PMT16-02873 City of Menifee Permit No.: PMT1 6-02873
29714 HAUN RD. Type: Residential Mechanical
-�ACCELA�b MENIFEE, CA 92586
MENIFEE Date Issued: 09102J2016
P E R M I T
Site Address: 23486 CASA BONITA AVE,MENIFEE,CA Parcel Number: 351-102-021
92587 Construction Cost: $9,000.00
Existing Use: Proposed Use:
Description of HVAC REPLACEMENT,2.5 TON A/C(BACKYARD)2.5 TON HEAT PUMP
Work:
Owner Contractor
DANIELTHOMAS W C HEATING&AIR CONDITIONING INC
23485 CASA BONITA AVE 41085 GOLDEN GATE CIR
MENIFEE,CA 92587 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 City Amount W
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.
AkBIdgPermil—Template.rpt Page 1 of 1
CITY OF MENIFU
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 700D)of Division 3 of the Business and ci I am exempt firom licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason;
License Class C.0 6 License No. :1-12 E69 By my signature below I acknowledge that,except for my personal residence
Explres___�JS61 Lt._Signature (6_�NVJI(o 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
o 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 370D of the La bor Code,for the performance of work for which
this permit is issued. vvww.IeRinfo.ca.goy/caIavv.htmI.
Policy# Date
-Kil 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 insurance carrier and p olicV owner or authorized to act on the property owner's behalf.I have read this
numberare: application and the information I have provided is correct.I agree to comply
wifth all applicable City and county ordinances and state laws relating to
building construction.I authorize representatives of this City or county to
Policy# 4)wulosk-1clExpires X 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,
Ishallnotemolo any persons in any manner so as to become subject to the CITY BUSINESS LICENSE 11 0--36 -�o 9,
worker's 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 appIft:ant orfuture building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greaterthatthe
Applicant ku'u� \-0&AQ� Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAIRETO SECURE WORKEWS COMPENSATION COVERAGE IS a Yes 41"o
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applica nt or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($10D,0011),IN occupant require a permit for the construction or monfiflation from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See pennitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldelines
CONSTRUCrION LENDING AGENCY ci Yes E�No
I hereby affirm that under the pena Ity 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) a Yes Pwo
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 I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractor's Ucense 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 D
Business and Professions Code).Any city or county that requires a permit to %*k L' k6&49n� Date
construct,alter,improve,demolish or repair any structure,prior to its PROPEEVIOWNER 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[RRP1
License Law(Chapter 9(commencing wlith 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 or Section 7032.5 by residence or childcare faciflitV to be RRP-certilfied firms and comply with
an Appricant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($500). managerswho do the paint-disturbing workthemselves orthrough their
o 1,as owner ofthe property,ormy employee with wages as theirsole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )allofor( )portion ofthe work,and the structure is www.epa.goy/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 Contractor's State License Law does not apply to an owner of a a An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees!or personal effort,builds or improvias the
property provided that the improvements a re not intended or offered for Certified Firm Name.,
sale.if,however,the building or improvement is sold mdthlin one year of Firm CertillimItion No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. E3 No EPA Lead-Safe Certified Firm 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 Prcifessions
Code:The Contractoes State License Law does not apply to an owner of a Ifyour pmject does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
& SAFETY PERM IT/PLAN CHECK APPLICATION
1-Wenifee
DATE 08/30/2016 PERMIT/PLAN CHECK NUMBER C);)s-n
TYPE: F-ICOMMERCIAL [Z]RESIDENTIAL []MULTI-FAMILY F]MOBILEHOME OPOOL/SPA []SIGN
SUBTYPE: F]ADDITION EJALTERATION E]DEMOLITION F]ELECTRICAL [ZIMECHANICAL
ONEW F]PLUMBING F1 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK HVAC REPLACEMENT-2.5 TON A/C(BACKYARD);2.5 TON HEAT PUMP
PROJEcTADDRESS 05&A,?5 (20,e;a 6-1-e 006'7�-1
ASSESSOR'S PARCEL NUMBER JD',-
)- \ LOT TRACT
PROPERTY OWNEWS NAME DANIELTHOMAS
ADDRESS 23465 CASA BONITA AVE
PHONE (951)383-9372 EMAIL
APPLICANTNAIME JILLWESTON
ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA 92123
PHONE (619)384-6622 EMAIL
CONTRACTOR'S NAME RUSSELL COCHRAN OWNERBUILDER? [:]YESZNO
BUSINESSNAME 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$ $9.000-00 SQ FT 1283 L SQ FT
I APPLICANT'S SIGNATURE DATE
CITYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION MIP CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE � GREENF—Ts
INVOICE PAIDAMOUNT
AMOUNT I I OCASH OCHECK# OCREDITCARD VISAIMC
PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# OCREDITCARD VISVMC
OWNER BUILDER VERIFIED 0 YES 0 No DILNUMBER NOTARIZEDLEITER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
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