PMT15-01698 City of Menifee Permit No.: PMT16-01698
29714 Type: Residential Mechanical
MENIFEEEE,, CA 92586 C 92
40" , MENIFEE Date Issued: 06/19/2015 �I
PERMIT
Site Address: 29627 AVENIDA DE REAL, MENIFEE, CA Parcel Number: 336-262-019
92586 Construction Cost: $5,550.00
Existing Use: Proposed Use:
Description of REPLACEMENT OF EXISTING HVAC SYSTEM WITH NEW 3 TON HVAC SYSTEM
Work:
Owner Contractor
MARIA NORLAND CASTILLO HEATING&AIR CONDITIONING INC
29627 AVENIDA DE REAL 32105 HEATHER LANE
MENIFEE, CA 92586 MENIFEE, CA 92584
Applicant Phone: 9513014452
ADRIANA CASTILLO License Number: 548323
CASTILLO HEATING &AIR CONDITIONING INC -
32105 HEATHER LANE
MENIFEE, CA 92584
Fee Description Qtv Amount l$1
Air Handling/Condensing Units SFR 1 133.00
uldlrti a lvs cer :7i00'-
GREEN FEE - 1 1.00
$310,00
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 Pagel of 1
City Of Menifee
LICENSED DECLARATION
I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with ,(Icensed.
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions
License
icens a Professions Code and my license Is In full torte and effect. Code:The Contractor's License Law does not apply to an owner of a property
License Glass,�,..ZLicense No, L4 who builds or improves thereon, and who contracts for the projects with a
Expires( Signaturef1.�;11 licensed contractar(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DE RATION -.
❑ 1 am exempt from licensure under the Contractors'State License Law for the
❑ I hereby affirm under penalty of perjury one of the following declarations: following reason:
I have and will maintain a Certificate of consent of self-insure for workers' By my signature below I acknowledge that,except for my personal residence In
for by
Section 3700 of the issued
Labor Code,for th the Director of e performancal e Hons as of work for whichh this which I must have mslded for at least one year prior to completion of
permit is issued. improvements covered by this permit,I cannot legally sell a structure that I have
Policy# _ _ ______. --___—_ built as an owner-building if it has not been constructed in Its entirety by licensed
-- -- contractors. I understand that a copy of the applicable law,Section 7044 of the
I have and will maintain warkers' compensation insurance, as required by Business and Professions Code,is available upon request when this application Is
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:htto/lwww leginfo ca ovlcalaw html.
permit is.issued.My workers'compensation insurance tamer and policy number are:
Carrier G0,T E ropey wneror u arse gent Date
Expires i 0 ++ 01 j Z 0 1 S Policy# CIf.7 29 5(o
Name of Agent< rg, e1 01h&00 Phone ❑ By my Signature below, I certify to each of the following: I am the property
owner or authorized to act on the property owners behalf. I have read this
(This section need not be completed If the permit Is for application and the information I have provided is correct. I agree to comply
one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building
construction.I authorize re re ati es of his�C1ry or count to enter the above-
0 "I certify that in the performance of the work for which this permit is issued,1 identified proparty.for m salon pru 6r! y
shall not employ any persons In any manner so as to become subject to the /// s
workers"compensation laws of California, and agree that if I should become I�o e 0 JI / l$/17/2015 subject to the workers'compensation provisions of Section 3700 of the Labor pr ner orAuthorized A
Code,I shall forthwith comply with those provisions. gent Date
Date; 6/17/2015 Applicant; City B mass License# C a 7
WARNING, FAILURE TO' ECURE WORKERS' H® ARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS NLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL.FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000),IN ADDITION TO THE COST OF COMPENSATION, ❑YES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A 'DAMAGES AS PROVIDED FOR IN:SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL"LABOR CODE,INTEREST,AND ATTORNEYS FEES NO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LE,U61Ne3 AGENIPY SPECIFIED ON THE HAZARDOUS MATERIALS
I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE?
agency for the performance of the work which this permit is issued (Section 3097 Civil Code) WILL THE INTENDED USE OF THE BUILDING BY THE
APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name ❑Y�ES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address t FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
0 DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
I hereby affirm under penalty of perjury that I elm exempt from the Contractor's PRINT NAME:—
License Law for the reason(s)Indicated below by the checkmark(s)I have placed OYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s)(Section 7081.5.Business and Professions Code:`A BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
`Airy city or county that requires a permit construct,alter,Improve,demolish, IO SCHOOL?
or repair any structure,prior to its 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 License Law(Chapter 9(commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions.Code)or that he or OES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($600).) CODE SECTION 2550 33 AN C NCERNING
❑ I, as owner of the property. y employees g HAZARDOUS MATER EP`RTIN .p p rty, or m am Ia ees with wages as their sole i
compensation,will do( )all of or( )porting of the work,and the structure is PROP RTY� WNE AYY 1
not Intended or offered for sate.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a pmparty, X 4 tom_
who, through employees'or personal effort, builds or improves the property, C f —'--
provided that the improvements are not intended or offered for sale.If,however, J -
the building or Improvement is sold within one year of completion,the owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
C & SAFETY PERM IT/PLAN CHECK APPLICATION
Y ' M.
City of Menifee Menifee
Building Dept 1 DATE ,�mg PERMIT/PLAN CHECK NUMBER ��L�'a(0 q 1 p D
TYP • t I:' COMMERCIAL RESIDENTIAL 0 MULTI-FAMILY : MOBILE HOME �> POOL/SPA ;i SIGN
S leCeriv vO'o O ALTERATION O DEMOLITION :' ELECTRICAL VMECHANICAL
NEW . UMBING 'i RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK replacement of existing system with new 3 ton HVAC system
PROJECT ADDRESS 29627 Avenida de Real Sun City, CA 92586
ASSESSOR'S PARCEL NUMBER LOT 119 — TRACT
OWNER NAME Maria Nordland
ADDRESS 29627 Avenida de Real Sun City, CA 92586
PHONE 951-672-6196 EMAIL marynordland@hotmail.com
APPLICANT NAME Adriana Castillo
ADDRESS 32105 Heather Lane Menifee, CA 92584
PHONE 951-301-4452 EMAIL info@castillohvac.net
CONTRACTOR'S NAME Art Castillo OWNER BUILDER? 0 YES "NO
BUSINESS NAME Castillo Heating and Air Conditioning, Inc.
ADDRESS 32105 Heather Lane Menifee, CA 92584
PHONE 951-301-4452 EMAIL info@castillohvac.net
CONTRACTOR'S STATE LIC NUMBER 548323 LICENSE CLASSIFICATION C20
VALUATION$ 5,550 SO FT 1600 L SQ FT 7405
APPLICANT'S SIGNATURE DATE
6/17/2015
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT :% CASH 0CHECK# ^CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT :iCASH ::iCHECK# :%CREDITCARD VISA/MC
OWNER BUILDER VERIFIED -C%YES C) NO DL NUMBER NOTARIZED LETTER O YES :% NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.citycfinenifee.us Inspection Request Line 951-246-6213
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