PMT15-02837 t
i
City of Menifee Permit No.: PMT15-02837 j
29714 HAUN RD, Type: Residential Re-Roof
' CCI!i MENIFEE, CA 92586
MENIFEE Date Issued: 09/15/2015
PERMIT
Site Address: 28466 PEBBLE BEACH DR, MENIFEE, Parcel Number: 337-193-009 '
CA 92586 Construction Cost: $6,000.00
Existing Use: Proposed Use:
Description of TEAR OFF EXISTING LAYERS, INSTALL NEW COOL ROOF SHINGLES
Work: **CRRC#0850-0014`**
Owner Contractor
ROBERT MCCONVILLE
28466 PEBBLE BEACH DRIVE
MENIFEE, CA 92586
Applicant License Number:
ROBERT MCCONVILLE
28466 PEBBLE BEACH DRIVE
MENIFEE, CA 92586
Phone: 3103720065
Fee Description 9-ty Amount Amount l$$
S
Inspections not specified 98 98.00
General Plan Maintenance Fee-Building 1 4.90
$130.90
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 am exempt from licensure under the Contractors'State License Law for the
I hereby affirm under penalty or perjury that I am Licensed under provisions of following reason:
Chapter 9 (commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence in
Professions Code and my license is in full force and effect. which I must have resided for at least one year prior to completion of
License Class License No. improvements covered by this permit, I cannot legally sell a structure that I have
Expires Signature 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
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one of the following declarations: httpi/www.leoinfo.ca.govlcalaw.html.
I have and will maintain a certificate of consent of self-insure for workers'
compensation,issued by the Director of Industrial Relations as provided for by Date
Section 3700 of the Labor Code, for the performance of work for which this
permit is issued. Property Owner or Authorized Agent
Policy# ❑ By my Signature below, I certify to each of the following: I am the property
❑ 1 have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read this
section 3700 of the Labor Code, for the performance of the work for which this application and the information have provided is correct. agree to comply
permit is issued.My workers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to building
a��f
horize representatives of this city or county to enter the above-
Carrier ihe.i �pecti poop S. Cf
Policy# Expires � �"`"" Date
party caner or Authorized Agent
(This section need not be completed if the permit is for City Business License#
one-hundred dollars($100)or less)
HAZARDOUS MATERIAL DECLARATION
❑ I certify that in the performance of the work for which this permit is issued, I
shall not employ any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a
workers'compensation laws of California, and agree that if I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide?
Code, I shall forthwith comply with those provisions. ❑YES ❑NO
Applicant; Date; Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES ❑ NO
_ CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of a school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑YES ❑ NO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist. I understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous material reporting.
OWNER BUILDER DECLARATIONS ❑YES ❑ NO
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT
next to the applicable item(s)(Section 7031.5. Business and Professions Code:
Any city or county that requires a permit to construct, alter, improve, demolish, EPA RENOVATION REPAIR AND PAINTING (RRP)
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 The EPA Renovation, Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's State License Law (Chapter 9 (commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with
she is exempt from licensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than ($500).) employees.For more information about EPA's Renovation Program visit:
www.epa.gov/lead or contact the National Lead Information Center at
❑ I, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323).
compensation, will do ( ) all of or( ) porting of the work, and the structure is
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 ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however, Certified Firm Name:
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 Firm Certification No.:
purpose of sale).
❑ I, as owner of the property an exclusively contracting with licensed ❑ No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044, Business and Professions
Code:The Contractor's License Law does not apply to an owner of a property
who builds or improves thereon, and who contracts for the projects with a
licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
, Menifee
DATE O PERMIT/PLAN CHECK NUMBER ^
TYPE: 0 COMMERCIAL RESIDENTIAL a C> MULTI-FAMILY " MOBILE HOME POOL/SPA 0 SIGN
SUBTYPE: i'ADDITION O ALTERATION C DEMOLITION () ELECTRICAL C:: MECHANICAL
3 NEW O PLUMBING WRE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK ,bjL r.0
(Q�
PROJECTADDRESS �0 1 P_ I� BenJ D
ASSESSOR'S PARCEL NUMBER >�-�1� � LOT TRACT
9
OWNER NAME 06QYIr r J IJ s CCo y� 9
ADDRESS 1 {,
Q 1 Y UQ&C CA 0,C
PHONE 310 *3��` _ nr&5- EMAIL City Of Menifee
_ a e y opt.
