PMT14-02354 City of Menifee Permit No.: PMT14-02354
29714 HAUN RD. Type: Residential Mechanical
49HGCEt., MENIFEE, CA 92586
MENIFEE Date Issued: 09/03/2014
PERMIT
Site Address: 27625 MAPES RD, MENIFEE, CA 92585 Parcel Number: 329-270-004
Construction Cost: $7,163.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT,A/C 16 SEER, 80,000 BTU FURNACE
Work:
Owner Contractor
SYLVIA HOWELL SOUTHLAND AIR CONDITIONING AND HEATING
27625 MAPES ROAD 43397 BUSINESS PARK DR STE D-5
MENIFEE, CA 92858 TEMECULA, CA 92590
Applicant Phone: 7144754958
JASON SOCORRO License Number: 955722
SOUTHLAND AIR CONDITIONING AND HEATING
43397 BUSINESS PARK DR STE D-5
TEMECULA, CA 92590
Fee Description 0-tyt Amount f$1
%Forced Alcor G It�� ,T e Furor et e(; ar Burner y tx �, y 1+ Tj49 OQ au � �+e4 _ ..ic.�!.4AFa"i.',.5 '.�'p�iat"J':a n.vLmYdin3: "YaeY.arv-.lY"
Air Handling/Condensing Units SFR 1 133.00
BLI�Iding PeYrit{i5 dfjC�'Y,pe,�� `w '$ i t r� `'�' *+ MR0' '�c
.,.ux„.�..�.mr.s._:...ivxumws4.+s.�...,,zi. W4v.�✓ ti:A .n �,1_.a,�4k�t�,...ea-.�dw,;.Ja r;ni�u� �.,����sti�y� �'
GREEN FEE 1 1.00
$310.00
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing building operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee. Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA_Blog_Permit_Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION
I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions
Professions CodVan$my license is in ful o�&e�0 effect. Code:The Contractor's License Law does not apply to an owner of a property
License Cgqlass d� Licen�5g�lo ) '! 2 who builds or improves thereon, and who contracts for the projects with a
Expires 12--31^2D1 YSignature .�� licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ 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:
1 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
NI have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is
on 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:htto'//www Ieainfo ca gov/calaw html.
permit is issued.My workers'compensation insurance carrier and policy number are:
T 1 !' �P` -i Property Owner or Authorized Agent Date
Carrier Jul !�"'w+,o1 d-'t f �yi heo,
Expires '� - 3 Policy#M✓C 30T5
tt��-- ❑ By my Signature below, I certify to each of the following: I am the property
Name of Agent 4r 4" Phone# 3 1 o- 341 -7 b Yo 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 pro,art r 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 I
subject to the workers'compensation provisions of Section 3700 of the Labor Property Owner rAulhorized A Date
Code, I shall forthwith comply with those provisions.
City Business License#
Date; Applicant.
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 MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ONO 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 DYES 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 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 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL ifEPOR1 ING.
compensation, will do( )all of or( )porting of the work, and the structure is PROPS ER OR TH RIZED AGEN
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property x_
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY O ME IFEE PLCKNo Permit No:
City of Menifee u
29714 Haun Road Building & Safety Dept. Date: Date:
Menifee, CA 92586
Phone: (951)672-6777 SEP 0 3 2014 Amount: Amount:
Fax:(951)679-3843 Received I �—
Ck#: Ck#:
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F: L: Rt: R
Property Address: 2 _ Assessor's Parcel Number: I
Project/Tenant Name: rh 1� J 1c�t-7 Unit# -loor W
Name: J oC ! P ogg N.. q a_ I� a Fax No.
Property Address: 1P� ,g c nitlJN`uumber / Zip Code
Owner < �. J .y 4L a' UYh.� G' /2 - - 5
Email Address:
Name:lr'S � Phone No. Fax No.
Applicant Address: Unit Number Zip Code
Email Address: i, f
�t CO
Name: Phone No. Fax No.
Contractor Add s � � vJ _S CNy�r� G✓f Srfe - Zip.fio
Contractors City BusmOSS License NO. Contractor6f i late gfga ifornia License No. Classification: C _
Number of Squares:
Square Footage
Description of Work: C Cost of Work:$
Applicant's Signatuq Date:
To Be Completed By City:Staff Only
Indicate As R-Received or N/A-Not Applicable
5 Completes sets of fully dimensioned,drawn to sale plans which include: 1 set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Soils Report(on cd only)
❑ Plat/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on B'/n x 11)
❑ ❑ [I 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' El Retrofit' Revision to Existing Permit' Required? YES NO
Proposed Building Use(s): Existing Building Usefs):
#Buildings: #Units: #Stories: Will the Building Have a Basement?
Y of N
Bldg.Code Occupancy Group Indicate Indicate if YES or NO Indicate all Geo-tech.Haz.Zone
Al Project Construction Sprinklered that apply: Coastal Zone
Completion: Type(s): C of O Noise Zone
Required? YES or NO
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 I JElec.Vehicle Charger Landmark Seismic Retrofit bpcoai Case:bldg.
