323).
Code;The Contractors 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'ar 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 Finn 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 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.
J
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
4�(1
Menifee JUN 10 2016
Rr
DATE 0 6/1 012 01 6 PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA []SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION []DEMOLITION ❑ELECTRICAL ❑MECHANICAL
❑NEW ❑PLUMBING FIRE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK INSTALLING 4 TON A/C; FURNACE PACKAGE UNIT.
PROJECT ADDRESS 27607 CHARLES TOWN
ASSESSOR'S PARCEL NUMBER 'Jj7fj�a1.11-�^1tr LOT TRACT
PROPERTY OWNER'S NAME LEE MURPHY
ADDRESS 27107 CHARLES TOWN,MENIFEE, CA 12514
PHONE (951)244-9539 EMAIL
APPLICANT NAME JILL WESTON
ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA 92123
PHONE (619)384-6622 EMAIL J
CONTRACTOR'S NAME RUSSELLCOCHRAN - OWNERBUILDERP ❑YES❑JNO
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 O CASH O CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH 0 CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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