PMT15-01102 I
City of Menifee Permit No.: PMT16-01102
29714 HAUN RD. Type: Residential Mechanical
1` MENIFEE, CA 92586
MENIFEE Date Issued: 04/29/2015
PERMIT
Site Address: 27136 BOTTLEBRUSH LN, MENIFEE, CA Parcel Number: 335-363-010
92586 Construction Cost: $7,744.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, 3-TON A/C, COIL, 15 SEER, 80,000 BTU FURNACE
Work:
Owner Contractor
MARJORIE MARTIN THIRD GENERATION HEATING&AIR
27136 BOTTLEBRUSH LANE CONDITIONING -
MENIFEE, CA 92586 27315 JEFFERSON SUITE J125
Applicant Phone: 2087205630
SIERRA CHIDESTER License Number: 969231
THIRD GENERATION HEATING&AIR CONDITIONING
27315 JEFFERSON SUITE J125
TEMECULA, CA 92590
Fee Description O_yt Amount I$1
Air Handling/Condensing Units SFR 1 133.00
.Bul d m°���., a �nG� � 'm '�` �' you n�ts�s2 " rya' -✓�'��:"�7x�0',
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
I
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 y license is in full force and effect. Cade:The Contractor's License Law does not apply to an owner of a property
License Class = License No. who builds or improves thereon, and who contracts for the projects with a
Expires I /1 Signature licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ lam 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 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 as an owner-building if it has not been constructed in its entirety by licensed
Policy# 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:htti),//www.leginfo.m.aov/mlaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Property Owner or Authorized Agent Date
Carrier
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.
yy all not employ any persons in any manner so as to become subject to the
III Torkers'compensation laws of California, and agree that if I.should-become
V 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 provisions. /11
�� �,�--,,�� ����.. City Business License#
Date; ( ` Applicant;
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, DYES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA
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 PO 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 []YES 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 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
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 `ENO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) Ir HNARDOU9 MATERIA�BifEPORI'ING D-25534 CONCERNING
❑ 1, as owner of the property, or my employees with wages as their sole
compensation,will do ( )all of or( ) porting of the work, and the structure is PROPERT QWNHR RAU RIZED AGEf�T
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
BUILDING • SAFETY PERMIT/PLAN
• • • APPLICATION
t
Menefee
DATE a PERMIT/PLAN CHECK NUMBER
TYPE: []COMMERCIAL < 'RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA [-]SIGN
SUBTYPE: []ADDITION ALTERATION [-]DEMOLITION ❑ELECTRICAL ❑MECHANICAL
[-]NEW []PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK e n 3L�1 LI Vl
Ma-Csz S C)\
PROJECT ADDRESS Uri 'sun CA
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME Mc, r Yi-p—
ADDRESS of Dqpn,f
PHONE 1.��—L021 5 EMAIL 8 U i Iding I Safety D pt.
APPLICANT NAME APR 2 9 201
ADDRESS 2Y, \'t,
PHONE qCj` JIJLQ �'�j�� EMAIL
CONTRACTOR'S NAME -tV \ OWNER BUILDER? ❑YES D4NO
BUSINESS NAME ra; - A' C ,
ADDRESS ` pw, SUI t o
PHONE q - — EMAIL , h
CONTRACTOR'S STATE LIC NUMBER '1$q a3 I LICENSE CLASSIFICATION
VALUATIONS 'nLALA , VV SOFT LSQFT Lou
APPLICANT'S SIGNATURE DATE
CITYSTAFF USE ONLY
DEPARTMEPO DISTRIBUTION CNY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT ''.
AMOUNT 1- CASH 'CHECK# ?CREDIT CARD VtWW
PLAN CHECK FEES PAIDAMOUNT CASH „=CHECKa ' -CREDR CARD VBA/MC
OWNER BUILDER VERIFIED 0 YES ',-- NO DL NUMBER NOTARIZED LETTER -- YES NO
City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CF1R-ALT-04-E lRevised 06/14 CALIFORNIA ENERGY COMMISSION '.
CERTIFICATE OF COMPLIANCE CFIR-ALT-04-E
Alterations- HVAC CZ 2,and 8-15(formerly CF-IR-ALT-HVAC) (Page 1 of 1)
Site Address: - Enforcement Agency: Date Prepared: Permit#:
c! .3 1�b �1 1/U` USG 5-01 10a
Equipment T e Equipment Efficiency New Ducting,Plenums,Lineset: Conditioned
Type y Required R-value Floor Area(sq ft) Thermostat
❑Packaged System Evaporator Coil AFUECOP iAR-
❑R-S: (CZ 11,14,15)Ducting gft
6 (CZ2,8-13)Ducting Served y system Setback
-A Split System Condensing Unit (If not already
I,�D s
❑Mini Split ❑Compressor SEER HSPF ❑R-6(all CZ's)Plenums present,must
Furnace ❑Lineset be installed)
0 TXV EER ❑R-5 or R7.5)LineseN
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At pe tya6�I "Rugs
form is allowed to be filled out by hand. For final inspection all forms are to be registered(no hand filled forms allowe p I 't g '[,
0 1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
All Equipment, CF1R-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23 or 24)'-HERS,MECH-25-HERS'
Compressor,TXV,Lineset, CF3R: MECH-20-HERS,MECH-(23 or 24)-HERS',MECH-25-HERS'Air Handler/Furnace'(Can include new ducting) Receive d
Installer Requirement:Duct leakage L15%,or<10%to outside,or seal all accessible leaks),Air Flow>_300 CFM/ton,Refrigerant Charge.
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' CF1R-ALT-02-E
including Mini Split CF2R: MECH-01,MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS',MECH-25-HERS'
CF3R: MECH-20-HERS,MECH-22-HERS,MECH-(23 or24)-HERS',MECH-25-HERS'
Mini Splits require CF1R-ALT-02-E,CF2R-MECH-01,and (CF2R-CF3R)MECH-25-HERS
Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/CFM),Air Flow 2 350 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 following CFIR-ALT-02-E
replaced:Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23 or 24)-HERS,MECH-25-HERS
Compressor,TXV,Lineset,Furnace' CF3R: MECH-20-HERS,MECH-(23 or 24)-HERS,MECH-25-HERS
Installer Requirement:Duct leakage<6%,Air Flow 2 350 CFM/ton(or alternative),Refrigerant Charge
Exempted from duct leakage testing if:0 1. 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 Ducts' CF1R-ALT-02-E,CF2R: MECH-20-HERS,CF3R: MECH-20-HERS
Installer Required to:Duct leakage L15%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 ft Installed and R-6 when less than 40 ft installed. This includes in walls,between floors etc.
'Heating only systems and Air Handler/Furnace changes do not require Air Flow 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 up 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)
4 R-5(1"thick insulation)for linesets 1"and less. R-7.5(1.5"thick insulation)for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%",2.5-3T-2%",3.5 to 4T-2Ys",5T-4X"
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.
Responsible Desig rIN Res nsi le signers ure: Date Si ned: License:
eu r t 9 (5 31
Company ress: 1 C�/State/Zip: Phone:
14.;� ;en$ ( ) gXpil y 333
For assistance or questions regarding the Energy Stand ,contact the Energy Hotline at: -80D-772-3300