PMT18-04053 City of Menifee Permit No.: PMT18-04053
,� 29714 HAUN RD. Type: Residential Mechanical
'/ MENIFEE, CA92586
MENIFEE MENIFEE Date Issued: 08/16/2018
PERMIT
Site Address: 28398 JENNY LN, MENIFEE,CA 92584 Parcel Number: 388-022-004
Construction Cost: $8,152.00
Existing Use: Proposed Use:
Description of REPLACE 5 TON CONDENSER AND 7 DUCTS
Work:
Owner Contractor
KEN LEN W C HEATING&AIR CONDITIONING INC
28398 JENNY LANE 41085 GOLDEN GATE CIR
MENIFEE, CA 92584 MURRIETA, CA 92562
Applicant Phone:9516000700
W C HEATING&AIR CONDITIONING INC License Number:779604
41085 GOLDEN GATE CIR
MURRIETA,CA 92562
Phone:9516000700
Fee Description OQt Amount 1$)
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 6.65
$167.65
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_Permft_Template.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 l 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 0 l am exempt from llcensure under the Contrdctafsstate License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class C'Z{. License NO. By my signature below l acknowledge that,except formy personal residence
Expires-61-301
x ires-61-30FF 2.0 Signature -�-Z— in which lmust have resided for at least one year pdorto completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that I
have built as an owner-builder if it hasnot been constructed in its entirely 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 request when
compensation,issued by the Director of industrial Relations as provided for this application is submitted or at the following website:
by Section 370D of the Labor Code,for the performance of work for which
this permit Is issued. www.Ieginf s".eov/calaw.html.
Polirye Date
oz6l 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 ,y my signature below l certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carrier and polity r owner or authorized to act an the property owner's behalf.I have read this
numberare: application and the information I have provided is correct.I agree to comply
Carrier Sir n rn c r, with all applicable city and county ordinances and state laws relating to
�' building construction.I authorize representatives of this city or county to
Policyll LJC �C-90>6-7:. Expires I,r �r�q 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 114SIIFI
PROPERTY OWNER OR AUTHORIZED AGENT
01 certify that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to become subject tothe CITY BUSINESS LICENSE R 03czno
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compematian 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 S.s.r.sy- Date 15 $ g ma q 6 mixture containing a hazardous material equal to or greater that%—�-
amounts sp�ctfred on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS a Yes ll.Jdo
UNLAWFUL,AND SHALLSUBIECT 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($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(5CAQMD)7 See permitting checklist
IN SECTION 3705 of THE LABOR CO DE,INTEREST,AND ATTORNEYS FEES for gutdeli ees
CONSTRUCTION LENDING AGENCY O Yes l`
I hereby affirm that under the penalty of perjury there is a construction will the proposed building or modified facility he within 1000 feet ofthe
lending agency for the performance ofthe work which this permit is issued outer boundary ofa school?
(Section 8097 Civil Code) 0 Yesc:§19
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that l am exempt from the permitting checklist.I understand my requirements under the State of
Contractols License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25S05 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to 1 0 �_
Date L S I$
construct,also alter,Improve, applicantsh for the any permitm file a prior tsta PROPERTY OWNER 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 IRRPI
License Law(Chapter 9(commencing with Section 700D)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)
Business and Professions Code)or that he or she is exempt from licensure P g( requires contractor's
receiving compensation for most work that disturbs paint in a pre-1978
and the basisforthermitsdects th a Any violation
toad of Section of not o residence or childcare facility to be RRP-certified firms and comply with
than
Applicant fora permit subjects the applicant too civil penalty of not more required practices.This includes rental property owners and property
than($5001• managers who do the paint-disturbing work themselves or through their
01,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.eovAired or contact the National Lead Information Center at
not Intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LFAD(5323).
Code,The Contractor's State License Law does not apply to an owner ofa aAn 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:
01,as owner of the property am exclusively contracting with licensed
contrectors 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.
c-ems - � K
BUILDING & SAFETY PERMIT/PLAN
• APPLICATION
Menifee
DATE 08/16/2018 PERMIT/PLAN CHECK NUMBER PMr Q VV)�
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL MULTI-FAMILY ❑MOBILEHOME POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION []ALTERATION [—]DEMOLITION [—]ELECTRICAL ❑✓ MECHANICAL
[]NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace 5 ton condenser and 7 ducts
PROJECTADDRESS 28398JennyLaane
ASSESSOR'S PARCEL NUMBER O� ' `2 "VIJ� LOT TRACT
OWNER NAME Ken LenOki Dey-
e��iee
ADDRESS 28398 Jenny Lane qQ
PHONE (909)208-0669 EMAIL G 0
U
APPLICANT NAME Steven Schnierer pp °
ADDRESS 31225 La Baya Drive Suite 213 Westlake Village, CA 91362 V
PHONE (818)735-7876 EMAIL swschnierer@roadrunner.com
CONTRACTOR'S NAME We Care OWNER BUILDER? ❑YES❑✓NO
BUSINESS NAME We Care
ADDRESS 41085 Golden Gate Circle Murrieta,CA 92562
PHONE (961)600-0700 EMAIL
CONTRACTOR'S STATE LIC NUMBER 779604 LICENSE CLASSIFICATION C20
VALUATION $ $8.152.00 SQ FT L SO FT
APPLICANT'S SIGNATURE �^ "' �— DATE 08/16/2018
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE `'Q''I to PAID AMOUNT
O 0
AMOUNT L�'l. `- `� O CASH CHECK# CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OaltcK# O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6717
www.cityofinenifee.us Inspection Request Line 951-246-6213
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