PMT14-02775 1
City of Menefee Permit No.: PMT14-02775
29714 HAUN RD,
MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 10/20/2014
i
PERMIT
Site Address: 28583 AMBORELLA WAY, MENIFEE, CA Parcel Number: 364-212-018
92584 Construction Cost: $14,700.00
Existing Use: Proposed Use:
i,
Description of REPLACEMENT OF EXISTING HVAC SYSTEM WITH NEW XV20I SLIT HORIZONTAL SYSTEM
Work:
Owner Contractor
JENNIFER PROGER CASTILLO HEATING &AIR CONDITIONING INC
28583 AMBORELLA WAY 32105 HEATHER LANE
MENIFEE, CA 92584 MENIFEE, CA 92584
Applicant Phone: 9513014452
MARGARITA CASTILLO License Number: 548323
CASTILLO HEATING&AIR CONDITIONING INC
32105 HEATHER LANE
MENIFEE, CA 92584
Fee Description QtV Amount 1$1
P3rd d�i �GPau' t'R-"Ty'' F re 'r, o f f,0
Air Handling/Condensing Units SFR 1 133.00
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 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_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 L_ DO Licen e Nwho builds or improves thereon, and who contracts for the projects with a
Expires IU .3U r� Signatura licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION ECPARATION7'
❑ I am exempt from licensors 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.
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
❑ 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:hlto iiwww.leginfo.ca.aov/calaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier L3C C IC Property Owner or Authorized Agent Date
Expires 1 Policy# QQ����6 �� �
Name of Agent U s Phone# 0/16 • �� ❑ By my Signature below, certify to each of the following: I am the property
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 In a- rovided is correct. I agree to comply
one-hundred dollars($100)or less) with all applicanl and coun rdina�ces and state laws relating to building
construction.I a horiz re
pre n tives f this city or county to enter the above-
❑ I certify that in the performance of the work for which this permit is issued,1 1 entified pr arty r. in ecti in ses.
shall not emolov any persons in any manner so as to become subject to the
workers' compensation laws of California, and agree hl I sho d'beccbme i ell �9 v l�.^--
subject to the workers'compensation provisions of S coon 70 f tr rop rty Ow er or Authorized Agent Da e
Code,I shall forthwith comply with those p ov'sio s.
City Busin s License#
Date; tJ—/-� Applicant;
WARNING: FAILURE TO �iaURE 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, AYES 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 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 ❑YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
/ FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address �v0 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 AYES 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, 0 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 HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or ES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I U TAN D�M-Y� REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STAT OF CALIF fRN IA HEALTH AND SAFETY
a civil penalty of not more than ($500).) COD , SECTION 05 25 3 AND 255 CONCERNING
❑ 1, as owner of the property, or my employees with wages as their sole H DOUS ER EP R�INCI+. /
compensation,will do ( )all of or( ) porting of the work, and the structure is P P Y NER OR 0 /ZED/ EN
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 MJUl'9llFJt E PLCK No: P it
29714 Haun Road City of Menifee Date: Date: 2
Menifee, CA 92586 Building & Safety Dept. to h7 I
Phone: (951)672-6777 Amount: Amoun�
Fax:(951)679-3843 OCT 2 0 2014 Ck#: Ck#:
Building Combination Perceived G'
3'1 To Be Completed By Applicant
Legal Description: Replacement of existing HVAC equipment. Planning Case: F: L: Rt: R:
Property Address:28583 Amborella Way Assessor's Parcel Number.
3 lc4- a1 a-�01 1?
Project/Tenant Name: Jennifer Proger Unit M Floor#:
Name: Jennifer Proger Phone No. 951-532-9604 F N
Prop
Owner y axo.
Address:28583 Amborella Way Unit Number Zip Code
92584
Email Address: nrsjn@aol.Com
Name:Margarita Castillo Phone No. 951-301-4452 Fax No.
