PMT16-04113 City of Menifee Permit No.: PMT16-04113
29714 HAUN RD. Type: Residential Mechanical
<A-CCIELA> MENIFEE, CA 92586
MENIFEE Date Issued: 12116/2016
P E R M I T
Site Address: 25290 SHERMAN RD, MENIFEE, CA Parcel Number: 329-290-002
92585 Construefion Cost: $9,200.00
Existing Use: Proposed Use:
Description of HVAC REPLACEMENT,3.5 TON A/C(BACKYARD)90,000 BTU FURNACE(ATTIC)AND ALL DUCT
Work: WORK
Owner Contractor
LOU RNA BARN ETT W C HEATING&AIR CONDITIONING INC
25290 SHERMAN ROAD 41085 GOLDEN GATE CIR
MENIFEE, CA 92585 MURRIETA, CA 92562
Applicant Phone: 9516000700
JILL WESTON License Number:779604
W 0 HEATING&AIR CONDITIONING INC
41085 GOLDEN GATE CIR
MURRIETA,CA 92562
Fee Description QtV Amount J$1
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 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 BidgPermit Template.rpt Page 1 of 1
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 With a licensed contractor(s)pursuant to the Contractors State License Law).
Chapterg(commencing with section 7000)of Diviislon 3 of the Business and o I am exempt from[immure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the followhig reason:
License Class 0,0 6 License No._�] By mysignature below I acknowledge that,except for my personal residence
Explres__(��.(S61 IL Signature S4�ca In which I must have resided for at least one year prior to completion of
0 improvements covered by this permit.I cannot legally sell a structure that I
WORKEWSCOMPENSATIO1 DECLARATI 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 a nd 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 webeite;
by Section 3700 of the La bor Code,for the performance of work for which wwwleginfo.m.govIcalavulitmi
this permit is issued.
Policy N Date
-KII have and will maintain worker's Compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
Isection 370D of the Labor Code,for the performance of the work for which a 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 policy owner or authorized to act on the property owner's behalL I have read this
numberare: application a nd the information I have provided is correct I agree to comply
With all applicable city and county ordinances and state laws relating to
Carrier bev KsWure, A.AaAja_� building construction.I authorize representatives of this city or county to
Policyti b)C'WQ"10 Macl_Expires k%, L�7 — 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,
Ishallnotemplo any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# Q-�36,�og,
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 370D of the 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 !I;NaL, kj) Date &*b_7%;- UL amounts specified an the Hazardous Materials Information Guide?
WARN ING:FVAURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 0 Yes "o
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FI NES UP TO ON E HUNDRED THOUSAND DOLLARS($101),00D),IN occupant require a permit for the construction or modiflorion from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See penitting checklist
IN SECRON 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES forgUldElines
CONSTRUCTION LENDING AGENCY o Yes "o
I hereby affirm that under the penalty of perjury there is a construcrion Will the proposed building or modified facility be within 100D 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) 0 Yes I�Ncr
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 2550S and 25534 concerniing
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 ciYes EMo
Business and Professions Code).Any city or county that requires a permit to V.%*%L, II,6&Ziq� Date
construct,alter,improve,demolish or repair any structure,prior to its P ROPEFI 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(RRP1
License Law(Chapter 9(commencing mdth 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 cirildcare facility to be Rlip-certlified firms and comply with
an Applicant for 2 permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($50D). managers who do the paint-disturbing work themselves orthroughtheir
o 1,as owner of the property,or my employee with wages as theirsole employees.For more information about EPA!s Renovation Pnigram Visit:
compensation,will do( I all of or I )portion of the work,and the structure is www.epamov/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 11cense Law does not apply to an owner of a 0 An EPA Lead-safe Certiffied 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 will have the burden of proving that it was
not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project bemuse:
o 1,as owner of the property am exclusively contracting With licensed
contra clors 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 12/13/2016 PERMIT/PLAN CHECK NUMBER
TYPE: F-ICOMMERCIAL E]RESIDENTIAL []MULTI-FAMILY [-]MOBILEHOME E]POOL/SPA F]SIGN
SUBTYPE: [-]ADDITION F]ALTERATION []DEMOLITION [-]ELECTRICAL EMECHANICAL
F]NEW F]PLUMBING FIRE-ROOF-NUMBEROFSQUARES-
DESCRIPTION OF WORK HVAC REPLACEMENT.3.5 A/C(BACKYARD)90K BTU FURNACE(ATTIC) ;
ALL DUCT WORK.
