PMT14-01082 City Of Menifee Permit No.: PMT14-01082
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Mechanical
s°""'"""*W k., MENIFEE Date Issued: 06/12/2014
PERMIT
Site Address: 27466 TERRYTOWN RD, MENIFEE, CA Parcel Number: 336-330-019
92586 Construction Cost: $5,400.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, SPLIT SYSTEM, HEAT 70,000 BTU, COOL 36,000 BTU
Work:
Owner Contractor
DEBORAH CRAFT MONK'S AIR CONDITIONING
27466 TERRYTOWN ROAD P 0 BOX 128
MENIFEE, CA 92586 SUN CITY, CA 92586
Applicant Phone: 9516794502
MONK'S AIR CONDITIONING License Number: 912194
27466 TERRYTOWN ROAD
MENIFEE, CA 92586
Fee Description l3ty Amount f$1
dr(fed �y,oi, aRt Ur c o'B Reh• 49'U0
Air Handling/Condensing Units SFR 1 133.00
Bulldi 9:F?e"°jZ ls�ua ce m ,re =A
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 licensee
Chapter 9 (commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Profession:
Professions Co d my license is in full rce and effe Code:The Contractor's License Law does not apply to an owner of a propert,
License Class,2Q License N . __ _ _ ., _ who builds or Improves thereon, and who contracts for the projects with
Expire Signatur licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensure under the Contractors'State License Law forth
❑ 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 I
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 i
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 1 hav
permit Is issued. built as an owner-building if it has not been constructed In its entirety by license
Policy# _ contractors. I understand that a copy of the applicable law, Section 7044 of th.
❑ 1 have and will maintain workers' compensation insurance, as required by Business and,Professions Code,is available upon request when this application
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http,//www.leainfo.m.ciov_zgglaw.htmi.
permit is issued.My workers'compensation insurance carrier and policy number are:
�^± Property Owner or Authorized Agent Date
Carrier w(1�
Expires �1 — Policy# I�A 1 2_ A Z
❑ 8y my Signature below, I certify to each of the following: I am the proper
Name of Agent Phone# owner or authorized to act on the property owner's behalf. I have read it
(This section need not be completed ff the permit is for application and the info on 1 have provided is correct. I agree to comp
one-hundred dollars($100)or less) with all appli ble city a unty ordinances and s�tate laws relating to buildii
constmctio . onz r presentafives of this citycounty to enter the abov
❑ 1 certify that in the performance of the work for which this permit is issued,I identified arty f t inspection purposes. .r
shall not emolov any persons in any manner so as to become subject to the
workers' compensation laws of Califomia, and agree th if I should become
subject to the workers'compensation provisio of Se n 3700 of the Labor pro ner Authorized Agent Date
Code,I shall forthwith com ly`Jwith those pro ons.
�5 H Z�_ City Business License#��
Date; ppljc t; -
WARNING: FAILURE TO SECURE 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, OYES 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 PRINT NAME:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
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 MATERIAI
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 OYES INFORMATION GUIDE AND THE SCAQMD PERMITTIN(
she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENT:
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFET
a civil penalty of not more than($500).) CODE, SECTION 25AL6 25533 AND 25534 CONCERNIM
HAZARDOUS❑ I, as owner of the property, or my employees with wages as their sole
compensation, will do( )all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code; -
The Contractor's State License Law does not apply to an owner of a property X a 4'R '
who, through employees' or personal effort, builds or improves the property, +r 1 ,
provided that the improvements are not intended or offered for sale.If,however, R�`'-'
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENIFEE PLCK No: Permit No:
29714 Haun Road V�Lk-cneAz
Menifee, CA 92586 Gity of Menifee Date: Date:
Building & Safety Dept. 51 1$ 1
Phone: (951)672-6777 Amount Amount:
Fax:(951)679-3843 MAY 12 2014 3
Ck#: Ck#:
Building Combination Plrlmitived
To Be Completed By Applicant
Legal Description: , Z�O%\J L.07- Planning Case: F: IL: Rt: R
Property Address: Assessor's Parcel Number.
