PMT14-02367 City of Menifee Permit No.: PMT14-02367
29714 HAUN RD. Type: Residential Mechanical
MENIFEE, CA 92586
MENIFEE Date Issued: 09/04/2014
PERMIT
Site Address: 28937 ROCK HARBOR CT, MENIFEE, CA Parcel Number: 340-190-027
92584 Construction Cost: $9,000.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT
Work:
Owner Contractor
ALAN STEVENS RIZZO HEATING&AIR CONDITIONING
28937 ROCK HARBOR CT 27062 BRISTOL LANE
MENIFEE, CA 92584 MENIFEE, CA 92584
Applicant Phone: 9516720397
ROXANNE EASLEY License Number: 349958
RIZZO HEATING&AIR CONDITIONING
27062 BRISTOL LANE
MENIFEE, CA 92584
Fee Description 0ti Amount ISI
g r reYFy �meu D
Air Handling/Condensing Units SFR 1 133.00
u Id 11�'PFerDii Is$pee* �+ ��a
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 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 licens4DELARATIO
r e ct. Code:The Contractor's License Law does not apply to an owner of a property
License Class�i ZQ Lice who builds or improves thereon, and who contracts for the projects with a
Expires �_ Signature licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATIO
❑ I 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
Section 3700 of the Labor Code, for the performance of work for which this which I must have resided for at least one year prior to completion of
permit is issued. improvements covered by this permit, I cannot legally sell a structure that I have
Policy# built as an owner-building if it has not been constructed In its entirety by licensed
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://wm.leginfo.ca.aov/calaw.html.
permit Is issued,�Myy workers'corrtpensation insurance carrier and policy number are:
Carrier �C 6Ul/(llvrw Property Owner or Authorized gent Date
Expires Policy
Name of Agent Phone# By my Signature below, I certify to each of the following: I am the property
6w at 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-
�01 ertify that in the performance of the work for which this permit is issued,I identified p erty o 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 Code, I shall forthwith comply with tho rovmon P rh' Agent Date
Date; OL uA Applicant;
City Business License# IJJ��S�
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, t,�S OCCUPANT HANDLEA HAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE Y` MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑NO 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 [ ES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
❑NO DISTRICT (SCAQMD) SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
I hereby affirm under penally of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reasons)indicated below by the checkmark(s)I have placed ES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable larn(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 OYES 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 LP10 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than ($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
El I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIALF EPORI'ING.
compensation,will do ( ) all of or ( ) porting of the work, and the structure is OPRPL 2 TY OWN OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF JV E 9 IFE ti PLCK No: P It o:
29714 Haun Road �� fO1
Date: Date:
Menifee, CA 92586 4 Lk
Phone: (951)672-6777 Amount: Amount:
bw
Fax:(951)679-3843 Ck#: Ck#:
Building Combination Permit G1
To Be Completed By Applicant
Legal Description: 'a, Y�G ;X Planning Case: F: L: Rt: R
Property Address: 26"I✓1 7p "WOW
Assessor's Parcel Number: 4 o m
Project[Tenant Name: CA p /eA, C Unit#: Floor#:
Name: A I/t ,(tR /`Vn rn� \J M Fax No.
Property Address: /� «jtY l�ry 1VC�NI\Cil Unit Number Zip
Owner Lib I Q ' V
Email Address:
Name: r,,, n ��
Applicant Address:/),5�Q p p 111
G1/GJ CW Unit Number J [T'pdepj^G ,
Email Address: bNk[AA
t � w 0q'
Name:
Contractor Address: M01 1 Vl�l2 MIM S S
M GMKO
ontractor'Is lv I Clppl
f'SC)nse o Contractor's rnia License No. Classification:
Number of Squares:
Square Footage .-So 0
Description of Work: 6 C Vb/I/
Cost of Work:$ /
Applicant's Sig ure 1 I �
Date: f L, Ic I
To Be Completed By City Staff Only 'i `1
Indicate As R-Received or N/A-Not Applicable
5 Completes sets of fully dimensioned,drawn to sale plans which Include: t set of documents which Include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8'/2 x 11)
El Foundation Plan ❑ Cross Section ❑ Structural Calculations
❑ 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' Retrofit' Revision to Existing Permit' Required? YES NO
Proposed Building Use(s): Existing Building Use(s):
If 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.Has.Zone
At Project Construction Sprinklered that apply: Coastal Zone
Completion: Type(s): Coro Noise Zone
Required? YES or NO
Listed an Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board I I Landmark Comm. Planning Comm.Zoning Administrator
Fee Exempt: City Project Else.Vehicle Chargerl I Landmark Seismic Retrofit I Sceciai Case.61 g.
