PMT16-02055 City of Menifee Permit No.: PMT16-02055
29714 HAUN RD. Type: Residential Mechanical
<''ACCEL/> MENIFEE, CA 92586
MENIFEE Date Issued: 07/05/2016
PERMIT
Site Address: 28268 SUMMITROSE DR,MENIFEE, CA Parcel Number: 340-390-020
92584 Construction Cost: $6,400.00
Existing Use: Proposed Use:
Description of REPLACEMENT OF EXISTING HVAC SYSTEM W/NEW 4 TON HVAC SYSTEM
Work:
Owner Contractor
LEE CHEN CASTILLO HEATING&AIR CONDITIONING INC
28268 SUMMITROSE DR 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 QQt r Amount(SI
Forced-Air or Gravity-Type Furnace 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
$324.10
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA_Bldg_Permil_Template.rpt Page 1 of 1
BUILDING & SAFETY PERMIT/.PERMIT/PLAN CHECK APPLICATION
"I"'Menifee
DATE PERMIT/PLAN CHECK NUMBER r ` OX155
TYPE: O COMMERCIAL VRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION VALTERATION O DEMOLITION O ELECTRICAL VIMECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK replacement of existing HVAC system with new 4 ton HVAC system
PROJECT ADDRESS 28268 SUMMotroSe pr. Menifee. CA 92584
ASSESSOR'S PARCEL NUMBER �5 LOT TRACT
OWNER NAME Lee Chen
ADDRESS 28268 Summitrose Dr. Menifee, CA 92584
PHONE 951-246-4168 EMAIL fen1468@yahoo.com
APPLICANT NAME Adriana Castillo
ADDRESS 32105 Heather Lane Menifee, CA 92584
PHONE 951-301-4452 EMAIL info@castillohvac.net
CONTRACTOR'S NAME Art Castillo OWNER BUILDER? O YES ONO
BUSINESS NAME Castillo Heating and Air Conditioning, Inc.
ADDRESS 32105 Heather Lane Menifee, CA 92584
PHONE 951-301-4452 EMAIL info@castillohvac.net
CONTRACTOR'S STATE LIC NUMBER 548323 LICENSE CLASSIFICATION C20
VALUATION$ 6,400 S 2,121 LSQFT 7,000
APPLICANT'S SIGNATURE DATE 6/29/2016
OTY STAFF USE e v
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN 1 SMIP
INVOICE �� .1• PAID AMOUNT
AMOUNT O CASH OCHECK lY OCREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZEDLETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
City Of Menifee
LICENSED DECLARATION
I hereby atflrm 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 20 License No. who builds or Improves thereon, and who contracts for the projects with a
Exp(re5 f`7 !�Q111 Signatu /. (: licensed contractor(s)pursuant to the Contractors State License Law).
// ''1
WORKERS'COMPENSATION DECLARATION
❑ 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 for by which I must have resided for et least one year prior to completion of
Section 3ssu of the Labor Code, for the performance of work for which this improvements covered b this permit, I cannot legally sell a structure that I have
permit is issued. P Y P 9 Y
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:htto:/Avww.leginfo.ca.aovlcelaw html.
permit is Issued.My workers compensation insurance carrier and policy number are:
Carrier SC.TF Property Omer or Authorized Agent Dale
Expires 10/01/2016 1 Policy# oo 29 (0 65
Name of Agent.j i�ff)P$. . i„k011 Phone# -I$(Z b 5:'4'A A�j ❑ By my Signature below, I certify to each of the following: I am the properly
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
construction.I authorize repre a of is ty or county to enter the above-
❑ '1 certify that in the performance of the work for which this permit is Issued,I identified propeert�farr��aa in action pu s
shall not employ any persons to any manner so as to become subject to the //1.2^ !
workers'compensation laws of California,and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the Labor Prorfe t er or Authorized Agent Date
Code,I shall forthwith comply with those provisions. r/ty�O
Date; Applicant; City Bb Iness License# d 0 8 720
WARNING: FAILURE TO ECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS 14NLAWFUL, 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 HAZARDOUS MATERIAL ORA
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 WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Coda) 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 affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reason(s)Indicated below by the chackmark(s)I have placed OYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable items)(Section 7031.5. Business and Professions Code: /O
'Any city or county that requires a permit to construct, alter, improve,demolish, 10 IN 1000 FEET OF THE OUTER BOUNDARY OF A
BE BE WITHIN
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 � I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or V?ES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she Is exempt from Iicensure 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 GANC NCERNING
❑ I, as owner of the ro HAZARDOUS MATER EP.R'Tp party, or my employees with wages as their sole
compensation,will do( )all of or( )porting of the work,and the structure is PROP R WNE AlY
not Intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's Slate 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).
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