PMT17-04050 City of Menifee Permit No.: PMT17-04050
29714 HAUN RD. Type: Residential Mechanical
�CCEL^4 MENIFEE,CA92586
MENIFEE Date Issued:
11/17/2017
PERMIT
Site Address: 28205 INSPIRATION LAKE DR, Parcel Number: 364-064-005
MENIFEE,CA 92584 Construction Cost: $10,000.00
Existing Use: Proposed Use:
Description of HVAC REPLACEMENT 3.5 TON A/C(BACKYARD), 90,000 BTU FURNACE(GARAGE), INSTALL NEW
Work: DEDICATED CIRCUIT
Owner Contractor
TYRUS HOOPER W C HEATING&AIR CONDITIONING INC
28205INSPIRATION LAKE DRIVE 41085 GOLDEN GATE CIR
MENIFEE,CA 92584 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 Ott Amount lsl
Receptacle,Switch,Outlet&Fixture 1 116.00
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
AirHandling/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
General Plan Maintenance Fee-Electrical 1 5.80
$446.90
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.
M_Bldg_Pennit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
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 Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class C90 License No. naq('0M
By my signature below I acknowledge that,except for my personal residence
Expires "So a Signature W 00 + in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARAT 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,Section
have and will maintain a certificate of consent of self-insure for workers 7044 of the Business and Professions Code,is available upon requestwhen
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 thisap licatiassub fitted ra
this permit is issued. www.lr�c�I GG��
Policy# WCuc--abew s Date
o I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which 0 By my signature below I 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
Carrier S with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy �,5 l.�C.. 3M Expires la/lam enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($300)or less
PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit is issued, r�
Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that If I should become 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�4 `1 Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:F LURE TO SECURE WORKER'S COMPENSATION COVERAGE IS 0 Yes "0
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(SCtionor modification
checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forCoast
Airlines
Qua
CONSTRUCTION LENDING AGENCY 0 Yes pwo
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 0 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
Contractors 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 ❑)e F .��t _^
construct,alter,improve,demolish or repair any structure,prior to Its W [�0 Date
issuance,also requires the applicant for the permit to file a signed statement PROPERTY 1 INER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractors 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 licensure receiving compensation for most work that disturbs paint in apre-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
than
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
0I,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 ❑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. 0 No EPA Lead-Safe Certified Firm is required for this project because:
❑I,as owner of the property am exclusively contracting with lirensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors 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.
Menifee
DATE 3 PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL []RESIDENTIAL MULTI-FAMILY ❑MOBILEHOME POOL/SPA []SIGN
SUBTYPE: []ADDITION ❑ALTERATION ❑DEMOLITION eELECTRICAL EdMECHANICAL
❑NEW [_]PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 1> / \
0 'CU G 2L 1 1 cfd\ CAPs� O
PROIECTADDRESS ps LLL.IC Y of Men
�yL ,,�,� � 1 mg Dept.
ASSESSOR'S PARCEL NUMBER JLOLA -QUL4- Q0�5 LOT TRACT
PROPERTY OWNER'S NAME �yru NOV 13 2017
ADDRESS C,'
6O PHONE 6 kq- -l-yw�j EMAIL
APPUCANT NAME r^westp
ADDRESS S U n '0-
PHONE qgq- EMAIL
CONTRACTOR'SNAME CQ`(- OWNERBUILDER7 ❑YES❑NO
BUST.•LES NAME -
ADDRESS p e \-p_,
PHONE Q rr7�- �-DO' -IQ'Y_J EMAIL
CC;.TPACfOR'S STATE UC NUMBER -rigL t-' LICENSE CLASSIFICATION C
VALUAnwis k0,00p SOFT kZ(Dn LSQFT
APPLICANT'S SIGNATURE DATE
1 I '
?:9ARTN-�'Yf D �,�� IITY OF MENIFEE BUSINESS LICENSE NUMBER
s c ns putts VS E?i-aVEExx� t7RE GREEN I SMIP X
.`•: ' 1 (U� PIJD AMOUNT
�V O::hT 1 '-t _I V USH O OiECK C Q CiEDrt CARD V1S1/AIC'
PLAN CHECK FEES PA16 AMOUNT O CASH O,CIEEK S 0 CREDIT CARD \I&VMC
OY/NER BUll)ER VERIFIED ='YES = NO OL NUMBER NOTARIZED LETTER 0 YES O NO
c r M,,,;.,;,2 Bu7d,''rn& Sgfe4,Oeparrrent 29714 Haun Rd. Veni ee, CA 9258E 951-677-6777
h:vw.[iryafinenr•'ee.us lnspeaicn Request line 951-2 6-0`213 _
Scanned by CamScanner
^D c w o o a o o D v D n
an m m N in N w f+ N N a A
> ?
