PMT17-04299 City of Menifee Permit No.: PMT17-04299
29714 HAUN RD.
�CC.EL/� MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 12105/2017
PERMIT
Site Address: 29961 WESTLINK DR, MENIFEE, CA Parcel Number: 340-110-004
92584 Construction Cost: $3.500.00
Existing Use: Proposed Use:
Description of REPLACE EXISTING FAU ONLY 60K 3 TON, SAME LOCATION
Work:
Owner Contractor
JACQUELINE CASTRO TRUTEAM OF CALIFORNIA INC
29961 WESTLINK DRIVE 475 NORTH WILLIAMSON BLVD
MENIFEE,CA 92584 DAYTONA BEACH, FL 32114
Applicant Phone:3863042222
TRUTEAM OF CALIFORNIA INC License Number:221517
475 NORTH WILLIAMSON BLVD
DAYTONA BEACH, CA 32114
Phone:3863042222
Fee Description Qy Amount r51
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Mechanical 1 7.45
$184.45
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specfications 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
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 1 am under provisions of with a licensed contractor(s)pursuant to the ContrecbmState License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and D l am exempt from Rcensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class z-zr Ucel No. Z! !!7 By my signature below I acknowledge that,except rot my personal residence
Expires _Signature in which l must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION have
covered by this permit.I cannot legally sell a structure that I
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 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 websile;
by Section 370D of the Labor Code,for the performance of work for which www.leainfo.ca.eov/calasv.lstml.
this permit is issued.
Policy If Date
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 o By my signature below l certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carder and policy owner or authorized to act on the property owners behalf.I have read this
number are. ,�J — application and the information l have provided is correct.I agree to comply
Carrier( "' /Ytf Pn r C dr with all applicable city and county ordinances and state fam relating to
building construction.I authorize representatives of this dry orcounty to
Paliry g jt)L tZ( 478G n r in Expires //4,T 1lr, /7 enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred / _.oe Date lDh7hc1 F
dollars($100)or less RTY OWNER OR AUTHORIZED AGENT
a I certify that in the performance of the work for which this permit is Issued,
Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSER
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,1 shall fortthhwwJ'J�comply withh'ttbo�seprovisions. / Will the applicant or future building occupant handle hazardous material or a
Applicant/- f" �-- Date /01711 r mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes "0
UNLAWFUL,AND SHALL SUBJECTAN 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 SECT10N 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY oyes 07",
I hereby affirm that under the penalty of perjury there is a constmction Will the proposed building or modified facility be within 100D 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) ciYes [PRO
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penally of perjury that I am exempt from the permitting checklist.I understand my requirements underthe State of
Contractors License Law for the reason(s)indicated below by the California Health 8:Safety Code,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 00
Business and Professions Code).Any city or county that requires a permitt o Oyu /�, Date 101711(r
construct,alter,improve,demolish or repair anystructure,priartoirs PROPERTY OWNER OR AUTHORIZED AGENT
issuance,also requires the applicant for the permitto flea signed statement
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIRAND 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 70315 by residence or childcare facility to be RRP-certified firms and comply with
an Applicant for a perm it subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($SDD). managers who do the paint-disturbing work themselves or through their
Dl,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 1-800424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a ❑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. D 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.
i
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Men ifee
DATE: PERMIT/PLAN CHECK NUMBER �—
TYPE: O COMMERCIAL YRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION C ALTERATION O DEMOLITION O ELECTRICAL *MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK c k I T Ir % '
PROJECTADDRESS .JRCIf'a� LC)Gx'TLli,lc r�--��A ZIP )5 J-L
ASSESSOR'S PARCEL NUMBER 340 • �, 10 • V OgOT TRACT
OWNERNAME CA5Zr, . IA
ok
ADDRESS }, (11/,
PHONE. 61 EMAIL
APPLICANT NAME _
ADDRESS L75" jfloeM1A ,S/ • 40 en3/ a 025"0�
PHONE 25-/- OC�-3 "J'y2j EMAIL
CONTRACTOR'S NAME jff4jJI,4sLj OWNER BUILDER? 0 YES ONO
BUSINESS NAME -4i epwi c)t= CA , nn
ADDRESS 75' /2l Ve-Lh 5l 00, /T17✓en5 CA . 9a Sd/
PHONE g'S j"6o k3 -1111I EMAIL
CONTRACTOR'S STATE UCNUMBER 00/S ) 7 LICENSE CLASSIFICATION C--ZU
VALUATION$ .3670(0 SO FT 10 7 3 L SQ FT
APPLICANT'S SIGNATURE /� iti /f i - DATE 12 1°/1Y 7
1
_ A_FF USE:QNLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
ACCEPTED BY: Yw BUILDING PLANNING ENGINEERING FIRE
PERMIT FEE V• vi SMIP GREEN
PLAN CHECK FEE INVOICETOTAL
OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER CC YES % NO
City of Menifee Building&Safety Department 29714 Haun Rd.Menifee, CA 92586 951-672-6777
www.cityofinenifee.us
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