PMT17-01899 City of Menifee Permit No.: PMT17-01899
29714 HAUN RD. Type: Residential Mechanical
�CCELX.. MENIFEE,CA 92586
MENIFEE Date Issued:
0 611 4/2 01 7
PERMIT
Site Address: 29564 BOYNTON LN, MENIFEE, CA Parcel Number: 338-330-029
92586 Construction Cost: $3,700.00
Existing Use: Proposed Use:
Description of REPLACE 1.5 TON DUCTLESS MINI SPLIT SYSTEM IN SIDE YARD, REPLACE 1.5 TON HEAT PUMP
Work: IN SIDE YARD AND AIR HANDLER
Owner Contractor
DAVID RICHARDSON LUCKY AIR INC
29564 BOYNTON LANE 4049 BURGESS WAY
MENIFEE, CA 92586 RIVERSIDE, CA 92501
Applicant Phone: 9516828573
STEVEN SCHNIERER License Number.836498
LUCKY AIR INC
4049 BURGESS WAY
RIVERSIDE, CA 92501
Fee Description Qtv Amount IEl
Forced-Air or Gravity-Type Furnace or Sumer 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 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
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that 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 D I am exempt from licensure under the Contractors state License Law for
Professions Code and my license is in full force and effect. the following reason:
License Gass 220 License No. (e'_Isalm3 By my signature below I acknowledge that,except for my personal residence
Expires )O 3l I 11 Signature in which I must have resided for at least one year priorto 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
❑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 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 website:
by Section 3700 of the Labor Code,for the performance of work for which www.IeKinfo_ca.Rov/caIaw.htmL
this permit is Issued.
Policy# Date
�0'1 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 l ey my signature below I certify to each of the follovring:l am the property
this permit is issued.My workers compensation insurance carrier and policy r O er or authorized to act on the property owners behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
Carrier S'�-A�� �V+�.c�. with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# 9 i_5a %" Expires a-Us- I—) enterthe above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred ,.%Z � Date t7 14 11
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
D I certify that in the performance of the work for which this permit is issued,
I shall not errolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 014 OaOq
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
mixture containing a hazardous material equal to or greater that the
Applicant r ��� Date Ca I-t V') amountsxs�cified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS D Yes /�No
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 guI'd ell i rIes
CONSTRUCTION LENDING AGENCY Dyes o
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 issued outer bourIdary of a school?
(Section 3097 Civil Code) D Yes o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I 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�azardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Yes ONO c'� /� " �' I—)
Business and Professions Code).Any city or county that requires a permit to (/� �,s-`p���/�--Bau —cam
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 IRRPI
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.eov/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 D An EPA Lead-Safe Certified Renovator will be responsible for this 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. ❑No EPA Lead-Safe Certified Firm is required for this project because:
D 1,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 out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Him
Menifee
DATE 06/14/2017 PERMIT/PLAN CHECK NUMBER v C7 lo�
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL []MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION []DEMOLITION [-]ELECTRICAL ❑✓ MECHANICAL
❑NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace 1.5 ton ductless mini split system in side yard,replace 1.5 ton heat pump in side yard
and air handler
PROJECTADDRESS 29564 Boynton Lane
ASSESSOR'S PARCEL NUMBER 338-330-029 LOT 29 TRACT 3OD40-2
OWNER NAME David Richardson
itee
ADDRESS 29564 Boynton Lane Sun City,CA 92586 City Rijildi
Me)ep1
PHONE (951)205-7429 EMAIL
JUN
APPLICANT NAME Steven Schnierer 4 2017
ADDRESS 31225 La Baya Drive Suite 213 Westlake Village,CA 91362
PHONE (818)735-7876 EMAIL swschnlerer@roadrunner.com
CONTRACTOR'S NAME OWNERBUILDER? ❑YES❑✓NO
BUSINESS NAME Lucky Air Inc.
ADDRESS 4049 Burgess Way Riverside,CA 92501
PHONE (951)682-8573 EMAIL
CONTRACTOR'S STATE LIC NUMBER 836498 LICENSE CLASSIFICATION C20
VALUATION$ $3,700.00 SO FT L SO FT
APPLICANIrs SIGNATURE DATE 06/14/2017
C17YSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENNIFEEE DUUS/I.N/ES LICENSE NUMBER
BURRING PLANNING ENGINEERING FIRE GREEN
INVOICE PAID AMOUNT
AMOUNT ID O CASH O CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 1 OCASH 0 CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED DYES O NO DLNUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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