PMT15-03136 City of Menifee Permit No.: PMT15-03136
29714 HAUN RD. Type: Residential Mechanical
�CC!l MENIFEE, CA 92586
MENIFEE Date Issued: 10/08/2015
PERMIT
Site Address: 29457 PEBBLE BEACH DR, MENIFEE, Parcel Number: 338-073-004
CA 92586 Construction Cost: $3,500.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT,60,000 BTU FURNACE, 3-TON CONDENER, COIL
Work:
Owner Contractor
PATRICIA DIAZ TRUTEAM OF CALIFORNIA INC
29981 GOLDMINE CIRCLE 260 JIMMY ANN DRIVE
MENIFEE, CA 92586 DAYTONA BEACH, FL 32114
Applicant Phone:3863042222
ED PONCE License Number.221517
TRUTEAM OF CALIFORNIA INC
475 RIVERA ST, UNIT D
RIVERSIDE, CA 92501
Phone:9517226905
Fee Description 2y. Amount I51
Forced-Airdr Gravity-Type Furnace or Burner 1
Air Handling/Condensing Units SFR 1 . 133.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Mechanical 1 T 14.10
$324.10
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 carded on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a peril 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_Templatarpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ 1 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 cZ2/6`/7 License o. /J improvements covered by this permit, I cannot legally sell a structure that I have
Expires 9/3r�Zo 17 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 the following declarations: hfo:/Avww.leginfo.m.uov/mlaw.htmi
I have and will maintain a certificate of consentt 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
561 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 I have provided is correct. I agree to comply
permit Is issued.My workers'compensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to building
r construction.I authorize representatives of this city or county to enter the above-
Carrier .kt=c r ter— identified roparty for the inspection purposes.
Policy# Q1 ZC 45-/Y)5-63 Expires CAP Date /0 IgI
Property Owner 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
❑ 1 certify that in the performance of the work for which this permit is issued,I
shall not emolov 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. DYES I&NO
Applicant; /- Date; /d lfS// S 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 GRNO
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 DYES 43 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) hazardo material reporting.
I O NER BUILDER DECLARATIONS DYES IN
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
"I ,_ Date /O/fr�v 5�
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 IRRPI
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 EPKs Renovation Program visit:
www.epa.govAead 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 O 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
Acknowledqement.
BUILDINGPERMIT/PLAN APPLICATION
-
= Menifee
r
DATE 10/08/2015 PERMIT/PLAN CHECK NUMBER P1U� rJ—O�J
TYPE: []COMMERCIAL []RESIDENTIAL MULTI-FAMILY ❑MOBILEHOME ]POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION []DEMOLITION ❑ELECTRICAL MECHANICAL
❑NEW []PLUMBING [:IRE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK HVAC changeout(FAU,Condenser and Coil)
60KBTU and 3 ton
PROJECT ADDRESS 29457 Pebble Beech Dr 01019ar
ASSESSOR'S PARCEL NUMBER 338-073-004 LOT 185 TRACT 2404
PROPERTY OWNER'S NAME Patricia Dim .T J-41City of M nSafeitBDept.
ADDRESS 29981 Goldmine Cir,Menifee,CA 92586
PHONE (951)672-2000 EMAIL
APPLICANT NAME Ed Ponce FleceiVed
ADDRESS 475 Rivera St,Unit:D, Riverside,CA 92501
PHONE (951)722-6905 EMAIL
CONTRACTOR'S NAME. Truteam of CA Inc OWNER BUILDER? ❑YES®NO
BUSINESS NAME
ADDRESS 475 Rivera St,Unit:D, Riverside,CA 92501
PHONE (951)683-4429 EMAIL
CONTRACTOR'S STATE LIC NUMBER 221517 LICENSE CLASSIFICATION C20
VALUATION$ $3,500.00 SO FT 992 L SQ FT
\\
APPLICANT'S SIGNATURES _ DATE 10/08/2015
WE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS UCENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN 1 SMIP X
INVOICE PAIDAMOUNT
AMOUNT - I • ( Q O CASH O CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 1 0 CASH 0 CHECK# O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Deportment 29714 Hawn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-245-6213
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVACj (Page 1 of 3)
Project Name: Rosa Moreno Date Prepared: 2015.20-07
A.General Information
CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit.When multiple dwelling units must be documented,
use one CF111-ALT-02 document for each dwelling unit.
01 Project Name Rasa Moreno 02 Date Prepared 2015-10-07
03 Project Location 29457 Pebble Beach Dr 04 Building Type Single family
O5 CA City Menifee 06 Dwelling Unit Name Rosa Moreno GiTv De 4.
07 Zip Code 92586 08 Dwelling Unit Conditioned 992
Floor Area(ft2)
Number of space conditioning
09 Climate Zone 10 10 (SCI systems in this dwelling 1
unit.
