PMT14-02599 i'
i
City of Menefee Permit No.: PMT14-02599 j
29714 HAUN RD. 3
CCE1- MENIFEE, CA 92586 Type: Residential Mechanical
sIN xs�t� P MENIFEE Datelssued: 09/26/2014
PERMIT
Site Address: 31749 BRENTWORT ST, MENIFEE, CA Parcel Number: 372-430-011
92584 Construction Cost: $26,265.00
Existing Use: Proposed Use:
Description of REPLACE 2 COMPLETE HVAC SYSTEMS 1-3 TON& 1-4 TON
Work:
Owner Contractor
KEIKO HOLLOMAN A-AVIS PLUMBING HEATING&AIR CONDITIONING
31746 BRENTWORT ST INC
MENIFEE, CA 92584 600 EAST VALLEY BLVD
Applicant Phone: 9098253600
STEVEN SCHNIERER License Number: 630503
A-AVIS PLUMBING HEATING&AIR CONDITIONING INC
600 EAST VALLEY BLVD
COLTON, CA 92324
Fee Description
Q�tr Amount
'Forded Plr ryGraVaType F rac ar Bur�er„�'-j y,.::"�`" `A�� y
Air Handling/Condensing Units SFR 1 133.00
BUldCRr g�
GREEN r m
4srti:= m ' 27.cQ0=:
FEE 1 2.00
$311.00
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 and my license is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class C, C License No.(030_tX)3 who builds or improves thereon, and who contracts for the projects with a
I
Expires)0 3r Signatures licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ lam 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
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.leciinfo.ca.gov/calaw.html.
permit is issued.My workers'compensation insurance carder and policy number are:
carrier Ts. Go CA-' ��.V e 51 Property Owner or AuthorizedAgent Date
.
Expires 8�5�IS Policy# W_PL502'-131/1OL q
r-m By 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 secfion 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 ��„ry �— 2,5 J I'+
subject to the workers'compensation provisions of Section 3700 of the Labor property Owner or Authorized Agent Date
Code,I shall forthwith comply with those provisions.
City Business License# 0�3 Ca OQ 0i
Date; CA ZS I>4 Applicant; v
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, 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 FEES0 EQUAL TO OR GREATER THAN THE AMOUNTS
Y SPECIFIED ON THE HAZARDOUS MATERIALS
CONSTRUCTION LENDING AGENC
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 kli�AIO 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: S'Fea.cr. Sa�.rx�¢:Y°cv
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 items)(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, AO 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 //— E S INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensors 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($500).) CODE, SECTION
C I ON 25505RIAL f7 5533 AND 25534 CONCERNING
El 1, as owner of the property, or my employees with wages as their sole
compensation, will do( )all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENIFEE PLCKNo: P it
29714 Haun Road Dale: Date:
Menifee, CA 92586 aS
Phone: (951)672-6777 1770 nt Amount.
t ot,
Fax:(951)679-3843 Ck#: Ck#:
Building Combination Permit �a
To Be Completed By Applicant
Legal Description 5f 3 l -T Planning Case: F: L: RL R
Property Address: w Assessor's Parcel Number:
Projec enant Name: nit#: Floor#:
Name: Gi kn 1l� y1 Phone No. Fax No.
Properly Address: Unit Number ZipCode
Owner
311y 6i Cr� g2Sgy
Email Address:
Name: CC�� Phone No. Fax No.
Applicant Address:31225 Lc. a� Unit Number 1`Z Zip Code q f L n
Email Address:
Name: Phone No. Fax No.
A- A,,;5 '\�w,b;r ; = A 019-g2S-2�
Contractor Address:eoo 0.,1G �,a City/ l{b� Sta�t� Zip qZ�
on roc op3 ty_yaps s tense o. Contractor's CI StateOof3Celifornila•LlOcense No. Classiflce0on: GZv
Number of Squares: tDC. `l
Square Footage
Description of Work: �+ Cost of Work:$
eP\act otvv � � vAC S s ems 3tovt F 1 y-1oy-,
Applicant's Signature / 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 ed only)
❑ Plol/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 else.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan 1 ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition' Means/Methods
Work Type. Repair' Retrofit' Revision to Existing Permit' 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 Indicate if Indicate all Geo-tech.Haz.Zone
At Project S rinklered YES or NO
Completion: Constructionp that apply: Coastal Zone
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
Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit Pec al ass: g.
OfliclalA meal
Expedite Project(s): Child Care City Project Green Building Landmark I Affordable Housing
For Staff Use Only
Building/Safe!Building/Safe!X I Permit Specialist City Planning I Civil Engineering EPWM-Admen Transportation Mgmt. I Rent Control
THANK YOU FOR HELPING US CREATE ABETTER COMMUNITY
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE
CF1R-ALT-04-E �
Alterations- HVAC CZ 2,and 8-15 (formerly CF-IR-ALT-HVAC) (Page 1 of 1)
Site Address• Enforcement Agency: Date Prepared:
tjl
31"79416 Ci-I OQ me nt�et ct 7 ty rM
Equipment Type Equipment Efficiency New ucting,Plenums,Lineset: Conditioned Thermostat
Required R-value Floor Area(sq ft)
❑Packaged System JK Evaporator Coil ❑R-6 (CZ 2,8-13)Ducting Served by system WSetback
ASplit System lkCondensing Unit 91AFUE COP _
❑R-8 (CZ Il,14,15)Ducting IrA50 sgft (If not already
❑Mini Split ❑Compressor LSEER HSPF present,must
JCurnace El Lineset ❑ R-5(all CZ's)Plenums
—
EER ❑ R- or R7.5)Lineset" be installed)
❑TXV
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 copy left on site.
W1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
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/Furnace2(Can include new ducting)
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❑2.There is less than 40 linear feet of duct in unconditioned space,or
❑3.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-HERS2
CF3R: MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS',MECH-25-HERS2
Mini Splits require CFIR-ALT-02-E,CF2R-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 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 or 24)-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:O 1. Existing duct systems are constructed,insulated or sealed with asbestos
[14.New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts3 CFIR-ALT-02-E,CF2R: MECH-20-HERS,CF3R: MECH-20-HERS
Installer Required to:Duct leakage(<15%or,<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.
2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24),or Refrigerant Charge verification MECH-25
3 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 W'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-2s/e",2.5-3T-2G 3.5 to 4T-2%",5T-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.
5. 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.
(Re*sponsible Designer Name: Responsible Designer Sgnature: _ Date Signed: License
r& :
-'e.VC,y% —Q-Vy"ever S— Ci 2-6 G-.3os 03
Company: Address: City/State/Zip: Phone:
1�1vm : 4A GOO f V l \4a Cp1loY C `12 Z-1 C1&q-%7S-3GW
For assistance or questi ns regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300