PMT16-04266 City of Menifee Permit No.: PMT16-04266
29714 HAUN RD. Type: Residential Mechanical
<A—CCEL:A-> MENIFEE, CA 92586
MENIFEE Date Issued: 12/2112016
P E R M I T
Site Address: 28060 LEMONWOOD DR,MENIFEE,CA Parcel Number: 340-064-013
92584 Construction Cost: $12,000.00
Existing Use: Proposed Use;
Description of REPLACE 3 TON A/C IN BACK YARD, COIL,45,000 BTU FURNACE IN ATTIC AND DUCTS
Work:
Owner Contractor
GERALD BERGENER TOTAL COMFORT INC
28060 LEMONWOOD DR 390 E HARRISON STREET
MENIFEE, CA 92584 CORONA, CA 92879
Applicant Phone: 9517352574
STEVEN SCHNIERER License Number: 935238
TOTAL COMFORT INC
390 E HARRISON STREET
CORONA, CA 92879
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 effors 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.
A&_Bldg_Pennft-Ten1plate.rpt Page I of 1
CITY OF MENIFEE
LICENSED DECLARATION propertywho builds orimprom thereon,andwho contracts fortheprojects
I hereby affmin under penal"f pedury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State theme Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and a I am exam pt from Acensure under the Contractors State License Law for
Professions Code and my license Is in full force and effect. the following mason:
License Class C:��L_D License No. 9��-S 9.c: By my signature below I acknowledge that,except for my personal residence
Expires 31'S I I I PS.Signature '::7 In which I must haw resided for at least one year prior 10 completion Of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builderifit has not been constructed in Its entirely by
o I hereby affirm under penalty of pedury one of the following deciaratham:I licensed contractors.I understand that 2 copy of The applicable law,Section
have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon request when
compensation,issued by the Director OF Industrial Relations as provided for this application is submitted or at the following welishis
by Section 3700 of the Labor Code,for the performance of work for which www.leginlo.m.eoy/calaw.himl.
this permit Is issued.
Policy# PROPERTY OWNER OR AUTHORIZED AGENT Date—
',t(have and will maintain workees comperisation insurance,as required by my sfipia lure below I certify to each of the following.,I am the property
section 3700 of the Labor Code,for the performance oFthe work for which A
this permit Is issued.My worker's compensation Insurance carder and policy owner or authorized to act on the property owner's behalf.I have read this
numberare: application and the information I have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this chycircounlYto
policy u Ar Expires enter the above identified property for Inspection purposes.
(This section need not to be completed Is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit is Issued,
Ishatinotemol any persons In anymannerso asto becomesubjecttothe CITY BUSINESS LICENSE 9 C>_!5 —C14
worker's compensation laws of California,and agree that if I should became HAZARDOUS MATERIAL DECLARATION
subject to the worker�s compensation provisions of Section 3700 of the Labor
Code,I shall fordiwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous oultzdal equal to or greater that the
amounts 19ecified on the Hazardous Materials Information Eakin?
Applicant_ ZZ-7, Date 11L.
AARNING-FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 0 Yes—AIND
UNLAWFUL,AN D SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL71ES will the Intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($10,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Ar Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTERESTi AND ATTORNEYS FEES forgind U at
CONSTRUCTION LENDING AGENCY ,yes
I hereby affirm that under the penalty of perjury there Is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is Issu ad outer bou5dary of a school?
(Section 3097 Civil Code) a Yes 45P�o
OWNER BUILDER DECLARATIONS I haw read the Hazardous Material Information Guide and the SCAOMO
perm Itting checklist I understand my requirements under the State of
I hereby a from under pena Ity of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)Indicated below by the rd us material reporting.
checkm2rk(s)I have placed nut to the applicable item(s)(Section 7032-S
Business and Professions Code).Any city or county that requires a permit to Date TJISJI(�
construct,after,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT
issuance,a[so requires the applicant for the permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Coritmetor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI
License Law(Chapter 9(commencing with Section 700D)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)A ale requilres contractors
Business and Profassions Code)or that he or she Is exempt from ricensum raceiviing compensation for most work that disturbs paint In a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RIP-certified firm and complywilth
a n Applicant for a permit subjects the applica nt to a civil penalty of not mote required practices.This includes rerataf property Owners and property
than($500). managers who do the palm-dIsturbing work themselvaor throughtheir
a 1,as owner of the property,or my employee with wages as their sale employces.For more informattion about EPKs Renovation Program visit:
compensation,Y411 do( )211 of or J I portion of the work,and the structure Is ..epa.goullead or contact the National Lead Informalion Center at
not intended or offered forsale.(Section 7044,sushims and Professions 1-800424-LEAD(5323).
Code;The Contractor's State Ucense Law dam not apply to an owner of a a An EPA Lead-Safe Certified Reinavatar will be responsible for this project
property who,through employeesor persona I effort builds or improws the
property provided that the improvements am not intended or offered for Certified Firm Name:
sale.if,however,the building or Improvement Is sold within one year of Firm Certification No.:
completion,the Owner-BuIlder will have the burden of proving that it was o No EPA Lead-Safe Certified Firm is required for this project bemuse:
not built or improved for the purpose of sale.
ci 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and limlassions
Code:The Ccintractoes State License Law dam nut apply to an owner of a if your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 12/21/2016 PERMIT/PLAN CHECK NUMBER 15)
TYPE: F-1 COMMERCIAL [Z]RESIDENTIAL [:]MULTI-FAMILY [:1 MOBILE HOME POOL/SPA SIGN
SUBTYPE: F]ADDITION []ALTERATION [-]DEMOUTION []ELECTRICAL [ZIMECHANICAL
ONEW [-]PLUMBING F1 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace 3 ton A/C in back yard,coil,45,000 btu furnace in attic,and 10 ducts
PROJECTADDRESS 280601-emonwood Drive
ASSESSOR'S PARCEL NUMBER 340-064-013 LOT 239 TRACT 22131
OWNER NAME Bergener,Gerald
ADDRE,, 28060 Lemonwood Drive Menifee, CA 92584
PHONE (951)246-7928 EMAIL
APPLICANT NAME Steven Schnierer
ADDRESS 31225 La Baya Drive Suite 112 Westlake Village,CA 91362
PHONE (818)735-7876 EMAIL swschnierer@roadrunner.com
CONTRACTOWS NAME Total Comfort Inc. OWNERBUILDER? [-]YES[ZNO
BUSINESSNAME Total Comfort Inc.
ADDRESS 390 E Harrison Street Corona,CA 92879
PHONE (844)824-4247 EMAIL
CONTRACTOR'S STATE LIC NUMBER 935238 LICENSE CLASSIFICATION C20
VALUATION$ $ 12.000.00 SO FT 1,299 L SQ FT 4,791
1 APPLICANTS SIGNATURE DATE 12/21/2016
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION C TY OF MENIFEE BUSINESS LICENSE NUMStR
BUILDING PLANNING ENGINEERING FIRE � GREEN SMIP
INVOICE PAIDAMOUNT
AMOUNT I I OCASH OCHECK# OCREDITCARD VISAIMC
PLAN CHECK FEES PAIDAMOUNT I I C)CASH C)CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES C NO DIL NUMBER NOTARIZED LETTER 0 YES 0- NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmemfee.us Inspection Request Line 951-246-6213
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