PMT16-00483 City of Menifee Permit No.: PMT16-00483
29714 HAUN RD.
"AGCELA7. MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE Date Issued:
02/25/2016
PERMIT
Site Address: 26227 SHADYWOOD ST, MENIFEE, CA Parcel Number: 335-422-037
92586 Construction Cost: $8,500.00
Existing Use: Proposed Use:
Description of AC/FURNACE REPLACEMENT,3 TON/70,000 BTU
Work:
Owner Contractor
NANCY CLEM A R S AMERICAN RESIDENTIAL SERVICES OF
26227 SHADYWOOD ST CALIFORNIA INC
MENIFEE,CA 92586 965 RIDGE LAKE BLVD SUITE 201
Applicant Phone: 9512769744
CASEY MCCABE License Number.765074
A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNU
965 RIDGE LAKE BLVD SUITE 201
MEMPHIS, CA 38120
Fee Description QQt r Amount f$)
Forced-Air or Gravity-Type Furnace or Sumer 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 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 MEN IFEE
LICENSED DECLARATION property who builds or improves thereon,and who wntracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractors)pursuant to the Contractors State License law).
Chapter9(commencing with section 7000)of Division 3 of the Business and O I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect the following reason:
License Classes�C,/dd,a ZD,c-3 6 License No. 0 7V By my signature below I acknowledge that,except for my personal residence
Expires&//7 Signature in which l must have resided for at least one year prior to completion of
improvements covered by this permit I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
❑I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for workers 7044 of the Business and Professions Code,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website:
by Section 3700 of the labor Code,for the performance of work for which www.leeinfo.ca.eov/calaw.htmL
this permit is issued.
Policy# Date
iTI have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which O By my signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
G •/ _ with all applicable city and county ordinances and state laws relating to
CCarriersuz- f building construction.I authorize representatives of this city or county to
Policy#Lv L7L3 s20(Z/ Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($S00)or less PROPERTY OWNER OR AUTHORIZED AGENT - -I�
of certify that in the performance of the work for which this permit is issued, D�J.�I(�(►,�.�
IshaRnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# �'✓✓��J07TT ��'
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to.the workers compensation provisions of Section 3700 of the Labor
Code,1 shall fort ith comply with those ovisions. Will the applicant orfuture building occupant handle hazardous material or
Applicant Date 2 of mixture containing a hazardous material equal to or greater that the
amounts sp ified on the Hazardous Materials Information Guide?
WARNING:FAILU TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes to
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR CoastAir Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY aYes V<O
hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) ❑Yes Plo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist I understand my requirements under the State of
Contractors License Law for the reason(s)indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning
hazardous material reporting.
chsiness and
Professions
placed next to the applicable item(s)(Section permit 0�� /
Business and Professions Code).Any city arcounty that requires permit to Date Z' zs- /�
construct,alter,improve,demolish or repair any structure,prior to its PROP.MeY OWNER OR AUTHORIZED AGENT
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 Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
Ol,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is vvww.eoa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-80D-424-LEAD(5323).
Code,The Contractors State License Law does not apply to an owner of a O An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
❑I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP role please fill out the RRP
Acknowledgement.
UILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
'''-Menifee
DATE �L r� ' PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL Qf RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL MECHANICAL
NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK ez
-ro„ 1 70K ;3TU
PROJECTADDRESS '7 S /1� (y`aj "-
ASSESSOR'S PARCEL NUMBER /355 ^4-,�.Q31 LOT TRACT
GA L
OWNER NAME l . Dp
ADDRESS 2-27 (/54i WoOor S �'
PHONE ��j� ^ 67 2 ' Dq'6 1 EMAIL
APPLICANT NAME y� /I
ADDRESS 1L7e- Ifs AD4L- STe-
PHONE 1N^ - 707Ot EMAIL - aD/U✓La9S
CONTRACTOR'S NAME Ll S�7/�r�,�j OWNER BUILDER? O YES ONO
BUSINESS NAME
ADDRESS a2go
PHONE vl 9f / (/ EMAIL (i vle
CONTRACTOR'S STATE LIC NUMBER ?GSv7 / LICENSE CLASSIFICATION 644- W
VALUATION$ 5/Ov SQFT LSQFT
APPLICANT'S SIGNATURE DATE
•
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN tC SMIP
INVOICE
AMOUNT � PAID AMOUNT QCASH OCHECK# OCREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building& Safety Department 29714 HQUn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 06114 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFIR-AL%04-E]
Alterations-HVAC CZ 2,and 8-15(formerly CF-IR-ALT-HVAC) (Page
Site Address: / n Enforcement Agency: Date Prepared:
f7 O� D
New Ducting,Plenums,Lineset: Conditioned
Equipment Type Equipment Efficiency Required R-value Floor Area(sq ft) Thermostat
❑Packaged System ❑Evaporator Coil , AFUE COP 13 R-6 (CZ Z,8-13)Ducting Served by system ❑Setback
.RrSplit System ❑Condensing Unit � ❑R-8' (CZ 11,14,15)Ducting gft (If not already
❑Mini Split ❑ ^�Compressor SEER t` HSPF ❑R-6(all CZ's)Plenums present must
'Furnace 13 TXV set ILEER ❑R-5 or R7.5)Uneset4 be installed)
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.
1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
All Equipment, CF111-ALT-02-E
Condenser Unit,Evaporator Coll, CF2R: MECH-03,MECH-20-HERS,MECH-(23 or 24)2-HERS,MECH-25-HERS2
Compressor,TXV,Uneset, CF3R: MECH-20-HERS,MECH-(23or24)-HERS21MECH-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 z 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 Ductsa CFIR-ALT-02-E
including Mini Split CF2R: MECH-01,MECH-20-HERS,MECH-22-HERS,MECH-(23 or24)-HERS2,MECH-25-HERS2
CF3R: MECH-2D-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS2,MECH-25-HERS2
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 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 Ductsa and one or more of the following CFIR-ALT-02-E
replaced:Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23 or24)-HERS,MECH-25-HERS
Compressor,TXV,Lineset,Furnace2 CF3R: MECH-2D-HERS,MECH-(23 or 24)-HERS,MECH-25-HERS
Installer Requirement:Duct leakage<6%,Air Flow 2 350 CFM/ton(or alternative),Refrigerant Charge
Exempted from duct leakage testing if:❑1. 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' CFSR-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.
2 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 Iinesets over 1 Inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%",2.5-3T-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 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 forthe information on this document.
3. That the energyfeatures 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 energyfeatures 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 approval with this building permit application.
Respo Ie Designer Nam Responsibo Designer signature: Date Signed: license:
camp n Address: City/State/Zip: I Phone:
14 zs—o 257-C13- 2L-
For assistance or questions regarding the Enfty Standards,contact the Energy Hotline at:1-800-772-3300