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PMT14-01372 City of Menifee Permit No.. PMT14-01372 29714 HAUN RD. Type: Residential Mechanical t91CCEi..A�. MENIFEE,CA 92586 MENIFEE Date Issued: 05/29/2014 PERMIT Site Address: 27081 SCHOOL PARK DR, MENIFEE, CA Parcel Number: 360-072-015 92584 Construction Cost: $4,995.00 Existing Use: Proposed Use: Description of REPLACE 60,000 BTU FURNACE, 3-TON A/C, COIL, DUCT WORK AND DISCONNECT BOX, SAME Work: LOCATION Owner Contractor JO SCHAEFFER VENVEST BALLARD INC 27081 SCHOOL PARK DRIVE 3030 MYERS STREET MENIFEE, CA 92584 RIVERSIDE, CA 92503 Applicant Phone: 9512769744 VENVEST BALLARD INC License Number:878533 3030 MYERS STREET RIVERSIDE, CA 92503 Fee Description ON Amount($1 Forced-Air or Gravity-Type Furnace or Burner 1 149.00 Air Handling/Condensing Units SFR 1 133.00 Building Permit Issuance 1 27.00 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_Permil_Templatarpt 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 Codef of and y license is in fu oe lieet. Code:The Contractor's License Law does not apply to an owner of a property License Class��J Lice se No. "J who builds or improves thereon, and who contracts for the projects with a Expires-2)`I^Ito Signature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DE LA TION ❑ 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:http�//www.leciinfo.ca.00v/calaw.html. permit is issued.My workers'compenn�sation insurance carrier and policy number are: Carrier \�'fx:�, Lo t- \ho weSv WVL Property Owner or Authorized Agent Date Expires �� `�] Policy# Cif ;)-ASn(o\I0\ ,.\�,_-- l ❑ By my Signature below, I certify to each of the following: I am the property Name of Agent �' �t �A�11'd�Ne - 1' ° owner or authorized to act on the property owner's behalf. 1 have read this (This section need not be completed if the permit is for application and the information have provided is correct. 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- 0 1 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 5 g workers' compensation laws of California, and agree that if I should become (. subject to the workers'compensation provisions of Section 3700 of the Labor Prop' O err Authorized Ci Basin cerise It ��Agent Date Code, I shall forthwith comply with those provisions. Q ty C] Date; _�a-�a Applicant; WARNING: FAILURE TO SE RE WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS UNLAWUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAV 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 OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address ❑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: License Law for the reason(s)indicated below by the checkmark(s)I have placed OYES 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 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($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING El 1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING. compensation,will do ( ) all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). CITY OF MENIFEE PLCK No: _-- Permit No: 29714 Haun Road Date: Date: O a Menifee, CA 92586 Phone: (951)672-6777 ° "t Fax:(951)679-3843 Ck#: Ck#: Building Combination Permit To Be Completed By Applicant Legal Deswphon: Planning Case: F: L: Rt: R: Property Addre Assessor's Parcel Number. �`I Ord t K rw - -O ProjectlTenant Name: Unit#: Floor#: Name: P ne No. Fax No..� Property gtldress* Uni umber Zip Code Owner p� s O qxK O�Xve �-I Email Address: y n q?c q N. : V �Q� Applicant Address: Unit Number Zip Cqe O K 1 Enae d ss: C. -itt Name: \ P one No. F Contractor Ad J City St p Z Code ontrac(prs�t us Hess L eensa o. C rector's City S at of Cahf mia License Na. Classification: Number of Squares: S°uare Footage \\dc)Jr Description of Work: Cost of Work:$ a b � �oe_.�,f 1 Applicants Signature �uL �y.� t Dat : r--- - ILi To Be Co eted By City Staff Only D pv'- Indicate As R-Received or NIA-Not Applicable 5 Completes sets of fully dimensoned,drawn to sale plans which include: t set of documents which include ❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Soils Report(on cd only) ❑ Plot I Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 2d Energy(on 8 K x 11) ❑ Structural Calculations ❑ Foundation Plan ❑ Crass Section ❑ Plumbing Plan ❑ Single Line diagram for elec,Services over 400 AMP ❑ Floor Plan ❑ SWctural Framing Plan 8 Delails ❑ Shoring Plan ❑ Sound Report-Residential Class Code: Indicate New Construction Alteration' Addition' Means/Methods Work Type: Repair* Retroffr Revision to Esisli Permit'Required? 