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PMT15-01363 City of Menifee Permit No.: PMT15-01363 29714 HAUN RD. 9 CCE.. MENIFEE, CA 92586 Type: Residential Mechanical MENIFEE Date Issued: 05/20/2015 I PERMIT 's f Site Address: 25897 SANDY LODGE RD, MENIFEE, CA Parcel Number: 339-053-012 92586 Construction Cost: $10,000.00 5 Existing Use: Proposed Use: Description of REPLACE EXISTING HVAC, 70,000 BTU FURNACE, 3-TON A/Cj Work: Owner Contractor MICHAEL HALLMAN AMBER AIR CONDITIONING INC 25897 SANDY LODGE ROAD 29885 2ND STREET UNIT A&B MENIFEE, CA 92586 LAKE ELSINORE, CA 92532 Applicant Phone: 9516746974 ANGIE RODRIGUEZ License Number: 621742 AMBER AIR CONDITIONING INC 29885 2ND STREET UNIT A& B LAKE ELSINORE, CA 92532 Fee Description Qtv Amount f$1 fF9r 0 =Atr-.o„�r��ravzs'�^uE'�`r a B=or.•B ne' `a, , t, •<r s Air Handling/Condensing Units SFR 1 133.00 full Ing;Petm JS3._-. .e . <. 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 Menlfee. 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 Cod and my license is in full f orce and effect. Code:The Contractor's License Law does not apply to an owner of a property License Class C-2r9 License No. who builds or improves thereon, and who contracts for the projects with a Expires Signatur licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DE ❑ lam exempt from licensure under the Contractors'State License Law for the QA 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 LU/I -- Policy# built as an owner-building if has not been constructed in its entirety licensed O'a contractors. I understand that a copy of the applicable law, Section 700 44 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:htto:/Iwww.leoinfo.ca.00v/calaw.html. permit is issued. My worrtk-ers'compensation insurance carrier and policy number are: Carrier �iJ xr Property Owner or Authorized Agent Date Expires Policy ❑ 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 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 slate 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 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 prov' ions. City Business License# Date; �l� �S Applicant; WARNING: FAILURE TO S E 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 OWNER BUILDER DECLARATIONS GUIDE LINES I hereby affirm under penalty of perjury that 1 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 1 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORtING. compensation,will do( )all of or( )porting of the work, and the structure is PROP RTY OW E O AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Idd-mki, Menifee I DATE S- lcI-75 PERMIT/PLAN CHECK NUMBER tr I I TYPE: [:]COMMERCIAL RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION [-]ALTERATION []DEMOLITION ❑ELECTRICAL Q/MECHANICAL ❑NEW []PLUMBING [I RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Ins I"` 1L P4.+I If 141r C{r rL L� 8n)n 5 5'�eM -7D,coo BTU Fuu�r/nace• 3 G*n X/ (� PROJECT ADDRESS 25 S�/ fW L� ,VLIn �!p'''I ww ASSESSOR'S PARCEL NUMBER ��jq"D�"©GL LyOT /-� TRACT " & Safety Dept. OWNER NAME /'� / �LyC/ Al /"7a� � /"t ll n-v / MAY 2 0 2015 ADDRESS 25 8 / Al sao Led '� )k4 PHONE 957- z`/0-913/ EMAIL �G1i�G�S�'JE!/7�'f er z et APPLICANT NAME R n1le, Iwo` rt k-eZ ADDRESS PHONE , n EMAIL CONTRACTOR'S NAME P/7 l�L �hCa/f OWNERBUILDER? ❑YES[]NO BUSINESSNAME /-UI 6� All' ADDRESS p2C9805 C:PO ISL7/` uod A 015, �/'� / -7s PHONE I ✓�-��T-�1 ` T77 L� EMAIL a /c -Qm/K!Q/�"CDr t117(�)/ CONTRACTOR'S STATE LIC NUMBER &;2/-7T/- LICENSE CLASSIFICATION G2� VALUATION$ �C1 OD"L SOFT /��� LSQFT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT AMOUNT CASH %CHECK# Ci CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT CASH '.CHECK OCREDITCARD VISA/MC OWNER BUILDER VERIFIED %YES NO DL NUMBER NOTARIZED LETTER < YES NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-5777 www.cityofinenifee.us Inspection Request Line 951-246-6213 5 -OI CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 1 of 3) Project Name: Michael Hallman Date Prepared: 2015-05-18 A.General Information CFSR-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit.When multiple dwelling units must be documented,use one CF1R-ALT-02 document for each dwelling unit. 01 Project Name Michael Hallman 02 Date Prepared 2015-OS-18 lidinnifeig 03 Project Location 2SS97 Sandy Lodge 04 Building Type single fa m.I Y BOW% 21afeltY Delt 05 CA City Menifee 06 Dwelling Unit Name Michael Hallman 07 Zip Code 92586 08 Dwelling Unit Conditioned 1146 15 Floor Area(ft2) Number of space conditioning 09 Climate Zone 10 10 (SC)systems in this dwelling 1 Received unit. io @,� B.Space Conditioning(SC)System Information - 01 02 03 04 05 06 07 08 09 10 Is the SC Installing SC System SC System CFA served system refrigerant Installing new SC Installing Installing Installing Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System(ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type Entirely new or hvac house 1146 No Yes Yes No No Yes complete replacement