OfficelApproval
Expedite Project(s): Child Care City Project Green Building ILandmark Affordable Housing
For Staff Use Only
Building/Safety I Permit Specialist City Planning ICivil Engineering EPWM-Admen Transportation Mgmt. Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
STATE OF CALIFORNIA - -'
ALTERATIONS - HVAC
CEC-CFI1R-ALT-04-E Revised 06114 CALIFORNIA ENERGYC'O'Fv1b115510N
CERTIFICATE OF COMPLIANCE CF1R-ALT-Of-E
Alterations-HVAC CZ 2, and 8-15(Formerly CF-IR-ALT-HVAC) CL I MATE ZONE 10 (Page 1 of 1)
Si a Addr ss: Enf rcement Agency: Date Prepared: Permitft:
a ►' RAP Rurvw ��S� ac r -3 -ao
Ne Ducting,Plenums,Lineset: Conditioned
Equipment Type Equipment Efficiency Required R-value Floor Area (sq ft) Thermostat
❑Packaged System Evaporator Coil AFUE COP 11 R-6 (CZ 2,8-13)Ducting Serve stem etback
*plit System ondensing Unit / I not already// ❑R-8 (CZ Il,14,15)Ducting [ sgft (f t
❑Mini Split ❑Compressor 1b SEER HSPF ❑R-6(all CZ's)Plenums present,must
Furnace ❑Lineset
❑TXV EER 0 R-5 or R7.5)Lineset4 be installed)
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered(no hand filled forms allowed)and a co tQLtp(blf 4enifB
1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: UPf,
All Equipment, CFIR-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23 or 24)'-HERS,MECH-25-HERS'
Compressor,TXV,Lineset, CF3R: MECH-20-HERS,MECH-(23 or 24)-HERS',MECH-25-HERS'
Air Handler/Furnace'(Can include new ducting) Receive
Installer Requirement:Duct leakage(<15%,or<10%to outside,or seal all accessible leaks),Air Flow-300 CFM/ton,Refrigerant Charge.
Exempted from duct leakage testing if:
❑1.Duct system registered with HERS provider as previously sealed,or 0 2.There is less than 40 linear feet of duct in unconditioned space,or
[13.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building
❑2.New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts' CFIR-ALT-02-E
including Mini Split CF2R: MECH-01,MECH-20-HERS, MECH-22-HERS,MECH-(23 or 24)-HERS',MECH-25-HERS
CF3R: MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS',MECH-25-HERS'
Mini Splits require CFIR-ALT-02-E,CFIR-MECH-01,and (CF2R-CF3R)MECH-25-HERS
Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/CFM),Air Flow_350 CFM/ton(or alternative),Refrigerant Charge
❑3.All New Ducts with Replacement I Required Compliance Documents to be left on site for Final:
All New Ducts'and one or more of the following _CFIR-ALT-02-E
replaced:Condenser Unit,Evaporator Coil, CF2R; MECH-01,MECH-20-HERS,MECH-(23 or24)-HERS,MECH-25-HERS
Compressor,TXV,Lineset,Furnace' CF3R: MECH-20-HERS,MECH-(23 or 24)-HERS,MECH-25-HERS
Installer Requirement:Duct leakage<6%,Air Flow>_350 CFM/ton(or alternative),Refrigerant Charge
Exempted from duct leakage testing if: ❑1. Existing duct systems are constructed,insulated or sealed with asbestos
❑4.New Ducting over40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts''., CFIR-ALT-02-E,CF2R: MECH-20-HERS,CF3R: MECH-20-HERS
Installer Required to:Duct leakage(<IS%oi,-<10%to outside or,or seal all accessible leaks)
❑ EXCEPTION:Existing duct systems constructed,insulated or sealed with asbestos.
'All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls,between floors etc.
'Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24),or Refrigerant Charge verification MECH-25
'All New Ducts is when at least 75 percent of the duct system is new duct material,and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system(e.g.,registers,grilles,boots,air handler,coil,plenums,duct material)
° R-5(1"thick insulation)for linesets 1"and less. R-7.5(1.5"thick insulation)for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%",2.5-3T-2YV,3.5 to 4T-2Y..",ST-4Y.."
Contractor(Documentation Author's/Responsible Designer's Declaration Statement)
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24,Parts 1 and 6 of the California Code of Regulations(CCR).
4. That the energy features and performance specifications,materials,components,and manufactured devices for the building design or
system design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the CCR.
S. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents,worksheets,calculations,plans and specifications submitted to the enforcement
agency for approval
`with
,.this building permit application.
R " Ie Des er Name: ,-a 'gner5ignature: pate Signed:� -
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V-lP nY/•WC /"vf{�. ✓�'✓ll�S !�✓e( ( Wf/i.✓'x D✓i / Ci[ I[3te/Zip: /
For assistance or questions regarding the Energy Standards,contact the Energy Hotline t:`1-800-772-3300 /l/