Loading...
PMT17-01646 City of Menifee Permit No.: PMT17-01646 29714 HAUN RD. <-►CCEU/ MENIFEE, CA 92586 Type: Residential Mechanical MENIFEE Date Issued: O5/24/2017 PERMIT Site Address: 26208 ALBANY DR, MENIFEE, CA 92586 Parcel Number: 335-262-003 Construction Cost: $11,450.00 Existing Use: Proposed Use: Description of HVAC CHANGE OUT, PACKAGE UNIT 14 SEER,3 TON Work: Owner Contractor BARBARA POTTS AIR FORCE ONE HEATING AND AIR INC 26208 ALBANY DRIVE 31566 RAILROAD CANYON ROAD MENIFEE,CA 92586 #682 Applicant Phone:9512440916 KATHERINE COUCH License Number: 955952 AIR FORCE ONE HEATING AND AIR INC 31566 RAILROAD CANYON ROAD #682 CANYON LAKE, CA 92587 Fee Description aty Amount(SI 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 General Plan Maintenance Fee-Mechanical 1 14.10 $324.10 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing building operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA_Bldg_Pennit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contacts for the projects hereby affirm under penalty of perjury that 1 am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and effect. the following reason: License Class �License 1No. ,1-9 By my signature below I acknowledge that,except for my personal residence Expires 7 31 20($ Signature �1�01=rW..C X)I-cA, in which 1 must have resided for at least one year priorto completion of improvements covered by this permit.)cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by V,dereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure for workers 7044 of the Business and Professions Code,is available upon request when compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website: by Section 3700 of the Labor Cade,for the performance of work for which www.Ieginfo_m.gov/caIaw.htmL permit is issued. Policy If Date .-rhave and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which ❑By mysignature below I certify to each of the following:I am the property this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this number are: 1 application and the information I have provided is correct.I agree to comply CarrierS�UJY'tF Nq-��a•1a� ,nSu 1^cw nc.¢_ Co.,n G✓c . with all applicable city and county ordinances and state laws relating to P building construction.I authorize representatives of this city or county to Policy#swo kit 5-) t Expires I 1 2-0 t"1 enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($300)or less PROPERTY OWNER OR AUTHORIZED AGENT D I certify that in the performance of the work for which this permit is Issued, I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall rthwit comply whh those pr visions. Will the applicant or future building occupant handle hazardous material ora � rj Z mixture containing a hazardous material equal to or greater that the Applicant _ '`--CJ l Date ) amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS 0 Yes 0 No UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South IN SECTION 3706 OF THE ADDITION TO THE OF COST LABOR CODE,INTEREST,AND ATTORNEYS FEESCOMPENSATION,DAMAGES AS PROVIDED FOR Coast Air quality Management District(SCAQMD)?See permitting checklist for guidelines CONSTRUCTION LENDING AGENCY ayes ONO I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) 0 Yes 0 No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD 1 hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of California Health al Safety Code,Section 25505 and 25539 concerning Contractors License Law for the reason(s)indicted below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 703LS Business and Professions Code).Any city or county that requires a permit to OYes ❑Na - Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT 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 Contactors State EPA RENOVATION,REPAIR AND PAINTING(RRP) License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contactors Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-1979 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves orthrough their Ol,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a 0 An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the Improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. 0 No EPA Lead-Safe Certified Firm is required for this project because: o I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RAP rule please fill out the RRP Acknowledgement. BUILDING i SAFETY PERMIT/PLAN APPLICATION DATE �5 24 1-7 PERMIT/PLAN CHECK NUMBER —1 'Q UL AU TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME 0 POOL/SPA 0 SIGN SUBTYPE: O ADDITION C ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK %( - ll,kvi4 \n ck me. ko i . I L1 PROJECTADDRESS 2L91.0 A%)OOLpM br. rA 92 ASSESSOR'S PARCEL NUMBER 3?�- Lo - LOT TRACT City aca) of Menif -. Dept. OWNER NArME 'a)( 0\rCA- _ ADDRESS 4LQ�-b00,,� pCAA Q S a.Q PHONE 01Sl - Lelq -LeLl3o EMAIL Y\ C1 If11oce .� APPLICANT NAME Q V1 G v\ ADDRESS 3 iS Le ug 1 1 rd u d C L2 2 n l.F1L'�R Q25F'i 1 PHONE qS i I Le EMAIL Ck j C. cam CONTRACTOR'S NAME Chayjf l ^ OWNER BUILDER? 0- YES •NO BUSINESS NAME \ ,, C l A" ADDRESS 3kSLf?Le 1c(,\l1Y'Dadl.