PMT14-03186 1
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City of Menifee Permit No.: PMT14-03186
29714 HAUN RD. Type: Residential Mechanical
MENIFEE, CA 92586i;
%;4" MENIFEE Date Issued: 12/05/2014
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I
PERMIT
Site Address: 28625 PORTSMOUTH DR, MENIFEE, CA Parcel Number: 339-174-006
92586 Construction Cost: $8,000.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT
Work:
Owner Contractor
BILL O'BRIAN THE COOL GUYS
28625 PORTSMOUTH DR P 0 BOX 2544
MENIFEE, CA 92586 HUNTINGTON BEACH, CA 92647
Applicant Phone: 7144652545
DOUG JOHNSON License Number: 804593
THE COOL GUYS
P O BOX 2544
HUNTINGTON BEACH, CA 92647
Fee Description Qtv Amount
Alr Handling/Condensing Units SFR 1 133.00
GREEN FEE 1 1.00
$311
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 slated,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
('rhereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed
apter 9(commencing with section 7000)of Division 3 ofthe Business and contractors to construct the project(Section 7044, Business and Professions
fessions 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
ense Class 2.0 LicensseeNo..,,,��- O�P 3 who builds or improves thereon, and who contracts for the projects with a
piresa 0 .)alC Signatures licensed oontractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATIOON DECLARATION
❑ lam exempt from licensure under the Contractors'Stale License Law for the
❑ I hereby affirm under penalty of perjury one of the following declarations: fallowing 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
❑ 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�//www.leginfo.ca.ciovicalaw.htm].
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier 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 state laws relating to building
construction.I authorize representatives of this city or county to enter the above-
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 become7ee
_ /� - 5- — /Ysubject to the workers'compensation provisions of Section 3700 of the Labor ner or Authorized Agent Date
Cade,I shall forthwith comply with those provisions.
License#/Iql
ate; t �- �—f� Applicant;WARNING: FAILURE TO SECURE WORKERS' AZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARSILL THE APPLICANT OR FUTURE BUILDING
($100,000), IN ADDITION TO THE COST OF COMPENSATION, CCUPANT HANDLE A HAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THEIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES QUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY PECIFIED ON THE HAZARDOUS MATERIALS
I hereby affirm that under the penalty of perjury there is a construction lendingNFORMATION GUIDE?agency for the performance of the work which this permit is issued (SectionILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) PPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address ROM THE SOUTH COAST AIR QUALITY MANAGEMENT
ISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS UIDE LINESI hereby affirm under penalty of perjury that I am exempt from the Contractor'sRINT 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: q BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, O 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 g 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 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 HAZAPDOUS MATERIAL ikEPORTING.
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).
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Y ♦C
Menifee DATE - fLl PERMIT/PLAN CHECK NUMBER P'_,A 1 — O-N g(Q
TYPE: O COMMERCIAL ESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME C; POOL/SPA O SIGN
SUBTYPE: O ADDITION C%ALTERATION ::' DEMOLITION 0 ELECTRICAL .MECHANICAL
O NEW O PLUMBING % RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK G/n M G u Bc✓5+-� a'-/`
✓i r �97e
PROJECT ADDRESS Y rr,S✓�eo� urn 1
ASSESSOR'S PARCEL NUMBER 33�i - ���-pp(o LOT TRACT
OWNER NAME /
ADDRESS JP . ' ,.r
PHONE (iag) 7 72 - la 2 EMAIL
APPLICANT NAME
ADDRESS car✓I e -_r
PHONE EMAIL
CONTRACTOR'S NAME M 4,1 c 1-7 OWNER BUILDER? C YES ,�f O
BUSINESS NAME �-
ADDRESS P 6J� c{ Hc,,.ehJy -la ewc C' 6
PHONE &f(Z/) golr- 0 rgyS EMAIL S &/rCaa1 f/ci C61-1
CONTRACTOR'S STATE LIC NUMBER goo-5,9-0 LICENSE CLASSIFICATION 6 - 2 p
VALUATION $ g606`= SQ FT L SQ FT
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 '`.i CHECKN CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT oCASH C%CHECKri <'CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER O YES 0 NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
STATE OF CALIFORNIA ' .� �q
ALTERATIONS - HVAC �
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CEC-CFIR-ALT-04-E(Revised 06114) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE
CFIR-ALT-04-E
Alterations-HVAC CZ 2, and 8-15 (formerly CF-IR-ALT-HVAC) C-1- 7(ATE ZONE 10 (Page 1 of 1)
Site Address: �t ,S',�y G' Enforcement Agency: Date Prepared: ' iM
New Ducting,Plenums,Lineset: Conditioned
Equipment Type Equipment Efficiency Required R-value Floor Area(sq Ft) Thermostat
❑Packaged System Q Tvaporator Coil f3p AFUE COP I�T'6 (CZ 2,8-13)Ducting Served 6y system
M E9'S-etback
"si-cdit System G1Londensing Unit ,
❑ R-8 (CZ 11, 14,15)Ducting 17GQ sgft (If not already
❑Mini Split lmpressor SEER HSPF
❑Furnace 9-ti"neset ❑R-6(all CZ's)Plenums present,must
Ca'r'XV SEER ❑R-5 or R7.5)Lineset` be installed)
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.
.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-HER$'
Compressor,TXV,Lineset, CF3R: MECH-20-HERS, MECH-(23 or 24)-HERS',MECH-25-HERS'
Air Handler/Furnace'(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.
Exegoted 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' CF1R-ALT-oLE
including Mini Split CF2R: MECH-01,MECH-20-HERS,MECH-22-HERS, -(23 or 24)-HERS',MECH-25-HERS`
CF3R: MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS',MECH-25-HERS' -
Mini Splits require CFIR-ALT-02-E,CF2R-MECH-01,and (CF2R-CF3R)MECH-25-HERS
Installer Requirement:Duct leakage<6%,Fan Efficacy(.SSW/CFM),Air Flow a 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 to flowing .CFIR-ALT-02-E
replaced:Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-Zo-HERS,MECH-(23 or 24)-HERS,MECH-25-HERS
Compressor,TXV,Lineset,Furnace' CF313: -MECH-20-HERS,MECH-(23 or24)-HERS,MECH-2S-HERS
Installer Requirement:Duct leakage<6%,Air Flow>_350 CFM/tan(or alternative),Refrigerant Charge
Exempted from duct leakage testing if: Ell. Existing duct systems are constructed,insulated or sealed with asbestos
4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ductsa'�. 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 fit installed and R-6 when less than 40 It installed. This includes in walls,between floors etc.
'Heating only systems and Air Handler/Furnace changes do not require Air Flom MECH-(23 or 24),or Refrigerant Charge verification MECH-25
' All New Ducts is when at least 75 percent of the duct system is new duct material,and,pp 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(1"thick insulation)for linesets 1"and less. R-7.5(1.5"thick insulation)for Iinesets over 1 inch. Most mfg will require Suction firte Diameter
with insulation as the following 1.5-2T-2%",2.5-3T-2'/.",3.5 to 4T-PJ.",ST-4Z" -
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.
N e;ponsihl=_D=_sig'n"'e}r�Na/me: R on;ibl=_Dzsi;ner signature: Date Signed Hiensz
�d c-le4 s - l `( a`(
Cempa - dress T,/State/zip- Phone_:
7-6 vrn
For assistance or lifiestions regarding the Energy Standards,contact the Energy line at: 1-800-772-3300
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