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PMT16-01916 City of Menifee Permit No.: PMT16-01916 29714 HAUN RD. Type: Residential Mechanical <A-CCEL/-> MENIFEE, CA 92586 MENIFEE Date Issued: 0 6/2 312 01 6 PERMIT Site Address: 29320 SEA PINE DR, MENIFEE, CA Parcel Number: 340-190-092 92584 Construction Cost: $9,200.00 Existing Use: Proposed Use: Description of REPLACE 5-TON A/C(BACKYARD)90,000 BTU FURNACE(ATTIC) Work: Owner Contractor TOM GLEESON W C HEATING&AIR CONDITIONING INC 29320 SEA PINE DRIVE 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 QQtt( Amount($1 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_Bldg_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 contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the,Business and D I am exempt from Iicensure under the Contractor's State License Law for Professions Code and my license is in full force and effect / the following reason: License Class 0 '16 tUcense No.( 1-12 hV9 By mysignature below l acknowledge that,except for my personalresidence Expires `S6 Signature UgCQWPC2ACWO in which l must have resided for at least one year prior to completion of 0 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 a 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 ofthe 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 www.leeinfo.m.eov/calaw.html. this permit is issued. Policy# Date ,y 11 have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT 'section 3700 of the Labor Code,for the performance ofthe work for which ❑By my signature below l certify to each ofthe following:I am the property this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act an the property owners behalf.I have read this number are: application and the information I have provided is correct.I agree to comply CartierC trr'Rv'rl with all applicable city and county ordinances and state laws relating to I�trx�bt�1 building construction.l authorize representatives of this city or county to Policy# We_.WC.�"1.03�Z�l Expires�/ (T,1�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($S00)or less PROPER NER OR AUTHORIZED AGENT O I certify that in the performance ofthe wotk forwhich this permit is issued, D�5 ao a I 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 of Section 3700 ofthe Labor Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant W Date c7 $' L mixture containing a hazardous material equal to or greaterthat the amounts specified on the Hazardous Materials Information Guide? WARNING-FA URE TO SECURE WORKER'S COMPENSATION COVERAGE 15 OYes "o 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($10D,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 OYes Oo 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) ❑Yes [No OWNER BUILDER DECLARATIONS i have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.l understand my requirements under the State of I hereby affirm under penalty of perjury that lam exempt from the California Contractor hazardous s License Law for the reason(s)indicated below by the Health&Safetyinode,Section 25505 and 25539 concerning rdous m a m checkmark(s)I have placed next to the applicable item(s)(Section 70315 material reporting. Business and Professions Code).Any city or county that requires a permit to DYes` r�� �. '^ pate 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(RRPI License Law(Chapter 9(commencing with Section 70001 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 Iicensure 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($50D). managers who do the paint-disturbing work themselves orthrough their ❑I,as owner of the property,or my employee with wages as theirsule employees.For more information about EPA's Renovation Program visit. compensation,will do( )allofor( )portion ofthe work,and the structure is www.ena.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 aAn 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: 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 Ackmnwledeement. PERMIT/PLANSAFETY APPLICATION Menifee DATE 06/17/2016 PERMIT/PLAN CHECK NUMBER TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION []ELECTRICAL ❑MECHANICAL ❑NEW ❑PLUMBING El RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK REPLACE 5 TON A/C (BACKYARD),90,000 BTU FURACE(ATTIC) PROJECT ADDRESS 29320 SEA PINE DR ASSESSOR'S PARCEL NUMBER LOT TRACT PROPERTY OWNER'S NAME TOM GLEESON rqy of Menifee ADDRESS 29320 SEA PINE DR. Building Dept PHONE (951)301-6580 EMAIL JUN 17 2016 APPLICANT NAME JILL WESTON ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA 92123 PHONE (619)384-6622 EMAIL 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 1814 L SO FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP )C AMOUNT .i PAIDAMOUNT •I� O CASH C CHECK p C CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT C CASH O CHECK It O CREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES C NO DL NUMBER NOTARIZED LETTER C YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. 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