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PMT14-01375
City of Menifee Permit No.: PMT14-01375 29714 HAUN RD. Type: Residential Mechanical '5�0CELA_ MENIFEE,CA 92586 MENIFEE Date Issued: 05/29/2014 PERMIT Site Address: 29554 CEDAR GLEN LN, MENIFEE, CA Parcel Number: 340-320-012 92584 Construction Cost: $15,000.00 Existing Use: Proposed Use: Description of REPLACE 80,000 BTU FURNACE,4-TON (14 SEER),A/C AND COIL, SAME LOCATION Work: Owner Contractor JUDITH KEHMANN A R S AMERICAN RESIDENTIAL SERVICES OF 38554 CEDAR GLEN LANE CALIFORNIA INC MENIFEE, CA 92584 965 RIDGE LAKE BLVD SUITE 201 Applicant Phone: 9012719700 A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNI( License Number: 791820 965 RIDGE�LAKE BLVD SUITE 201 MEMPHIS, `;A 38120 Fee Description 41rt Amount($) 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 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 anci my license is in full forcpe'ann'd effect. Code:The Contractor's License Law does not apply to an owner of a property License Class C� C3(oLice a N . {1 DD13 who builds or improves thereon, and who contracts for the projects with a Expiresa ate Signature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATIOND CLA TION""� ❑ 1 am exempt from licensure under the Contractors'Stale 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. 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 lection 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:htti),//www.leciinfo.ca.gov/calaw.html. permit is issued.My workers'compensation insurance carrier and policy number are: Carrier II�,,—4 Property Owner or Authorized Agent Date Expires Policy# WVA10-51 SDS I2310\91 /+ 1"1 1 ❑ By my Signature below, I certify to each of the following: I am the property Name of Agent )L l . Phone# lY''t�0'CJ1 �30� 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 workers'compensation laws of California, and agree that if I should become a i OSIM�C) _ 1� M� subject to the workers'compensation provisions of Section 3700 of the Labor z Code,I shall forthwith comply with those provisions. �r pertypw �r or Authorized Agent L4 Date City Busi ass License 1 Date;�__ �I— r _ Applicant; z J WARNING: FAILURE TO BE URE WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS U A UL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI A 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($500).) CODE SECTION MATERIAL25505f�E5533fWG AND 25534 CONCERNING ❑ 1, as owner of the property, or my employees with wages as their sole compensation,will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's Slate License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). CITY OF M1f NIFEE PLCK No P nnit No: -7 29714 Haun Road City Of Menifee Date: D Menifee, CA 92586 Building & Safety Dept. Phone: (951)672-6777 Amount: Amount: Fax:(951)679-3843 MAY 2 9 2014 Ck#: Ck#: / Building Combination pgmftived To Be Completed By Applicant Legal Description: Planning Case: F: L: Rt: R: Property Address: Ass7r's Parcel Number. ProjectiTenant Name: Unit#: \ Floor#: Noma: \` l N _O -I Faz Na Property Address: r�R Unit N CA umber Zip Code Owner C Email Address: Name: ho o. Fn Applicant IV3 �D ✓\ Unit Number Zip Code Email Addr s{: nr Name: ` _ 1 P�hOniNo. Fax No. Contractor Address: h `!Y\d �\v a City,r�y`Q, Ste Zip Dad \ ontmctor s W Bus, LIc o. I Contractor's City State of CalUomia License No. far Number of Squares: Square Footage lI u co Description of Work: Cost of Work:$ Applicants Signature p..(C Lo11L — �5Q-iyr2 Dale: 15 To Be Completed By Clty Staff Only :J Indicate As R-Received or NIA-Not Applicable 5 Completes sets of fully dirnens.cne , o sale p ans which includes 1 set of documems which include ❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech7Sods Report(on cd only) ❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on&Y x 11) ❑ Structural Calculations ❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP ❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan ❑ Sound Report-Residential Class Code: Indicate New Construction Alteration' Addition' Means/Methods Work Type: Repair' Retrofit" Revision to Exisfing PermiP Required? YES NO Proposed Building Use(s): Existing Building Use(s): #Buildings: #Units. is Stories' Wit)the Building Have a Basement? Y of N Bldg,Code.Occupancy Group Indicate Indicate if YES or NO Indicate all Geo-tech.Hu.Zone At Project Construction Spnnklored that apply: Coastal Zone Completion: Type(s): C Of OYESorNO Noise Zone Re uired? 