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PMT15-02927 I I City of Menifee Permit No.: PMT16-02927 _ 29714 HAUN RD. �LIk MENIFEE, CA 92586 Type: Residential Mechanical MENIFEE Date Issued: 09/24/2015 i PERMIT i Site Address: 31755 COUNTRY HAVEN LN, MENIFEE, Parcel Number: 360-200-011 CA 92584 Construction Cost: $5,500.00 " Existing Use: Proposed Use: Description of REPLACEMENT OF EXISTING HVAC SYSTEM W/NEW 3.5 TON 13 SEER HVAC SYSTEM Work: Owner Contractor JULIE HUNT CASTILLO HEATING&AIR CONDITIONING INC 31755 COUNTRY HAVEN LN 32105 HEATHER LANE MENIFEE, CA 92584 MENIFEE, CA 92584 Applicant Phone: 9513014452 BRENDA ROJAS License Number: 548323 CASTILLO HEATING&AIR CONDITIONING INC 32105 HEATHER LANE MENIFEE, CA 92584 Fee Description QQrt Amount lip ill Air Handling/Condensing Units SFR 1 133.00 B f GREEN FEE 1 1.00 - Gel- $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 i City Of Men°tfee LICENSED pECLARATION I hereby affirm under penalty or perjury,that 1 am licensed under provisions of ❑ 1, 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 Cads 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,ttr21 "License No. who builds or improves thereon, and who contracts for the projects with a Explrei;12L4,84 Signatur=DEC� C licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATIFRAT'10 `� '. ❑ lam 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 which I must have resided for at least one year prior to completion of Section 9 of the Labor Code, for the performance of work for which this improvements covered by this permit,I cannot legally sell a structure that I have permit is Issued. built as an owner-bulidin If it has not been constructed in its entire b licensed Policy# g entirety Y ---- -- -- -- - ----- —- --- contractors. 1 understand that a copy of the applicable law, Section 7044 of the ;a" 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:httaglyAvw leginfo ca gov/calew html. permit is Issued.My workers'compensation insurance carder and policy number are: Carrier G C rE Property Owner or Authorized Agent Date Expires 10 / 0 2 o Is Policy k..p1'7 29 5_56 __ g r 0t ❑ By my Signature below, I certify to each of the following: I am the property Name ofA ant Ones YIr15f)rl Phone# Q5( '9", owner or authorized to act on the property owner's 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 constructlon.1 authorize rep] tiN f his Ity,or county enter the above- ❑ '1 certify that in the performance of the work for which this permit is issued,I Identified propen fio in action ! shall not emolov 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 ( ,,. `/ 2 9'/21/1 5 subject to the workers'compensation provisions of Section 3700 of the Labor Prq a oar oprizad Agent Coda,1 shall forthwith comply with those provisions. 9 Data Data; 9/21/15 Applicant; n City B ness Liconse#_ 0 09790 WARNING FAILURE TO ECURE WORKERS' HAZARDOUS 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, AYES 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,IHQW 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 WILL THE INTENDED USE OF THE BUILDING BY THE Lender's Civil Cads) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE der's Name_ OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address ®, FROM THE SOUTH COAST AIR QUALITY MANAGEMENT O DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR OWNER BUILDER DECLARA -hM GUIDE LINES I hereby affirm under penatyy 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 EYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable item(s)(Section 7031.5.Business and Professions Code: „ ,�^0 BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A "Any city or county that requires a permit to construct,alter, improve,demolish, 4t7"N BE WITH? or repair any structure, prior to ds 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 049 INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from liaensum and the basis for the alleged exemption. Any CHECKLIST. 1 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($600).) CODE, SECTION 2550 33GNC��NCERNJNG ❑ I, as owner of the roe employees g HAZARDOUS MATER I I E ORTp p rty or my era to ass with wa es as 4heir sole �Acompensation,will do( )all of of ( )parting of the work,and the structure is PROP RTY� WNEF3+Q�Aimnot Intended or offorad for sate.(Section 7044,Business and Professions Code; /The Contractor's State License Law does not apply to an owner of a property X who, through employees'or personal effort, builds or improves the property, provided that the improvements are not Intended or offered for sale.If,however, J the building or Improvement Is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or Improved for the - purpose of sale). BUILDING & SAFETY • APPLICATION n Menifee ^ DATE 9/21/15 PERMIT/PLAN CHECK NUMBER TYPE: () COMMERCIAL RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME O POOL/SPA 0 SIGN { SUBTYPE: O ADDITION O ALTERATION C%DEMOLITION O ELECTRICAL . MECHANICAL O NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Re (cement of existing HVAC system with new 3.5 ton 13 See HVAC system. PROJECTADDRESS 31755 Country Haven Ln. Menifee, CA 92584 City Of MenifeE ASSESSOR'S PARCEL NUMBER ��� '�00'�1 I LOT � TRACT Building & Safety E ept. OWNERNAME Julie Hunt SEP 2 4 201 ADDRESS 31755 Country Haven Ln. Menifee, CA 92584 T . PHONE 951-315-6447 EMAIL APPLICANT NAME Brenda Rojas ADDRESS 32105 Heather Lane Menifee, CA 92584 PHONE 951-301-4452 EMAIL info@castillohvac.net CONTRACTOR'S NAME Art Castillo OWNER BUILDER? 0 YES "NO BUSINESS NAME Castillo Heating and Air Conditioning, Inc. ADDRESS 32105 Heather Lane Menifee, CA 92584 PHONE 951-301-4452 EMAIL info@castillohvac.net CONTRACTOR'S STATE LIC NUMBER 548323 LICENSE CLASSIFICATION C20 VALUATION$ 5,500.00 SC,FT 3482 L SQ FT APPLICANT'S SIGNATURE Brenda Rojas - ^° DATE 9/21/15 OTYSTAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I to SMIP INVOICE 1� 'O PAID AMOUNT AMOUNT J O CASH u'CHECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED G YES C NO DL NUMBER NOTARIZED LETTER 0 YES G NO City of Menifee Building&Safety Department 29714 Houn Rd. 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