PMT16-03742 City of Menifee Permit No.: PMT16-03742
29714 HAUN RD. Type: Residential Mechanical
'1;kCCEL;Fv-3' MENIFEE,CA 92586
MENIFEE Datelssued: 1112812016
P E R M I T
Site Address: 29915 AVENIDA DE REAL,MENIFEE, CA Parcel Number: 336-243-008
92586 Construction Cost: $9,200.00
Existing Use: Proposed Use:
Description of HVAC REPLACEMENT, 2.5-TON A/C,90,000 BTU FURNACE
Work:
Omer Contractor
TIM MERRILL W C HEATING&AIR CONDITIONING INC
29915 AVENIDA DE REAL 41085 GOLDEN GATE CIR
MENIFEE, CA 92586 MURRIETA, CA 92562
ApplIcant Phone: 9516000700
JILL WESTON License Number:779604
W C HEATING&AIR CONDITIONING INC
41085 GOLDEN GATE CIR
MURRIETA, CA 92562
Fee Description QtY Amount I$)
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
Air HandlinglConclensing 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 otherv0se 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 Bidg_Pen-nit-Ternplatesin Page 1 of 1
CITY OF MENIFEIE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirin under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contmctors State license Law).
Chaptei-9(commencing with section 7000)of Division 3 of the Business and E3 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 mason:
License Class 0,0 6 License No. �1-lq �64 By my signature below I acknowledge that,except for my personal residence
Expires__Q56f IL Signature IL, IL 6-&n3lil� 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
WORKER'S 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 appikable 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 applimtion is submitted or at the following website:
by Section 3700 of the Labor Code,for the performance of work for which www.leginfe.�.Roy/cii1aw.linni
this permit is issued.
Policy# Date
rave and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
'It!'on 3700 of the Labor Code,for the performance of the work for which o By my signature below I certify to each orthe following:I am the property
this permit is issued.My workees compensation insurance a mer and policy owner or authorized to act an the property owner's 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
building construction.I authorize representatives of this city or county to
P0licY4 QWQ�ILOSVYOL Expires— L:7 enterthe 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,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS UCENSE# Q--36202,
worker's compensation laws of California,and agree that if I should become 14AZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions ofSection 3700 ofthe Labor
Code,I shall forthwith comply With those provisions. Will the applimnit or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applicant Date 'ZI IL L amounts specified on the Hazardous Materials Information Guide?
MLARNING-FAWURE TO SECURE WORKEWS COMPENSATION COVERAGE IS 0yes "
UNLAWFUL,AND SHALL SUBJECrAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use ofthe building by the applicant or future building
AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a pernfit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See parinitting checklist
IN SECrION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidellnes
CONSTRUCTION LENDING AGENCY a Yes "a
I hereby affirm that under the penalty of perjury there IS 2 constnicrion 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 qw,
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQvi D
permitting checklist.I understand my requirements under the State of
I hereby affim under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractors 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 "o
Business and Profmions Code).Any city or county that requires a permit to V�'-%L' ISA�k2kgn, Date
construct,alter,improve,demolish or repair any structure,prior to its PROPEFV-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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRPI
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-certlfmd firms and comply with
an Applicant for a permit subjects the applimnt to a civil penalty of not more required pnictices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves orthrough their
E3 1,as owner of the property,or my employee with wages as theirsole employees.For mom information about EPA!s Renovation Program visit:
compensation,will do( )all of or( )portion oMe work,and the structure is www.eria.goy/lead 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 Contractor's State License Law does not apply to an owner of a 0 An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employeEsor personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sa le.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. 0 No EPA Lead-safe cerfified Firm is required for this project bemuse:
ci 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 if your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE PERM IT/PLAN CHECK NUMBER LAC-:)-
TYPE: OCOMMERCIAL ZRESIDENTIAL [-]MULTI-FAMILY [-]MOBILEHOME [-]POOL/SPA [-]SIGN
SUBTYPE: F]ADDITION F]ALTERATION F]DEMOLITION DELEcTRICAL ZMECHANICAL
FINEWE]PLUMBING [-IRE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK HVAG REPLACEMENT.2.5 TON(LEFrSIDE YARD)90K BTU FURNACE(GARAGE)
PROJECTADDRESS 29915 AVENIDA DE REAL COC2!i�g
ASSESSOR'S PARCEL NUMBER SZLp - 0LA7>- e)0S LOT TRACT
PROPERTY OWNER'S NAME TIMMERRILL City Oj Menifee
6UIIQI%'�j IDen't
ADDRESS 29915 AVENIDA DE REAL
PHONE (951)775-0207 EMAIL Nov 2 1
APPLICANITNAME JILLWESTON FlerQivnd -
ADDRESS 3645 RUFFIN RD330-335 SAN DIEGO, CA92123
PHONE (619)384-6622 EMAIL
CONTRACTOR'S NAME RUSSELL COCHRAN OWNERBUILDER? 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$ $9,200-00 SQ Fy 1340 L SO FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION SMIP CITYOFMENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN
INVOICE
AMOUNT PAID AMOUNT 5aq- 1010CASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT I I () CASH 0 CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 No DLNUMBER NOTARIZED LE17ER 0 YES C 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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