PMT14-01374 City of Menifee Permit No.: PMT14-01374
29714 HAUN RD. Type: Residential Mechanical
'C;kCCELA_ MENIFEE, CA 92586
ren«oxre 50kna. MENIFEE Date Issued: 05/29/2014
PERMIT
Site Address: 27425 TERRYTOWN RD, MENIFEE, CA Parcel Number: 336-331-004
92586 Construction Cost: $4,995.00
Existing Use: Proposed Use:
Description of REPLACE 60,000 BTU FURNACE AND COIL ONLY
Work:
Owner Contractor
CAROL MASSARA VENVEST BALLARD INC
27425 TERRYTOWN ROAD 3030 MYERS STREET
MENIFEE, CA 92586 RIVERSIDE, CA 92503
Applicant Phone:9512769744
VENVEST BALLARD INC License Number:878533
3030 MYERS STREET
RIVERSIDE, CA92503
Fee Description Q�t Amount
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
$177.00
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)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions
Professions Coda and my license is in fu ofSe n g);fe�t. Code:The Contractor's License Law does not apply to an owner of a property
License Class Lice se No. 1 �j"J who builds or improves thereon, and who contracts for the projects with a
Expires5-�j I^_`�{j Signature �Qp licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DE LA TION' Q'
❑ 1 am exempt from licensure under the Contractors'Stale 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 permit is issued. improvements covered by this permit, I cannot legally sell a structure that I have
Policy# built as an owner-building if it has not been constructed in its entirety by licensed
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
action 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http�//www leoinfo ca ciov/calgw html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier lweSv WV1:: Property Owner or Authorized Agent Date
Expires ,,�\\^^Polliic�cty""#��
Name of Agent-_S`t , XI1 NCPamileY r ❑ By my Signature below, I certify to each of the following: I am the property
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-
El 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 _� ,j L
subject to the workers'compensation provisions of Section 3700 of the Labor pro e O er or Authorized A Code, I shall forthwith comply with those rovisions. p gent ^ Q Date
City Busin cans,# 04 C�
Date; 5" � Applicant; y
WARNING: FAILURE TO S WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UN44 , AND SHALLSUBJECT AN EMPLOYER TO CRIMIINALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DYES 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 ❑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 EYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Li 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 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
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 DYES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from Iicensure 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
Elro property, or my employees with wages as their sole I, as owner of the HAZARDOUS MATERIAL IAEPORI'ING.
compensation,will do ( )all of or( )porting of the work,and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's Stale License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY O 1`71iGNIlFEE PLGKNo: P nnitNo:
_ IJ
29714 Haun Road Date: Date: _1
Menifee, CA 92586
Phone: (951)672-6777 �^ou^t: Amount:
Fax:(951)679-3843 Ck& ck#:
Building Combination Permit
To Be Completed By Applicant
;�, tion: Planning Case: F: L: Rt: R:
ress, Assessor's Parcel Number. 1
—I LA r -,
ant Name: Unit#: Floor#:
me: Phone No. 1 -O O F
X- 5S
dress: UnitNumber Z!p dmail Address: 1lM l aame: PoAP ne No. F x NK-ASX�C• l - 7d ass: Unit Number Zip"'qs mail fydtl ss:
Name:` Phone No. Fax N".A
St Zip
Caotmeter Address: C a
eX•� S� tve,YS O
n Yacter 5 ty u^tress L tense o. Contractor's 'ty State of Caido�mia license No. Classification
Number of Squares:
Square Footage ` Oop}
I `(� C
Description of Work Cost of Work:$O � £ � µ �'t—t J.
Applieanf-Si lur A n r Date:
To Be Completed By City Staff Onl -
Indicate As R-Received or NIA-Not Applicable
5 Compl¢tes sets of fully di trod,drown to sale plans wnich incude:
'I set of documenls which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Gen Tech/Soils Report(on cd only)
❑ Title 2d Energy(on&`/.x 11)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Structural Calculations
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ SWdural Framing Plan&Details ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition• MeanslMetnods
Work Type Repair' RetrofiP Revision to Existimj PemeC 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 it Indicate all Geo-tech.Haz.Zone
P y P Indicate YES or NO
At Project Construction Sprinklered that apply: Coastal Zone
Completion: Type(s): C of O YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. Planning Comm.Zoning Administrator
aperlal .ase�.ICq
Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit omdal royal
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Bulldmq!Safety Perini!Specialist City Planning Gwl E ineenng EPWM-Atlmin '`mnsportalion Mgmt. Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
Simplified Prescriutive Certificate of Comp lance 2008 Resident HHVAC A&erahons
CF lR ALT-HVAC
Climate Zones 10 to 15
D permit#:-O 751
En oreemeru envy: (
Site ddress: �7
r`f' Conditioned Floor Thermostat
Dud insulation re uirement Area
ui meet T ' List Minimum Efficient ' 5 Setback
Packaged Unit �AFUE Sb COp_ Over e ft of ducts added or Served by system Jnot already
EaFumace laced n unconditioned space ` -t sf present,must be
Indoor Coil EER_ ®HSPF_ R 6 (CZ 10-13) - installed)
Condensing Unit
QEER_ Resistance R S (CZ 14-15)
Other 8 t more Chars one system,use arsother CF-1 R-ALT-HVAC for each system.
