PMT16-00389 City of Menifee Permit No.: PMT16-00389
29714 HAUN RD.
-1X6CF1/? MENIFEE,CA 92586 Type: Residential Mechanical
"1_119"""'° MENIFEE Date Issued:
02/16/2016
PERMIT
Site Address: 26540 MEHAFFEY ST, MENIFEE, CA Parcel Number: 335-281-008
92586 Construction Cost: $6,600.00
Existing Use: Proposed Use:
Description of REPLACE 3 TON PACKAGE UNIT ON ROOF
Work:
Owner Contractor
DAN PUSZERT AIR FORCE ONE HEATING AND AIR INC
26540 MEHAFFEY ST 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 Qtv Amount ISI
Forced-Air or Gravity-Type Fumace or Burner 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_BIdg_Permit_Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION
I hereby affimr under penalty or perjury that l 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 Coda and my license Is In full farce and effect. Code:The Contractor's License Law does not apply to an owner of a property
Ucense Class C2a License No. ITS59Sz, who builds or improves thereon,and who contracts for the pmJeclo with a
Expires _6 Signature � licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
D 1 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 far 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. coveredbuilt as an owner-building If it has not been constructed in Its entirely by licensed
Policycy# 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:htto�/hvww.leainro.ca govkalaw htmi.
permit is issued.My workers compensation insurance order and policy manner are: '
Property Omer or Authorized gent
carderR�u61zL' Uvvde2lA.Yf'�P�CS Date
Expires to 130 Policy#-aT1x coo 9 "X5
Name ofAgent Phone# Ay my Signature below, I certify to each of the following:I am the'properfy
owner or authorized to act on the property owner's behalf. I have read this
(This section need Og1 be completed if the permit Is for application and the Irdormation I have provided is cored. 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 representatives of this city or county to enter the above-
❑ 1 certify that in the performance of the work for which this permit is Issued,I identified property for the Inspection purposes.
shall not employ any persons In any manner so as to become subject to the _
workers'compensation laws of California,and agree that If I should become
subject to the workers'compensation provisions of Section 3700 of the Labor Pro Owner orAutharized ant
Code,I shall forthwith,comply with those provisions. Property A9 Date
City Business License# 039542
Date; Z W tU Applicant;
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, DYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE,INTEREST,AND ATTORNEYS FEES JO 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 WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address „(„O FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
✓6"' 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 PRINTNAME: 'P>.r� Sc�tviterel
License Law for the reason(s)indicated below by the checkmarKs)I have placed AYES WILL THE 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, 0 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(mmmencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of DMslon 3 of the Business and Professions Code)or that he or INFORMATION GUIDE AND THE SCAOMD PERMITTING
she is exempt from ficensure and the basis for the alleged exemption.Any CHECKLIST. f 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
DOUS ON 255505ERIAL 1�E5533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole
compensation,will do( )all of or( )porting of the work,and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended proffered for sale.(Section 7044,Business and Professions Code; ��� •.
The Contractors 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,
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).
: , MIIIs 01t
Menifee
DATE 02/16/2016 PERMIT/PLAN CHECK NUMBER WWI
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 3ton Package Unit On Roof Building & Safety Dept.
FEB 16 2016
PROJECTADDRESS 26540 Mahaffey Street �p t'
ASSESSOR'S PARCEL NUMBER '� _agl,oo4d LOT (g5:5 TRACT
OWNER NAME Dan Puszert
ADDRESS 26540 Mahaffey Street Sun City,CA 92586
PHONE (949)295-2069 EMAIL
APPLICANT NAME Steven Schnierer
ADDRESS 31225 La Baya Drive Suite 112 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 $ $6,600.00 SOFT LSQFT
APPLICANT'S SIGNATURE DATE 02/16/2016
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING NGINEERING FIRE I GREEN I SMIP
INVOICE /J PAIDAMOUNT
AMOUNT �J 0CASH 0CHECK# 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK H OCREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92585 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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