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PMT15-03943
City of Menifee Permit No.: PMT15-03943 29714 HAUN RD. Type: Residential Mechanical <►CCEL/k� MENIFEE, CA 92586 MENIFEE Date Issued: 1 2/2 212 01 5 PERMIT Site Address: 28094 STILLWATER DR, MENIFEE, CA Parcel Number: 364-043-020 92584 Construction Cost: $7,900.00 Existing Use: Proposed Use: Description of REPLACE 3 TON A/C IN SIDE YARD&70,000 BTU FURNACE IN GARAGE Work: Owner Contractor RANDY ENGSTROM AIR FORCE ONE HEATING AND AIR INC 28094 STILLWATER DR 31566 RAILROAD CANYON ROAD MENIFEE,CA 92586 #682 Applicant Phone:9512440916 STEVEN SCHNIERER License Number:955952 AIR FORCE ONE HEATING AND AIR INC 31566 RAILROAD CANYON ROAD #682 CANYON LAKE, CA 92587 Fee Description City Amount(Sl Forced-Air or Gravity-Type Furnace or Bumer 1 149.00 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 14.10 $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_Permg_Template.rpt 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 Contractors License Law does not apply to an owner of a property License Class C7-0 License No. R�SZ who builds or improves thereon, and who contracts for the projects with a Expires 3131116 Signature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ I am exempt from licensure 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 3700 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. 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 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:hHo:lhw .leginfo.ca.aovlcalaw.html. permit is issued.My workers'compensation Insurance carder and policy number are: Carrier�op��`.�U-.Ae.nor;}zYS Property weer or Authorized Agent Date Expires 1O13'0I lb Policy# ATTLiansz.3(m By my Signature below, I certify to each of the fallowing: I am the property Name of agent Phone# 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 construclon.I authorize representatives of this city or county to enter the above- 0 1 certify that in the performance of the work for which this permit is issued,I identified property for the inspection purposes. shall not emolov any persons in any manner so as to become subject to the workers' compensation laws of California, and agree that If I should becomeTL subject to the workers'compensation provisions of Section 3700 of the Labor Property Owner or Authorized Agent Date Code,I shall forthwith comply with those provisions. r— City Business License# 0�554R Date; l Applicant; �>z� � WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS UNLAWFUL, 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, OYES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE '"�"� MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES 410 EQUAL TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDING AGENCY v SPECIFIED ON THE HAZARDOUS MATERIALS I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE? agency for the perromance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY THE 3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE Lender's Name OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address ,�1„ FROM THE SOUTH COAST AIR QUALITY MANAGEMENT ba"" DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR OWNER BUILDER DECLARATIONS GUIDE LINES I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME: SQ- '- n, Cc— �rT'PY License Law for the reason(s)indicated below by the checkmark(s)I have placed OYES WILLTHE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable item(s)(Section 7031.5.Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A Any city or county that requires a permit to construct,alter, improve, demolish, 00SCHOOL? 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 �..�Ce I HAVE READ THE HAZARDOUS MATERIAL Section 7000)of Division 3 of the Business and Professions Code)or that he or W'u 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL AEPORI ING. compensation,will do( )all of or( )porting of the work,and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractors State License Law does not apply to an owner of a property X �•wty who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved for the purpose.of sale). BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION - ;Menifee DATE 12/22/2015 PERMIT/PLAN CHECK NUMBER P 1" ► 114:5—to TYPE: [-]COMMERCIAL ❑✓ RESIDENTIAL MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION ❑ALTERATION [-]DEMOLITION ❑ELECTRICAL ❑✓ MECHANICAL ❑NEW []PLUMBING El RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Replace 3ton A/C In Side Yard&70,000 BTU Furnace In Garage PROJECTADDRESS 28094 Stillwater Drive //G� ASSESSOR'S PARCEL NUMBER ?'AA O L )104? LOT '5 I TRACT OWNER NAME Randy Engstrom ADDRESS 28094 Stillwater Drive PHONE (661)992-3924 EMAIL APPLICANT NAME Steven Schnierer ADDRESS 31225 La Baya Drive Suite 213 Westlake Village,CA 91362 PHONE (818)735-7876 EMAIL CONTRACTOR'S NAME Air Force One Heating&Air OWNER BUILDER? ❑YES❑/NO BUSINESS NAME Air Force One Heating&Air ADDRESS 31566 Railroad Canyon Road#682 Canyon Lake, CA 92587 PHONE (951)244-0916 EMAIL CONTRACTOR'S STATE LIC NUMBER 955952 LICENSE CLASSIFICATION C20 VALUATION$ $7,900.00 SQ FT L SO FT APPLICANT'S SIGNATURE DATE 12/22/2015 CITYSTAFFUSEONLY DEPARTMENT DISTRIBUTION 6 0 CITY OF MENIFEE BUSINESS UCENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE ' PAID AMOUNT O AMOUNT CASH OCHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED "YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Deportment 29714 Houn Rd. 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