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PMT17-01964 City of Menifee Permit No.: PMT17-01964 29714 HAUN RD. Type: Residential Mechanical �GCEL/—>. MENIFEE,CA 92586 MENIFEE Date Issued: 0612012017 PERMIT Site Address: 28390 E WORCESTER RD, MENIFEE, CA Parcel Number: 337-101-008 92586 Construction Cost: $9,200.00 Existing Use: Proposed Use: Description of HVAC REPLACEMENT,3.5 TON A/C(RIGHT SIDE YARD),90,000 BTU FURNACE(CLOSET) Work: Owner Contractor MILDRED LERNER W C HEATING&AIR CONDITIONING INC 28390 E WORCESTER ROAD 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 City Amount W 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 I herebyaffirm 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 Iicensure under the Contractor's State License Law for Professions Code and my license is in full force and effect ,� the following reason: License Class Ain License No. n o J&Y By my signature below I acknowledge that,except for my personal residence Expires L Signature WDO� in which l 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 ❑I hereby affirm under penalty of perjury one of the fallowing declarations:I licensed contractors.I understand thata copy of the applicable law,section have and will maintain a certificate of consent of self-insure for workers 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.IeRinfo.ca.Rov/caIaw.htmL permit is issued. Policy# Date y1rhave and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT s lion 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: application and the information I have provided is correct.I agree to comply Carrier_ beri(shirC, LJ with all applicable city and county ordinances and state laws relating to F building construction.l authorize representatives of this city or county to Policy#WC.tJ(.10'Sl 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($10O)or less PROPERTY OWNER OR AUTHORIZED AGENT 0 l certify that in the performance of the work for which this permit is issued, I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE It 635'a.a DL worker's compensation laws of California,and agree that if I should became HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor 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 that the amounts specified on the Hazardous Materials Information Guide? WARNING:FA RE TO SECURE WORKER'S COMPENSATION COVERAGE 15 O 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 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)?see permitting checklist IN SECTION 37060FTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY O 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) O Yes -9,No 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 hazardous Health al safety Code,section 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Oyes Ao, Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,priorto its PROPER 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 Contractor's State EPA RENOVATION.REPAIR AND PAINTING(RRP) 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 Iicensure 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-certified firms and 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 O I,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.Rov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-80D-424-LEAD(5323). Code,The Contractor's State License Law does not apply to an owner of a ❑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. ❑No EPA Lead-Safe Certified Firm is required for this project because: 0 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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION PW 'Men'fee DATE 06i1812017 PERMIT/PLAN CHECK NUMBER TYPE: [-]COMMERCIAL QRESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA []SIGN SUBTYPE: ❑ADDITION ❑ALTERATION []DEMOLITION []ELECTRICAL []MECHANICAL [-]NEW [-]PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK HVAC REPLACEMENT.3.5 TON AfC(RIGHTSIDE YARD),90K BTU FURNACE(CLOSET) c enifee PROJECT ADDRESS 28390 E.WORCESTER RD, SUN CITY CA 92586 BUlldin ASSESSOR'S PARCEL NUMBER 331_ 101- O0g LOT TRACjU PROPERTY OWNER'S NAME MILDRED LERNER r. ADDRESS 28390 E.WORCESTER RD e PHONE (951)679-8184 EMAIL APPLICANT NAME JILL WESTON ADDRESS 3645 RUFFIN RD 330-335 SAN DIEGO,CA 92123 PHONE (619)384-6622 EMAIL CONTRACTOR'S NAME RUSSELLCOCHRAN OWNERBUILDER? ❑YESQNO 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$ $9,200.00 SQ FT 1874 L SO FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP X INVOICE AMOUNT 3a Ib PAID AMOUNT ��1� Or. vCASH `J CHECKq OCREDR CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# 0CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. 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