PMT14-01893 City of Menifee Permit No.: PMT14-01893
29714 HAUN RD. Type: Residential Mechanical
`91CCFi.A�k. MENIFEE, CA 92586
MENIFEE Date Issued: 07/22/2014
1
i
PERMIT
Site Address: 29957 COOL MEADOW DR, MENIFEE, Parcel Number: 339-401-022
CA 92584 Construction Cost: $6,500.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT
Work:
Owner Contractor
JOANNE C DESHELES BCI SOLUTIONS INC
29957 COOL MEADOW DR 1757 GALLOWAY LANE
MENIFEE, CA 92584 CORONA, CA 92881
Applicant Phone: 9518934121
SHARON BEYLER License Number: 985071
BCI SOLUTIONS INC
1757 GALLOWAY LANE
CORONA, CA 92881
Fee Description QQrt Amount
Air Handling/Condensing Units SFR 1 133.00
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 slated,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 Cod nd m license is in full and effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class Llcense No. 4 $WQ who builds or improves thereon, and who contracts for the projects with a
Expires? � Si re " licensed contractors)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION ❑ 1 am exempt from licensure under the Contractors'State 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 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
❑ 1 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:hltp'f/www.IeqInfo.ca.Qov/caIaw.htmI.
permit is issued.My workers'compensation insurance carrier and policy number are:
Property Owner or Authorized Agent Date
Carrier
Expires Policy#
62'ty 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-
certify that in the performance of the work for which this permit is issued,I Ide ifi p rty 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 ,
subject to the workers' compensation provisions of Section 3700 of the Labor Property Owneror Authorized Agent Date
Code,I shall forthwith comply with those .o 'sions.
City Business License#
Date; � Applica
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, DYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE ,L,� MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES , 4� IV0 EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY 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 ❑YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
��
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
�(
Lender's Address �f�lO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS PRINT NAME:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
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 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 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($500).) HO E, SECTION 2 5051�250R31'WGD 25534 CONCERNING
MATE❑ I, as owner of the property, or my employees with wages as their sole
compensation, will do ( ) all of or( ) porting of the work, and the structure is P WNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENIFEE PLCK No: P•�1�tnit o
29714 Haun Road Dale: pal � I —�' ��
Menifee, CA 92586 �1 l L{
Phone: (951)672-6777 Amount Amount_ 10�
Fax:(951)679-3843 Ck u: ck f 7J-
Building Combination Permit V
(911
To Be ComPleted By Ap Ilcant
Legal Description: I ..rr � tanning Case: F: L: Rt: R
Property Address: .� L,f�J l� Assessor's Parcel Number 33,1 - 40 - a>-
Projec enant Name: Unit# Floor#:
Name:
tin c e.. No. Fax No.
Property
Owner dress: / T r Unit Number Zip Code �
Email Adtlresa: �
Name: P Noty,3 _4_/ Fax
Applicant Address: _ // Unit Number
Email ss: G O
a[fG a �Y—
Name: 9 Phone No.
Fax No.
Contractor Address: City State Zip Coda
Contractor's City Business License No. Cmtraclo' t ifomia License No.
Classification:
Number of squares:
square Footage
Description of Work: C. C 63 / Cost of Work:$
Applicant's Si re
c ` �T
To Be Completed By City Staff Only
Indicate As R-Received or N/A-Not Applicable
5 Canpletes sets of fully dimensioned.drawn to sale plans which include: t set of documents which melude
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Soils Report(on ed only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8%x 11)
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ structural Calculations
❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan 6 Details ❑ Storing Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration* Adrdition• Means/Melhods
Work Type. Repair' Retrofit• Revision to Existing Permit' Required? YES NO
Proposed Building Use(s): Existing Building Use(s):
M Buildings. p Units: t/Stories: Will the Building Have a Basement?
Y of N
Bldg.Code Occupancy Group Indicate IMtrale d YES or NO Indicate all Geo-tech.Haz.Zane
At Project Construction spnnkieretl 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. %anning Comm.Zoning Administrator
Fee Exempt: City Project I JElec.Vehicle Charger Landmark Seismic Retrofit Ipcet ale'Bldg
Ofsdw Amoi
Expedite Project(s): Child Care City Project Green Building Landmark Agordable Housing
For Staff Use Only
euilortil5alety I Fernifl5pecialistCity Planning I Civil 1,ngineenng I EPWM Admin I lmrkspwafionmgrnt. I Rent Coneoi
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
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Simplified Prescriptive Certificate of Compliance: 2008 Residential Hiit C,4lterativns CF-IR-ALT-HVAC
Climate Zones 8
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3Sii `7 d/ nmrmrnt en Dole:
�� Pr min b: 4 O I
5VI`
E ui meat Tv List Minimum Effic,.enc.r Conditioned F oor Area Thermostat
❑Packaged L nit
RTU—riac ❑AFUE ❑COP Served by system ❑Setback
p'fadoorCoil i EMERJJ� ❑HSPI —13'Condensing Unit ❑EBR Ufanralreadypres2m mustbrirzrrdley
ClClResistance
❑Other
1. Equipment Type:Choose the equipment being installed if more than one system use another CF-I R.ALT-HV'AC for each sysiem.