Projec7Tenant Name: Unit#: Floor#:
Name: D�Q-o \-J, ho No. F No
Property Address: �'�'Z 3 l
Owner Z�-- unit Number Zip Code
Email Address: �" ��
Name:
G042 V n o nk hone No.
Applicant
Address: a� 61%'��2 qsl b l2 2012
30>3 O t�v fGYUs ETA IM Unit Number Zip Code q,Z,
Email Address:
tMoJV�5l4rt0.� yt/�tiClGli•C,ptM
Name: hone
lMoNAGS A lc ��1>o.
N61cli-W b2 (e°L�\'� 1772-Zo)2
Contractor Address: 30 5,3--D City State Zip Code
vnss iruceN YLO m�=v�sF.FLF � q7'!9"
Contractor's y us�ness License o. Contract ;Z,tyl ate of California License No. Classification: �Z u
3 S6
Number of Squares:
Square Footage 13-}0
Description of Work: Wv � _C 5 toL�T EaLryar: 7 0 le-6Tv Cost of Work:$
b s sn�vn Cuo� at. I�r�Tv $� o (� —
Applicant's Signature Date: S ) L
Y�
Completed By_6ity Staff Only,
indicate As R-Received or NIA-Not Applicable
5 Completes sets of fully dimensioned.drawn to sale plans which include: 1 set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Gen Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8%x 11)
❑ Foundation Plan ❑ Cross Section
❑ Plumbing Plan ❑ Structural Calculations
❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan 8 Detalls ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition* Means/Methods
Work Type: Repair' Retrofit' Revision to 6dsgng Permit' Required? YES NO
Proposed Building Use(s): Existing Building Use(s):
#Buildings: #Units: #Stories: Will the Building Have a Basement?
Y of N
Bldg. Code Occupancy Group Indicate Indicate if Indicate all Geo-tech.Haz.Zone
At Project Sprinklered YES or Ni
Completion: Construction that apply: Coastal Zone
Type(s): C a O YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commis Arch.Review Board Landmark Comm. Planning Comm.Zoning Administrator
Fee Exempt: City Project Elec.Vehi Is Charger Landmark Seismic Retrofit space ase:aleg.
of. roval
Expedite Project(s): Child Cam City Project Green Building Landmark Affordable Housing
For Staff Use Only
Building/Safety I Permit Specialist I City PlanningI Ui il Engineering I EPWM Admin I Transportation Mgml Rent Control
I2 — l THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10- 15
Site Address: Enforcement Agency: Date: Permit#:
27466 Terrytown Rd Menifee, CA 92586 City of Menifee I May 9, 2014 to$z
Duct insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 requirement Area Thermostat
❑Package Unit
®Furnace ®AFUE 78% ❑COP_ R 6 CZ 10-13 Served by system ®Setback
®Indoor Coil ®SEER 13. ElHSPF ( ) If not already present, must be
®Condensing Unit ❑EER_ [3 Resistance ❑R 8 (CZ 14-15) 1370 sf installed)
[3 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, 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-411
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-6R shall also be on site for final inspection.
®1. HVAC Changeout I Required 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-4R forms: MECH-21 and (for split systems) MECH-25
. Furnace
e
For Split Systems: Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement),TMABUilding & Safet Dept.
O L J 16111itmi gust leakage
Exempted from duct leakage testing if:�c ^ ^-}
❑1. Duct system was documented to have been previously sealed and confirmed through HERS verification,or MAY 12 2 14
❑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) d
112. 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
114. New Ducting over 40 feet I Required Forms:
.Includes adding or replacing more than 40 CF-6R 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: Gary Monk Signature: Gory Monk
Company: MONK"S AIR CONDITIONING Date: May 9, 2014
Address: P O BOX 128 License: 912194
City/State/Zip: SUN CITY/ CA/ 92586 Phone: (951) 679-4502
Reg: 214-A0032956A-000000000-0000 Registration Date/Time: 2014/05/09 18:40:15 HERS Provider:. CalCERTS, Inc.
2008 Residential Compliance Forms July 2010