PMT15-03282 City of Menifee Permit No.: PMT15-03282
29714 HAUN RD.
�CCF-LA— MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE Date Issued:
10/22/2015
PERMIT
Site Address: 30275 VIA PALERMO, MENIFEE, CA Parcel Number: 364-103-007
92584 Construction Cost: $5,850.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT,W/DUCT WORK 3 TON,60,000 BTU FURNACE, CONDENSER COIL
Work:
Owner Contractor
DAVID DAUER TEMECULA VALLEY HEATING&AIR
30275 VIA PALERMO 41804 HUMBER DR
MENIFEE,CA 92584 TEMECULA, CA 92591
Applicant Phone:9516762162
KENNETH NAKONY License Number:597999
TEMECULA VALLEY HEATING&AIR
41804 HUMBER DR
TEMECULA,CA 92591
Fee Description Q1t r Amount!$1
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
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 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 building operations being caned on thereunder when in violation of the Building Code or of any other
ordinance of City of Men'dee.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_Permil Templale.rpl Page 1 of 1
City Of Menifee
L/ICENSED DECLARATION
I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ 1, 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 effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class C-7 O Licens No/ who builds or improves thereon, and who contracts for the projects with a
Expires?/Zi I I to Signatur / licensed contractor(s)pursuant to the Contractors State License Law).
ORKERS'COMPENSATION DECLARATION
�^ ❑ 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:
JI 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
1 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
f 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 7D44 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
sewW ction 3700 of the Labor Cade, for the performance of the work for which this submitted or at the following Web site:htto,l/www Ieainfo.ca.00vlcalaw html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier rzL�p Property Omer or Authorized Agent Date
Expires !-47,q 16 Policy# :eCOU2
Agent— Phone# El By my Signature below, I certify to each of the following: 1 am the property
Name of
A9 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-
0 1 certify that in the performance of the work for which this permit is issued,I identified property for the inspection purposes.
shall not emolov any persons in any manner so as to become subject to the
workers'compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the Labor i ��
Code,I shall forthwith comply with those provisions. roJ1 n r or Authorized Agent 59y-Q�Date
- City ess License# O i `p
lS Applicant
WARNING: FAILURE O SECURE WORK - HAZARDOUS MATERU\L 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), 1N ADDITION TO THE COST OF COMPENSATION, AYES 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 `(SNO 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 OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address qNO FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
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, `!,-d,NO 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 9YES INFORMATION GUIDE AND THE SCAOMD 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL AEPOWING.
compensation,will do( )all of or( )porting of the work, and the structure is PROP77 WNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
.rnt
:tmenifee
DATE \ PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL ESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME O�POOL/SPA O SIGN
SUBTYPE: C;ADDITION O ALTERATION O DEMOLITION O ELECTRICAL ;ymECHANICAL
O NEW O PL IUMBING O RE-ROOF-NUMBER OF SQUARES!
DESCRIPTION OF WORK !�G boi, LIv-G wrV,n duel Wd-k
3 Ta Y, kv b r`k- rl-, a-ce— con/ "PeA—CC;L
PROJECTADDRESS Z J N �y�I�y'e�-��7mo I'"` �i [ C-A •���
ASSESSOR'S PARCEL NUMBER 'IJ�A - jO 'T 0 / LOT Alb TRACT Dt)
OWNER NAME ba U
ADDRESS D IO6)Q �- " Co��� � ���'� ��
PHONE �l�l y / 3 "'�-S�`S EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME iLQ.1,rl OWNERBUILDERP OYES NO
BUSINESS NAME , mp Cul C 4- P C--,
ADDRESS 4 /f in o- �ejA &-,
PHONE EMAIL ^V I C�Y Ct(IsC'0
CONTRACTOR'S STATE LIC NUMBER 5 yn `T q 1 LICENSE CLASSIFICATION
VALUATION$ 5-�50 '� nS�Q FT ] �&0 L SO.FT
APPLICANT'S SIGNATURE !� ` "F
� Y , i?tr DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
A'N}NIING ENGINEERING FIRE GREEN SMIP INVOICE �J��•,0PAIDAMOUNT OCASH OCHECK# 0CREDIT CARD VISA/MC
CHECK FEES PAID AMOUNT O CASH O CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER 0 YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-5213
SLATE OF DADFORNIA City of Menifee
ALTERATIONS -HVAC Gtlilding & Safety Dept.
