PMT14-01105 1
City of Menifee Permit No.: PMT14-01105
29714 HAUN RD. Type: Residential Mechanical
' CCIEO MENIFEE, CA 92586
MENIFEE Date Issued: 05/14/2014
PERMIT
i
Site Address: 29176 BOULDER CREST WAY, Parcel Number: 341-210-004
MENIFEE, CA 92584 Construction Cost: $10,709.00
Existing Use: Proposed Use:
Description of REPLACE 4-TON A/C, COIL, &90,000 BTU FURNACE
Work:
Owner Contractor
MEGAN BUSCEMI W C HEATING&AIR CONDITIONING INC
29176 BOULDER CREST WAY 41357 DATE ST
MENIFEE, CA 92584 MURRI ETA, CA 92562
Applicant Phone: 9516000700
W C HEATING&AIR CONDITIONING INC License Number: 779604
41357 DATE ST
MURRIETA, CA 92562
Fee Description Qtv Amount l$1
Fo�rc�e�yAir;�orG.[.,avity�Type�Furn "Ce�ot"Burns �'�. � �, `, '�, ��;
Air Handling/Condensing Units SFR 1 133.00
YW'N'2#*Y' "p 4fAM� 32T SS'5 '9 '••
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 P; License No. '77`I(-0+ who builds or improves thereon, and who contracts for the projects with a
Expires 4 3u I'd Signature I 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' 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:htto//www,leqinfo.ca.ciov/calaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
S Property Owner or Authorized Agent Date
Carrier�e�gg b`tt�-l�v���rwc:i-e-r
Expires i I' 1 Policy# A'YW 0p3j7N4W
/�.C�y._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 emolov any persons in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become ]N-
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 provisions.
City Business License# C`735ZC)
Date; Applicant;
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, AYES 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 O 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 []YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
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: skel.,w, t Prey
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, 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 pKj-ES 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 ($500).) CODE SECTION 25505, 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation,will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED. ,GENT
not intended or offered for sale,(Section 7044,Business and Professions Code; -- �—'
The Contractor's State License Law does not apply to an owner of a property X who, through through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF 1�"1 t ENIF City of Menifee
��JID9 & safety Dept. pLCK No: Permit No:
29714 Haun Road MAY 14 2014 Date: Date:
Menifee, CA92586 5h��
Phone: (951)672-6777 Amount: Amount:
Fax: 951 679-3843 Received 3
( ) Ck#: Ck#:
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F: L: Rt: R
Property Address: Z 9 Assessor's Parcel Number.
�_.
Projectfrenant Name: Unit#: Floor#:
Name: Phone No. Fax No.
Mr 7(oo--70-7- zzZt_
Property Address: Unit Number Zip Code Z�&�
Owner 3ovlder Cx-es� lr.. e
Email Address:
Name: S Phone No. Fax No.he av� Se\.+11exe� 9SI-zyl-6811<
Applicant Address: Unit Number Zip Code
ZSZs t A\essoo cl c� \�1 d 92553
Email Address:
Name: Phone No.
L)c- A C Fax No.
Contractor Address: City State Zip Code
S� (Y1 urc;etc, 4ZSbZ
Contractor's City Business i Contractor's CityState of California License No. Classification:
cense o.
03S2o2 � gfoU} GZO
Number of Squares:
Square Footage
Description of Work: 1 Cost of Work:$
ad,c tll-ov� A c i � Rio � t3Tu �u n4cc to '7oq. rn
Applicant's Signature
Date: S i I y ry
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 ❑ Geo Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 Y x 11)
❑ Foundation Plan ❑ Plumbing Plan ❑ Structural Calculations
❑ Cross Section
❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan I ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition' MeanslMethods
11
Work Type: Repair" Retrofit` Revision to Existing Permit' Required9 YES NO
Proposed Building Use(s): Existing Building Use(s):
#Buildings: #Units: it 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 NO
Completion: Construction that apply: Coastal Zone
Type(s): C Of YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Cornrniss Arch.Review Board Landmark Comm. Planning Comm.Zdning Administrator
Fee Exempt City Project Elec.Vehicle Chargerl I Landmark Seismic Retrofit I Special case_Mug
-
Official Approval
Expedite Project(s): Child Care City Project Green Building Landmark I Affordable Housing
For Staff Use Only
Building/Safely Permit Specialist City Planning Civil Engineering I LPWM-Admin I Transportation Mgmt. Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAltefations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address: Enforcement Agency: Date: Permit#:
29176 BOULDER CREST WAY Menifee, CA 92584 City of Menifee I May 13, 2014 - I►OS
Duct insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 requirement Area Thermostat
❑Package Unit
®Furnace ®SEER AFUE 7 0 ❑HSPF ❑R 6 (CZ 10-13) Served by system If of already present, must be
Hck
Indoor Coil ❑R 8(CZ 14-15) 1700 sf
®Condensing Unit ❑EER ❑Resistance 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, 7.7115PF 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-1R
and CF-611 shall also be on site for final inspection.
®1. HVAC Changeout lRequired Forms.
.All HVAC Equipment CF-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS 1 y & SafetyDept.
replaced CF-4R forms: MECH-21 and (for split systems) MECH-25 Building
.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 MAY 14 20%
. Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA < 300 CFM/ton (Minimum Air Flow Requirement),TMAH
Exempted from duct leakage testing if: Reeeived
❑ 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
[14. 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 Chaogeout with CF-6R"forms: MECH-04, MECH-20-HERS,and (for split systems)MECH-22-HERS, and
new ducts: (all new. MECH-25-HERS
dusting and all new--.-- CF-4R forms: MECH-20, and(for split systems)MECH-22,and MECH-25
equipment)
For Split Systems:.Duct leakage;t 6 percent; RC,CCA 2350 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 aft 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: Dud leak-age < 6 percent
❑4. 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: May 13, 2014
Address: 41357 DATE ST License: 779604
City/State/Zip: MURRIETA/CA/92562 Phone: (951)600-0700
Reg: 214-AD033881A-000000000-0000 Registration Date/Time: 2014/05/13 16.10.55 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010