9 951-679-8632
Applicant Address: it Nu
mber umer Unit Zi Code
32105 Heather Lane Menifee, CA p 92584
Email Address:info@castillohvac.net
Name: Castillo Heating and Air Conditioning, Inc. Phone No. Fax No.
951-301-4452 951-679-8632
Contractor Address: 32105 Heather Lane DityMenifee state CA Zip Code 92584
Contractor's CItyUBusinOess icense o. Contractor's City State of California License No. Classification: C20
UU 4832
Number of Squares:
Square Footage 2904
Description of Work: Replacement of existing HVAC system with new XV20i split horizontal system. Cost of work:$ 14,700
Applicant's Signature
Dale_
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/Solis Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 Y x 11)
❑❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan Structural Calculations
❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan 8 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):
#Buildings: #units: #Stories: Will the Building Have a Basement?
Y of N
Bldg.Code Occupancy Group Indicate Indicate it Indicate all Geo-tech.Haz.Zone
At Project Spdnklered YES or NO
Completion: Construction that apply: Coastal Zone
Type(s): C of 0 YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. I Planning Comm.Zoning Administrator
Fee Exempt: lElec.Vehicle Charger I Landmark Seismic Retrofit special Case:Bldg_
OfficialApproval
Expedite Project(s): I I Child Care I City Project Green Buildin
9 Landmark Affordable Housing
For Staff Use Only
Building/Safety Permit Specialist I City Planning Civil Engineering I EPWM-Admin 1 Transportation Mgmt. I Rent Contrail
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-SR-ALT-HVAC
Climate Zones 10- 15
Site Address: Enforcement Agency: Date: r i #•
28583 Amborella Way Menifee, CA 92584 City of Menifee Oct 16, 2014
Duct insulation Conditioned Floor
Equipment Type1 List Minimum Eficieri requirement Area Thermostat
❑Package Unit
®Furnace ®AFUE 80% ❑COP_ R 6(CZ 10-13) Served by system ®Setback
®Indoor Coil ®SEER 20 00 ❑HSPF If not already present must be
®Condensing Unit [3EER ❑Resistance R 8(CZ 14-15) 2904 sf installed)
❑Other
1.Equipment Type:Choose the equipment being installed;If more than one system, use another CF-iR-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 j
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 I Required Forms:
.All HVAC Equipment CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced CF-4R forms: MECH-21 and (for split systems) MECH-25
.Condenser Coil and/or CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
.Indoor Coil and/or CF-4R forms: MECH-21 and (for split systems) MECH-25
.Furnace
For Split Systems`Duct leakage < 15 percent; RC, CCA < 300 CFM/ton (Minimum Air Flow Requirem3TI �'eni:1g & Safety Dep .
Exempted from duct leakage testing if:❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verificatioOGT 2 Q 2014
[12. 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 Char
❑2. New HVAC System Required Forms:
.Cut in or Gh'dngeout with `•"
new ducts: (all new MECHR 5-HE MM CH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and
ducting an all new MECH firms RS
equipment) CF-4R�forms: MECH-20, and (for split systems) MECH-22, and MECH-25
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 < 6percent
❑3. New Ducts with/or without Required Forms:
Replacement
.Includes replacing or installing all new
ducting and/or outdoor condensing unit CF-611 forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some CF-4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For split systems: Duct leakage < 6 percent; RC,CCA>_ 300 CFM/ton,TMAH
For Packaged Units: Duct leakage < 6 percent
114. New Ducting over 40 feet I Required Forms:
.Includes adding or replacing more than 40 CF-6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space. CF-4R forms: MECH-21
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: Art Castillo Signature: Art Castillo
Company: CASTILLO HEATING &AIR CONDITIONING INC Date: Oct 16, 2014
Address: 32105 HEATHER LANE License: 548323
City/State/Zip: MENIFEE/ CA/ 92584 Phone: (951) 301-4452
Reg: 214-A0119071A-000000000-0000 Registration Date/Time: 2014/10/16 15:17:43 HERS Provider: CaICERTS, Inc.
2008 Residential Compliance Forms July 2010
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