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 if Indicate all Geo-tech.Haz.Zone At Project Indicate Spdnklerea YES or NO that apply: Coastal Zone Completion: ConsWction Type(s): C Of YES yES or NO Noise Zone Required? Listed on Historic Resources Irventory CITY PLANNING STAFF ONLY APPROVALS: Costal Cornmiss Arch.Review Board Landmark Comm. Planning Comm.Zoning Admmistrator Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit apes u.'c fll1e9 Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing For Staff Use Only Burdmg!Satety I Permi!Specialfsi City Planning I Owl Fn ineru, g EPWM-Admin ILansportalion Atgmt. I Rent Control it THANK YOU FOR HELPING US CREATE BETTER COMMUNITY Sim lifted Prescriptive Certificate of Com liance: 2008 Residential HVAC Alterations 111 CF-IR-ALT-HVAC Climate Zones 10 to 15 Site evs e. Permit#: Enfar envy: .. —1 : SC\. O0 �(3,v- �� . '—I Q t'� Conditioned Floor rea E ui ment T i List Minimum Efficien Duct insulation re uirement p Thermostat Packaged Unit Over 40 ft of ducts added or [)$otback Furnace SEER ©COP_ r laced in unconditioned space erved by system (ynot already Indoor Coil p ®HSPF_ [ R 6 (CZ 10-13) jjW sf Present tna) t 6e Condensing Unit QEER_ Resistance �]R 8 (CZ 14-15) Other 1.Equipment Type:Choose the equipment being installed:ifmore than one system,use another CF-1 R-ALT-NVACjor eac system. 2.Minimum Equipment Efficiencies:13 SEER, 78%AFUE, 7.7HSPFjor typical residential systems- Listed Listed below are four HVAC alteration Options. The installer do the form s shall be ,, bat work is bing done and HERS VERIFICATION SUM left on site for final picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted.A copy 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 si ed. innin October 1,2010,a 'registered co of the CF-1R and CF-0R shall also be on site for final ins action. 1.HVAC Changeout Required Forms: CF-6R forms: MECH-04,MECH-2I-HERS and(for split systems)MECH-b-HERS • All HVAC Equipment replaced CF-4R forms: MECH-21 and for s lit stems MECH-25 City of Menifee • Condenser Coil and/or CF-6Rforms: MECH-2I-HERS and(for split systems)MECH.25-HERS Building & Safety Dept, • Indoor Coil and lot CF-4R forms:.MECH-21 and(for split systems) MECH-25 • Furnace eq TM1v y 2 9 2014 For Split Systems:Duct leakage<15 percent RC,CCA>_300 CFM/ton(Min imum Air Flow R uire ment), For Packaged Units: Duct leakage<15 percent Exempted from duct leakage testing if: Received 1.Duct system was documented to have been previously sealed and eonfumed through HERS venfication,or 2.Duct systems with less than 40 linear feet in unconditioned space,or 3.Existin ducts stems are constructed,insulated or sealed with asbestos77 ,W Z1 Aul! In day 2.New HVAC System Required Forms: • Cut in or Changeout with new CF-6R forms: MECH-04,MECH-20-HERS,and(for split systems)MECH-22-HERS,and MECH-25-HERS ducts:(all new ducting and all CF-4R forms: MECH 20-,and(for split systems)MECH-22,and MECH 25 new a ui mrnt) PP- For Split Systems:Duct leakage<6 percent;RC,CCA>_350 CFM/ton,FWD,TMAH,STMS,and either HSPP or PS For Packaged Units:Duct leakage<6 percent 3.New Ducts with/or without Replacement Required Forms: p MECH-25-HERS • Includes replacingor installingall new ducting CF-6R forms: MECH-04,MECH-20-HERS,and(fors lit systems) MECH-25 and/or outdoor condensing unit and/or indoor coil CF-0R forts:MECH-20 and(for split systems) and/or furnace. No or some equipment changed. For Split Systems:Duct leakage<6 percent,RC,CCA>_300 CFM/ton,TMAH For Packa ed Units:Duct leakage<6 percent 4.New Ductin over 40 feet R aired Forms: • Includes adding or replacing more than 40 CF-6R forms: MECH-04,MECH-2I-HERS CF-4R forms: MECH-21 linear feet of duct in unconditioned space. For split s stem or packaged units: Duct leakage<15 percent EXCEPTION:Existin duct stems 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. • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate Compliance. I certify that the energy features and performance specifications for the design identified on this Certificate of Cottryliance conform to the requirements of Tide 24, Pars 1 and 6 of the California Code of Regulations. 6 The design features identified on this Certificate of Compliance are consistent with the infornation documented on other applicable compliance forms,worksheets, calculations,plans and specifications submitted to the enforcement en fora roval with it a lication. Name:Laura Yenulonis -Agent Signature: Company: 9 Date: Venvest Ballard Inc., dba: Ri hTime Air Conditioning & H ti 5—aq—1 Address:3030 Myers Street License:878533 city/stateaip:Riverside, Ca 92503 Phone:951-276-9744 2008 Residential Compliance Forms March 2010