D D
� O � m O y N � N a D O• O 1 � � 2 O (1
ao � m 3 3 3 n n � m• o o m a ° a
m m m ^ 0 w 3 c v w n
n A r 7 o N n y 3
�n N N O to O d Z
O
N
f+ O VI 7 U1 lD N N 00 N
o s o o ' <
0 o u > > > n
of m
� 3 0• 3 ,,, � -ri
eT V y (1 n
O VI m O O = N
2 G > > > S
=a 0 a
n N a• pq U
m
w vi
0
w w ° O w N
'm ° m m �?,• c o f F
.• _ c in d .� n Z a m ry
C N •y
w
v
Y 3
- w C
VI
m
� £ m
ry J
2
N = n0 nm
m
A
Y a D D �\� n m n
O m 0=9 O (D N A D
m n < m •� w crt, r 7ri
C NJ 7
I CS
t+
3 w w rn
n Ap TI m
m » N a N a
m ' ^ ^ a a F z % c N Q N D A A
r! �? 6 6 6 fl Z O Q
wwmwdoo 3 3ym m o n
m Z U N o m 3 o CL m
c Z m w 84
pQ 3 m N i x xav » Ol vi T
3 n ?
n —
,2 D 3 3 ^ xm Fw Goo m � 3a3u a � r_
o m 7
w m
.� c ri o a o y f m 3 T D 3 2 D 00 O
�- w fD fD a d m o eF a o N a w = B O IA w
D
o m � N
o0 3 n c o ?
» $ n w
h o m m E N o F v VI
Ei
2L0 ¢ < 1+ n
3 o n < °' 'm x m ro a O1 °
Q D
3 0
N
o m n n
3 qp c p A o
OO
Ul
FF
W H N y m
0
F+ N
A
r = m n C N
s
ui -
�
c o
m rn m O
R1 a
m
m n Q O
a o o. "
m N
N n
C
c m a n
Z
e<du G ^ DT 9 md d a Aa n n S � pim
O _ �
3 O
m
N Er
N N ii O y Pf
94 D a _ ,� .o n ,^� c .a. n p W W Z D ^ O
J Twt ^ fl m w Noe » m a m N !° N S O
FF
w N QQ O. w A N N a: ^ 'y: N M Z
J un O N i w O x
N O mj O N m m N c 1l1 (l elf
v
g aw' 5 - oo �a a m
a3R � M
3 o m 3 �^ °' 3 N = '" a 71
SL awr
s ^ N D
a A O d a r
�^ m 3 — nnc3 ^o 7 <
�m aa Po
m NN e n
o o�
CL
=v w as nF 39 = o C
Qom _
� N j d1�4 tbn = Jr Oa zN cnna n � W � fln Ooo zo
=, O' n^
o O d CCv_i N a ¢w N lD !D t+ x J c 3 N
a o N
a m F' �^ f..
? 41 0 � m 3OAi
O F+ N Tp o tL m m » d f S O V !u
mm V �'T 3 c g m n3
o g 3
is
•T YI N r� OV (t^J C
g
3 a n v
5 3 0 dF � Q
m a a
8 S o
m =
93 o m
,,a
S o o N
^ m d m 3 v
� N 2 � C a n
19
w ry m E 00
o
w
x
w m Q S N
UI N N