PMT16-02864 City of Menifee Permit No.: PMT1 6-02864
29714 HAUN RD. Type: Residential Mechanical
<��CCELA.' MENIFEE,CA 92686
MENIFEE Date Issued: 09/02t2016
P E R M I T
SiteAddress: 30668 LAJOE ST, MENIFEE, CA 92584 Parcel Number: 360-433-028
Construction Cost: $9,200.00
Existing Use: Proposed Use:
Description of HVAC REPLACEMENT,5 TON AtC(BACKYARD)AND 90,000 BTU FURNACE(ATTIC)
Work:
Owner Contractor
SERGIO ZAPATA W C HEATING&AIR CONDITIONING INC
30668 LAJOE STREET 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 PA Amount
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 operabons 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.
APLl3ld9_Permit—Temp1ate.rpt Page 1 of I
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 o I 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:
UcenseClass ("An License No. -1-Ig (,64 By my signature below I acknowledge that,except for mypersonal residence
Expires__(n'JS6J IL Signature in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKEWS COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
Ei 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
this permit is issued. www.leginfin.ca.goy/calaw.1-arril.
Policy# Date
YQJI have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
isection 3700 of the Labor Code,for the performance of the work for which Ei By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's compensation insura noe carrier and p olicy owner or authorized to act on the property ownees behalf.I have read this
number are: application and the information I have provided is correct I agree to comply
With all applicable city and county ordinances and state laws relating to
Carrier b'V_'rKSACjL'm building construction.I authorize representatives of this City or county to
Poll 4 QCWQ,-1O'5VJq Expires enterthe above Identified property forinspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or[us PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE It 0-36.-�09,
workees compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant orfuture building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greaterthat the
Applicant \,O a�A-Q-, Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FATURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ci Yes "
UNLAWFUL,AND SHALL SUBJECr AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applica nt or fliture building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modifiation from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR CoastAir Quality Management District(SCAQMD)?See permitting checklist
IN SECHON 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldelines
CONSTRUCTION LENDING AGENCY a 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 30!37 Civil Code) a Yes ?No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SC:AQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety,Code,Section 25505 and 25534 concerning
Contraictoes 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 oYes rMo
Business and Professions Code).Any city or county that requires a permit to kz%,%L' kJi�Aawtl� Date S-26—['E,
construct,alter,improve,demolish or repair any structure,prior to its PROPEFV_0WNER 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter 9(commenchig 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 Rcensure 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-cerfifi ad 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
o 1,as owner of the property,or myemployee with wages as theirsole employees.For more information about EPA's Renovation Program visit:
compensation,will do I I all of or( )portion of the work,and the structure is www.epa.elovifleaci or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800424-LEAD(5323).
Code,The Contractor's State License Law does not apply to an Owner of a u 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 wifli have the burden of proviing that it was
not built or improved for the purpose of sale. E3 No EPA Lead-Safe Certified Finn is required for this project bec:ause:
o 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractoes 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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
,,,�,&.1, Me n I fe e
DATE 08/29/2016 PERIVIIT/PLAN CHECK NUMBER
TYPE: OCOMMERCIAL ZRESIDENTIAL [-]MULTI-FAMILY F]MOBILEHOME [-]POOL/SPA [:]SIGN
SUBTYPE: [:]ADDITION []ALTERATION [-]DEMOLITION [:]ELECTRICAL RIMECHANICAL
ONEW OPLUMBING FIRE-ROOF-NUMBEROFSCLUARES
DESCRIPTION OF WORK HVAC REPLACEMENT.5 TON A/C(BACKYARD;90,000 BTU FURNACE(ATTIC)
PROJECTADDRESS 30668LAJOEST oko-XFA!�A
ASSESSOR'S PARCEL NUMBER LOT TRACT
PROPERTY OWNER'S NAME SEGIOZAPATA
ADDRESS 30668 LAJOE ST, MENIFEE CA
PHONE (951)233-8956 EMAIL
APPLICANTNAME JILLWESTON
ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA92123
PHONE (619)384-6622 EMAIL
CONTRACTOR'S NAME RUSSELLCOCHRAN OWNERBUILDER? [-]YESZNO
BUSINESSNAME WC PLUMBING, HEATING&AIR
ADDRESS 41085 GOLDEN GATE GIR MURRIETA,CA 92562
PHONE (951)600-0700 EMAIL
CONTRACTOR'S STATE LIC NUMBER 779604 LICENSE CLASSIFICATION C20
VALUATION$ $9,200.00 SO FT 2304 L SO.FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION U I Y M MENIFU BU�INE:��LIUME NUITIT1717
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP � y
INVOICE PAID AMOUNT 0 CASH 0 CHECK# OCREDITCARD ViSA/MC
AMOUNT IC) t
PLAN CHECK FEES I PAID AMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDERVERIFIED -I YES 0 No DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.citvofmenifee.Lis Inspection Request Line 951-246-6213
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