PMT15-03853 City of Menifee Permit No.: PMT15-03853
29714 HAUN RD.
�A-�CCEL/_> MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE Date Issued:
1211612015
PERMIT
Site Address: 28929 HOGAN DR, MENIFEE, CA 92586 Parcel Number: 337364-016
Construction Cost: $6,000.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, 3 TON,65,000 BTU
Work:
Owner Contractor
KATHLEEN MANN KEN STARR INC
28929 HOGAN DR 3162 EAST LA PALMA AVENUE
MENIFEE, CA 92586 SUITE E
Applicant Phone:7146328289
ADOLFO IBANEZ License Number.974908
KEN STARR INC
3162 EAST IA PALMA AVENUE
SUITE E
ANAHEIM, CA 92806
Fee Description OQtt Amount tEl
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 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 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 ❑ 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 O 20 License No. 7 improvements covered by this permit,I cannot legally sell a structure that I have
Expires 7— rl/—/f Signature a� ^ 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: htto:/Avww.leginfo.ca.gov/calaw.htfnl.
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
❑ 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 carter and policy number are: 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-
Carrier ham/ fir_ identified/property forth i sp i n puirpooses.
Policy# dam`// T�/ Expires 7 ` / ^ / �"" �4`Ly^—�G'� Dale
Property Owner crAuthorized AgdK
(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,1 HAZARDOUS MATERIAL DECLARATION
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. G'fES ❑NO
///e '-
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 ECURE 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 OYES Cd'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 OYES ❑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 n
+DYE .
OWNER BUILDER DECLARATIONS S ❑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 PROPERT NER OR AUTH ZED AGENT
next to the applicable Rem(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 firths 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.govAead or contact the National Lead Information Center at
❑ I, as owner of the property, or my employees with wages as their sole 1-800-024-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 Slate 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 Finn Certification No.:
purpose of sale).
❑ I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Finn 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 pmjects 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
4�
Men1fee
DATE Z !6 I S" PERMIT/PLAN CHECK NUMBER 15' 3267j
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA OSIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL �6'MECHANICAL
O NEW O PLUMBING LO/R,E-ROOF-NUMBER OF SQUARES-
DESCRIPTION
DESCRIPTION OF WORK Q !7� 1-G
PROJECTADDRESS
ASSESSOR'S PARCEL
�/NUMBER
�" ✓�1 ��� LOT 1",j TRACT �-5�
OWNER NAME /C'�
ADDRESS -2-9-g
PHONE VIP ) G ��Z m•�F?7AT EMAIL
APPLICANT NAME �a� Z,�/E-�4,
ADDRESS ^ /YS
PHONE 7//) 0 G,,y EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES ONO
BUSINESS NAME
ADDRESS /G 455�7 ' /�--� Q.•-"�' rS E Q✓`Q�.J°^ �_iF� ln.Zdro
PHONE 7/`�) ` =l Z ���/ EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION C
VALUATION $ 0-25�0 SQ FT L SO FT
APPLICANT'S SIGNATURE G- DATE
DEPARTMENT DISTRIBUTION CITY OF MEI1F�EE BUSINESSS SENUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN l SMIP J V
INVOICE I PAIDAMOUNT
AMOUNT �' O CASH O CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O 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 Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
STATE OF CALIFORNIA "IF
ALTERATIONS - HVAC City of Menifee
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) 1 6. 2015 (Page 1 of 1)
Site Addres�� �r ` ,.Erif cemerit A enry� Date) repair d: r 44
FFJJJJ
Equipment Type Equipment Efficiency New Duct' ,Plenums,Lineset: nditi ed Thermostat
Required R-value Floor Area(sq ft)
P kaged System ❑Eva for Coil ❑AFUE COP R-6 (CZ 2,8-13)Ducting Served by system ack
Split System onde
❑ nsing Unit ❑R-8' (CZ 11,14, �15)Ducting � sgft (lino[already
❑tv�a'ii Split ❑Compressor SEER _HSPF ❑R-6(all CZ's)Plenums present,must
Furnace ❑Uneset EER ❑R-5 or R7.5)Uneset' 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' owed 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.
1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
All Equipment, CF111-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23 or 24)'-HERS,MECH-25-HERSa
Compressor,TXV,Uneset, CF3R: MECH-20-HERS,MECH-(23 or 24)-HERS',MECH-25-HERS'
Air Handler/Furnace'(Can include new ducting)
Installer Requirement:Duct leakage(<15%,or<10%to outside,or seal all accessible leaks),Air Flow 2 300 CFM/ton,Refrigerant Charge.
Exempted from duct leakage testing if:
❑1.Duct system registered with HERS provider as previously sealed,or 0 2.There is less than 401inear feet of duct in unconditioned space,or
❑3.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building I
❑2.New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ductsi CF113-ALT-02-E
including Mini Split CF2R: MECH-01,MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERSa,MECH-25-HERS'
CF3R: MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERSa,MECH-25-HERS'
Mini Splits require CFSR-ALT-02-E,CF2R-MECH-01,and (CF2R-CF3R)MECH-25-HERS
Installer Requirement:Duct leakage<6%,Fan Efficacy(.SSW/CFM),Air Flow 2 350 CFM/ton(or alternative),Refrigerant Charge
❑3.All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New Ductsa and one or more of the following CF111-ALT-02-E
replaced:Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23 or 24)-HERS,MECH-25-HERS
Compressor,TXV,Uneset,Furnace' CF3R: MECH-20-HERS,MECH-(23 or 24)-HERS,MECH-25-HERS
Installer Requirement:Duct leakage<6%,Air Flow z 350 CFM/ton(or alternative),Refrigerant Charge
Exempted from duct leakage testing if:0 1. Existing duct systems are constructed,insulated or sealed with asbestos
❑4.New Ducting over40 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(!c15%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
a 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)
4 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-2a%",2.5-3T-2Y",3.5 to 4T-2%",5T-4Y"
Contractor(Documentation Author's/Responsible Designer's Declaration Statement)
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 forthe 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 OCR.
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.
Re�spo�nsib�leDesi��yyner Name: Responsible Design Si tur Date Sign d: License: f
Company: 1GZ Oty/S[ate/Zip: Phone
For assis ce or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300