PMT18-04056 City of Menifee Permit No. PMT18-04056
29714 HAUN RD.
MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE MENIFEE Date Issued: 08/16/2018
PERMIT
Site Address: 25126 WOODEN GATE, MENIFEE, CA Parcel Number: 339-421-018
92584 Construction Cost: $22,985.00
Existing Use: Proposed Use:
Description of REPLACE 4 TON/80,000 BTU COMPLETE HVAC SYSTEM
Work:
Owner Contractor
LEONARD PENNER KEN STARR INC
25126 WOODEN GATE 1120 N TUSTIN AVE
MENIFEE, CA 92584 SUITE B
Applicant Phone:8887693009
KEN STARR INC DBA HOME COMFORT USA License Number:974908
1120 N TUSTIN AVE
ANAHEIM, CA 92807
Phone:8887693009
Fee Description P!Y Amount I$)
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 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_Permll 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 l am under provisions of with a licensed contmdor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and a 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:
License Class C2-cj License No. 91�h96`6 By my signature below l acknowledge that,except for my personal residence
Expires - 3 11 18 Signature S-ws4 in which l must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements 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
ci 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
this permit Is issued. www.le=info.ca eov/calaw.html.
Policy g Date
I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
se ion 3700 of the Labor Code,for the performance of the work for which y my signature below l certify to each of the following:I am the property
this permit is Issued.My worker's compensation insurance carrier and polity ow It or authorized to act on the property owner's behalf.I have read this
number are: application and the information I have provided is correct.1 agree to comply
Carrier Av-, =-� with all applicable city and county ordinances and state laws relating to
building construction.)authorize representatives of this city or county to
Policy N 77—A6)CT Z52.+!;' Expires L1 t 17 enter the above identified property for inspection purposes.
x
(This section need not to be completed is the permit is for one-hundred r � Date 5 —1 t I
dollars($100)or less
PROPERTY OWNER OR AUTHORIZED AGENT�}.�
❑I certify that in the performance of the work for which this permit is issued, O "J I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE N -Jq 031
worker's compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's 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
Applicant Date 9 "J t) mixture containing a hazardous material equal to orgreater thatthe
amounts s ifred on the Hazardous Materials Information Guide?
WARNING:FAILURETO SECURE WORKER'S COMPENSATION COVERAGE 15 aYes �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 THECOST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District construction
Seepcation from
checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES farguideli za
es
CONSTRUCTION LENDING AGENCY D Yes�No
I herebyaffirrn thatunder the penalty of perjury there ksa 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 boun ary of a school?
(Section 3097 Civil Code) a Yes 5,1510
OWNER BUILDER DECLARATIONS 1 have read the Hazardous Material Information Guide and the SCAQMD
1 hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 2S534 concerning
checkmark(s)I have placed next to the applicable Items)(Section 7031.5 hazardous material reporting.
D No
Business and Professions Code).Any city or county that requires a permit to es �
construct,alter,improve,demolish or repair any structure,prior to its "'�� mate
issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWN ER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractor's 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 nt to civil
Section 7031.5 by residence or childcare facility to be RRP-certlfied firms and comply with
than
Applicant fora permit subjects the applicanttoo civil penalty of not mom required practices.This includes rental property ownersand property
than($500). managers who do the paint-disturbing work themselves or through their
D I,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-BBD-424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of DAn EPA lead-Safe Certified Renovator will be responsible for this project
property who,through employees!or personal effort,builds or improves the p p J
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-Sullder 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:
a I,as owner of the pmperty am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP role please Oil out the RRP
Acknowledgement.
54e-re4n 5ch h i er r - keh 5[a rr
SAFETY PERMIT/PLAN CHECK APPLICATIONILa
Men ifee
DATE 08/16/2018 PERMIT/PLAN CHECK NUMBER 0 ' CLforjII
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL []MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION []ALTERATION []DEMOLITION []ELECTRICAL ❑✓ MECHANICAL
❑NEW ❑PLUMBING ❑RE-ROOF-NUMBEROFSQUARES
DESCRIPTION OF WORK Replace 4 ton/80,000 BTU complete HVAC system
PROJECTADDRESS 25126 Wooden Gate Menifee,CA 92584 ✓
ASSESSOR'S PARCEL NUMBER "( �- 'l2A -01� LOT TRACT
OWNER NAME Leonard Penner
City of Menifero
ADDRESS 25126 Wooden Gate Menifee,CA 92584 Building Dept.
PHONE (951)529-3575 EMAIL
APPLICANT NAME Steven Schnierer
ADDRESS 31225 La Baya Drive Suite 213 Westlake Village,CA 91362 Received
PHONE (818)735-7876 EMAIL swschnierer@roadrunner.com
CONTRACTOR'S NAME Home Comfort USA OWNER BUILDER? ❑YES ONO
BUSINESS NAME Home Comfort USA
ADDRESS 1120 N Tustin Ave Anaheim, CA 92807
PHONE (888)769-3009 EMAIL
CONTRACTOR'S STATE LIC NUMBER 974908 LICENSE CLASSIFICATION C20
VALUATION$ $22,985.00 SO FT L SO FT
�,w� z 08/16/2018
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION �,, CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP vl `
INVOICE PAID AMOUNT
AMOUNT C O CASH O CHECK N 0 CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES 0 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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