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 Efec.Vehide Charger Landmark Seismic Retrofit oPlp"lA as al Expedite Project(s): Child Care City Project Green Building 1-and arki I Affordable Housing For Staff Use Only Bu0ding75afely. Permir Specialist Guy Planning Civil Fn ineenng EPWM-Admin 'rransportalion Mgmt. Rent ConUol THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAfteratlons CF-IR-ALT-HVAC Climate Zones 10 to 15 Site Address; EnforcementAgenry: Dote: rntit#: C 5— -I - -19 Conditioned Floor I, ui nem I'Vise List Minimum Efficiencv' Duct insulation requirement Ana Thermostat Packaged knit ® Over 40 ft of ducts added or ®Setback Furnace AFUE 4sb t' ©cop- re laced in unconditioned space Served by systcm -/lfmoralrrad)- Indoor Coil �SEER_L'Ll ❑HSPF n R 6 !CZ I X I1 i )40O'sf Prewar.muss he Condensing unit EER ❑Resistance ❑R 8 r(,Z 14-15) Other 1.Equipment Type-Choose the equipment being installed:if more dean line system.use another CF-1 R-A1,T-HV.4C,jor ew nmem. '.:Minimum Equipment Efficiencies: 13 SEER. 78S AFLE. T 711.5PP'jar npcal residential systems. HERS VERIFICATION SUMMARY Usted below are four HVAC alteration Options. 11c installer decides what work Lv 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 insralicr. The inspector also verifies that each apprapriate CF-bR and registered CF'-4R forms(no hand filled CF-4Rs allowed)are filled out and sixted, Beginning October 1,2010,a registered copy of the CF-IR and CF-6R sball also be on site for final inspection. 1-HVAC Chan eout Required Forms: • All IiVAC Equipment replaced CT-6R Corms: NIECH-04,MECH-2I-HERS and(for split systems)MECH-25-IfERS C7r-4R forms: IvIEC:H-21 and(for split s stemsi MF.CI-1-23 • Condenser Col and ror City of Mani ee • Indoor Coil and/or CF'•6R forms: MECH-'i-HERS and(for split systems)MECF3--5-HERS Building & Safet De i CF-4R forms: MECFI-_1 and(fur split systems) MECH-25 p[. • Furnace For Split Systems:Duct leakage< 15 percent RC,CCA'>3(l0 CFM/ton(Minimum Air Flow Requirement),TMAH MAY 2 9 2 14 For Packaged Units: Duct leakage< 15 percent Exempted from duct leakage testing it.,1.Duct srslem was documented to have been previously sealed and confimwd through HERS verification.or e C e I V ttip,.,g 2.Duct systems with less than 40 linear feet in unconditioned space,or 3.Existing ducts stems are constructed.insulated or sealed with asbestos ?.New HVAC System Required Forms: • Cut in or Changeour with new CF-6R forms: MECH-04,MECH-20-HERS.and(for split systems)MECH-212-HERS,and MEC14-25-HERS ducts:(all new ducting and all (T-tR forms: MECH-20,and(for split systems)MECH-22,and MECH-25 new 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<b percent ©3.New Ducts with Replacement IRequired Forms: • Includes replacing or installing a6 new ducting CF-(iR forms: MECH-04,MECH-20-HERS,and(for split systems)MECR-25-I1ERS readier outdoor condensing unit and/or indoor CF-tR roams:MECH-20 and(for split sysrems)MECI1-25 coil and/or furnace. Not all equipment changed. For Split Systems:Duct leakage<6 percent,RC,CCA;>300 CFM1ton,TMAH For Packaged Units: Duct leakage<b percent 4,New Duicting over 40 feet Required Forms: • Includes adding or replacing more than 40 CF-6R forms: MEC14-04,MECH-2I-HERS CF-4R forms: MECH-21 linear reel of duct in unconditioned space. For split stem or paekaged units: Duct leakage< 15 percent EXCEPTI ng duct systems canstnuted.insulated or sealed with asbestos. Contractor(Documentation Author's/Responsible Designer's Declaration Statement) • Iccmlf that this Certificate ofCompliamx eWceunemation is accurate and complete. • I ant eligible tmdder Divisan 3 of the Calirmia Business and Ptpfessions Code in acept ruponsibilay for the design idcmified on this CeniBcate orcomptame e, • I certify that the energy features and perfbmiance specifiemions for the design identified on this Gxttneaw of Compliance::antorm to the requirements of"I itic:4. Parts I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance we consistent with the in mtcd - eon, eafcoianons.Plans ands specifications submitted to flte enforcement!acne ire a oral tth the 't i Name: DANIEL TRAVERSI signata Company: ARS ate: Address: 1225 GRAPHITE DERIVE Li�`n'� 791820 cir>rstaterlp: CORONA, CA 92881 1 Phone: 951-280-3101 Wink 0.,.��dn,..f,.J!`nr.,.,li..«.-.:F.,.nm I.A. With