PMT16-04234 City of Menifee Permit No.: PMT1 6-04234
29714 HAUN RD. Type: Residential Mechanical
<ACCELA—> MENIFEE, CA 92586
MENIFEE Date Issued: 12119/2016
P E R M I T
Site Address: 28081 RADFORD DR, MENIFEE, CA Parcel Number: 339-041-016
92586 Construction Cost: $8,500.00
Existing Use: Proposed Use:
Description of HVAC REPLACEMENT,2-TON A/C(LEFTSIDE YARD)90,000 BTU FURNACE(CLOSET)
Work:
Owner Contractor
WALTER WOLF W C HEATING&AIR CONDITIONING INC
28081 RADFORD DRIVE 41085 GOLDEN GATE CIR
MENIFEE, CA 92586 MURRIETA, CA 92552
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 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 13[dg_Permit—Templaterpt 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).
Chapter9(commencing with section 7000)of Division 3 of the,Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code a nd my license is in full force and effect. the followling mason:
Vicense Class C.6 o LicenseNo. �1-)q L64 By mysignature below I acknowledge that,except for my personal residence
Expires (a(SWIL—signature �VQL, tLa/-A� 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
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 applicable law,Secrion
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 3700 of the Labor Code,for the performance of work for which www.Iegmfo.ca.goy/oiIa%v.htmI
this permit is issued.
Policy It Date
Y_11 have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
�ection 3700 of the Labor Code,for the performance ofthe work for which ri By my signature below I certify to each ofthe following:I am the property
this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act an the property owner's behalf.I have read this
number am: 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
Policy4f 'ZCWe-AO'3V15_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 work for which this permit is issued,
Ishallnotemplo any persons In any manner so as to become subject to the CITY BUSINESS LICENSE If 0 91
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 wifth those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greaterthatthe
Applicant I ' W zt�k4QZ Date L amounts specified on the Hazardous Materials Information Guide?
WARNING;I:FA UBE TO SECURE WORKER'S COMPENSATION COVERAGE IS oYes "o
UNLAWFUL,AND SHALL SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES 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(SCAQMID)?See pentritting checklist
IN SECHON 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldelines
CONSTRUCTION LENDING AGENCY 0 Yes "o
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be with-in 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) 0 Yes �No
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 affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 2S505 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 ciYes "o
Business and Professions Code).Any city or county that requires a permit to kz%*%L� kk�&Aqn� Date
construct,after,improve,demolish or repair any structure,priorto its PROPEFV-OWNER ORAUTHORIZED AGENT
issuance,also requires the appliontforthe permitto file a signed statement
that he orshe is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renov%ition,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from licensum 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 FIRP-certifted firms and comply with
an Applicant for a permit subjects the a pplicant 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 orthrough their
ci 1,as owner of the propeft or my employee with wages as their sole employees.For more information about EPRS Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gov/fead 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 ci 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 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. 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 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
ON,k",
DATE 12/16/2016 PERMIT/PLAN CHECK NUMBER &—mu
TYPE: F-ICOMMERCIAL EIRESIDENTIAL DMULTI-FAMILY F]MOBILEHOME [:]POOL/SPA [:]SIGN
SUBTYPE: [-]ADDITION E]ALTERATION [-]DEMOLITION [-]ELECTRICAL EMECHANICAL
[-]NEW [-]PLUMBING [-]RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK HVAC REPLACEMENT.2 TON(LEFTSIDE YARD)90K BTU FURNACE(CLOSET)
PROJECT ADDRESS 28DB1 RADFORD DR,SUN CITY 6MI15%0
ASSESSOR'S PARCEL NUMBER LOT TRACT City.Of klenifee
Q1
—.1ulfly Uept
PROPERTY OWNER'S NAME WALTERWOLF
ADDRESS 28081 RADFORD DR,SUN CITY DEC 19 2016
PHONE (951)679-6002 EMAIL Rep% � :. - - I
APPLICANTNAME JILLWESTON V t�L
ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA92123
PHONE (619)384-6622 EMAIL
CONTRACTOR'S NAME RUSSELLCOCHRAN OWNERBUILDER? [:IYESPINO
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$ $8,500-00 SOFT 1146 LSQFT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION ICITY MOFMENIFEE BUSINESS LICENSE NUMBER
BUiLDING PLANNING ENGINEERING FIRE GRE SMIP
INVOICE PAIDAMOUNT
AMOUNT ZQL%-10 -to 1 0 CASH 0 CHECK 111 0 CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 7, OCASH OCHECK# OCIREDITCARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LE17ER 0 YES 0 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
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