PMT15-01358 City of Menifee Permit No.: PMT15-01358
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 0612 012 01 5
PERMIT 1
Site Address: 27825 SPRING MEADOW CT, MENIFEE, Parcel Number: 333-263-052
CA 92585 Construction Cost: $8,500.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT 2.5 TON HEATING &A/C
Work:
Owner Contractor
CHARLE GALLO LUCKY AIR INC
27825 SPRING MEADOW CT 4049 BURGESS WAY
MENIFEE, CA 92585 RIVERSIDE, CA 92501
Applicant Phone: 9516828573
MICHAEL BRADY License Number: 836498
LUCKY AIR INC '..
4049 BURGESS WAY
RIVERSIDE, CA 92501
Fee Description P!Y. Amount is
c
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 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 license is in full force and effgct. Code:The Contractor's License Law does not apply to an owner of a property
License Class C-^d3� License No. 3 �Jr 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'COMPENSATION DECLA ION
❑ I am exempt from licensure 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. 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
t' 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,//ww leginfo,Ga.gov/calaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
?3,a _/ Property Owner or uthorized Agent Date
Carrier / ems! ,�`,�-�`—
Expires G'�/�� _Policy# � jell&30 —Wi
,,,.-, By my Signature below, I certify to each of the following: I am the property
Name of Agent to E Phone# T ner or authorized to act on the property owner's behalf. I have read this
t be completed if the permit is for application and the information I have provided is correct. I agree to comply
(This section need no
one-hundred dollars be 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-
El I 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 become J
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.
,(�,� City Business License# _J�`C/ V
Date; Z "
WARNING: FAILURE TO SIE IORKERS' 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 OR A
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE _,MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES dtS 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 AYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address 'I �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 DYES 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, ;,* 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 (Chapter9 (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 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than ($500).) CODE, SECTION
E S MOT 5505AL fE 5533O�ff AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole
compensation,will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUT RIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property XO�'
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale. If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
{
I
Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL RESIDENTIAL []MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN
SUBTYPE: []ADDITION ❑ALTERATION []DEMOLITION ❑ELECTRICAL43MECHANICAL
❑NEW ❑PLUMBING ❑RE-ROOLF-NUMBEROFSQUARES
DESCRIPTION OF WORK /I/ec./ ) /Z�l� //(hrJ� G}- Alc
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER 3 �- -Qrj� LOT 14 TRACT 17� p�rj
OWNERNA%M��E
ADDRESS d
PHONE (�3 7 /_7 f EMAIL
APPLICANT NAME
ADDRESS
PHONE / EMAIL
CONTRACTOR'S NAME �U( -�d� -//'Ji72.t WNERBUILDER? ❑YESN?NO
BUSINESS NAME GUC(C •� h
ADDRESS , r f`
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER H�y LICENSE CLASSIFICATION C
VALUATION$ &J z c-) SOFT ( � L SQ FT
APPLICANT'SSIGNATUR DATE J �<S�
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENNIFEEBUSINESS LICENSE NUMBER
3 J BUILDING PLANNING ENGINEERING FIRE GREEN ' SMIP 0 BU g
INVOICE �wrp PAIDAMOUNT
AMOUNT V <`CASH %CHECK# ''CREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT CASH 'CHECK# C)CREDITCARD VISA/MC
OWNER BUILDER VERIFIED C YES 0 NO DL NUMBER NOTARIZED LETTER :% YES NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations-HVAC CZ 2, and 8-15(formerly CF-IR-ALT-HVAC) city Merlifee (Page 1 of 1)
Building 81 z5aterty Lieut.
Site Address / /G,//�� Enforceme j Vep�y Date Prepared:
Equipment Type b ( Equipment Efficiency New Ducting,Plenums,Lineset: Conditioned Thermostat
R uired R-valpe Floor Area(sq ft)
❑Packaged System aporator Coil AFUE COP ) ng _ Served by System 0 Setback
,K-Split System Condensing Unit -g� (CZ11,14,IS)Ducting ��JJ sgft (if not already
❑ Mini Split ❑Compressor SEER HSPF ❑R-6(all 11 Plenums present must
❑Furnace ❑ Lineset TXV EER ❑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.
F.
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-03,MECH-20-HERS,MECH-(23 or 24)2-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)
Installer Requirement:Dud leakage(<15%,or<30%to outside,or seal all accessible leaks),Air Flow 2 300 CFM/ton,Refrigerant Charge.
Exempted from dud 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 Ducts3 CF111-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 or 24)-HERSs,MECH-25-HERS'
Mini Splits require CF111-ALT-02-E,CF2R-MECH-01,and (CF2R-CF3R)MECH-25-HERS
Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/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 Duds'and one or more of the following CF1R-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,Furnaces CF3R: MECH-20-HERS,MECH-(23 or 24)-HERS,MECH-25-HERS
Installer Requirement:Duct leakage<6%,Air Flow 2 350 CFM/Yon(or alternative),Refrigerant Charge
Exe ted 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' CF111-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 ft installed and R-6 when less than 40 ft installed. This includes in walls,between floors etc.
s Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24),or Refrigerant Charge verification MECH-25
3 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)
°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-2'/",5T-4Ye"
Contractor(Documentation Author's/Responsible Designer's Declaration Statemeut)
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 I 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 applicati
Respon ble Designer Name Responsible resigner Signature: Date Signed: License:
Company: Address: City/State/Zip: Phone:
For assistance or questions regarding the Energy Standards,,96ntact the Energy Hotline at:1-800-772-3300