B.Space Conditioning(SC)System Information K ro
01 02 03 D4 05 06 07 Do 09 10
Is the SC Installing
SC System sesystem CIA served system refrigerant Installing new SC Installing Installing Installing
Identification or Location or Area by this SC ducted containing system more than 4a entirely new entirely new
Name Served System(ft2) system? compf nent? components? feet of ducts? duct system? SC system? Alteration Type
System 1 Location 1 992 Yes Yes Yes No No No Altered space
conditioning system
C.Extension of Existing Duct System,Greater Than 40 Feet(Soctlon1S0,2(b)1DIIb)
This section does not apply to this project
Registration Number:215-A6351207A-000000000-0000 Registation Date(Dme: 2015.10-0715:32:11 HERS Provider:CaICERTS
CA Building Energy Efficiency standards-2013 Residential Compliance Report Version:2013.1.006 Report Generated:2015.10.07 15:29:56
Schema Version:0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 2of 3)
0.Altered Space Conditioning System(Sections 150.2(b)SE and F)
01 02 03 04 OS 06 07 08 09 10 11 12
Heating Cooling
System Heating Altered Heating Minimum Altered Cooling Minimum Required New or
Identification System Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Replaced New Duct
or Name Type Components Type Value System Type Components Type Value Type Duct Length R-Value
Central gas All new Central split All new This field or This field or
System 1 heating AFUE 0.7B cooling SEEP 13 Setback sedian is not section is not
furnace components AC components applicable applicable
Remi(ed Documentation
CF2R-MCH all E-Space Conditioning Systems Ducts and Fans
-Dud Insulation requirement for new plenums:R6.
CF211-MCH-20-11 Is CF3R-MCH-2U-H-Duct Leakage testing required when healing or cooling components are Installed In ducted systems,or when more than CO 0 of dud length is replaced.
-Leakage rate compliance:5 tSB,or s loss leakage to outside,or seal all accessible leaks.
CF211-MCHIR-H&CP3R.MCH-25-H Refrigerant Charge VeriRcanon required when refrigerant contaloing components are Installed or altered(applicable In C2 2,8.15).
CF2RCF3R-MCH-23 Is Cf3R MCI 23 Air Flow 2300 CFM/non required Oman MCH-251s required.
Exceptlimm,
-Dud systems registered with HERS provider as previously sealed are exempt train MCHQO Duct Leakage Testing requirements.
Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH-23,or Refrigerant Charge MECH-25.
-Existing dud systems conrtrvded,Insulated or sealed with asbesras are exempt from MOI.20 Cud Leakage Testing requirements.
E.Entirely New or Complete Replacement Duct System,with or without Equipment Changeout(Sections 150.2(b)1011a and 150.2(b)1E,F)
This section does not apply to this project.
F.Entirely New or Complete Replacement Space Conditioning System(Section 150.2(b)1C)
This section does not apply to this project.
Registration Number:215-A6351207A-000000000-0000 Registration Date/Time; 2015-10-0715:32:11 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013-1.006 Reportcimeeted:201540-0715:29:56
Schema Version:0.55550D
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 3 of 3)
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature: e. yiy
Ponce,Edward
Company: Signature cote:
Masco Contractor Services 2015-10-0715:32:11
Address: CEA/HERS Certiflotion Idenli0a0on(if appllobla):
1015 N MARKET BLVD
city/state/Zlp: Phone:
SACRAMENTO CA 95834 916419-4012
Responsible person's Declaration statement
I certify the following under penalty of perjury,underehe laws ofthe Stete of CalHornla:
1. The Information provided on thisCertlRote of Compliance is true and erred.
2. lam eligible under Was[on 3 of the Business and professions Code to accept respamibillty for the building design or system design Identged onthis Cettdiole of rampliame Irespamible designer).
3. That the energy haturesand performance apedflatiom,materials,mmponents,and manufactured devises far the building design orssteen design Identified on this Cer0fiate ofrompllasce conform to the
repulrementsofT le24,Nn%aMNn6ofthe Glgornia Codeof Rggulallons. _
4. The building design feawrea or system desigofratans:demiffed on this Certlflats of Campllance are musutent with the Information provided another appllabk compliance doaments,worksheets,
calculations,plans and speclgations submitted to the enforeamentagencyfnrappmnlwllh this building permit op Ication.
S. I will ensure that a registered copy of this Cenlfiate of Cumpllana shall be madeayaliable with the bugdhg parmitid issued for Ow building,and made avabble b the enforcement agency for all applicable
Ino,ath ns.l undmsund that.taglnered copy of this Ctnifiate of Cmnpliance b m,lrad to be Included with the documentation the builder provides to the building owner at Decupanry.
Responsible Designer Name: - Responsible Designer Signature'.
Ponce,Edward
Company: Data Maine:
Masco Contractor Services 2015-10.07 15:32:11
Address: vame:
1015 N MARKET BLVD 221517
City/stote/21p: Phis:
SACRAMENTO CA 95834 916-419-4012
ngXaltyaigned6y CaICFgTS.nda digiklsrynolweiapmvNedNorderioauurc Ne canknt olNis regiasreddorument andlnno wayimpGee gegiaratianl+mnderreapons3iGryhrNeecarxyoilhenramarion.
Registration Number:215-A6351207A-000000000-0000 Registration Date/Time: 2 01 51 0-07 15:3211 HERS Provider.CaICERtS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013-1.006 Report Generated:2015-10-07 15:2956
Schema Vernon:0.555SDD