2.Minimum Equipment Efficiencies: 13 SEER,78%Al'Cti,7711S1'F for apical residential srsterns.
HERS VERIFICATION SUMMARY Listed below are three 11VAC alteration Options. The installer decides.shatnvork i5 being
done and picks one of the appropriate Options. Each Option lists the HGRS measures that must be conducted.A copy of the fomu shall
be left on site for final im-peedon and a copy-given to the homer mer. At final,the inspector serines that the work listed on this fornt
was in fact the work completed by the installer. The inspector also scrifies that each appropriate CF-6R and registered CF-4R forms(no
hand TIIW CF-4Rs allowed)are Tiled out and signed. Beginning October 1,2010,a registered copy of the CF-IR and CF-6R shall
1 also on site for final ins ection.
.HVAC Changeou! _ Required Forms:
• All HVAC Equipment CF-6R farms \TECH-M,M1-CH- '_5-11ERS
renlaccd C'FAR forms VECH 25
• Condenser Coi l and;or CF-6K forme- Aff.CH-25-H'ERS
• Indoor Coil and or CP-4R forms. ;MECH-25
• Furnace
For Split Systems: RC, CCA?300 CFtvi'ton,TMAH
For Packaged Units: No testing required
❑2.New HVAC System Required Forms:
• Cut in or Changeout with CF•6R forms: MECH-04,MECH-25-HERS
sew ducts.(all new ducting CFAR Conns-. MECH-25
and all new ccui m.-n) -
For Split Systems: RC.CCA? 300 CFM'ton, T'MAII.
For Packaged Units: No testing required
73. Necv Ducts with Replacement Required Forms:
• hrcludes replacing nr installing all new CP-6R forms MECH-25-HERS
ductng andfor outdoor condensing_unit C-1:-aft forms MECH-25
and or indrnor coil acid%or fumace- No;all
c,iturnrient changed'
For Split Systems: RC,CCA?300 CFMhon,Th4AH
For Packaged Units:No testing required
Contractor(Documentation Author's/Responsible Designer's Declaration Statement) -
• I cerlifi that this Certificate of Comphance documer,iatien is acau:ae::nd complex.
• I am eligible under Division 3 or the Califomia Business and Professions Code to accept responsibilip for the design idenu Ged on
this Certificate of Compliance
• I certify that the mergc fcamres and performance specifications for the design identified on this Certitia7re of Compliance conform
It,the requirements of Title 24.Part` I 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
Nafng: Sim to -
Companyt r Date,
r�
Address: / 757.. : License
Cim'stat-'Zip: CG L.C. _.. /Y' Phone- �') z,— lr
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20U8 Residential Compliance Forms� Harch 2010
, i
20Q813uilding Eti ! fri ' taudaxcls godo'et a,UVAG
A er th ns 1 1 a�t� pok :$
T1U." ESS AND PROFI SS70NS G9DE aE�t 9T N r110
WilIWTI,6 delibecxtet)1sre ardarid)talattoudithe'Iljt(dtng7a»s tneluditagtheGahfo%ma$wfdi4gCode,and
Ii alperraa-requttcnits pnofLute ncnusef'ordiscrplvYa acltonhorn{ Con�actYrs tat iGcnse aard
)toYki<g in copjunciian zvitb the`local bufldin8alepnrtipen'e_ This eutinn may censist'of lines p to' >,000 per'
fi ilaYiah or suspen'sfc rhrpvoeauon o2 a:nynfractor's h Anse,
�Yi•IEN TS A PERMLT Rli{�UIRE➢�
as vntten co sm ct ogpettit�t shall bs bbtamed fro„n1 the enfori ement xgeocv}srtor to the erectaau ronstrpctia ;
rzeonsirucfr4CtStn�taltattgnsleioc3itmrahcratzor3pfanxttee tantaaisysfem ezeepyespernuned.tnAppeiir7 c ,hapter1,
Se4tian 1 i,2 f dte�007.Uali£grtia fylegixanical Code' T'rQjects r uir ng P. rntlts 1riClude,bps ura not IimitCA 10; -
* Netv}3VAG Jnstallat`iore Reloeatian of an extsti g IfV_AC unh
I�VAC Cpxn$eouf lWing pr rgpfaCtng tjuorC 401
Replaeententaf£uniace, coi;FAU,or duennginuucondi hedSQa
eoudeiiscx
20(I8 BUILOMCr ENERGY EFFlGil NCYSTANDARbS Tltte 24 >A&4)REb(IIREM€ T-S INtfOOD
I, 'Heatiri$equipmed must have a infnfmum 78° AFIIE O xirption g1aj1B tloo'r t k races zagnt h�,a Ys);-
2. Central air conditiorfers k heat pvmps less than 65,A0 BhOkr ttiust har,6 a rhtfiinit`pa d�SEER,
. Newly Sr satfed ar replaced ducts t m lluSt have a nultumnsutabon (alnc of R d,r,
4, Ase€back;type thermos at(24 hr clock udth fob set pginti a required tar alter goats and hew yip lled
S. New or rel lacehteni ducts trust meet the mandatory requirements of;5ectf04,l'S0(m
• All joints and opdntugs in the;in dte liti s.)•stem tnusr be scaled.
