PMT14-01016 City of Menifee Permit No.: PMT14-01016
29714 HAUN RD. Type: Residential Mechanical
- MENIFEE, CA 92586
ewerawmrx BcAn+�o MENIFEE Date Issued: 06/07/2014
PERMIT
Site Address: 25951 CHERRY HILLS BLVD, MENIFEE, Parcel Number: 339-092-035
CA 92586 Construction Cost: $5,000.00
Existing Use: Proposed Use:
Description of REPLACE GAS PACK UNIT
Work:
Owner Contractor
JANICE LONG BEAR CREEK HEATING AND AIR CONDITIONING
25951 CHERRY HILLS BLVD INC
MENIFEE, CA 92586 24069 CHATENAY LANE
Applicant Phone: 9516002882
BEAR CREEK HEATING AND AIR CONDITIONING INC License Number: 779461
24069 CHATENAY LANE
MURRIETA, CA92562
Fee Description Qy. Amount I$1
Fore Ai ,a r T pe,: 9. uc'eY 0`
Air Handling/Condensing Units SFR 1 133.00.
Bu"c1 rg 67W,ssua 1:
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
specifcations 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
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 Cod 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�V Licens6 A)o. —nc{ k� 1�� — who builds or Improves thereon, and who contracts for the projects with a
Expires Signature _/`,'�—�' licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensure under the Contractors'Stale 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' By my signature below I acknowledge that, except for my personal residence in
compensation,issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of
Section 3700 of the Labor Code, for the performance of work for which this improvements covered by this permit, I cannot legally sell a structure that I have
permit is issued. built as an owner-building if it has not been constructed in its entirety by licensed
Policy# 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 request when 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:http'//www.lgciinfo.ra.aov/calaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Property Owner or Authorized Agent Date
Carrier
Expires Policy#
❑ By my Signature below, I certify to each of the following: I am the property
Name of Agent Phone# 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 state laws relating to building
construction.I authorize representatives of this city or county to enter the above-
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
subject to the workers'compensation provisions of Section 3700 of the Labor Property Owner or Authorized Agent Date
Code,I shall forthwith comply with those provions.
^1 ' `1 City Business License#
Date; , — 1� Applicant;
WARNING: FAILURE TO SECUIAE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
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, AYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑NO 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 WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address ❑NO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
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: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, ❑NO 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 I HAVE READ THE HAZARDOUS MATERIAL
provisions of the Contractor's State License Law(Chapter 9 (commencing with
Section 7000)of Division 3 of the Business and Professions Code)or that he or DYES 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 255L5ATERIAI�25533IAND 25534 CONCERNING
HAZARDOUS❑ I, as owner of the property, or my employees with wages as their sole
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 Stale 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 MluNI EE PLCK No: Permit No:
City of MenifeeR-Ml-k low
29714 Haun Road Building & Safety Dept, Date: Date:
Menifee, CA 92586
Phone: (951)672-6777 MAY 0 7 2014 Amount: Amount:
Fax:(951)679-3843 1O
Ck#: Ck#:
Received
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F: L: Rt: R
Property Address:'` \ i 1 Assessor's kS Parcel Number.
Project/Tenant Name: Unit#: -O Floor#:
Name: ` 1 P Fax No.
Property Address: "7 , C'1�`1 ` \
Owner L-r7 v �p� y S Unit Number Zip Code
Email Address:
Name: Phone N
.(- Zf'ty Z_ Fax No.
Applicant Address�DAO wat n\\ ._ �� Unit Number 'D� Zip
Email AddressZ~II.JJ �y�}' l�
rCre�K 'DSt,>i�tl�e�. 1 Cc,•-�
Name: i Phone No. Fax No.
Contractor Address: (_ City jv,1 ate Zipn ` rz
Contractors City Business License No. Contrac is Ci§S\)epf Califomial License No. Classification: 10
Number of Squares: _ l 'l> 1
Square Footage ill371
Description of Work: I '14
Cost of Work:$
Applicant's Signature
Date:
To Be Completed By City Staff Only.
