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PMT14-01373 City of Menifee Permit No.: PMT14-01373 29714 HAUN RD. Type: Residential Mechanical 9 CCIEILA> MENIFEE, CA 92586 A�Awt` MENIFEE Date Issued. 05/29/2014 PERMIT Site Address: 27870 MOONRIDGE DR, MENIFEE, CA Parcel Number: 333-252-015 92585 Construction Cost: $8,250.00 Existing Use: Proposed Use: Description of REPLACE 60,000 BTU FURNACE,2.5-TON A/C&COIL, SAME LOCATION Work: Owner Contractor SILVA&BRANDY PAIVADA VENVEST BALLARD INC 27870 MOONRIDGE DRIVE 3030 MYERS STREET MENIFEE, CA 92585 RIVERSIDE, CA 92503 Applicant Phone: 9512769744 VENVEST BALLARD INC License Number: 878533 3030 MYERS STREET RIVERSIDE, CA 92503 Fee Description ON Amount ISI 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_Permit_Template.rpt Page 1 of i 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 Coder and my license is in fu L o�Se lest. Cade:The Contractor's License Law does not apply to an owner of a property License Class Lice se No. 1 "J who builds or improves thereon, and who contracts for the projects with a Expiresb-lb\- �(Q Signature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DE LA TION ;X_� ❑ 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 `{Q 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.leoinfo.c@.Qov/calaw.html. permit is issued.My workers'compensation insurance carrier and policy number are: N Property Owner or Authorized Agent Date Carrier "CN�S. cc) ,Q \`t o wesS - �.v� Expires \e-) Policy# -,r;"_ ❑ By my Signature below, I certify to each of the following: I am the property Name of Agent \t 1.�1Ppetk t ° 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- 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 employ any persons in any manner so as to become subject to the �\ �p f workers'compensation laws of California, and agree that if I should become tp� subject to the workers'compensation provisions of Section 3700 of the Labor proper( O er or Authorized Agent U Date Code, I shall forthwith comply with those revisions. \\�� e City Bum tense# ✓�� + O - Date;��q-� Applicant; WARNING: FAILURE TO BE RE WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS UN��AW UL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINA 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 LENDINGAGENCY SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? I hereby affirm that under the penalty of perjury there is a construction lending 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 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 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, ONO 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 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING HAZARDOUS MATERIAL I EPORffING. ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER ORAUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). CITY OF ME1 IFEE PLCK No: P rmit No: _ 3 29714 Haun Road Data: Date: Menifee, CA 92586 -I Phone- (951)672-6777 Amount: oun' Fax:(951)679-3843 Ckrk Ck#: Building Combination Permit To Be Completed BY Applicant Legal Description: Planning Case: Rt: R Property Address: Assessor's Parcel Num`bber. 'l yvr t Projecu remant Name: Unit#: Floor#: Name: St�v t[t �'C OIN`OL 'Q0.tVod�. PtwneN Fax No. Property Adores srL , rJ r1,_. Unit u her -I ZIP Code as85 Owner dd Email Address: Name: Applicant Ad ress t Unit Number Lp Code O 3030 v s Ema4dress: - Vl `7 L Phone Name: ` -bi No . ,t,nA� V S � :In Q St "I Zp�ode Contractor Address: SST 44 \\4er,51cu ontrector.s ty tMiialcenrso we.,U. Contractor's City State of California License No, Classilicalian: 7-(0049 Number of Squares: Striate Footage }- Description of We \ Cost of Work:$ n a t Appl-icant's Signature D _ S OA�Q`E�Ixq Dale: To Be COMP12122 By.City Staff Only - -J Indicate As R-Received or WA-Not Applicable 5 Canpicies sets of fully dimensioned,drawn to sale plans which include: 1 set of documents which include ❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Goo TeclVSolls Report(on cd only) ❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title Structural Energy(on x'It) ❑ Calculations ❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for else.services over 400 AMP ❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan ❑ Sound Report-Residential Class Code: I Indicate I lNew,Construction Alteration' Addition' Means/Methods Work TyPdr I Repair' Retrofit' Revision to Efisling Pend! Required? YES NO Proposed Building Use(s): Existing Building Use(s): #Buildings: #Units: #Stories' Atheilding Have a Basement? Y of N Bldg.Code Occupancy Group Indicate if Indicate ailGeo-tech.Hi z.Zone Indicate Sprmklered YESorNO that apply: Coastal Zone At Project ConsWction Completion: 7ype(s): Colo YES or NO Noise Zone Raquired? 