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PMT16-02451 City of Menifee Permit No.: PMT16-02451 29714 HAUN RD. �A-CCELA— MENIFEE,CA 92586 Type: Residential Mechanical MENIFEE Date Issued: 08105/2016 PERMIT Site Address: 30419 MIRANDA DR, MENIFEE, CA Parcel Number: 364-051-003 92584 Construction Cost: $9,200.00 Existing Use: Proposed Use: Description of HVAC REPLACEMENT,3.5-TON A/C(BACKYARD)AND 90,000 BTU FURNACE(GARAGE) Work: Owner Contractor ALISON OLSON W C HEATING&AIR CONDITIONING INC 30419 MIRANDA 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 - (3ty Amount 151 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 carded 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 orimproves 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 1 am under provisions of Chapter9(commencing with section 7000)of Division 3 of the.Business and D l am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effem the following reason: License Class License No..:]74 IS6� By mysignature below l acknowledge that,exceptfor mypersonal residence Expires S61 It, Signature ,Q� �l�Q,r2 L�J in which l must have resided for at least one year prior towmpletion of improvements covered by this 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 DIherebyaffirmunderpenaltyofperjuryoneofthefollowingdeclarations:) licensed contractors.I understand that a copy of the applimble 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 yvww.Ieeinfo.ca.Rov/calaw.html. this permit is issued. Policy# - Date �y/_I have and will maintain workers 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 owners behalL l have read this numberare: t �y application and the information l have provided is correct.l agree to comply Camierlr lC S�TLICG 1.7� t'VLr��"L!� with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city,or county to Policy# WC,W 1.O3VL5i Expires I I k ) enterthe above identified property for inspection purposes. (This section need notto be completed Is the permit is for one-hundred Date ' dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ol certify that In the performance of the work for which this permit isissued, O J�aoa I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSEg workers compensation laws of California,and agree that III should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions ofsection 3700 ofthe Labor Code,I shall forthwith comply with those provisions. I Will the applicant or future building occupant handle hazardous material or Applicant W -� Date 7r �l g' �1� mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FA URETO SECURE WORKER'S COMPENSATION COVERAGE IS Oyes "° UNLAWFUL,AND SHALLSUBIECT AN EMPLOYER TO 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 CoastAir Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY OYes 00 I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 100Dfeet ofthe lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) OYes ?NO OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that l am exempt from the California Health&Safety Code,Section 25SUS 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 OYe Business and Professions Code).Any city or county that requires a permitto 6 9,. , Date 5"2D'L'D construct,alter,improve,demolish or repair any structure,priorto 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 ofthe The EPA Renovation,Repair and Paintfng(RRP)Rule requires contractors Business and Professions Code)or that he orshe is exempt from licensure receiving compensation for most work that disturbs paint in a pre4976 and the basis for the alleged exemption.Any violation ofsection 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 workthemselves orthrough their Ol,as owner ofthe property,or my employee with wages as theirsole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all ofor( )portion ofthe work,and the structure is www.eoa.RuyAead 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'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 Certirrcation No: completion,the Owner-Builder will have the burden of provingthat it was not built or improved for the purpose of sale. O No EPA Lead-Safe Certified Firm is required forthis project because: O 1,as owner ofthe property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does notapply to an owner of a Ifyour project does notcompfy with EPA RRP rule pleasefill out the RRP Acknowledgement. APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK Menifee DATE 0110BI2016 PERMIT/PLAN CHECK NUMBER TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA [:]SIGN SUBTYPE: ❑ADDITION ❑ALTERATION [-]DEMOLITION ❑ELECTRICAL Z MECHANICAL ❑NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK HVAC REPLACEMENT.3.5 TON A/C (BACKYARD)90,000 BTU FURNACE(GARAGE) PROJECTADDRESS 30419 MIRANDA DR Ct P113.,f♦ ASSESSOR'S PARCEL NUMBER LOT TRACT of Menifee PROPERTY OWNER'S NAME ALISON OLSON Bullding &S2 Y pt. ADDRESS 30419 MIRANDA DR AUG PHONE (951)285-9068 EMAIL APPLICANT NAME JILL WESTON ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA 92123 PHONE (619)384-6622 EMAIL CONTRACTOR'S NAME RUSSELLCOCHRAN OWNERBUILDER? ❑YESONO 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 SQFT LSO,FT APPLICANT'S SIGNATURE DATE CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN I SMIP k INVOICE PAID AMOUNT AMOUNT •0 •1 D O CASH O CHECKN O CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH OCHECK# OCREDIT CARD VISA/MC OWNER BUILDER VERIFIED 0 YES U NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menefee Building& Safety Department 29714 Houn Rd. 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