PROJECTADDRESS 25290SHERMANRD 15
ASSESSOR'S PARCEL NUMBER ��- P,15�0 -CX>Qt LOT TRACT
PROPERTY OWNER'S NAME LOURNABARNETT City of MeniteE
In. Iding Dept
ADDRESS 25290 SHERMAN RD DEU
PHONE (951)316-3056 EMAIL
APPLICANTNAME JILLWESTON R tz
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 CIR MURRIETA,CA 92562
PHONE (951)600-0700 EMAIL
CONTRACTOR'S STATE LIC NUMBER 779604 LICENSE CLASSIFICATION C20
VALUATION$ $9,200.00 SQ FT 1605 L SO FT
U9111=5 511,91:11,112TURE
FIWSTAFFUSEONLY
DLPARTMLNT U15TKIBUTION CITY UF M N[FtL HUS11 L55 ULLN
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP � >C
INVOICE I
T� �'I- 10
AMOUN LA. IC) PAIDAMOUNT 0 CASH 0 CHECK# OCREDITCARD VISAI
PLAN CHECK FEES I PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 No OIL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menfee Building&Safety Department 29714 Hour;Rd. Menifee, CA 92596-951-672-6777
www.cityofirnenifee.us Inspection Request Line 951-246-6213
E
0
0
u u c (3)
0 t- w
C�j
LU
z ID
t
bo u 0
7@U
Lb
-LU
z
0
0
Z u 0 w
4
0 u 0
wc E
0 j-
0 C3 0 a U: z
0
E
0
t E
C)
0
0.
0 r=
0
u
u
m
U
0 E E 0
E 0 E
m
0
z �o
(D
E c
w W � M
0 E 0 w
.2 u 0 it
z :t 0 w
c 0 u Z; tic
0 o m he
u 0
w m 0 a
0 u i w x L rz
v E F� w 0
E a
0 m 'Z 0 0 E
w z r E c c z
0
0 M E
u 0 z U
w w
c c = Z
w 0 m U
a CL
f
u u <
w u
0
16
o wu a
C7
u
tf
0 w 0
M
AR
-6
Uo
r4
3 Ln
4)
o
u u 6 0
0
0 0 0
o 0
;Fc u E E
0 -a g
0 4) Ln a c
M Z
E 0
>
CL a M
E 0 0
0 .0
cr
0 0
0 <
0
u
w E 0 E co
u Z 4) 'Z
u
u LA
E 2 0
<
E JC W :E
'0 0 0
M 73 E .2 2 w c
0 M ci W 1�1 E cc -- .§ a
M 0 z 1EL 0
2 —_ u
E
SE
E �u
C; 0
u E
u 0
u
0 -Z a CL
M
0 w
4)
E E
4) aj
4) t 6 u 0 0
0 % 0 a 0 CL 9
M — E r <
E
0
0
u u
M
z
<
CL 0
am E u E
0 a 0 0 c
<
N w M m lo w
w
0 w U E o 0 0 L3
U .0 0
u
w 2 E E 3:
0 w 4) E
E z z
w
M u Mu
31' w
0
u -u
uu L6_j
0 Sm
<
CL
U0
E
CT
m 49
.5 C vj�a
V o �Ei C�,Q.
a uj�
.0 AD Lu a T 66
% 0 Z�, 0
00 Uzo
E 4q
0 V
E P .5-
E
ap C)
.2 u t66 m E w m 0,-16
t 0 U
00
mw W.
W E x hi W .. Wis
S 5. o 'o 0
0 m vw :5 a t2
o 0 m
0
E
b 1� tA E
w
E uo
0
t; -0 E
-u E E
0 ':E w
w - m
-6
M
0 0 m w E
2
-9 q E V 8 E
w t o E
E -.2 u w 8
> c 0 0 .2
E E
r U0 U
w
c U.
0
CL w E m
c E u c u
0 w .
u E - - E
E - . - t4
> -m _0 . 0 sb
f cm ��o L E!
bB a
u 0 u u
0 JZ a
z ia
'Ec
M 0 0 0
a; u E a 0 -w ap u
r �o o w 2 Eo u
< u
co
0 z co
m
r M
z
u
0
M u w m
M Lo V
P:
u u E CL U m
= .4 4 �i li ui a
0
u 41
0 �r u 2 w w u
�4 0 1 1 a �: