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PMT16-04123 City of Menifee Permit No.: PMT16-04123 29714 HAUN RD. Type: Residential Mechanical <ACCELA—> MENIFEE, CA 92596 MENIFEE Date Issued: 1211512016, P E R M I T Site Address: 26509 LAZY CREEK RD, MENIFEE, CA Parcel Number: 338-110-009 92586 Construction Cost: $5,300.00 Existing Use: Proposed Use: Description of REPLACE EXISTING HVAC SYSTEM WINEW 2.5 TON 14 SEER SPLIT UP FLOW CENTRAL HVAC Work: Owner Contractor KEVIN MCCAUCHEY CASTILLO HEATING&AIR CONDITIONING INC 26509 LAZY CREEK RD 32105 HEATHER LANE MENIFEE,CA 92586 MENIFEE,CA 92584 Applicant Phone: 9513014452 MARGARITA CASTILLO License Number: 548323 CASTILLO HEATING&AIR CONDITIONING INC 32105 HEATHER LANE MENIFEE, CA 925134 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 errors In the plans and specificafions or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Manifee.Except as otherwise stated,a permit for construction under which no work is commenced Wthin six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shali be forfeited. AA.I3Idg_Perrnit—TernpIate.rpt Page 1 of I City Of Menifee LICENSED DECLARATION I hereby affirm under penalty or perjury that I am licensed under provisions of 13 1, as Owner of the property an exclusively contracting with licensed Chapter 9(ccmimencing 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 ICI 20 License No. 54 51-32� who builds or improves thereon, and who Contracts for the projects with a Expire 2 Siginstu.ttl, t.1i, licensed contractor(s)pursuant to the Contractors State License Law). (�1 45� WORKEPS'COMPENSATION DE&ARATION 0 1 am exempt from ficensurs 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 cerifficate of Consent of agif-Insure for workers' By my signature below I acknowledge that, except for my persoml reisidence,in compensation.issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code,for the performance of work for which this which I must have resided for at least one year prior to completion of permit I*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 cantractors. 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 Profew4ons Code,is available upon request when this application is section 3700 Of the Labor Code, for the P01107rance of the worh for which this submitted or at the following Web lifte:http,,/Avww.leoinfo.co.govia9w.htmI permit is Issued.My workers'compensation insurance carder and policy number are: Carrier C,T F property Owner or AuthorizecTAgent 3ate Explres_ji��POICY# 002,9256 Name of Agent ul affl& -a�a�Qp Phone# q.517L6 Sl;.+jrq_ [:I By my Signature below, I ceritify 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 comact. I agree to comply one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building Of Is i or county to enter the above- construction.I authorize repr"kOes ty 0 1 cartify that in the performance of the work for which this permit is issued,I Identified pl:i� n7oeali ./ prupe7lb on pu rlo", shall not employ any persons In any manner so as to become subject to the P WOrk8rS*Compensation laws of California, and agree that 0 1 should become 77 12/15/16' subject to the workers'compensaflon provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions PMF(E dvner or Authorized Agent Date Date; 12/15/16 city 8"in s License# Q 0 9 72 Q Applicant;%�� WFUL, AND SHALL WARNING, FAILURE TO' ECURE WORK COMPENSATION COVERAGE IS HAZARDOUS MATERtAL DECLARATION SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CrVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING ($1011,000). IN ADDITION TO THE COST OF COMPENSATION, OYES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LA13OR CODE, INTEREST,AND ATTORNEYS FEES ffglo� EQUAL TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDING AGENC SPECIFIED ON THE HAZARDOUS MATERIALS I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE? agency for the perfo"2nce of the work which this perrinit is issued(Section 3097 Civil Code) WILL THE INTENDED USE OF THE BUILDING BY THE Lender's Name APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION FROM THE SOUTH COAST AIR QUALRY MANAGEMENT Lender's Address k<O DISMCT(SCACMD)SEE PERMITTING CHECKLIST FOR QWNER BUILDER DECLARATION GUIDE LINES I hereby offirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME: License Law for the reasorl 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: 'Any city or county that requires a permit to construct,alter, improve, demolish, hB<O BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A or repair any structure, prior to its issuance, also requires the applicant for the SCHOOL? permit to file a signed statement that he or she is licensed pursuant to the previsions 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 WES INFORMATION GUIDE AND T14E 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($500).) CODE SECTION 2&90 5 AN C;NCERN ING r5 R, NJ RkDg"411OUS MATER Eli kyl 1. as owner of the property, or my employees with wages as their sole 'GN compensation,will do( )all of or( )porting of the work and the structure is PROPPF TYPN not Intended or offered for sale.(Section 7044,Business and Professions Code; The Contractors State License Law does not apply to an owner of a property X / who, through employees' or personal effort. builds or improvas the property provided that the improvements are not intended or offered for sets.If,however, the building or Improvement Is sold within one year of completion,the Owner- Builder will have the burden of proving that It was not built or improved for the purpose of sale). BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE 12/15/16 PERMIT/PLAN CHECK NUMBERF (,�w 0 TYPE: OCOMMERCIAL VRESIDENTIAL 0MULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN SUBTYPE: OADDITION VALTERATION ODEMOLITION 0ELEcTRICAL VIVECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES— DESCRIPTION OF WORK Replacement of existing heating and air conditioning equipment with new 2.5 ton 14 seer split up flow central heating and air conditioning system. PROJECTADDRESS 26509 Lazy Creek Rd,Sun City,CA 92586 ASSESSOR'S PARCEL NUMBER 0---OM— LOT (C= 0 TRACT 0 OWNER NAME Kevin McCauchey ADDRESS 26509 Lazy Creek Rd,Sun City,CA 92586 PHONE 951-757-6667 Kevin EMAIL APPLICANTNAME Brenda Rojas ADDRESS 32105 Heather Lane Menifee, CA 92584 PHONE 951-301-4452 EMAIL info@castillohvac.net CONTRACTOR'S NAME An Castillo OWNERBUILDER? OYESONO BUSINESS NAME Castillo Heating and Air Conditioning, Inc. ADDRESS 32105 Heather Lane Menifee, CA 92584 PHONE 951-301-4452 EMAIL info@castillohvac.net CONTRACTOR'S STATE LIC NUMBER 548323 LICENSE CLASSIFICATION C20 VALUATION$ 5,300.00 SO FT 1024 L SQ FT 6,970 APPLICANT'S SIGNATURL--- etze,6& DATE 12/15/16 OTYSTAFFUSEONLY DEPARTMEN'T DISTRIBUTION C1 IY UF BUILDING PLANNING ENGINEERING FIRE � GREEN � 100 SMIPT INVOICE *b)o(f-10 PAIDAMOLINT AMOUNT 1 0 CASH 0 CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# OCREDITrARD VISA/MC LOWNER BUILDER VERII IED OYES 0 NO DLNUMBER NOTARIZEDLETTER 0 YES 0 NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofmenifee.us Inspection Request Line 951-246-6213 n co 0 0 0 0 0 c r) T > n > 1 ;7 m 27 In rl w M 0 M z - = , n 4 m 0 0 m mm 3 n 0 Z 0 cm 3 0 m CD< 0 0 < Z! 0 0 0 m m 3 0 :E IE cnv t 2. 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