« Only.ULM,M ifiA,orIIL1Sl,Bopprovedtapes=or mastic shall t-be used toseal_ductoodnings.
« Connections of rrietals ducts,aitd the inner care offle-k duets shall°be mecbanicall3 fasteidd' Plea dbdis
tnusrbe couneeted using-a metal 5leevefc`bupling, r
+ Flex ducts that are susper ded must be supported eve a 4f1.max Par horizontal runs with IIp mor that :2"
xrfsa -bettiYeeri swppoits and b ft.max 3or'vertical,ru §
WHEN ITS -ATION REQURD ANIj-WFTAT FOUMSA `REQUIRRF
A'HERS e ➢�
special inspector£¢r the bwldi gdepanrnet i The bvildmg inspector may aisp request to be onafte to
it i t n c s s te5tingby th6,coniraetar au 'ot H>;RS racer, The'in siaher picks orid bf the three options on the dF" IR-AL"T-
HVAC Forni That describc the work b0ffig'eonduc ed, Each opr4on I sfs the£arri s requlrej to be&III joh site llir final;
x CF-0 Forms shall be completed and subrriftbad by ihB trrstatim •pomractpr f;or ftnal msgiechott
+ GF 4R Tor ns sha11 be completed,reI t toed ttl?a?rappr �ed ft,,0llirovidevr cannot be completed,by hand
11
and subrultted by the HERS ItaEct`for final rnspeetzoneffeetivej4oihalY I0,
DESTl2IP''TTOti''F Fit S TESTS Bl 1.OVV('Foil descriptions£at itd s f Etxsidential Appen lix RA 3 an"cl Itesisfen[al
C¢Oitnif Cad Airpow(CCrt)—V hen;a Ae£r)perant charge test is requjredlthe sy"scem ttluSE fiat be,,'tesletl to move a
in timtapt 300 CFEv�per tpQ of cooling: AnQierg charge caiipgt be Conducted avith a r ftorys lower,ihan 300 GFVt pet tots
oEcoaling.. Au'flow>oan;nsvallj he increased by;add'in a largez ret un dhiat and gr%(1_or a sesppko trn duet anA gr ll.
'Refrfgerant'Charge-(rRC) the iirstatier,is required to verify the;charge incorrect. '£the Quts+¢s tempetg[ure'is bglow 55
degeos then de-ueigh io ietf od mijsl ba used bytffe instal,lef. When the uel'$h in method is used the HERS Eater tat ist
retest when the temperature is SS and above psing the standard testing protocol inR[v3 A charge i,ndicatar display pr
(CTD) an be used in piaoa of eanductipg on RC. the purpose of Che CIL)!s to prouide real time,fnjo)7nal ton to ihh
�fruildmg ft—u nV bbut'0 stag of 1,he sy stem reiri$er Cut charge'.'meCert ig device attd caoli ig cotl.afrfiow.
MlarinfaCtirrersmrer<urr�nt�develoging4hisdevfce.
Teihoiitature MeaIbi iirement Access'Holes(T6 ATIT--Installer must dnit and marls stoles to measure iemperature,sP4
NOTE, The C'x bR-MECH44 is required for all HVAC alterations,
*For final inspection ALL compliance forms(CF>I Rs,Ck-tufts,and CF4JRs)shall be registeYed with an approved
HERS Provider for bufltling permit apptf'cattons"submitted on or aftet October I,2010,
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