PMT16-03070 City of Menifee Permit No. PMT16-03070
29714 HAUN RD. Type: Residential Mechanical
<A-CCELA-> MENIFEE, CA92586
MENIFEE Date Issued: 0912012016
P E R M I T
Site Address: 30431 TEAL BROOK DR,MENIFEE, CA Parcel Number: 364-154-013
92584 Construction Cost: $15,400.00
Existing Use: Proposed Use:
Description of REPLACEMENT OF EXISTING HEATING&AIR CONDITIONING SYSTEM V\nTH NEW 3 TON SPLIT,
Work: UPFLOW CENTRAL HVAC,20 SEER
Owner Contractor
ERMA JUNE HOUGHTELIN CASTILLO HEATING&AIR CONDITIONING INC
30431 TEAL BROOK 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 Qtv Amount
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 emors in the plans and
specifications or from preventing buillding 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_Permit-Template.rpt Page 1 of 1
City Of Menifee
L]CrNSrD DrECLARATION
I hereby affirm under penalty or perjury that I am licensed under provisions of 0 1. as owner of the property an exclusively contracting with Icensed
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 Ucense Law does not apply to an owner of a property
License Class ry 20 License No. 4 who builds or improves thereon. and who contracts for the projects with a
:�O/fi.Signatura*11,r licensed contracton(s)pursuant to the Contractors State License Law).
Expires
F--T,w
WORKERS'COMPI RATION
0 1 am exempt from licensure under the Contractors'State License Law for the
11 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 that,except for my personal re'sidence,in
compensation.issued by the Director of Indusbial Relations as provided for by which I must have resided for at least one year pftr to completion of
Section 3700 of the Labor Code, for the performance of work 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 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
;1-' 1 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 Me performance of the work for which this submitted or at the following Web site:httD7/AmwN.loginfo.m.gQykglaw.html.
permit Is Issued-My workers'compensation insurance carrier and policy number are:
Carrier C,-F E Property Owner or Authorized Agent Date
Expiras-1 policy# 002-9656
Name of Agenj rames Q-Af6QQ Phone# 9.6 1_1_ 0 By my Signature below, I certify to each of the following:I am the property
owner or authorizsd to act an the property owner's behalf. I have read this
(This section need fLat be completed If the permit Is for application and the information I have provided is correct. I agree to comply
ona-hundred dollars(Sl 00)or less) with all applicable city and county ordinances and state lam relating'to building
construction.I authorize ralprasariG-Wes ofPhis " or county to enter the above.
0 1 certify that In the Performance of the work for which this permit is issue identified proper in ction p'u
shall not emplo 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'compansation provislons of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Prop(e Agent Date
C =erorAuit-horlzed
ness
Date; Appllcint;2�u( mass Ucense# 6 0 S 7 10
WARNING, FAILURE TO'��EWCURE� WORKERS'
N
N F:U
COMPENSATION COVERAGE IS LAWFUL, AND SHALL HAZARDOUS MATERIAL 13ECLARATION
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 ORA
DAMAGES AS PR0%ADFID FOR IN SECTION 3706 OF THE 4 MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE,INTEREST,AND ATTORNEYS FEES n, 0 EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGrNC SPECIFIED ON THE HAZARDOUS MATERIALS
I hereby affirm that under the penalty of perjury there is a construction tending 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
APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address k<O DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
I hereby aMrm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
License 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: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
-Any city or county th2t requires a permit to construct,sitar, Improve,demolish, 13<0 SCHOOL?
or repair any structure,prior to it3 issuance, also r-quIres 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(Ch2ptef 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or ZES 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 ONO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE SECTION -aCONCERNING
11 1. as owner of the property or my employees with wages as their sole H�KiMDOUS MATER515". EPC3RT'IAN,Cl-W
compensation,will do all of or porting of the work,and the structure is PROP7,RTY VNEt"A7U��Aff-ff'/
not Intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractces State License Law does not apply to an owner of a property X /112ZEW
who, through employees' or personal effort, builds or improves the property; Ll
provided that the improvements are not intended or offered for sale.If,however,
the building or Improvement is sold within one year of completion, the Owner-
Builder will have the burden of Proving that it was not built or improved for the
purpose of sale).
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
M e n i f e e
DATE 9-15-16 PERMIT/PLAN CHECK NUMBEREPITho- 030-70
TYPE: OCOMMERCIAL 3? RESIDENTIAL OMULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN
SUBTYPE: OADDITION XALTERATION ODEMOLITION OELECTRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-N UMBER OF SQUARES—
DESCRIPTION OF WORK Replacement of existing heating and air conditioning system with new 3 ton split
upflow central heating and air conditioning system rated at 20 SEER.
PROJECTADDRESS j()4qjTpqIFIrnnkr)rmvpMp mfp
(,A q F;A
9 4
ASSESSOR'S PARCEL NUMBER LOT Jk04 TRACT 140-3
OWNER NAME Erma June Houahtelin ni Menifee
Building & Safety Depi
ADDRESS 'AQ4q1 Teni Brook Dravp Mpn'fpe CA 92984
PHONE 998-587-1,lil 9 EMAIL 'unbuc160citlink.net SEP 2 0 2016
APPLICANTNAME Castillo Heating and Air Conditioning, Inc. Recoive(--,
ADDRESS 32105 Heather Lane Menifee, CA 92584
PHONE 951-301-4452 EMAIL info@caStillohvac.net
CONTRACTOR'S NAME Art Castillo OWNER BUILDER? 0 YES ONO
BUSINESS NAME Castillo Heating and Air Conditioning, Inc.
ADDRESS 32105 Heather Lane Menifee, CA 92584
PHONE 951-301-4452 EMAIL info@castillohvac.net
CONTRACTOR'S STATE LIC NUMBER 548323 LICENSE CLASSIFICATION C20
VALUATION$ $15,400 SQ FT 1030 LSQFT
APPLICANT'SSIGNA URE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN � log SMIP
INVOICE I 10 1
[A N PAID AMOUNT OCASH OCHECK# OCREDITCARD VISA/M
MOU T PAID AMOUNT
P N CHE FEES OCASH OCHECK# OCREDITCARD VISA/MC
OW U1 V
ENER B LDER ERIFIED 0 YES 0 NO DLNUMBER NOTARIZEDLETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.citvofmenifee.us Inspection Request Line 951-246-6213
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