PMT14-01059 City of Menifee Permit No.: PMT14-01069
29714 HAUN RD. Type: Residential Mechanical
eR- MENIFEE, CA 92586
MENIFEE Date Issued: 0510 812 01 4
PERMIT
Site Address: 30209 VIA PALERMO, MENIFEE, CA Parcel Number: 364-103-016
92584 Construction Cost: $10,000.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT 4 TON AC 90,000 BTU FURNACE
Work:
Owner Contractor
MATTHEW WALDMANN COOL AIR SOLUTIONS INC
30209 VIA PALERMO 41162 SANDALWOOD CIR STE 101
MENIFEE, CA 92584 MURRIETA, CA 92562
Applicant Phone: 9516762665
COOL AIR SOLUTIONS INC License Number: 874502
41162 SANDALWOOD CIR STE 101
MORIAH@COOLAIRSOLUTIONS.COM
MURRIETA, CA 92562
Fee Description Qtv Amount
Fof d A.,:.!.f'oT
Alr Handling/Condensing Units SFR 1 133.00
B11
l I .g Per Iti Isst�2 Re
.�
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 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)SS}}f Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions
Professions Code and my license is in If 11r. rce and effect.effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class�- License 7 S� 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'COMPENSATI LARAM
❑ I am exempt from licensure under the Contractors'State License Law for the
❑ I 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:rite'//www.Ieainfo.ca.qov/ca aw html.
permit is issued.My workers'compen ation insurance carrier and policy number are:
Property Owner or Authorized Agent Date
Carrier �� d
Expires/s Policy# &r V1_V1ML/
❑ 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 aut orize 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 fo inspection purposes.
shall not emulov any persons in any manner so as to become subject to the
workers' compensation laws of California, and�a§)ee that-if-1-_sttuld become �✓
subject to the workers'compensation provisions f Section 3700 oT'the Labor property O ojr h6rized Agent D to
Code, I shall forthwith comply with those pro lsi ns. �..f' try AA
r ✓J"
City Business License
Date; Applicant;
WARNING: FAILURE TO RE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CI-V-IL_FINES_UP_TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000), IN ADDITION TO THE COST OF COMPENSATION, ❑YES OCCUPANT HANDLE A HAZARDOUS-M-ATERIAL OR A
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES Li 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 AYES 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 items)(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 ($500).) CODE SECTION
E S MOT 25505,
50 R P533ORI,NG D 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZA_
compensation,will do ( )all of or( )porting of the work, and the structure is PROPERTY OWNER ORAUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not Intended or offered for sale. If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF TVI E NIFEE City of Menifee �
Building & Safety Dep PLCK No: Permit No:
29714 Haun Road
date' Da:e:
'Vleniree, Cl 925815 MAY 0 8 2014
Phone: (951)672-6777 Am�7n: Arnowil.
Fax:(951 )679-3843 Received ck# Ck=31O�
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F: I .
Rt: R
Property Add,eFc: Assessor's Parcel Number.
30ZO�f l�ra�aJ�ProjecV 364103o1(cTenant Name: Unit#: Floor#:
Name: ,1 r11. Viald[ A1L�1/t�1 RkA�17 P¢one No.�.,,1 Fax No.
Property `(5(— 1✓f'—B..J��O�
Address: I
Owner 30209 UIG�L►(Q,YMD Unit Number Zip CotleR25,
Email Address: 7
Name: �� (- Ph�oyn!e No y��J p !
