PMT16-02715 City of Menifee Permit No.: PMT16-02715
29714 HAUN RD. Type: Residential Mechanical
<A—CCELA? MENIFEE, CA 92586
MENIFEE Date Issued: 0812512016
P E R M I T
Site Address: 29771 AVIDA DR, MENIFEE, CA 92584 Parcel Number: 339-284-004
Construction Cost: $6,600.00
Existing Use: Proposed Use:
Description of REPLACEMENT OF EXISTING HVAC SYSTEM W/NEW 5 TON 14 SEER HVAC SYSTEM
Work:
Owner Contractor
JOHN VAN CASTILLO HEATING&AIR CONDITIONING INC
29771 AVIDA DR 32105 HEATHER LANE
MENIFEE, CA 92584 MENIFEE,CA 92584
Applicant Phone:9513014452
MARGARITA CASTILLO License Number., 548323
CASTILLO HEATING&AIR CONDITIONING INC
32105 HEATHER LANE
MENIFEE, CA 92584
Fee Description Ply Amount($
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
Air Handling/Condensing Units SFR 1 133.00
Building Permit Issuance 27.00
GREEN FEE 1.00
General Plan Maintenance Fee-Mechanical 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 Meriffee.Except as otherwise stated,a permit for construction under which no work is commenced vothin 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
City Of Menifee
LICENSrD DrCLARATION
I hereby affirm under penalty or peritury that I 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 Proiessions
Professions Cod y license is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a property
License Chsss7 oy License No. 4 who builds or improves thereon, and who contracts for the projects with a
Expire Signatut 'If/ licensed contractor(s)pursuant to the Contractors State License Law).
rq(—Tl 416
k �
WORI EATION
ON DELRATION
0 lam exempt from ficensure under the Contractors'State License Law for the
0 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-insu for workers' By my signature below I acknowledge the(,except for my personal re'sidence 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 mrk for which this
permit is issued. improvements covered by this permit, I cannot legally sell a structure that I have
Policy# built as an owner-building 0 It has not been constructed in its entirely by licensed
contractors. I understand that a copy of the appli�ble 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 Gode, for the performance of the work for which this submitted or at the following Web site:hftDjA5twwleginfo.co.ciov/calaw.htmI
permit is Issued.My workers'compenmhon insurance mrfler and policy number are:
Carrier SCY-F 17rape ffity-Umn—er—OF il onzed�gent Date
Explrea_E��Policy# 001985. 6
Name ofAgent-1-affiLS 1016A�Qp Phone# 951 6 0 By my Signature below, I certify to each of the following: I am the property
owner or authorized to act on the property owner's behalf. I have read this
(This section need Lot 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 repres if.
8 saves ofAl'!SAty or county to enter the above-
0 1 certify that in the performance of the work for which this permit is Issued,I idenfififid propi n7ecbon ou
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
Code,I shall forthwith comply with those provisions. Pro0z"Cowner or Authorized Agent Date
ine.,
Date; Applicant; city mess License# 00 S 710
I WARNING- FAILURE TO ECURE WORKERS,
HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS NLAWFUL, AND S641ALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FiNIE3 UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000), IN ADDITION TO THE COST OF COMPENSATION
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THi DYES OCCUPANT HANDLEA HAZARDOUS MATERIAL ORA
LABOR CODIE, INTEREST,AND ATTORNEYS FEES MIXTURE CONTAINING A HAZARDOUS MATERIAL
CONSTRUCTION LENDING AarNCY Y140 EQUAL TO OR GREATER THAN THE AMOUNTS
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
3097 Civil Code) WILL THE INTENDED USE OF THE BUILDING BY THE
Lender's Name APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
EIYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address iff<O DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
OWNER BUILDEEt OECLARAIJONS GUIDE LINES
I haroby affirim under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
Ucense Law for the reason(s)Indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s)(Section 7031.5.Business and Professions Code:
'Arry city or county that requires a permit to construct,after,Improve,demolish, BE WITHIN 1000 FEET OF THE OUTER BOUNI)ARY OF A
or repair any structure, prior to its Issuance. also requires the applicant for the SCHOOL?
permit to Die a signed statement that he or she is licensed pursuant to the
provisions of the Contractor's State U�nsia Law(Chapter 9(commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 70150)of Division 3 of the Business and Professions Code)or that he or VKES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from limnsure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS
violation or Section 7031.5 by any Applicant for a permit subjects the applicant to El NO UNDER THE STATE OF CAUFORNIA HEALTH AND SAFETY
N 5
a civil penalty of not more than($500).) CODE SECTIOTE�V5033 AN C NCERNING
.R
. 1 Ep N
0 1. as owner of [he property. or my employees with wages as their =is HAZARDOUS MA EP iWGIN
compensation,will do ail of or porting of the work and the structure is PRC A
TJ
not Intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property
who. through employees' or personal effort. builds or Improves the property,
provided that the improvements am not intended or offered for sale.If,however,
the building or Improvement Is sold Within one year of completion,the Owner-
Builder will have the burden of proving that It was not built or Improved for the
purpose of sale).
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: 0 COMMERCIAL VRESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: OADDITION VALTERATION ODEMOLITION CELECTRICAL IVIMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES-
DESCRIPTION OF WORK replacement of existing HVAC system with new 5 ton 14 SEER HVAC system
PROJECTADDRESs 29771 Avida Dr. Menifee, CA 92584
ASSESSOR'S PARCEL NUMBER �32,RX4" LOT Q(P TRACT 4--7
OWNER NAME John Van
ADDRESS 29771 AvIda Dr. Menifee, CA 92584
City Of Menifee
PHONE 951-264-9383 EMAIL Suildinq & qqjo,p.,t
APPLICANTNAME AUG
ADDRESS 32105 Heather Lane Menifee,CA 92584
PHONE 951-301-4452 EMAIL info@castillohvac.net Received
CONTRAcTOR'S NAME ArtCastillo OWNER BUILDER? 0 YES ONO
BUSINESS NAME Castillo Heating and Air Conditioning, Inc.
ADDRESS 32105 Heather Lane Menifee, CA 92584
PHONE 951-301-4452 EMAIL info@castillohvac.net
CONTRACTOR'S STATE LIC NUMBER 548323 LICENSE CLASSIFICATION C20
VALUATION$ 6,600 SO FT 1597 L SQ FT 7,405
APPLICaNT'S SIGNATURE DATE 8/18/2016
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION "'Ty Of MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE I PAIDAMOUNT
AMOUNT I I OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT I 1 0 CASH 0 CHECX# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO OIL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
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