PMT14-00977 City of Menifee Permit No.: PMT14-00977
29714 HAUN RD. Type: Residential Mechanical
OICCEI-f�k MENIFEE, CA 92586
MENIFEE Date Issued: 04/30/2014
PERMIT
Site Address: 29187 DESERT HILLS RD, MENIFEE, CA Parcel Number: 338-051-013
92586 Construction Cost: $10,620.00
Existing Use: Proposed Use:
Description of REPLACE 3 TON A/C, COIL&90,000 BTU FURNACE
Work:
Owner Contractor
DAN JONES W C HEATING&AIR CONDITIONING INC
29187 DESERT HILLS RD 41357 DATE ST
MENIFEE, CA 92586 MURRIETA, CA 92562
Applicant Phone: 9516000700
STEVEN SCHNIERER License Number: 779604
W C HEATING&AIR CONDITIONING INC
41357 DATE ST
MURRIETA, CA 92562
Fee Description Oft Amount
ct� Icor'G�a It 7 eFurnacorBurner''
Air Handling/Condensing Units SFR 1 133.00
"IF
rxs"S5 ,R k
n mil Ing Pe[m15suS ". y w�e 27,'AO,
GREEN FEE 1 1.00
$310.00
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 building 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
I 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 C:.Z0 License No. who builds or improves thereon, and who contracts for the projects with a
Expires43c)i4_. Signature licensed licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensure under the Contractors'State License Law for the
❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason:
I have and will maintain a certificate of consent of self-insure for workers'
compensation,issued by the Director of Industrial Relations as provided for by By my signature below acknowledge that, except for my personal residence in
Section 3700 of the Labor Code, for the performance of work for which this which I must have resided for at least one year prior to completion of
permit is issued. improvements covered by this permit, I cannot legally sell a structure that I have
Policy# built as an owner-building if it has not been constructed in its entirety by licensed
contractors. I understand that a copy of the applicable law, Section 7044 of the
I have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon requestwhen this application is
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:htbQ:/lwww lepinfo ca gov/calaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier tex�uhl�c_ l)vx d� �..ri•�rs Properly Owner or Aulhonzed Agent
Date
Expires Y tj 15- Policy#_ /4TW Oln37yl-FLw
Name of Agent Phone# �By my Signature below, I certify to each of the following: I am the property
owner or authorized to act on the property owner's behalf. I have read this
(This section need not be completed if the permit is for application and the information I have provided is correct. I agree to comply
one-hundred dollars($100)or less) with all applicable city and county ordinances and stale laws relating to building
construction. I authorize representatives of this city or county to enter the above-
El I certify that in the performance of the work for which this permit is issued,I identified property for the inspection purposes.
shall not employ any persons in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become C' r--
subject to the workers'compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Property Owner or Authorized Agent Date
Date; d G Applicant; �ZZ _r�- -?--- City Business License# 03,2.�,j
WARNING: FAILURE TO SECURE WORKERS'
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL HAZARDOUS MATERIAL DECLARATION
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, DYES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES
0 EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE?
agency for the performance of the work which this permit is issued (Section
3097 Civil Code) WILL THE INTENDED USE OF THE BUILDING BY THE
APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name ❑YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
$,NO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME: (�;VoNc.-
License Law for the reason(s)indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s) (Section 7031.5. Business and Professions Code: .�nI BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, I 0 SCHOOL?
or repair any structure, prior to its 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 Contractor's State License Law (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 oyES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure 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
a civil penalty of not more than($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
El I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation, will do ( ) all of or ( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code; ,
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale. If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENIFEE PLGK No: it
29714 Haun Road Date: Date:
Menifee, CA 92586 y11O I
Phone: (951)672-6777 Amount: Amount)��
Fax:(951)679-3843
Ck#: Cka��
Buildirig Combination Permit GI
To Be Completed By Applicant
Legal Description: ^� Plannin Case:
O 7r g F: L: Rt: R:
Property Address: Assessor's Parcel Number.
Z�11S7 1�es�xi }1;11 ProJecUTenant Name: 338 OS\ O13
Unit Floor
Name: Phone No.
Property C�r\GS G25-3SL1-12bb Fax No. _
Owner dress: Unit Number
Zc'IIS"7 \�05er.} N,`IS 'QA Zip Code C1zS81e Email Address:
Name: Phone No. Fax No.
Applicant Address: Unit Number ZiD Code
Email Address: ZSI a c B�. q2, 3
Name:
W G �P_G..}�h A G Phone No. Fax No.
Contractor Address:
LI\3�r-� � � - city State Zip Code
CA Contractor's iry Business tense NO. Contractor's City State of California License No.
D2 Classification: C.Z0
Number of Squares:
Square Footage
Description of N/ork: Cost of Work:$ .\tact 3?0, q - C0,1 s 90 OOc:a T�9 v cc 10
Applicant's Signature <� — _
Date: 1�
To Be Completed By City Staff Only - .