Indicate As R-Received or NIA-Not Applicable
5 Completes sets of fully dimensioned,drawn to sale plans which include: 1 set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Goo Tech/Soils Report(on led only)
❑ Plat/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 Y x 11)
❑ Structural Calculations
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for else.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan 8 Details ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition' Mearnal ethods
Work Type: Repair' Retrofit* Revision to Existing Perrnir Required? YES NO
Proposed Building Use(s): Existing Building Use(s):
#Buildings: #Units: 0 Stories: Will the Building Have a Basement?
Y of N
Bldg. Code Occupancy Group Indicate Indicate if Indicate all Geo-tech.Haz.Zone
At Project Indict le if YESor NO
Construction that apply: Coastal Zone
Completion: Type(s): C of o Noise Zone
Required? YES or 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:aldg.
Otflciai re:Bldg
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
Far Staff Use Only
Buildingisafety Permit Specialist City Planning I Civil Engineering I EPWM-Armin I Iransporta lion Mgmt. Rent Conhal
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10- 15
Site Address: Enforcement Agency: Date: Fermi #:
25951 cherry hills blvd Menifee, CA 92586 City of Menifee May 6, 2014 — 10I�j
Duct insulation Conditioned Floor
Equipment Typel List Minimum Eficiency2 requirement Area Thermostat
®Package Unit
❑Furnace ®AFUE 78% ❑COP ®Setback
❑Indoor Coil ®SEER im ❑HSPF_ ❑R 6(CZ 10-13) Served by system If not already
- - ❑R 8 7 sf Y Present, must be
[I Condensing Unit p EER ❑Resistance (CZ 14-15) �$ installed)
❑Other_
1. Equipment Type:Choose the equipment being installed;if more than one system, use another CF-SR-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 done
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-6R and registered CF-4R
forms (no hand filled CF-4Rs allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF-111
and CF-611 shall also be on site for final inspection.
® 1. HVAC Changeout Required Forms:
.All HVAC Equipment CF-6R forms: MECH-04, MECH-2I-HERS dJkia spi t systems) 04F!G.,
replaced CF-4R forms: MECH-21 emsei:s.lit syst..ws) MEG!-! 2
.Condenser Coil and /or CF-6R forms: MECH-04, MECH-2I-HERS (far and Split-• ---) . _GH-� "
_ m_�r
.Indoor Coil and/or CF-4R forms: MECH-21 a �t�---It- - _m-� Split" T" �" Building & Safety ept.
. Furnace
- 4
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if:
❑1. Duct system was documented to have been previously sealed and confirmed through HERS verification, cf� V ••II
❑2. Duct systems with less than 40 linear feet in unconditioned space, or ReCe Id
❑3. Existing duct systems are constructed, insulated or sealed with asbestos
❑4. The system will not be Ducted (le. Ductless Mini-Split System) (Also Exempt from Refrigerant Charge)
❑2. New HVAC System Required Forms:
•Cut in or Changeout with CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and
new ducts: (all new MECH-25-HERS
ducting and all new CF-4R forms: MECH-20, and (for split systems) MECH-22, and MECH-25
equipment)
For Split Systems: Duct leakage < 6 percent; RC, CCA ? 350 CFM/ton, FWD,TMAH, STMS, and either HSPP 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 and/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: Duct leakage < 6 percent
❑4. New Ducting over 40 feet Required Forms:
•Includes adding or replacing more than 40 CF-6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space. I CF-4R forms: MECH-21
For split system or packaged units: Duct 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: Barry Dungan Signature: Barry Dungan
Company: BEAR CREEK HEATING AND AIR CONDITIONING INC Date: May 6, 2014
Address: 24069 CHATENAY LANE License: 779461
City/State/Zip: MURRIETA/ CA/ 92562 Phone: (951) 600-2882
Reg: 214-A0031902A-000000000-0000 Registration Date/Time: 2014/05/06 15:15:34 HERS Provider: CaICERTS, Inc.
2008 Residential Compliance Forms July 2010