[�V\ n AkLxfrZ Qan f1 Lake CIA Q2S$ PHONE EMAIL Y\ CONTRACTOR'S STATE LIC NUMBER g5$95 2- LICENSE CLASSIFICATION C2.1O VALUATION$ SQQ FT ^,; ISO d L SQ FT APPLICANT'S SIGNATURE DATE 612 DEPARTMENT DISTRIBUTION �( CITYOFMENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP INVOICE PAID AMOUNT �, AMOUNT - ID •�D 0 CASH --CHECK# CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT --CASH 0CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO IVietlifee guilditig,S Safety Department 29714 Hatln Rd. iVienifee, CA 92530 951-b72-.; -% !vww.cirvof+,7enifoe.us inspection Request'f ine 9�1-245-6213 STATE OF CALIFORNIA ALTERATIONS - HVAC CEC-CFIR-ALT4)4E Revised 01/16 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF111-ALT-04-E Alterations-HVAC CZ 2,and 8-15 (Page 1 of 1) Site Address: En r mentqg�en ate Prepared: Permit#: I r Dr- k -I New Ducting or Uneset• Conditioned Equipment Type Equipment Efficiency Required R-value Floor Area(fe) Thermostat Packaged ❑Evaporator Coil u� rWFUE COP 0 R-6 VI-10,12&13)Ducts Served by system 0 Setback System ❑Condensing Unit 0R-81 (CZ 11,14-16)Ducts 1t50'D fe (if not already ❑Split System ❑Compressor SEER HSPF ❑2�R-2.8 Unesee present,must ❑Mini Split ❑Lineset EER be installed) ❑Furnace ❑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 le fr on site. I.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: ftjldopt. All Equipment, CF1R-ALT-02-E Condenser Unit,Evaporator Coil, CF2R-MCH-01-E,MCH-20-H,MCH-(23 or 24)4,MCH-25-1-1' Compressor,TXV,Uneset, CF3R-MCH-20-H,MCH-(23 or 24)-Hz,MCH-25-Ha MAY 2 4 201 Air Handler/Furnace'(Can include new ducting) yy Installer Requirement:Duct leakage(:-S1591,or<l0%to outside,orseal all accessible leaks),Air Flow_300 CFM/ton,if., Refrigerant�ee.. �� 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 ❑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-MCH-01-E,MCH-20-H,MCH-22-H,MCH-(23 or 24)-H2,MOH-25-H' CF3R-MCH-20-H,MCH-22-H,MCH-(23 or 24)-H2,MCH-25-1-12 Mini Splits require CF1R-ALT-02-E,CF2R-MCH-01-E,and(CF2R-CF3R)MCH-25-H Installer Requirement:Duct leakage<5%,Fan Efficacy(O.SSW/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 CF1R-ALT-02-E replaced:Condenser Unit,Evaporator Coil, CF2R-MCH-01-E,MCH-20-H,MCH-(23 or 24)-H,MCH-25-H Compressor,TXV,Uneset,Fumacea CF3R-MCH-20-H,MCH-(23 or 24)-H,MCH-25-H Installer Requirement:Duct leakage<5%,Air Flow z 350 CFM/ton(or alternative),Refrigerant Charge Exempted from duct leakage testing if.01. Existing duct systems are constructed,insulated or sealed with asbestos ❑4.New Ducting over 40 feet 1 Required Compliance Documents to be left on site for Final: New ducting but less than All New DuctO CFIR-ALT-02-E,CF2R-MCH-20-H,CF3R-MCH-20-H Installer Required to:Duct leakage L15%or,51.0%to outside or,or seal all accessible leaks) ❑ EXCEPTION:Existing duct systems constructed,insulated or sealed with asbestos. 'All new ducting requires R-8 insulation when more than 40 ft installed in CZs 11&14-16 and R-6 in CZs 1-10,12&13,and R-6 insulation when less than 40 ft installed.This includes in walls,between floors etc. a Heating only systems and Air Handler/Furnace changes do not require Air Flow MCH-(23 or 24),or Refrigerant Charge verification MCH-25 a All New Ducts is when at least 75%of the duct system is new duct material,and up to 25%may consist of reused parts from the dwelling units existing duct system(e.g.,registers,grilles,boots,air handler,coil,plenums,duct material) 4 R-2.8(1"thick insulation)for linesets 1"and less. Contractor(Documentation Author's/Responsible Designer's Declaration Statement) 1 certify the fallowing under penalty of perjury,under the laws of the State of California: L 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. Respowlble0esigner Name: ns I Oesigne nature: Date signed: License: 2 C20-tisS952- mpanY: Address: $tee-2 OtY/State/ip: Phone: 1 �6caF� o.d i 3usuie Raarac ( La Cp925$ qsi -2 ,l 9114 For assistance or questions regarding the Energy Stan ards,contact the Energy Hotline at:1-800-772-3300 * . v I3559S3 31566 Railroad Canyon Rd#682 Canyon Lake CA.92587 951-244-0916 May 1,2017 City of Menifee State License#C20-955952 Permit Department City of Menifee#035548 To Whom It May Concern Katherine Couch has permission to pull permits on behalf of Air Force 1 Heating&i Air Conditioning Inc. Thank you for your cooperation. Respectfully, c Linda Dieringer Owner,Vice-President CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ,�//I' �, ) County of R1 yerStCX , ) On before me� t �1 fV hN kkje a /, C Date Here Insert Name and Title of t Officer personally appeared goers who proved to me on the basis satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph JENNIFER J.KINGMAN is true and correct. Notary Public -California a Riverside County > WITNESS my hand and official seal. Commission N 2161822 M Comm.Expires Pu 1.2020+ Signature Signa of Not blic Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached DocumenitLt�' j Title or Type of Document: �Q q c 'Al �i� �k� t r tL41� Document Date: ___ Number of Pages: _ Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑Corporate Officer — Title(s): ❑Corporate Officer — Titie(s): ❑Partner — ❑Limited ❑General ❑ Partner — ❑Limited ❑General ❑Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: 02016 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item tf5907