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PMT17-00677 City of Menifee Permit No.: PMT17-00677 29714 HAUN RD. �J-\CCEU. . MENIFEE, CA 92586 Type: Residential Mechanical MENIFEE Date Issued: 03/07/2017 PERMIT Site Address: 28946 BAYWATER DR, MENIFEE, CA Parcel Number: 340-190-051 92584 Construction Cost: $3,D00.00 Existing Use: Proposed Use: Description of REPLACE 80,000 BTU FURNACE(ATTIC)&MISC DUCT WORK Work: Owner Contractor DALE FUNK W C HEATING&AIR CONDITIONING INC 28946 BAYWATER DRIVE 41085 GOLDEN GATE CIR MENIFEE,CA 92584 MURRIETA, CA 92562 Applicant Phone: 9516000700 JILLL WESTON License Number:779604 W C HEATING&AIR CONDITIONING INC 41085 GOLDEN GATE CIR MURRIETA, CA 92562 Fee Description Qtv Amount 1E) Forced-Air or Gravity-Type Furnace or Burner 1 149.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Mechanical 1 7.45 $184.45 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 carded 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_BIdg_Peonit_Templale.rpt Page 1 of 1 CITY OF MENIFEE 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 ❑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 reason: l io License Class n License No. ��—n LW­ By my signature below I acknowledge that,except for my personal residence Expires _��Signature in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed in its entirety by ❑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 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 by Section 3700 of the labor Code,for the performance of work for which this application is submitted or at the following website: this permit is issued. www.leeinfo.ca.eov/caiaw.htmL Policy# Date y'rhave and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT s ction 3700 of the Labor Code,for the performance of the work for which ❑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 behalf.I have read this number are: ,, l , \ application and the information I have provided is correct.I agree to comply Carrier bo rk&h1 vc, r�lc- 0.W°"� with all applicable city and county ordinances and state laws relating to Policy#�L0�'� I�q Expires building construction.I authorize representatives of this city or county to enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred dollars($100)or less Date PROPERTY OWNER OR AUTHORIZED AGENT O I certify 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# G 55-Q6 0/� < worker's compensation laws of California,and agree that if I should became subject to the worker's compensation provisions of Section 3700 of the Labor HAZARDOUS MATERIAL DECLARATION Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date mixture containing a hazardous material equal to or greater thatthe amounts specified on the Hazardous Materials Information Guide? WARNING:FA RE TO SECURE WORKER'S COMPENSATION COVERAGE IS 0 yes "a UNLAWFUL,AND SHALL SUB1ECr AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the intended use of the building by the applicant or future building ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist forguidelines CONSTRUCTION LENDING AGENCY ❑Yes 'YNo 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) ❑Yes 9No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting. Business and Professions Code).Any city or county that requires a permit to oyes Ao, ` _ — construct,alter,improve,demolish or repair any structure,prior to its Date issuance,also requires the applicant for the permit to file a signed statement PROPER WNER OR AUTHORIZED AGENT that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he orshe is exempt from licensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-1978 an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified firms and comply with than($500). required practices.This includes rental property owners and property managers who do the paint-disturbing work themselves or through their O 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-BOD-424-LEAD(5323). Code,The Contractor's State License Law does not apply to an owner of a property who,through employees'or personal effort,builds or improves the O An EPA Lead-Safe Certified Renovator will be responsible for this project 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 completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.: not built or Improved for the purpose of sale. O No EPA Lead-Safe Certified Firm is required for this project because: ❑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 & SAFETY PERM IT/PLAN CHECK A. . • Menifee DATE 03/07/2017 PERMIT/PLAN CHECK NUMBER TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: [-]ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑✓ MECHANICAL [-]NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK REPLACE 80K BTU FURNACE(ATTIC),MISC DUCT WORK. PROJECTADDRESS ASSESSOR'S PARCEL NUMBER - 1 LOT TRACT PROPERTY OWNER'S NAME DALE FUNK udin & Safety DeUi. city ADDRESS 28346 BAYWATER DR MAR 0 6 %01! PHONE (951)246-7833 EMAIL APPLICANTNAME JILLWESTON Fleceiv8t' ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO, CA 92123 PHONE (619)384-6622 EMAIL CONTRACTOR'S NAME RUSSELL COCHRAN OWNER BUILDER? ❑YES❑J NO BUSINESS NAME 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$ $3,000.00 SQ Ff 1986 L SO FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN I SMIP INVOICE 1 PAID AMOUNT AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT I 0CASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building& Safety Department 29714 Haun Rd. 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