Official Approval
Expedite Project(s): Child Care City Project Green Building I Landmarki I Affordable Housing
For Staff Use Only
Suilifing(Sailety Permit Specialist Cily Planning I Civil Engineering I EPWM-Admin I Transportation Mgmt I Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-iR-ALT-HVAC
Climate Zones 10- 15
Site Address: Enforcement Agency: Date: er it#:
28937 rock harbor Menifee, CA 92584 City of Menifee Aug 29, 2014
Duct insulation Conditioned Floor
Equipment Typel List Minimum Eficiency2 requirement Area Thermostat
❑Package Unit
❑Furnace ❑AFUE ❑COP ®Setback
❑Indoor Coil ®SEER 13.0 ❑HSPF_ R 6 (CZ 10-13) Served by system
®CondensingUnit O R 8 (CZ 14-15 2500 sf in not already present, must be
❑Other ❑EER_ ❑Resistance ) installed)
1.Equipment Type:Choose the equipment being Installed; if more than one system,use another CF-SR-ALT-HVAC for each system.
2.Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options.The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF-4R
forms (no hand filled CF-4Rs allowed) are filled out and signed. Beginning October 1, 2010,a registered copy of the CF-1R
and CF-6R shall also be on site for final inspection.
® 1. HVAC Changeout Required Forms:
.All HVAC Equipment CF-6R forms: MECH-04,P49C;H 21 HERS EXEMPTED and (for split systems) MECH-25-HERS
replaced CF-411 forms: MEGHH ;j;li EXEMPTED and (for split systems) MECH-25
.Condenser Coil and/or CF-611 forms: MECH-04,P+,_,91,14 21 WE,oe,EXEMPTED and (for split systems) MECH-25-HERS
.Indoor Coil and/or Furnace H CF-4R forms: Mrg �+ EXEMPTED and (for split systems) MECH-25
. --For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement),TMAH
_a URItsm Duet lea, peFePRt
Exempted from duct leakage testing if: c
❑1, Duct system was documented to have been previously sealed and confirmed through HERS verification, or
W 2, Duct systems with less than 40 linear feet in unconditioned space,or
❑3. Existing duct systems are constructed, insulated or sealed with asbestos
❑4.The system will not be Ducted (ie. Ductless Mini-Split System) (Also Exempt from Refrigerant Charge)
❑2. New HVAC System Required Forms:
.Cut in or Changeout with CF-6R forms: MECH-04,:;EgH 2@..,1_,9,S EXEMPTED, and (for split systems) MECH-22-HERS, and
new ducts: (all new MECH-25-HERS
ducting AllJ,all new CF-4R forms: nia(=H 29 EXEMPTED, and (for split systems) MECH-22, and MECH-25
equipment)
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD,TMAH, STMS, and either HSPP or PSPP,
For Packaged Units: Duct leakage < 6 percent
❑3. New Ducts with/or without Required Forms:
Replacement
.Includes replacing or installing all
new ducting and/or outdoor CF-6R forms: MECH-04, MEG14 29 1!ERG EXEMPTED, and (for split systems) MECH-25-HERS
condensing unit and/or indoor coil CF-4R forms: :4imig,j 29 EXEMPTED and (for split systems) MECH-25
and/or furnace. No or some
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >: 300 CFM/ton,TMAH
For Packaged Units: Duct leakage < 6 percent
L1 4. New Ducting over 40 feet lRequired Forms:
.Includes adding or replacing more CF-6R forms: MECH-04, MEG14 ;i 11_^S EXEMPTED
than 40 linear feet of duct in CF-4R forms: 114EQ14 jjj EXEMPTED
unconditioned space.
For split system or packaged units: Duct leakage < 15 percent
❑EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's/Responsible Designer's Declaration Statement)
.I certify that this Certificate of Compliance documentation is accurate and complete.
.I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
Compliance.
.I certify 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.
.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.
Name: Mike Rizzo Signature: Mike Rizzo
Company: RIZZO HEATING &AIR CONDITIONING Date: Aug 29, 2014
Address: 27062 BRISTOL LANE License: 349958
City/State/Zip: MENIFEE/CA/92584 Phone: (951) 672-0397
Reg: 214-A0085467A-000000000-0000 Registration Date/Time: 2014/08/29 10:49:38 HERS Provider: Cal CERTS, Inc.
2008 Residential Compliance Farms July 2010