PMT16-01897 City of Menifee Permit No.: PMT16-01897
29714 HAUN RD. Type: Residential Mechanical
\CCELA? MENIFEE, CA92586
MENIFEE Date Issued: 06/1612016
PERMIT
Site Address: 29559 UTOPIA CT,MENIFEE, CA 92584 Parcel Number: 340-292-014
Construction Cost: $9,200.00
Existing Use: Proposed Use:
Description of INSTALL 4-TON A/C(BACKYARD)90,000 BTU FURNACE,ALL DUCT WORK
Work:
Owner Contractor
KAREN ADAMS W C HEATING&AIR CONDITIONING INC
29559 UTOPIA COURT 41085 GOLDEN GATE CIR
MENIFEE, CA 92584 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 lit( Amount($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_BIdg_Permit_Templatespl Page 1 of t
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).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the.Business and D l am exempt from licensure under the Contractors State License taw for
Professions Code and my license is in full force and effect / the following reason:
License Class CM3 License No.��4 h By mysignature below l acknowledge that,except for my personal residence
Expires rSM Signature Q��02 in which l must have resided for at least one year priorto completion of
U improvements covered bythis permit I cannot legallysell 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 copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for workers 7044 ofthe Business and Professions Code,is available upon requestwhen
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 wwwJee-nfp.caeov/calaw.htm1.
this permit is issued.
Dale
Policy#
PROPERTY OWNER OR AUTHORIZED AGENT
YQIII have and will maintain workers compensation insurance,as required by
§ection 3700 of the Labor Code,forthe performance ofthe work for which O By my signature below l certify to each ofthe following:)am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.l have read this
number are: application and the information I have provided is correct.I agree to comply
1 L. with all applicable city and county ordinances and state laws relating to
Carrierher S(1'ILrC+ k wt�i n building construction.l authorize representatives of this city or county to
policy# We WC. 10 31101i Expires wa enterthe above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($SOD)or less PROPERTY OWNER OR AUTHORIZED AGENT
❑1 certify that in the performance of the work for which this permit is issued,
1 shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that IF l should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions ofsection 3700 ofthe Labor Will the applicant orfuture building occupant handle hazardous material or
Code,I shall forthwith comply with those provisions.
1 , mixture containing a hazardous material equal to or greaterthat the
Applicant IW Date r7�$' i� amounts specified on the Hazardous Materials Information Guide?
WARNING:FA URETO SECURE WORKER'S COMPENSATION COVERAGE 15 Dyes fro
UNLAWFUL,AND SHALL SUBIECTAN EMPLOYERTO CRIMINALPENALTIES Will the intended use ofthe 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)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY ❑Yes "o
I hereby affirm that under the penaltyofperjury there is a construction Will the proposed building or modified facility be within 1000 feet ofthe
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) D Yes T'"to
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist I understand my requirements under the State of
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 70315 oYes tMo I
Business and Professions Code).Any city or county that requires a permit to Date �-26—tO
construct after,improve,demolish or repair any structure,priorto its PROPEFQ OWNER OR AUTHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement EPA RENOVATIONp REPAIR AND PAINTING(RRP)
that he or she is licensed pursuant to the provisions of the Contractors State
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painttng(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 or through their
01,as owner of the property,or my employee with wages as their sole employees.For more information about EPAs Renovation Program visit:
compensation,will do( )allofor( I portion ofthe work,and the structure is www.eoa.gov/leador contact the National Lead Information Centers[
not intended or offered for sale.(Section 7044,Business and Professions 1-SOD-024-LEAD(5323).
Code,The Contractors State License Law does not apply to an owner ofa ❑An EPA Lead-Safe Certified Renovatorwill be responsibleforthis project
property who,through employees'or personal effort builds or improves the Certified Firm Name:
property provided that the improvements are not intended or offered for
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 D No EPA Lead-Safe Certified Rmn is required for this project because:
not built or improved for the purpose of sale.
1 I,as owner of the property am exclusively contracting with licensed
:pntractors to construct the project(Section 7044,Business and Professions
ode:The Contractor's state License Law does not apply to an owner ofa If your project does not comply with EPA RRP rule please fill out the RRP
BUILDING : APPLICATION
I "
® ,Menifee
DATE 05/15/2016 PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL [a RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION [-]DEMOLITION ❑ELECTRICAL ❑MECHANICAL
❑NEW ❑PLUMBING ❑RE-ROOF-NUMBEROFSQUARES
DESCRIPTION OF WORK INSTALL 4 TON A/C(BACKYARD),90,000 BTU FURNACE,ALL DUCT WORK
PROJECTADDRESS 29559UTOPIA
ASSESSOR'S PARCEL NUMBER 5LItO-,Q?G-njLA LOT TRACT
PROPERTY OWNER'S NAME KAREN ADAMS Clty Of Menifee
Dept.
ADDRESS 29559 UTOPIA, MEN]FEE,CA 92584
PHONE (951)246-0616 EMAIL
APPLICANTNAME JILLWESTON Received
ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA 92123
PHONE (619)384-6622 EMAIL JILL.WESTON@WEGREENINC.COM
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$ $9,200.00 SO FT 1734 L SQ FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN 1 SMIPINVOICE I 1<
AMOUNT .1O PAID AMOUNT
O CASH OYHECKp OCREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building& Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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