PMT16-03506 City of Menifee Permit No.: PMT16-03506
29714 HAUN RD.
-5A—CCI!l MENIFEE. CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 1013112016
P E R M I T
Site Address: 27583 CHATHAM LN, MENIFEE, CA Parcel Number: 333-293-014
925B5 Construction Cost: $9,200,00
Existing Use: Proposed Use:
Description of HVAC REPLACEMENT,4 TON A/C(RIGHTSIDE YARD)90,000 BTU FURNACE(ATTIC)
Work:
Owner Contractor
PAULARNOT W C HEATING&AIR CONDITIONING INC
27583 CHATHAM LANE 41085 GOLDEN GATE CIR
MENIFEE,CA 92585 MURRIETA, CA 92562
Applicant Phone:9516000700
JILL WESTON License Number:779604
W C HEATING&AIR CONDITIONING INC
41085 GOLDEN GATE CIR
IMURRIETA, CA 92562
Fee Description Amount($
Forced-Air or Gravity-Type Furnace or Burner 149.00
Air Handling/Condensing Units SFR 133.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Mechanical 1 14.10
$324.10
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of effors in the plans and
specifications or from preventing builicling operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months.shall expire,and fees paid shall be
forfeited.
AA�l3ldg_PerrniLTernplate.rpt Page 1 of 1
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& SAFETY PERMIT/PLAN CHECK APPLICATION
I",
M e n i fe e
.992
DATE 10/2412016 PERMIT/PLAN CHECK NUMBER
TYPE: []COMMERCIAL [aRESIDENTIAL [-]MULTI-FAMILY F]MOBILEHOME F]POOL/SPA FISIGN
SUBTYPE: F]ADDITION F]ALTERATION F]DEMOLITION F]EI-EcTRICAL [ZIMECHANICAL
F]NEW F]PLUMBING [-IRE-ROOF-NUMBEROFSQUARES
DESCRIPTION OF WORK HVAC REPLACEMENT.4 TON (RIGHTSIDE YARD);90K BTU FURNACE(ATTIC)
'y "o
PROJECTADDRESS 27583CHATAMLN qg�� Buildeiing &Safaety Dept.
ASSESSOR'S PARCEL NUMBER 35S- CPC�'2 LOT TRACT
III. ()cT 2 6 2016
PROPERTY OWNER'S NAME PAULARNOT d
ADDRESS 27583 CHATTAM LN
PHONE (858)539-3166 EMAIL
APPLICANT NAME JILL WESTON
ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA92123
PHONE (619)384-6622 EMAIL
CONTRACTOWS NAME RUSSELL COCHRAN OWNERBUILDER? [:IYESZNO
BUSINESSNAME WC PLUMBING,HEATING&AIR
ADDRESS 41085 GOLDEN GATE CIR MURRIETA,CA 92562
PHONE (951)600-0700 EMAIL
CONTRACTOR'S STATE LIC NUMBER 779604 LICENSE CLASSIFICATION C20
VALUATION$ $9,200-00 SO FT L SQ FT
I APPLICANT"S SIGNATURE DATE
rTmm--
FIFT.);:�sT�'A�,F�F"U�S�E.,15wi�Y
I UIEPAK I MEN I UIbTKI5UTIQN CITY OF ME NIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE e2IIIIIII, PAID AMOUNT
AMOUNT to I OCASH OCHECK# OCREDITCARD VISA/MC
I 3;)LA.
PLAN CHECK I PAIDAMOUNT CREDIT CARD VISAtMC
kPP1I I CASH OCHECK#
OWNER BUILDER VERIFIED OYES 0 NO DLNUMBER NOTARIZED LETTER 0 YESO NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
CITY OF MENIFEIE
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 mrith a licensed contractor(s)pursuant to the Contractors State License Law).
Chaptei-9(commencing wifth section 7000)of Divislion 3 of the,Business and ci I am exempt from licensure under the Contractoes State License Law for
Professions Code and my license is in full force and effect. the following reason:
LlcenseClass C.9-6 UcenseNo. -1-12 LA� By my signature below I acknowledge that,except for my personal residence
Expires QS611k,_Signature �Vllk, (6�,AAVYIO in which I must have resided for at least one year priortocompletion of
0 improvements covered by this pennito I cannot legally sell a structure that I
WORKEWS COMPENSATION DECLARATION have builtas an owner-builder ifit has not been constnicled in its entirety by
ci I hereby affirm under penalty of perjury one ofthe following declarations:I licensed contractors.I understand that a copy ofthe applicable law,Section
have and will maintain a certificate of consent ofself-Insure for worker's 7044 ofthe Business and Professions Code,is available upon requestwhen
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.IeRinfo.m.Roy/caIaw.htmI.
Policylt Date
'Kit have and will maintain workees compensation Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
'section 3700 of the Labor Code,for the performance of the work for which o By my signature below I certify to each of the fullowiing:I am the property
this permit is issued.My worker's compensation insurance carrier and policy 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
With all applicable city and county ordinances and state laws relating to
Carried building construction.I authorize representatives of this city orcounty to
Policy# 1J)CWU'10 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 OWNER OR AUTHORIZED AGENT
o I certify that in the performance of the wotk for which this permit is issued,
Ishallnotermil any persons in any manner so as to become subject to the CITY BUSINESS LICENSE N 0--36,�09,
worker's compensation laws ofCalifomia,and agree that if]should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions olSection 3700 ofthe 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 orgreaterthatithe
Applicant—koi , Uig�zkQ�� Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FN RE TO SECURE WORKERS COMPENSATION COVERAGE IS 0yes "
UNLAWFUL,ANDSHALL SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use ofthe building bythe applicant or future building
AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant requiine a permit forthe 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 Elyes "o
I herebyaffirm that under the penalty ofperjury there is a construction Will the proposed but ding or modified facility hewlithlin 1000feet ofthe
lending agency for the performance ofthe work which this permit is issued outer boundary of a school?
(Section 3097 Civil Gode) o Yes ywo
OWNER BUI LDER DECLARATIONS I have read the Hazardous Material information Guide and the SCAQM D
permitting checklist.I understand my requirements underthe 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 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 IMO
Business and Professions Code).Any city or county that requires a permit to V�Aaw�� -6
construct,alter,improve,demolish or repair any structure,prior to it, y4ts*�L, Date S-26-Li
issuance,also requires the applimnt for the permit to file a signed statement PROPEFV OWNER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contra ctoes state EPA RENOVATION,REPAIR AND PAINTING fRRP)
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 exemptfrom 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 childare facility to be RRP-certIfied firms and comply With
an Applicant for a permit subjects the applicant to a cindl penalty of not more requiiined practices.This includes rental property owners and property
then($500). managers who do the pamt-disturbing work themselves arthrough their
o 1,as owner of the property,or my employee With wages as theirsole employees.For more information about EP9s Renovation Program visit:
COMPEnsation,will do( )all of or( )portion ofthe work,and the structure is www.epa.govIlead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions I-SOD-424-LEAD(5323).
Code,The Contractor's State License Law does not apply to an owner ofa 13 An EPA Lead-safe certified Renovator Will be responsible forthis project
property whDi through emphryeesf or personal effort,builds or Improves the
property provided that the improvements are not intended or offered for Cerdfied Firm Name:
sale.if,however,the building or improvement is sold within one year of Firm Certification No.:
compfetion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpDse of sale. 0 No EPA Lead-safe Cerfiried Firm is required for this project bemuse:
0 1,as owner of the property am exclusively contracting With licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State License Law does not apply to an owner of a Ifyour project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.