PMT16-03030 City of Menifee Permit No.: PMT16-03030
29714 HAUN RD. Type: Residential Mechanical
<;kCCFLA> MENIFEE,CA 92586
MENIFEE Date Issued: 0911312016
P E R M I T
Site Address: 29124 FOGHORN CT,MENIFEE, CA Parcel Number; 333-341-016
92585 Construction Cost: $9,300.00
Existing Use: Proposed Use:
Description of HVAC REPLACEMENT,5 TON A/C(BACKYARD)90,000 BTU FURNACE(ATTIC)
Work:
Omer Contractor
CAROL MINER W C HEATING&AIR CONDITIONING INC
29124 FOGHORN COURT 41085 GOLDEN GATE CIR
MENIFEE, CA 92585 MURRIETA. CA 92562
Applicant Phone:9516000700
JILL WESTON License Number:779604
W C HEATING&AIR CONDITIONING INC
41085 GOLDEN GATE CIR
MURRIETA, CA 92562
Fee Description Qtv Amount($
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 ermrs 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_8ldg_Permlt-Temp1ate.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).
ChapterSi(commencing with section 7000)of Division 3 of the Business and c;I am exempt from Rcensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
Uicense Class C.0 6 License No._�]-Iq_�. By mysilgriature below I acknowledge that,except for my personal residence
Expires -signature in which I must have resided for at least one year priorto completion of
0 improvements covered by this permit.I cannot legally sell a structure that I
WORKEWS COMPENSATION DECLARATION have built as an owner-builder ifit 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 self4mure 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 www.IeRInfo.ca.goy1caIa%v.html.
this permit is issued.
Policy 4 Date
Y,11 have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
'section 3700 of the Labor Code,for the performance ofthe work for which o By my signature below I certify to each ofthe following:I am the property
this permit is issued.My workerrs compensation insurance carrier and policy owner or authorized to act on the property owner's behalf I have read this
numberare: applicaition and the information I have provided Is correct.I agree to comply
AAaAja_� with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this City or county to
PoIicV9 0CMU10 M-15-Expires— 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 OWN ER OR AUTHORIZED AGENT
ci I certify-that in the performance of the work for which this permit is issued,
Ishallnotemplo any persons in any manner so as to become subject to the CITY BUSINESS LICENSE
worker's compensation laws ofCallfornia,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions ofSection 3700 ofthe Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applicant ku'u' 0 A-.A-Q� Date 15--M- ILL amounts specified an the Hazardous Materials Information Guide?
WARNING:FAVURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 Oyes "
UNLAWFUL,AND SHALL SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use ofthe building by the applicant or future building
AND CIVIL PINES 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 pennitting checklist
IN SECTION 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguildellnes
CONSTRUCTION LENDING AGEN u Yes "o
I hereby affirm that under the penalty ofperjury there is a construction Will the proposed building or modified facility be within 1000 feet ofthe
lending agency for the performance ofthe work which this permit is Issued outer boundary ofa school?
(Section 3097 Civil Code) a Yes VND
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklisL I understand my requirements under the State of
I hereby affirrin under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concer*ning
contractor's 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,,rD
Business and Professions Code).Any city or county that requires a permit to .�L' kLA�2� Date -[,Ei
construct,alterimprove,demolish or repair any structure,priorto its PROPEq-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 Contra ctor's 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 Profiesslions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-1978
a nd the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to he RRP-certiffed 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 or through their
o 1,as owner of the property,or my employee winh wages as theirsole employees.For more information about EPA's Renovation Program visit:
compensation,wiffl do( )allofor( )portion ofthe work,and the structure is w%vu.epa.goyllead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions I-BOD-424-LEAD(5323).
Code;The ODntmctor5 State License Law does not apply to an owner of a ct 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 m6thm 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. ci No EPA Lead-Safe Certified Finn is required for this project because:
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 li I out the RRP
Acknowledgemeri
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
�"Men'fee
DATE 09/1212016 PERM IT/PLAN CHECK NUMBER
TYPE: EICOMMERCIAL ZIRESIDENTIAL F]MULTI-FAMILY [-]MOBILEHOME [:]POOL/SPA F]SIGN
SUBTYPE: E]ADDITION []ALTERATION E]DEMOLITION [-]ELECTRICAL RIMECHANICAL
E]NEW OPLUMBING [-IRE-ROOF-NUMBEROFSCLUARES
DESCRIPTION OF WORK HVAC REPLACEMENT.5 TON A/C(BACKYARD)90,000 BTU FURNACE(ATTIC)
PROJECTADDRESS 29124FOGHORN 01815W5
ASSESSOR'S PARCEL NUMBER ?03 - !3141 - nU LOT TRACT
PROPERTY OWNER'S NAME CAROL MINER CRY of Menifee
ADDRESS 29124 FOGHORN, MENIFEE Building Dept
PHONE (951)246-3021 EMAIL SEP 12 2016
APPLICANTNAME JILLWESTON RI- voceivec
ADDRESS 3645 RUFFIN RD330-335 SAN DIEGO,CA92123
PHONE (619)384-6622 EMAIL
CONTRAcroWS NAME RUSSELL COCHRAN OWNERBUILIDER? DYESRINO
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$ $9,300.00 SO FT L SO FT
APPLICANTS SIGNATURE ATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION LI I Y UF MtNIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP )e I
INVOICE - -X4 PAIDAMOUNT 0 CASH OCHECK
AM= '50 - It) I # 0 CREDIT CARD VISA/MC
PLAN CHECK FEES I PAIDAMOUNT 0 CASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DLNUMBER NOTARIZEDLETTER 0 YESO NO JI
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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