PMT15-01759 City of Menifee Permit No.: PMT15-01759
''''�y 29714 HAUN RD, Type: Residential Mechanical
4 iCCEI.,lr MENIFEE, CA 92586
MENIFEE Date Issued: 06/26/2015
PERMIT
Site Address: 30279 CALLE POMPEII, MENIFEE, CA Parcel Number: 364-121-014
92584 Construction Cost: $6,975.00
Existing Use: Proposed Use:
Description of REPLACEMENT OF EXISTING SYSTEM WITH INSTALLATION OF NEW 3.5 TON 15 SEER HVAC
Work:
Owner Contractor
MARY AGNES CAIN CASTILLO HEATING&AIR CONDITIONING INC
30279 CALLE POMPEII 32105 HEATHER LANE
MENIFEE, CA 92584 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
Air Handling/Condensing Units SFR 1 133.00
it in iPer Iti s ande< 2- OQ`
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.mt - Page 1 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 licensed
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044,Business and Professions
Professions Code and my license is In full force and effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class, License 44ff who builds or improves thereon, and who contracts for the projects with a
�
Expires_ �Signatur licensed contractors)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DE RATION
❑ 1 am exempt from licensors under the Contractors'State License Law for the
❑ 1 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
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 which I must have resided for at least one year prior to completion of
permit is issued. improvements covered by this permit, I cannot legally sell a structure that 1 have
Policy# built as an owner-building I it has not been constructed in its entirety by licensed
contractors. I understand that a copy of the applicable law,Section 7044 of the
ps I have and will maintain workers' 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:b9g2kww leginfo cs covl wI whtml.
permit is Issued.My workers'compensation insurance carer and policy number are:
Carrier G 0,-T F 11�1 roperty eror tit omeed gent Date
Expires 10 101 / Z U l5 Policy# 0029656
Name of Agent 121M S -jaft Q Phone ❑ By my Signature below, I certify to each of the following: I am the property
owner or authorized to act on the property owner's behalf. I have read this
(This section need Dgt be completed If the permit Is for application and the information I have provided is correct. I agree to comply
one-hundred dollars(S100)or less) with all applicable city and county ordinances and state laws relating to building
construction.1 authorize repre ati s of is�city or county to enter the above-
❑ 'I certify that in the performance of the work for which this permit is issued,1 iden6fiad propsrty.for In action p Sr/
shall not em ilov any persons in any manner so as to become subject to the -
workers'compensation laws of California, and agree that I I should become / G��4 ( � .• •.,� i 6/24I2015
subject to the workers'compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Pro a nor orAuthodzed Agent _ Date _
i7
Date; 6/24/2015 Applicant; % City B mess License# 0 0 8 7 2 0
WARNING: FAILURE TO I ECURE WORKERS'
COMPENSATION COVERAGE IS NLAWFUL, AND SHALL HAZARDOUS MATERIAL DECLARATION
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 @ENO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY 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 DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address BNO FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
I hereby of rm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reason(s)Indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s)(Section 7031.5. Business and Professions Code:A co // BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
rty city or county that requires a permit to construct,after, Improve,demolish, IEND 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(Chapter9 (commencing with � I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or E INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from ficensure 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($500).) CODE SECTION 2550 33 AN CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAVkikDOUS MATER EPRTIN
compensation,will do( )all of or( )porting of the work,and the structure is PROP RTY NE AH
not Intended or offered for sale.(Section 7044,Business and Professions Code; ��
The Contractor's State License Law does not apply to an owner of a property XZLC
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however, !
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or Improved for the
purpose of sale).
& SAFETY PERMIT/PLAN CHECK APPLICATION
Ateenifee
DATE PERMIT/PLAN CHECK NUMBER F tT s-017Sc1
TYPE: 0 COMMERCIAL RESIDENTIAL C) MULTI-FAMILY MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: "ADDITION C ALTERATION 0 DEMOLITION C) ELECTRICAL VMECHANICAL
O NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK replacement of existing system with installation of new 3.5 ton 15 SEER HVAC system
PROJECTADDRESS 30279 Calle Pompeii Menifee, CA 92584
ASSESSOR'S PARCEL NUMBER Iy' LOT 17[:7 TRACT
OWNER NAME Mary Agnes Cain
ADDRESS 30279 Calle Pompeii Menifee, CA 92584
PHONE 951-723-8513 EMAIL maryagneskt@gmail.com
APPLICANT NAME Adriana Castillo
ADDRESS 32105 Heather Lane Menifee, CA 92584
PHONE 951-301-4452 EMAIL info@castillohvac.net
CONTRACTOR'S NAME Aft Castillo OWNER BUILDER? YES 0 NO
BUSINESS NAME Castillo Heating and Air Conditioning, Inc.
ADDRESS 32105 Heather Lane Menifee, CA 92584
PHONE 951-301-4452 EMAIL info@castillohvac.net
CONTRACTOR'S STATE LIC NUMBER 548323 LICENSE CLASSIFICATION C20
VALUATION$ 6,975 SO FT 1,701 L SQ FT 6,790
7
APPLICANT'S SIGNATURE 464'� DATE 6/24/2015
CITYSTAFF USE ONLY ��WIII
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT %'CASH %CHECK <%CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH CHECK It C%CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED C1 YES C;. NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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