1.Equipment Type:Choose the equipment beirs installed;f
Equipment E rctencies:13 SEER, 78%AFUE, 7.7HSPF for typical residential systems.
2.Minimum Equip .ff bons. The installer decides what work is being done and
HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Op of the forms shall be left on site for final
picks one E the appropriate Options. Each Option lists the HERS measures that must be conducted.A copythe work
inspection and a copy given to the homeowner. At final,the inspector verifies that-4R forms listed
(no and fil form
ed CF-4Rs al owed)are filled out land
ed Y�e
installer. The inspector also verifies that each appropriate CF-6R and registered
si ed. 'onio October 1,2010,a istered co of the CF-1R and CF-6R shall also bed site forte al ins ection.
I.HVAC Changeout Required Forms:
CF-6R forms: MECH-04,MECH-2I-HERS and(for it systems)MECH 25-HERS
• All HVAC Equipment replaced CF-4R fortes: MECH-21 and for split SYstems) ME0-25
• Condenser Coil and/or CF-6R forms: MECH-2I-14ERS and(for split systems)MECH-25-HERS
of Menife
• Indoor Coil and/or CF4R forms:.MECH-21 and(for split systems) ME City Y opt,
• Furnace RC,CCA>_300 CF mtu
M/ton(Minin Air Flow Requirement),
< TMA
For Split Systems:Duct leakage 15 perDerr t; MAY 2 9 201
For Packaged Units: Duct leakage<15 percent
Exempted from duct leakage testing if: iousl sealed and confirmed through HERS verification,or
1.Dud system was documented to have been prey y
2.Duct systems with less than 40 linear feet in unconditioned space,or
3.Existin ducts stems are constructed^insulated or sealed with asbestos
02.New HVAC System Required Forms:
and for lit stems)MECH-22-HERS.and MECH-25-HERS
• Cut in or Changeout with new CF-6R forms: MECH-04,MECH-20-HERS, ( split sY
ducts:(all new ducting and all CF-4R forms: MECH 20-,and(for split systems)MECH'22,and MECH 25
new a in meet) TMAH,STMS,and either HSPP or PSPP.
For Split Systems:Dud leakage<6 percent;F2C,CCA>_350 CFM/ton,FWD,
For Packaged Units:Duct leakage<6 percent
3.New Ducts with/or without Replacement Required Forms:
• Includes replacing or installing all new ducting CF-6R forms: MECH 04,MECH-20-HERS,and(for split rystems)MECH-25-HERS
and/or outdoor condensing unit and or indoor coil CF-4R forms:MECH-20 and(for split systems)MECH-25
and/or furnace. No or some equipment changed.
For Split Systems:Duct leakage<6 percent,'.Rc,CCA>_300 CFMfton,TMAH
For Packa ed Units:Duct I e<6 cent R uiced Forms:
4.New Dusan over 40 feet
• Includes adding or rePlac'ag more than 40 CF-6R forms: MECH-04,MECH-2I-HERS CF�R forms: MECH-21
linear feet of duct in unconditioned ce.
For split s stem or packaged units; Duct leakage<15 percent
EXCEPTION:Existin dud stems dmswcted,insulated or sealed with asbestos.
ation Statement)
Contractor(Documentation AuthoPs/Etesponsible Designer's Declar
• I certify that this Certificate of Compliance documentation Is accurate and complete. ty reibiliertificate of Compliance conform to the requirements of Title 24,
for the design identified on this Certificate of Compliance.
• I am eligible under Division 3 of the California Business and Professions Code to accept respo
• I certify that the energyy features and performance spxifications for the design identified on this C
Parts I and 6 of the California Code of Regulations licable compliance forms,worksheets,
• The design featues identified on this Certificate of Compliance lieation.
we consistent with the information documented on other app
calculations.plans and ifications submitted to the enforcement on for St�afir a emit a
Name:Laura Yenulonm - Agent
Date:
company:Venvest Ballard Inc., dba: RighTime Air Conditioning & H tin
Addreas:3030 Myers Street License:878533
Phone951-276-9744
city/stateaip:Riverside, Ca 92503
March 2010
2008 Residential Compliance Forms