PMT17-00342 City of Menifee Permit No.: PMT17-00342
29714 HAUN RD. Type: Residential Mechanical
<A-CCELA- MENIFEE, CA 92586
MENIFEE Date Issued:
02107/2017
PERMIT
Site Address: . 23530 CIRCLE DR, MENIFEE, CA 92587 Parcel Number: 350-071-001
Construction Cost: $9,200.00
Existing Use: Proposed Use:
Description of HVAC REPLACEMENT, PACKAGE UNIT,3 TON A/C,90,000 BTU FURNACE(ROOFTOP)
Work:
Owner Contractor
MICHELLE WALLER W C HEATING&AIR CONDITIONING INC
23530 CIRCLE DRIVE 41085 GOLDEN GATE CIR
MENIFEE, CA 92587 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 I51
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_Bldg_Permit Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contmctor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter-9(commencing with section 7000)of Division 3 of the Business and ❑1 am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. 1,� the following reason: '
License Class l ao License No. ) ra� —OCO-i By my signature below I acknowledge that,except formy,personal residence
Expires _Signature Ws9\-Eky� in which l must have resided for at least one year prior to completion of
improvements covered by this permit I cannot legally sell a structure that
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
D 1 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 ofself4mure for workers 7044 of the Business and Professions Cade,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.leeinfo.w.eov/calaw.htmL
this permit is issued.
Policy# Date
gqT'fhhave and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
/s�'c[ion 3700 of the Labor Code,for the performance of the workfor which O By my signature below 1 certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
,(.` ,Y� l \ with all applicable city and county ordinances and state laws relating to
Carrier lX% Q .N building construction.l authorize representatives of this city or county to
Policy#Wc L3(- 1 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
❑Icertify that in the performance of the work for which this permit is issued, /�/1 /� /�
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# G5S/a0f�.
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers 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
Applicant A.9—� �� Date mixture containing a hazardous material equal to or greater that the
amounts specified an the Hazardous Materials Information Guide?
WARNING:FA RE TO SECURE WORKER'S COMPENSATION COVERAGE 15 Oyes "a
UNLAWFUL,AND SHALL SUBIECTAN 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(SCAQMD)7 See permitting checklist
IN SECrION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY OYes 'f'No
I hereby affirm that under the penalty of perjury there is a construction 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) O Yes 14PINo
OWNER BUILDER DECLARATIONS 1 have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist i understand my requirements under the State of
Contractors License Law for the reason(s)indicated below by the California HealthalSafety Code,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5
Oyes t`Jtlo, �_ 1�
Business and Professions Code).Any city or county that requires a permit to P6C�� Date
construct,alter,improve,demolish or repair any structure,priorto its pROPE WNER 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING iRRPI
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 mostwork that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of5ection 7031.5 by residence or childcare facility to be RRP-certified firmsand 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
❑1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure Is www.eoa.eov/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 Contractors State License Law does not apply to an owner of a O 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. O No EPA Lead-Safe Certified Firm is required for this project because:
O I,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.
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
�7
IMenifee
DATE 02/03/2017 PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL MULTI-FAMILY ❑MOBILE HOME POOL/SPA [-]SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑✓ MECHANICAL
❑NEW []PLUMBING [IRE-ROOF-NUMBEROFSQUARES
DESCRIPTION OF WORK HVAC REPLACEMENT. PACKAGE UNIT.3 TON A/C AND 90K BTU FURNACE(ROOFTOP)
PROJECTADDRESS 23530 CIRCLE OR MENIFEE
ASSESSOR'S PARCEL NUMBER '_ eo - 0,k- Co LOT TRACT
PROPERTY OWNER'S NAME MICHELLE WALLER City of Menifee
ADDRESS 23530 CIRCLE DR Building Dept
PHONE (951)660-0915 EMAIL
APPLICANT NAME JILL WESTON
ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA 92123 e c e i v e
PHONE (619)384-6622 EMAIL
CONTRACTOR'S NAME RUSSELL COCHRAN OWNER BUILDER? ❑YES❑✓NO
BUSINESS NAME WC PLUMBING, HEATING&AIR
ADDRESS 41065 GOLDEN GATE CIR MURRIETA,CA 92562
PHONE (951)600-0700 EMAIL
CONTRACTOR'S STATE LIC NUMBER 779604 LICENSE CLASSIFICATION C20
VALUATION S $9200.00 SO FT 1200 L SO FT
APPLICANT'S SIGNATURE DATE
CITYSTAFFUSEONL
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP X
INVOICE PAID AMOUNT
AMOUNT •ID •Io 0CASH 0CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCASH OCHECKII OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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