PMT17-01454 City of Menifee Permit No.: PMT17-01454
29714 HAUN RD. Type: Residential Mechanical
<ACCEL/-> MENIFEE, CA 92586
MENIFEE Date Issued:
05/08/2017
PERMIT
Site Address: 28875 BIARRITZ CT, MENIFEE, CA 92584 Parcel Number: 364-122-027
Construction Cost: $14,043.00
Existing Use: Proposed Use:
Description of REPLACE 5 TON A/C IN BACKYARD,80,000 BTU FURNACE IN GARAGE&13 DUCTS
Work:
Owner Contractor
WADE STOVER KEN STARR INC
28875 BIARRITZ CT 3154 EAST LA PALMA AVENUE
MENIFEE,CA 92584 SUITE B
Applicant Phone:7146328789
STEVEN SCHNIERER License Number:974908
KEN STARR INC
3154 EAST LA PALMA AVENUE
SUITE B
ANAHEIM, CA 92806
Fee Description Oft Amount f$1
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 staled,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_aldg_Permit Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjurythat I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
Ucense Class _ C-Z O License No. CT-2 -V 90 2 By my signature below I acknowledge that,except for my personal residence
Expires 31 $ Signature in which I must have resided for at least one year prior to completion of
Improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
o I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for workers 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 website:
by Section 3700 of the Labor Code,for the performance of work for which ,N,H,,y,leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy# Date
/9—(x'have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
'section 3700 of the Labor Code,for the performance of the work for which By my signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the properly owners behalf.1 have read this
number are: application and the information I have provided Is correct.1 agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier Arah. —L,rs. l r. building construction.I authorize representatives of this city or county to
Policy# ;z_A W C.325 Zr-}S Expires 1111117 enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Swr.�2 C��� Date S 8 11
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,
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# �70�
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date 5 `Z 17 _ mixture containing a hazardous material equal to orgreater that the
• amounts s ecified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes AJo
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guideli es
CONSTRUCTION LENDING AGENCY o Yeslo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1001)feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) ❑Yeslo
OWNER BUILDER DECLARATIONS I have read a Hazardous Material Information Guide and the SCAQMD
hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the h zardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5
Business and Professions Code).Any city or county that requires a permit to �7 Date 5 8 11
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from licensure receiving 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 he RRP-certified firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
D 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.aov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code,The Contractors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will he responsible forthis project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are 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
not built or improved for the purpose of sale. D No EPA Lead-Safe Certified Firm is required for this project because:
o I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill outthe RRP
Acknowledgement.
SAFETY PERMIT/PLAN APPLICATION
r
4e'
iY
Menifee
DATE 0 510 812 01 7 PERMIT/PLAN CHECK NUMBER t- 1 1 I
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA [-]SIGN
SUBTYPE: ❑ADDITION [-]ALTERATION []DEMOLITION ❑ELECTRICAL ❑✓ MECHANICAL
❑NEW ❑PLUMBING [I RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace 5 ton A/C in backyard,80,000 BTU furnace in garage,&13 ducts
PROJECTADDRESS 28875 Biarritz Court
L
ASSESSOR'S PARCEL NUMBER (?I)N700 LOT TRACT
OWNER NAME Wade Stover
ADDRESS 28875 Biarritz Court Menifee,CA 92584
PHONE (951)236-6149 EMAIL
APPLICANT NAME Steven Schnierer
ADDRESS 31225 La Baya Drive Suite 112 Westlake Village,CA 91362
PHONE (818)735-7876 EMAIL
CONTRACTOR'S NAME OWNERBUILDER? ❑YESQNO
BUSINESS NAME Home Comfort USA
ADDRESS 3154 E La Palma Avenue#B Anaheim,CA 92806
PHONE (714)632-8789 EMAIL
CONTRACTOR'S STATE LIC NUMBER 97490E LICENSE CLASSIFICATION C20
VALUATION$ $14,043.00 SO FT L SO FT
APPLICANT'S SIGNATURE w�SL ... DATE 05/08/2017
DEPARTMENT DISTRIBUTION `CITY OF ME11161 ,��SS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP �/,/�I`�I
INVOICE PAID AMOUNT AMOUNT 0CASH 0 CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED AYES O NO DLNUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee,CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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