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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