PMT17-00713 City of Menifee Permit No.: PMT17-00713
29714 HAUN RD. Type: Residential Mechanical
�ACCELA1? MENIFEE,CA 92586
MENIFEE Date Issued: 03/08/2017
PERMIT
Site Address: 29095 PARADISE CANYON DR, Parcel Number: 340-200-M
MENIFEE,CA 92584 Construction Cost $6,350.00
Existing Use: Proposed Use:
Description of REPLACEMENT OF EXISTING HVAC EQUIPMENT W/NEW 3 TON SPLIT HORIZONTAL CENTRAL
Work: HEATING AND AIR CONDITIONING SYSTEM
Owner Contractor
TERRY ALMY CASTILLO HEATING&AIR CONDITIONING INC
29095 PARADISE CANYON DR 32105 HEATHER LANE
MENIFEE,CA 92584 MENIFEE, CA 92584
Applicant Phone:9513014452
ANNA ESPINOZA License Number.548323
CASTILLO HEATING&AIR CONDITIONING INC
32105 HEATHER LANE
MENIFEE,CA 92584
Fee Description QQrt Amount IS)
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 carded 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
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' City Of Menifee
LICENSED DECLARATION
hereby affirm 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 1-1 ZUcense No. FRATIO�l
/ who builds or improves ther°..on, and who contracts for the projects vrilh a
Explres!,�Ip� }1,�Signatu L/ licensed mnoactor(s)pursuant to the Contractors Stale License Law).
WORKERS'COMPENSATION DEC
❑ 1 am exempt from licensura under the Conhactors'Sate License Law for the
❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason:
1 have and will maintain a centricate of consent of self-insure for workers' By my signature below I acknowledge ftL except for my personal residence 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
permit is Issued.Section 3 of the Labor Coda, for the performance of work for which this improvements covered by this permit 1 cannot legally sell a structure that I have
P built as an owner-bull ing if it has not been constructed in its entirely by licensed
Policy# contractors.I understand that a copy of the applicable law,Section 7044 of the
SY 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 pedermance Of the work for Which this submitted or at the fallowing Web site:hUD,IP.wm.leqinfo.o.gov/palaw.himi,
permit Is Issued.My worker compensation insurance carder and policy number are:
Cartier G E Property Omeror Authorized Agent Date
Expires i 0 0 L O j 5 Policy# 0029 65(n
1 J ` ❑ By my Signature below, I certify to each of the following:I am the property
{ Name of Agent„r.fY1 PJ �0�/t:Cl1 Phone Q$)L fo.s'�'9'•�-� owner or authorized to act on the property owner's behalf. I have mad this
( (This section need not be completed If the permit Is for application and the information I have provided is coned I agree to comply
t one-hundred dollars($100)or less) with all applicable city and county ordinances and sate laws relating to building
f construction.I authorize repre ti _s of his ' or county to enter the above-
0 1 certify that in the performance of the work for which lilts permit is issued.I identified property.ter in ectipn p
shall not employ any persons in any manner so as to become subject to the /,•`
workers compensation laws of California,and agree that I should become
subject to the workars compensation provisions of Section 3700 of the Labor �
Code,I shall forthwith comply with those provisions. Prope//ttyyrros ner or�Agent - Date
�71 City Bh�s License# d 0 9 710
Date; Applicant; i vi YYY"' ,!
WARNING- FAILURE TO /,S ECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
III COMPENSATION COVERAGE IS UNLAWFUL, 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 A HAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE Iv1DCrURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE,INTEREST, ,AND ATTORNEYS FEES ' 0 EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDINGAG=NCY SPECIFIED ON THE HAZARDOUS MATERIALS
1 1 hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE?
i agency for the performance of the work which this permit is issued(Section WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPUCANTOR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
O DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
t OWNER BUILDER DECLARATION,,5 GUIDE LINES
I hereby attain under penalty of perjury that I am exempt from the Contractor's PRINT NAME
License Law for the reason(s)Indicated below by the checkrnark(s)I have placed OYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the appicabie item(s)(Section 7031.5.Business and Professions Code: // BE WITHIN 11100 FEET OF THE OUTER BOUNDARY OF A
-Any city or county that requires a permit to construct,altar. Improve,demolish, 13 0 SCHOOL?
or repair any structure,prior a its issuance,also requlras the applicant for the
permit to Ole a signed statement that he or she is licensed pursuant to the
provisions of the Contractor's Sale License("(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 04ES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she Is exempt from licensura 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
r a civil penalty of not more than(S50D).) CODE.SECTION 2550 '"33,AN C NCERNING
❑ 1. as owner of the property, or my employees vrith vn es as their sole HAZAP.DOUS liATER REPORT( 1
componsaton,will do( )all of or( )porting of the work,and the structure is PROP R WN ANY,
9 i
not Intended or offered for sale.(Section 7044,Business and Professions Code; /; f,�� I
The Contractor's State License Law does not apply to an owner of a property X L�
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 completan, the Owner-
Builder will have the burden of proving that It was not built or improved for the
purpose of sale).
I
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
4;f
':
Menifee
DATE 3-8-2017 PERMIT/PLAN CHECK NUMBER I
TYPE: O COMMERCIAL XRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA 0 SIGN
SUBTYPE: C ADDITION O ALTERATION O DEMOLITION O ELECTRICAL '(MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK —Replacement of existing heating and air conditioning equipment with new 3 tons I
horizontal central heating and air conditioning system
PROJECTADDRESS 29095 Paradise
Canyon, Menifee 92584
ASSESSOR'S PARCEL NUMBER '-5L10_aQQtQ+P LOT LKO TRACT 5p6S
OWNER NAME Terry Almy
ADDRESS 29095 Paradise Canyon, Menifee 92584
PHONE 951-687-2080 EMAIL terry.almy@sbcglobal.net
APPLICANT NAME Anna Espinoza
ADDRESS 32105 Heather Lane Menifee, CA 92584
PHONE 951-301-4452 EMAIL info@castillohvac.net
CONTRACTOR'S NAME Art Castillo OWNER BUILDER? O YES XNO
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$ 6,350.00 SQ FT 1780 L SQ FT 6969
APPLICANT'S SIGNATURE DATE 3-8-17
DEPARTMENT DISTRIBUTION Up CITYOFMENIF �{SI ENUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP (o/ a
INVOICE (O PAIDAMOUNT
AMOUNT . OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-6 72-6 77 7
www.cityofinenifee.us Inspection Request Line 951-246-6213
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