APPLICANT NAME _ �-� 2�� (�
ADDRESS SLP ZU15
PHONE 0 2d V "2�� / EMAIL
CONTRACTOR'S NAME OWNER BUILDER? YES 0 NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ CQ O �a �L�OSSQ FT L SO FT
APPLICANT'S SIGNATURE •• DATE Lz I
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION t CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN ` r SMIP
INVOICE PAID AMOUNT
AMOUNT �—I %CASH <%CHECK# %CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT GCASH C%CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED `%YES C; NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6771
www.cityofinemfee.us Inspection Request Line 951-246-6213
City of Menifee
Building & Safety Dept.
SEP 15 2015
Received
CALIFORNIA ,avw
EXPI S : DRIVER-LICENSE
H03168SO CLASS:C MI
ROBERT DENNIS MCCDNVILLE
176e 137H ST
MOlY WT4 BCH CB 98266
HT SM31 HWTR198 DtJ8:T3b—D$--i[
�il7i2ees ees le mile
A1y �, ,���
State of California
County of O S
Subscribed and swom to or ffirmed)before me on
Asi this day of�20
6 5,
CommNsloo#20Y6619 by rQ"t; %�! i7,�/ IG %
Notary Polo'California personally known to me or proved to me on the basis
Loy MM CountyEnka Jan 27. of satisfactory evidr,ice to be the person(s)who
f appeared before me.
Signature �/y'
r�
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�Y
79
WOW fMA
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INSTALLATION CERTIFICATE:Residential Reroof CF-15R-ENV-01
Site Address: nforcemint arty: I.Flifflillit Number.
Z •�' S
If nwre than eea person her respontfb1t.1 for Inwolh titm of the items an film aertlflcnle,each person shall prepare and sign a eertlflmie
applicable ro the portion of comarrucnmr for which they are responsible;aftermtiwly,the person ayilh chief rerpnnubiliryfor construction shall
prrpare and sign this cerlijrcate for the entire cousiruction. All applicable Mandatory A4lea u,,x%pith cheek bows are required to be checked to
aurae the mandatory measures have been men.
CEILING INSULATION
Rigid: Brand Name: city of Menitee :
Batt or Blanket Type: Brand Name: Building & Safety Dept.
Loose Fill Type: Thermal Resistance(R-Value): SEP y 2015
Spray Foam Type: Brand Name:
Installed Actual Thickness(inches): Contractor's in installed weigWft' lb
Manufacturer's installed weight per square foot to achieve Thermal Resistance(R-Value): Received
❑ §150(a):Minimum R-19 insulation in wood-frame ceiling or equivalent U-factor.
O 111 S(a): Insulation installed meets Standards for Insulating Material.
❑ f 150(g):Mandatory vapor barrier installed in Climate Zones 14 or 16.
ROOFING PRODUCTS(COOL ROOFS)6151012
❑Check this box if the newly installed roof is exempted from the roofing product-Cool poor requirements as indicted on the CF-1 R-Aa-
Raroof form ror this project.Otherwise Ra in the table below.
Roof Slope Product Weight Aged Solar Thermal
CRRC Product ID Number' S2-12 >2:11 < swift ? 5IW11' ProdnaTypet Rellaetencd`' RatiWaca
_ ❑ ❑e .27 Al O,RO
❑ ❑ ❑ ❑ ❑'
1.CRRC-1 label infornall ie available Is on The package of the rooting product being instilled and attach the CRRC label to Ass farts.
2.buhcale the type ofirrudurf is being used for the rooflop,i.e.single ply roof,asphalt roof,metal roof,etc
5. Ifthe Aged Reflectance is not available in the Cool Roof Rating Comcil's Raled Product Directory then use the Initial-Reflects ce wire from the
same directory and nee the equation(0.2+0.7I0;,,e,r-0.2)to obtain a calculated aged value. Where p it the Initial Solar Reflectance.
.Chair box if the Aged Reffecronce is a calculated wine using the equation above.
o apply Liquid Field Applied Coatings,the coating must be applied sooner the entire roof serf v and meet the dry mil thickness or Beverage
in ruled by the coatings manufacturer slid meet minimum performance requirements listed in 1111404. Select the applicable coating:
Aluminum-rigmented Asphalt Roof Coating P Cement-Based Roof Cutting Pother
DECLARATION STATEMENT
• I certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and coact'.
• I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction,or an authorized mint3omativc
of the person responsible for construction(responsible person).
• I certify that the installed features,materinls,components,or manufactured devices identified on this certificate(the installation)conforms
to all applicable codes and regulations,and toe installation is consistent with the plans and speclficali0os approved by the enforcement
agency.
• I reviewed a copy of the Certificate of Complimuc(CF-IR)form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on me CF-IR that apply to the installation have been mct.
• I will ensure that a completed,signed copy of this Instnilatiots Certificate shalt he potted,or made available with the building
perma(s)Issued for the bulliling,and made available to the enforcement agency for all eppikabic inspoctioru. I understand that a
signs(]copy of this Installation Certificate is required to be included with the documentation the builder provides to the building
owner at occupancy.
