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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. 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