space conditioning system C.Extension of Existing Duct System,Greater Than 40 Feet(Section1S0.2(b)1Diib) This section does not apply to this project. Registration Number:215-AO13194SA-00000000MOOO Registration Date/Time: 2015-05-1812:25:37 HERS Pmyider.CaICERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-03-31 Report Generated:2015-05-18 1214!29 Schema Version:0.5555DD CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E Alterations to Space Conditioning Systems iformerly CF-IR-ALT-HVAC) (Page 2 of 3) D.Altered Space Conditioning System(Sections 15O.2(b)lE and F) This section does not apply to this project. E.Entirely New or Complete Replacement Duct System,with or without Equipment Changeout(Sections 15O.2(b)1Diia and 150.2(b)3E,F) This section does not apply to this project. F.Entirely New or Complete Replacement Space Conditioning System(Section 15O.2(b)1C) 01 02 03 04 05 06 07 08 09 10 11 Heating Cooling System Heating Minimum Cooling Minimum Required Identification or Heating System Altered Heating Efficiency Efficiency Cooling Altered Cooling Efficiency Efficiency Thermostat New Duct Name Type Component Type Value System Type Component Type Value Type R-Value This field hvac Central gas All new heating AFUE 0.8 Central split All new cooling EER 17 SetbackTher orsecti0n furnace components AC components mostat is not applicable Rcen red Documemabon' CF2R-MCHU1-E-Space CondRloning Systems Ducts and Fans -Duct insulation requirement her new plenums:Rg. CF2R&MR-MCH-20-H Duct leakage Verification required. -Leeloge rate compliance:s". CF2R&CF3R-MCH-22 Fan Efficacy Verification CF2R&CF3R-MCH-23 System Air Flow Rate Verification -Compliance:Fan Effiory 5 0.58 w/dfin and System Airflow 2350 con/ton. -Alternative Compliance:CF2R&CF31i-MCH-28 Return Dud Design Verification is an altemathis to MCH-22 and MCH-23 verification. CF2R&CF31i-MCH-25-H Refrigerant charge Verifiation required when refrigerant containing components are.-called or soared(applicable in U 2,8-15). Eace tins: Heafin,l systems are exempt from the 0.58 W/cfm and 350 cfrn/ton mquiremems. Not,. An"entirely new or replacement dud system"means at least 75 percent of the dud system is new dud material,and up to 25 percent may consist of reused parts from the dwelling unit's existing dud system(e.g., registers,grilles,boots,air handler,coil,plenums,dud mateHal)'d the reused parts are accessible and can be sealed to prevent leakage Registration Number:215-A0131945A-000000000-0000 Registration Date/Time: 2015-05-1812:25:37 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-03-31 Report Generated:2015-05-18 12:24:29 Schema Version:0.555SDD CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E Alterations to Space Conditioning Systems(formerly CF-iR-ALT-HVAC) (Page 3 of 3) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author signature: Minnis,Phil Company: signature Data: Amber Air Conditioning,Inc. 2015-05-18 12:26:37 Address: CEA/HERS Certification Identification(if applicable): 29885 2nd Street City/state/Zip: Phone: Lake Elsinore CA 92532 951674 6974 Responsible Person's Declaration statement I certaythe following under penalty of perjury,underthe laws of the State of California: 1. The information provided on this Certificate of Compliance istrue and correct. 2. 1 am eligible under0ivision 3 mthe Business and Professions Cade to accept responsibility for the building design orsystem design identified on this Certificate of Compliance(responable designer). 3. That the energy features and performance specifications materials,components,and manufactured devices for the building design or system design identified on this Certificate of[ompliance conform to the requirements of Title 24,Part 1 and Part 6 of the California Cade of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance a re consistent with the information pmvided on other applicable compliance documents,worksheets, calculations,plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a registered copy of this Certificate.of Compliance shall be made available with the building pennit(s)issued for the building.and made available to the enforcement agency for all applicable Inspections.I understand that a registered rely of this Certificate of Compliance is required to be included with the documentation the builder prowdes to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Minnis,Phil KL(/ Company: Dategigned: Amber Air Conditioning,Inc. 2015-05-18 12:25:37 Address: License: 29885 2nd Street 621742 Cry/stet-1hp: phone: Lake Elsinore CA 92532 951674 6974 Digitallyslyredby CeICFRTS.This digital signature is provided in order to secure life content ofthis registered document and in noway implies Registration Pravidermorresibiliy for the accuracy ofthe inipernim. Registration Number 215-A0131945A-000000000-0000 Registration Date/Time: 2015-05-1812:25:37 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-03-31 Report Generated:2015-05-18 12:24:29 Schema Version:0.555SDD