PMT16-02658 City of Menifee Permit No.: PMT16-02658
_ _ 29714 HAUN RD.
�CCELA4 MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 08/16/2016
PERMIT
Site Address: 29948 GIFHORN RD, MENIFEE, CA Parcel Number: 339-311-013
92584 Construction Cost: $9,300.00
Existing Use: Proposed Use:
Description of HVAC REPLACEMENT, 5 TON A/C(BACKYARD)90,000 BTU FURNACE(CLOSET)
Work:
Owner Contractor
NIGEL JOHNSON W C HEATING&AIR CONDITIONING INC
29948 GIFHORN ROAD 41085 GOLDEN GATE CIR
MENIFEE, CA 92584 MURRIETA, CA92562
Applicant Phone:9516000700
JILL WESTON License Number: 779604
W C HEATING&AIR CONDITIONING INC
41085 GOLDEN GATE CIR
MURRIETA, CA 92562
Fee Description QtV Amount(5)
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
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_Pevmit 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 ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effecL the following reason:
License Class 0,on License No.,l�-1 By my signature below l acknowledge that,except for my personal residence
Expires ` 6 Signature �\_�\QLtl�0,'- trJ in which l must have resided for at least one year prior to completion of
U 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
01 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:
by5ection 370D of the Labor Code,for the performance of work for which www.leeinfo.m.aov/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
4ecion 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 workees compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
number are: application and the information I have provided is correct I agree to comply
D,orlCshire, �! with all applicable city and county ordinances and state laws relating to
Carrier X t'VT&Q2LA building constmction.l authorize representatives of this city or county to
Policy# 0C,WU1O3lZ45i Expires 4 11 )_L:2 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, ��`..J ao a
I shall not emolov 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 worker's compensation provisions of Section 3700 of the Labor
Code,1 shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or
1 mixture containing a hazardous material equal to or greaterthat the
Applicant W Date r7-i $' tL amounts specified on the Hazardous Materials Information Guide?
WARNING:FA URE TO SECURE WORKER'S COMPENSATION COVERAGE IS Dyes "o
UNLAWFUL,AND SHALL SUBJECTAN 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(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 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) D Yes rWo
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 lam exempt from the
Contractor h
s License Law for the reason(s)indicated below by the Californiaealth al Safety Code,Section 25505 and 25534 concerning
hazardous
us material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Dyes t�"o
Business and Professions Code).Any city or county that requires a permit to \�, -% e 0 n' Date 3'La'1L6
construct,alter,improve,demolish or repair any structure,prior to its PROPS OWN ER 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
Dl,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
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-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 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 pmject does not comply with EPA RRP rule please fill out the RRP
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
II-
Menifee
DATE 08/15/2016 PERMIT/PLAN CHECK NUMBER ft—"%
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY [—]MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION [-]DEMOLITION []ELECTRICAL [-]MECHANICAL
❑NEW ❑PLUMBING ❑RE-ROOF-NUMBEROFSQUARES
DESCRIPTION OF WORK HVAC REPLACEMENT.5 TON A/C(BACKYARD),90,000 BTU FURNACE(CLOSET)
PROJECTADDRESS 29948 GIFHORN RD
ASSESSOR'S PARCEL NUMBER ta0j• :%jf3M LOT TRACT
PROPERTY OWNER'S NAME NIGEL JOHNSON
ADDRESS 29948 GIFHORN RD
PHONE (619) 750-7893 EMAIL
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
LIIC NUMBER 779604 LICENSE CLASSIFICATION C20
VALUATION$ "(�;JG.rvJ SO FT L SO.FT
APPLICANT'S SIGNATURE DATE
OTYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZEDLE17ER O YES O NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 9S1-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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