.. .,
Indicate As R-Received or NIA-Not Applicable
— 5-00mpte1as'set9`0f fully dimensioned,drawn to sale plans which include: 1 set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan
❑ Geo Tech/Solls Report(oncd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 V,x 11)
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Structural Calculations
❑
Floor Plan ❑ Single Line diagram for elec.services over 400 AMP❑ Structural Framing Plan&Details ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration• ]Use(s):
Addition'
Work Type: Means/hlethods
Repair• Retrofit' Revision to Existing Pemti(' Required? YES NO
Proposed Building Use(s): Existing Buildin#Buildings: #Units: it Stories: uilding Have a Basement? Y of N
Bldg.Code Occupancy Group Indicate ifAt Proeec[ Indicate YES or NO Indicate allGeo-tech.Haz.Zone
/ Construction Sprinklered that a ICompletion: PD Y� Coastal Zone
Type(s): C Of O Noise Zone
Required? YES ar NO
Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. Planning Comm.Zoning Administrator
Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit Special Case:Bldg_
DfriaalA pmval
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
building/Safety/Safely Permit Specialist City Planning Ci,nl Engineenng EPWM-Atlmin Transpodalion M1gmt. Rent Coneoi
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
Simplified Prescriptive Certificate of Compljafio6iv2(W8EResidential HVACAiterations CF-IR-ALT-HVAC
Climate Zones 10 - 15 - - - " -
Site Address: I��ppforcement Agency: Date: ryrlit 1
29187 DESERT HILLS ROAD Menifee, CA 9258Bf' `'' .i ,�'Cilty of Menifee Apr 29, 2014 M
Duct insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 reclqiret Area Thermostat
❑Package Unit .: -
®Furnace W AFUE 78% ❑COP ❑R 6(CZ So-13) Served by system ®Setback
®Indoor Coil ®SEER 14.0 ❑HSPF If not already present, must be
I@ Condensing Unit p EER ❑Resistance ❑R 8 (CZ 14-15) 1450 sf installed)
❑Other
1.Equipment Type:Choose the equipment being installed;if more than one system, use another CF-1 R-ALT-HVAC for each system.
2.Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options.The installer decides what work is being one
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final,the inspector verifies that the work listed on this
form was in fact the work completed by the installer.The inspector also verifies that each appropriate CF-611 and registered CF-411
forms(no hand filled CF-4Rs allowed) are filled out and signed. Beginning October 1, 2010,a registered copy of the CF-iR
and CF-611 shall also be on site for final inspection.
®1. HVAC Changeout lRequired Forms:
.All HVAC Equipment CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced CF-4R forms: MECH-21 and (for split systems) MECH-25
.Condenser Coil and/or CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
.Indoor Coil and/or CF-411 forms: MECH-21 and (for split systems) MECH-25
.Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
c Exempted from duct leakage testing.0
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑3. Existing duct systems are constructed, insulated or sealed with asbestos
❑4.The system will not be Ducted (ie. Ductless Mini-Split System) (Also Exempt from Refrigerant Charge)
❑2. New HVAC System Required Forms:
.Cut in or Changeout with CF-5R'forms: MECH-04, MECH-20-HERS, and (for spirt systems) MECH-22-HERS, and
new ducts: (all new MECH-25-HERS -
ducting and all new GF-4R forms:MECH-20, and(for split systems)MECH-22, and MECH-25
equipment) . -
For Split Systems: Duct leakage< 6 percent; RC, CCA 2 350 CFM/ton, FWD,TMAH,STMS;-and either HSPF or PSPp.
For Packaged Units: Duct leakage < 6 percent
❑3. New Ducts with/or without Required Forms::
Replacement
.Includes replacing:.or installing all-new
ducting acid/or outdoor condensing unit CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or Indoor coil and/or furnace.-No or some CF-4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage<.6 percent; RC, CCA > 300 CFM/ton,TMAH
For Packaged Units: Dud leakage< 6 percent
114. New Ducting over 40 feet lRequired Forms:
.Includes adding or replacing more than 40 CF-6R forms: MECH-04, MECH-2I-HERS
linear feet of dud in unconditioned space. CF-4R forms: MECH-21
For split system or packaged units: Dud leakage < 15 percent
❑EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor(Documentation Author's/Responsible Designer's Declaration Statement)
.I certify that this Certificate of Compliance documentation is accurate and complete.
.I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
Compliance.
.I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
.The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Rusty Cochran Signature: Rusty Cochran
Company: W C HEATING &AIR CONDITIONING INC Date: Apr 29, 2014
Address: 41357 DATE ST License: 779604
City/State/Zip: MURRIETA/CA/ 92562 1
jPhone: (951) 600-0700
Reg: 214-A0029739A-000000000-0000 Registration Date/Time: 2014/04/29 19:17:16 HERS Provider: Cal CERTS, Inc.
2008 Residential Compliance Forms July 2010