PMT15-03647 City of Menifee Permit No.: PMT15-03647
29714 HAUN RD.
SnCCEL/? MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 1112 312 01 5
PERMIT
Site Address: 26679 CALLE EMILIANO, MENIFEE, CA Parcel Number: 330-280-074
92585 Construction Cost: $980.00
Existing Use: Proposed Use:
Description of HVAC FURNACE REPLACEMENT ONLY
Work:
Owner Contractor
CAROLINE DANIELY THERMO WORKS
26679 CALLE EMILIANO 40100 OREGOLD CT
MENIFEE, CA 92585 LAKE ELSINORE,CA 92532
Applicant Phone:9517759665
MICHAEL DESHAZER License Number.. 951251
THERMO WORKS
40100 OREGOLD CT
LAKE ELSINORE, CA 92532
Phone:9517759665
Fee Description Qtv Amount lSl
Forced-Air or Gravity-Type Fumace or Burner 1 149.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Mechanical 1 7.45
$184AS
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_Pemlit_Templale.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ [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 Ir
Professions Code and my license is in full force and effect. J .2 S ' which I must have resided for at least one year prior to completion a
License Class
G License No. C/S improvements covered by this permit, I cannot legally sell a structure that I have
Expires Oki I 1 V b Signature lu— built as an owner-building if it has not been constructed in its entirety by licenser:
contractors. I understand that a copy of the applicable law, Section 7044 of the
WORKERS'COMPENSATION DECLARATI(.4N Business and Professions Code,is available upon request when this application ie
submitted or at the following Web site:
❑ 1 hereby affirm under penalty of perjury one of the following declarations: htto://www.lecinfo.ca.cov/calaw.hfml.
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 properti
❑ 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 thie
section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is carrecL I agree to compli
permit is issued.My workers compensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to bulldinc
-�- construction.I authorize representatives of this city or county to enter the above
Carrier I y4-��.ry�S�1''r LU G �r identified property for the inspection purposes.
Policy# `O LL ,01 11�(yphrrs 0 1(7C Date
Property Owner orAuthorized Agent
(This section need not be completed if the permit is for City Business License#
one-hundred dollars($100)or less)
❑ 1 certify that In the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION
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 spe0fled on the Hazardous Materials Information Guide?
Code,I shall forthwith comply with those provisions. DYES 9'NO
Applican� Date; G ��2- Z Will the Intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNIN FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guideline
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND ❑YES�❑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 boundarywschool?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES�❑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) hazyMous material reporting.
OWNER BUILDER DECLARATIONS YES ❑NO
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
Dale
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY.OW ER 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 RRPcertffled fimrs 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.
SAFETYBUILDING & . • APPLICATION
Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: :%COMMERCIAL ' RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION XALTERATION O DEMOLITION ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBEIR_OF SQUARES
DESCRIPTION OF WORK HV,+C rvrnaC, Vnif- C''l�✓'7 pcJ
PROJECT ADDRESS (o_7 / C(nl.l��•.�� 25c-S
ASSESSOR'S PARCEL NUMBER 'taf)2W" LOT Itv TRACT
OWNER NAME
ADDRESS G yY, 1 CA- /2
PHONE ys / y y-o3 y EMAIL
APPLICANT NAME (,hue,I Gtc'z'c' `/' c� 1� p
ADDRESS /13 2 � 8I ur-b1Y_d (O/1>�. Cs" ! Zt1 e
PHONE ri lj' 7?S % � S EMAIL YJ2Lg2j2bc„
CONTRACTOR'S NAME jC! oej !A?y„— OWNER BUILDER? O YES O NO
BUSINESS NAME 01�1,-1 o vvc7
ADDRESS 113 Z(o 61VP-o)✓d LA-r W'r'e.- (, [C
�Z--cF-&-2N
PHONE 961 72S }G (o 5 EMAIL
CONTRACTOR'S STATE LIC NUMBER ' LICENSE CLASSIFICATION �2
VALUATION $ `I$b•Oo SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE O/5
e i-iDEPARTMENT DISTRIBUTION VIV CITY OF NIFEE SIN SLICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE �/[� N PAID AMOUNT
AMOUNT Q • • OCASH O CHECK A OCREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCASH �'CHECK p 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 Department 29714 HDun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-245-5213
,f t
STATE OF CALIFORNIA �: �;< ,{ safeafetyy Dept.
ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 06/14 15 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-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: r i
I14f �l
Equipment Type Equipment Efficiency Required
Ducting,Plenums,Lineset: Conditioned Thermostat
Re uiredR-value Floor Area(sgft)
❑Packaged System ❑Evaporator Coil AFUE COP R-6 (CZ 2,8-13)Ducting Served by system tback
_
,6-Split System ❑Condensing Unit ❑R-81 (CZ11,14,15)Ducting sgft (If not already
❑Mini Split ❑Compressor SEER HSPF ❑R-6(all Cts)Plenums present must
Furnace ❑Uneset EER ❑R-5 or R7.5)Linesee be installed)
❑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 by hand. For final inspection all forms are to be registered(no hand filled forms allowed)and a copy left on site.
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,Uneset, CF3R: MECH-20-HERS,MECH-(23or24)-HERS2,MECH-25-HERS'
Air Handler/Furnace'(Can include new ducting)
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❑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' 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)-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 a 350 CFM/ton(or alternative),Refrigerant Charge
[13.All New Ducts with Replacement Required Compliance Documents to be left an site for Final:
All New Ducts'and one or more of the fallowing CFSR-ALT-02-E
replaced:Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23 or24)-HERS,MECH-25-HERS
Compressor,TXV,Uneset,Furnace' I CF3R: MECH-20-HERS,MECH-(23 or 24)-HERS,MECH-25-HERS
Installer Requirement:Duct leakage<6%,Air Flow a 350 CFM/ton(or alternative),Refrigerant Charge
Exempted from duct leakage testing if:111. 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(<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.
'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)
a 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%",2S3T-2%",3.5 to 4T-2%",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 Califomia:
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.
Respon,l Designer amen Responsible Designer Signature: Date Signed: License:
•Ct�al f�sG�� ��/Z3/gals y5/zt5/
Corn any: Address: [try/stateop: Phone G6 6 S
0 ow�S IJ3674 Akl—. /✓V/ Cf3 Sl7?5
For assistance or questions regarding the Energy Standards,conta he Energy Hotline at:1-800-772-3300