OEC-CFIR-ALT-o1-E ReNaed oeHl OAL IA MISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT.0
Alterations,HVAC CZ 2,and 8.15(formerly CF-IR-ALT-HVAC) (Page 1 of 1)
FDPackagad
dress: Enforcement Agenry:
ent Type Equlpment Effidency New Ducting,Menums,LneseC CondPoorre( Thermostat
Required R-value Floor Area ft)
System ❑Evaporator Cali CI A AFUE _COP R'6 (CZZ 8-13)Ducting Servedbyystem O Setbackystem OCondensing Unit 4= OR-8' (C211,I4,ISJOWI119 sqR fUaotafreodyplit ❑Compressor SEER __HSPF ❑R-6(off CZ-s)Plenums present mostce ❑Lineset EER ❑R-5 or R7.5)Lineset' be installed)
C3 TXV
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 b hand. For final Inspection all forms are to be registered no hand Riled forms allowed)and a co y left on site.
01.HVAC Changeout/Repsir Required Compliance Documemg to be left on site for Final:
All Equlpment, CFIR•ALT-02-E
Condenser Unit,Evaporator Coll, 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' fan include new ducting)
Installer Requirement:Duct leakage(<15%,or<1094to outside,or seal all accessible leaks),Air How a 300 CFM/ton,Refrigerant Charge.
Exempted from duct leakage testing If:
01.Duct system registered with HERS provider as previously sealed,or 13 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
0 2.New HVAC System Required Compliance Documents to be left on site far Final:
All new equipment and All New Ducts' CFSR-ALT-02-E
Including Mini Split CF2R: MECH•01,MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS',MECH-25-HERS1
CF3R: MECH•20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS',MECH-2S-HERS'
Mini Splits require CF1R-ALT-02-E,CF2R•MECH-01,and CF2R-CF3R)MECH-25-HERS
Installer Requirement:Duct leakage<6%,Fan Efficacy 1.58W/CFM),Air Flow 2 350 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 Ducts'and one or more of the following CFSR-ALT-02-E
replaced:Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-123 or 24)-HERS,MECH-25-HERS
Coco ssor,TXV,Lineset,Furnace' CF3R: MECH•20-HERS,MECH•(23 or 24)•HERS,MECH-25-HERS
Installer Requirement:Duct leakage 16%,Air Flow a 350 CFM/ton(or alternative),Refrigerant Charge
Exempted from duct leaks I='n if:13 1. Existin ducts stems are constructed,Insulated or sealed with asbestos
❑4.New Ductingover 40 feet Required Compliance Documents to be left on site for Final:
New ductingbut less than All New Ducts' CFiR-ALT-02-E,CF2R: MECH-20-HERS,CF3R: MECH-20•HERS
Installer Required to:Duct leakage(L 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 f:installed and R-6 when less than 40 It installed. This includes in walls,between Rows 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 handier,call,plenums,duct material)
4 R-5(1"thick Insulation)for Iinesets 1-and less. R-7.5(1.5"thick insulation)for Iinesets over 1 Inch. Most Mfg will require Suction fine Diameter
with insulation as the following 1.5.2T-2'W,2.S-3T-2%",3.5 to 4T-2Y",5T-4Y."
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 i of the Cai'domia eusmess and Professions Code to accept responstbBibI for the information an 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.
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 a roval with this building permitapplication.
Responsible Designer Name: Responsible OeegnerSignature: Date9gnrc4l: License:
company: ,� Address: CMistafe Phone:
\ ,Far a stance or grlestions regarding the Energy Standards,contact the Energy Patfine at:1.800-772.3300