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 sperla .ase:abg official AurS0,31 Expedite Project(s): Chiitl Care City Project Green Building I Landmark Affordable Housing For Staff Use Only 8ui!dingfSaiety Pem�i!Specialist City Planning I Gvd E ineenng EPWM-Admen I'ansporlatiorldgmt, Rent Control THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY Sim lifted Prescri tive Certificate of Com liance:2008 Residential HVAC Alterations CF-IR-ALT-HVAC Climate Zones 10 to 15 Permit P. Enfor enc5'c - Site Address; C]--� �( - Conditioned Floor List Minimum Efficien Duct insulation re eat Area Thermostat E ui ment T Setback Packaged unit F o COP__ Over 40 ft of ducts added or nar already Pomace © laced in unconditioned space Served b�system n esem.musr be ®Indoor Coil EERY_ eHSPF— R 6 (CZ 10-13) �ro— sf lied) Condensing Unit §EER Resistance R 8 (CZ 14-]5) Other p g more than one system,use another CF-]R-ALT-HVAC for each system. I.Equipment Type:Choose the e i ment bein instilled;if 2 Minimum Equipment EjWdenries: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 noes. Each option lists the HERS measures that must be conducted.A copy of the forms shall be left on site for final picks one of the appropriate Op inspection and a copy given to the homeowner. At final,the inspector vengtsed CF-4R formst(nO and fillfed CF-4Rs alin to ed)are filled outthe work tand ed Y e installer The inspector also verifies that each appropiate CF-6R and re si ed. 'onin October 1,2010,a r istered co of the CF-11 and CF-6R shall also be oo site for final ios et4ion. ®1.HVAC Changeout Required Forms: MECH-04,MECH-2I-HERS and(for split systems)MECH-25-HERS CF-6R forms: • All HVAC Equipment replaced CF-4R forms: MECH-21 and fors lit stems MECH-25 • Condenser Coil and/or CF-6R forms: MECH-2I-HERS and(for split systems)MECH-25-HERS city of Menifee • Indoor Coil and lot CF4R forms:,MECH-21 and(for split systems) ME tCH-25 y • TMAH Furnace < percent; RC,CCA>_300 CFM/ton(Minimum Air Flow Requirement), For Split Systems:Duct leakage 15 per t; MAY 2 9 2014 For Packaged Units: Dud leakage<15 percent Exempted from duct leakage testing HERS verification,or 1.Duct system was documented to have been previously sealed and confirmed through = 4 f 13Id 2.Duct systems with less than 40linear feet in unconditioned space,or 3.Existin duct s stems are constructed,insulated or sealed with asbestos []2.New HVAC System Required Forms: (a g CF-6R forms: MECH-04,MECH-20-HERS (for split systems)MECH-22-HERS,and MECH-25-HERS • Cut in Chan soot with new ducts:(all new ducting and all CF-4R fonts: MECH 20-,and(for split systetns)MECH•22,and MECH 25 new e ' ment) TMAH,STMS,and either HSPP or PSPP. For Split Systems:Dud leakage<6 percent;RC,CCA>_350 CFM/ton,FWD, For Packaged Units:Dud leakage<6 percent []3.New Duds with/or without Replacement Required Forms: • Includes replacing or install ng cell new ducting CF-6R forms: MECH-04,MECH-20-HERS,and(for split systems)MECH -25-HERS and/or ndoor coil CF-4R forms:MECH-20 and(for split systems)MECH-25 and/or outdoor condensing unit and/or furnace. No or some equipment changed. TMAH For Split Systems:Dud leakage -6 percent 'RC,CCA>_300 CFMhon, For Packa ed Units:Dud 1 e<6 ;cent R aired Forms: 4.New Ductin over 40 Peet • Includes adding or replacing more than 40 CF-6R forms: MECH-04,MECH-2I-HERS CF4R forms: MECH-21 linear feet of duct in unconditioned ce. 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. nsibiliry for the design identified on this Certificate of Compliance. • I am eligible under Division 3 of the California Business and Professions Code to accept repo I certify that the energy features and performance sp,,ifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts I and 6 of the California Code of worksheets,Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, calculations,plansand2Eifications submitted to the enforcementagelcy forapproval with the rmit a lieation. Nate Laura Yenulonis - Agent I Signature: Date: company:Venvest Ballard Inc., dba: RighTime Air Conditioning & Heat' g r� rYA Ada 3030 Myers Street License:878533 city/Stateaip:Riverside, Ca 92503 Phone:951-276-9744 March 2010 2008 Residential Compliance Forms