O J`1 Ate' �Q,V Q,IJ 2/" 7-c�lC7& 2[,G5 F`�1-(v7�,v 2"o
Applicant Address- pp / Cc J ( ( C �41 Zip Code p
PP d `?Z.✓ �tlal {n ®C7 i..reY' =t-f /®( Unit N' f>l/,( 1'Z Z-
Small AddreSS:
Name:/1 A �/� /�
L..00I Air SolAons P�S�o�/ldT Z&IVY
Contractor Address' ,/ CC�� � // '�-� ""'� /� 1� E3X-N�-&� Z(Q r
`t 116Z ✓cL,1dJ cc0 �r h3 to i City [Jf�IQ Staj,� , �j Zip Co e�( ']l9
�:rn t :PfPf (.if RUS r .r �:,�6
I Y less License Pic. Coast Cr Calitormia License No. 'Ctassificaiion. -
Number of Squares:
C-20
Square Footage '%VS
Description of W�o(rk:,r,It* '_ _ _ J w� Ac- qojt�� Cost of Work:$ _
I►A/Cr 'T �J�i��
Applicant's Signature
Dates P
- To Be;Completed BY City Staff Only -
.A,.mot-5sze..>^ssa+`;�a .sti's. ,uv>irt :
Indicate As R-Re<eived or N/A-Not Applicable
5 Completes sets or fully dimensioned draw"to sale plans which Include 1 ael of documents which Include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan
❑ Can Tech/Soils Report(on cut only)
❑ Ptot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 /x 11)
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan El Structural Calculations
❑ ❑ Single Line diagram for ales.services over 400 AMP
Rood Plan ❑ Structural Framing Plan 8 Details El Shoring Plan ❑ Sound Report-Residential
F#Buildings:
ss Code: Indicate New Construction Alteration' Addition'
Work Type Means/Methods
Repair' Retrofit* Revision to Existing Permit' Required? YES NO
posed Building Use(s): Existing Building Users):
#Units. #Stories. Will the Building Have a Basement?
Y of N
Bldg. Code Occupancy Group Indicate a Geo-tech. Haz Zane
At Project Ind;ca[� YES or NO Irdicale all
/ , Construction Sprinklered that apply: Coastal Zone _Completion:
Type(s): O CIO Noise Zone
Required? YES or NO
Listed on Hfsloric Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costai Commiss Arch- Review Board Landmark Comm. Planning Cooloning Administrator
Fee Exempt: City Project Elea Vehicle Charger Landmark Seismic Retrofit sceoal case.bid,,
oe.�lal�,p ra.al
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
,For Staff Use Only
BuildinnlSatefv Permit Speclarisl Gty Plan Rmg Civil Engineering EPINM,-gdnlin Transportation h:q:nl. Rent Ccntrel
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-SR-ALT-HVAC
Climate Zones 10- 15
Site Address: Enforcement Agency: Date: Permit#:
30209 Via Palermo Menifee, CA 92584 City of Menifee May 7, 2014
Duct insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 requirement Area Thermostat
❑Package Unit
®Furnace ®AFUE o/ ❑COP
®Indoor Coil ®SEER 18.0 ❑HSPF_ ❑R 6 (CZ 10-13) Served by system If of already present, must be
®Condensing Unit [3EER [3 Resistance ❑R 8 (CZ 14-15) 1965 sf installed)
❑Other_
1.Equipment Type:Choose the equipment being installed;if more than one system,use another CF-IR-ALT-HVAC for each system.
2.Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, Z7HSPF 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-iR
and CF-6R shall also be on site for final inspection.
®1. HVAC Changeout Required Forms:
•All HVAC Equipment CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced CF-411 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-4R forms: MECH-21 and (for split systems) MECH-25
.Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement),QItt,Al6 em e e
rap Packaged „_i•_e Duet l,._l._ge 4 ,5 ,..._.eRt Building 8, Safety
Dept.
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verifica�ppyor
❑2. Duct systems with less than 40 linear feet in unconditioned space, or MHI Q 8 20114
❑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: necelved
.Cut in or Ch t with
new ducts: (all
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and
all new MECH-25-HERS
ducting and all new equipment) CF-4R forms: MECH-20, and (for split systems) MECH-22, and MECH-25
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-611 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-611 forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space. 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: Moriah Neugebauer Signature: Moriah Neugebauer
Company: COOL AIR SOLUTIONS INC 122Le., May 7, 2014
Address: 41162 SANDALWOOD CIR STE 101 -License: 874502
City/State/Zip: MURRIETA/CA/ 92562 Phone: (951) 676-2665
Reg: 214-AO0323IIA-000000000-0000 Registration Date/Time: 2014/05/07 18:06:07 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010