Company Name: (Installing Subcontractor or General Contractor or BuiddedOwrer)
We n's Name: le e '¢ ignetute�
Q
CSLB License: Signed: P en Mile):
f
2008 Residential Compliance Forms August 2009
Prescriptive Certificate of Compliance: Residential Reroof CF-1 R-ALT-ReRoof
Project Adtl Cilm to Zones Permit
p . S
ROOFING PRODUCTS(COOL ROOFS)§161(lJ12
When tiro area of exterior roof surface to be replaced exceeds 50%of the existing roof area,or 1,005 ff,whichever is less,the new
roofing area must meet the rocri product"Cool Roof'requirements of§152(b)iH1,152(b)iHB,or 152(b)1HIIl.
Check applicable alternattw or exception below if the roof alteration is exempt from the roofing product'Cool Roof requirements,
❑ Cool roofs na required in Climates Zones 1-12, 14,and 16 with a low sloped roof pitch(lessor 2.12 Pitch).
❑ Cool roofs rw requir'ed in Climates Zones 1-9,and 16 vdth a steep-sipped roofs(greater pitch than 2:12)and product weight less than WWII'.
Alternatives to 11621b)1HI and 1152(b)HII,Steep-slope roof(pitch>2:12)
❑ Insulation with a thermal resistance of at least 0.85 hrflz•°F/Btu or at least a 314 inch air-space is added to the roof deck over an area;or
❑ 6dsting ducts in the attic are insulated and sealed according to§751(f)10;or
❑ In climate zones 10,12 and 13,with 1 h2 of free venfilation area of attic ventilation for every 150 ft2 of attic floor area,and
where at least 30 percent of the has ventilation area is within 2 feet vertical distance of the roof ridge;or
❑ Building has at least R-30 telling insulation;or
❑ Building has radiant barrier in the attic meeting the requirements of§151(f)2;or
❑ Building has no duds in the attic;or
❑ In climate zones 10,11,13 and 14.R-3 or greater roof deck insulation above vented attic
Exception to§162(b)1HII1,Low-slope roof(pitch 5 2:12)
❑ Building has no ducts in the attic.
Other Exceptions
❑ Roofing area is covered by building integrated:photovoltaic panels and solar thermal panels are exempt from the Cool Roof criteria.
❑ Roof constructions that have thermal mass over the rod membrane with at least 25 IVU are exempt from the Cod Roof criteria.
NOTE:If any one of fie alternatives or exception is checked the Aged Solar Reflectance and Thermal Emittance requirements for roofing
products in§118(1)are not applicable.Do not fill table below.
Roof Slope Product Weight Product Aged Solar Thermal
CRRC Product ID Number' s 2:12 >2:12 < 5tblfl 2 51tNkz T RaSectertlR3.1 Emltance SRIb
❑ 1 e 1 ❑ ❑' O.i7 .> 90 .
ue
❑ 1 ❑ ❑ 1 ❑ 1 1134
Aloft,If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance,
1.The CRRC Product ID Number can be obtained Flom the Cool Roof Rating Couricil's Rated Product likedory N rw»r.coakods era/nraduu'sheW h.ann
2.Indicate the type of product Is being used for the roof top,i.e.stngk-ply roof,asphalt roof,metal roof,aft.
If the Aged Reflectance Is not evadable in the Cool Roof Rating Councli's Rated Product Directory then use the Initial Reflectance value from tiro some
directory and use the equation(0.2.0.7(pr„,„—0.2)to obtain a calculated aged value. Where p is the Initial Solar Reflectance.
Check box lithe Aged Reflectance is a calculated value using the equation above.
5.Calculate the SRI value by using the SRr-Wcrksheet of hhoYAv ..enemy.ca.00vfit)024/and enter the resulting value In the SRI Column above and attach
acopy of the SRI.Worksheet to the CF1R.
o apply Ucluld Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in§118(1)4. Select the applicable mating:
❑ Aluminum-Pigmented Asphalt Roof Coating O Cerrient-Based Roof Coating ❑ Other
NOTE: When a Cool Rod is required,the installing contractor shall complete and submit the CF1111R--ENV-01 for Mal inspection.
Declaration Statement
• I Car*under penalty of perjury,under the tows of the State of California,the information provided an this form is accurate and complete.
• I cedity that the energy features and performance specifications identified on this Certificate or Conyllanco conform to the repWrementa of This 24,Pero
t and a ofthe California Code ofRoguriallons.
Name:
Company.
Address: N ,n C- License:
46U9
City/S te/Zkx may, PtronZ
For ass stance or questions regarding the Energy Standards,contact the Energy HohTne at. 1.800.772.3300.
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