PMT16-01653 City of Menifee Permit No.: PMT16-01653
29714 HAUN RD. Type: Residential Mechanical
't�kCCELA'. MENIFEE, CA 92586
......""'"" MENIFEE Date Issued:
05127/2016
PERMIT
Site Address: 29894 AVENIDA DE REAL,MENIFEE, CA Parcel Number: 336-244-011
92586 Construction Cost: $12,885.00
Existing Use: Proposed Use:
Description of HVAC REPLACEMENT
Work:
Owner Contractor
ANGELA CLEVELAND RENEGADE HEATING&COOLING
29894 AVENIDA DE REAL 39019 VIA LAS SINTRAS
MENIFEE, CA 92586 MURRIETA, CA 92562
Applicant Phone: 7143624551
ALAN FORSBERG License Number:872098
RENEGADE HEATING&COOLING
39019 VIA LAS SINTRAS
MURRIETA, CA 92562
Fee Description Qtv 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 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 MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code my license is in full force and effect. /y the following reason:
License Class ` �2 Ucens/ee No. ��ZO—I By my signature below I acknowledge that,except for my personal residence
Ex Tres .Z -20 ) Signature�,�� in which I 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
ORKER'S COMPENSATION DECLARATION have built as an owner-builder If it has not been constructed in its entirety by
o 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 Cade,Is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the fallowing websfte:
by Section 3700 of the Labor Code,for the performance of work for which www.le¢info.ca.eov/calaw.html.
this permit is issued.
Policy M Date
PROPERTY OWNER OR AUTHORIZED AGENT
D I have and will maintain worker's compensation Insurance,as required by
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 worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
POlicy N 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($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
�I certify that in the performance of the work for which this permit is issued,
1 shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE q
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forth 5 (comply[ Ith those provisions. / Will the applicant or future building occupant handle hazardous material or
5^Z�'/�i mixture containing a hazardous material equal to or greater that the
pplicant Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE ORKER'S COMPENSATION COVERAGE IS OYU 4NO
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 Coast Air Quality Management District(SCAQMD)7See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY D Yes ro
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 3000 feet of the
lending agency for the performance of the work which this permit is issued outer beNndary of a school?
(Section 3097 Civil Code) ❑Yes o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazardous material re rtmg.
checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5gs D No
Business and Professions Code).Any city or county that requires a permit to i � Date 27"�So
construct,alter,Improve,demolish or repair any structure,prior to its OPE OWN ER 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 IRRPI
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
D 1,as ownerof the property,or my employee with wages as theirsole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eaa.aov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-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. a No EPA Lead-Safe Certified Firm is required for this project because:
a I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATIONti
Menifee
DATE PERMIT/PLAN CHECK NUMBER TprlI0-611c, J
TYPE: O COMMERCIAL eH-RESIDENTIAL O MULTI-FAMILY 0 MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL '"ECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Ae J VAL II S
PROJECTADDRESS 2a l
ASSESSOR'S PARCEL NUMBER f'{1� I LOT TRACT L O
OWNER NAME ` ``
ADDRESS a d2 O
PHONE '71,n- (�- E,329 EMAIL J : f
APPLICANT NAME ` !
ADDRESS C �/ � `2 [A/l -
PHONE EMAIL �Cikxe
CONTRACTOR'S NAME e,, 9 OWNER BUILDER? O YES.,eNO
BUSINESS NAME
ADDRESS
PHONE EMAIL e✓le'O all a w�
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION C- ZC)
VALUATION$ SQ FT L SO FT
APPLI1 DATE �- '-7-
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN too SMIP
INVOICE PAID AMOUNT
AMOUNT I OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O. NO DL NUMBER NOTARIZED LETTER C YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.citycfinenifee.us Inspection Request Line 951-246-6213
STATE OF CALIFORNIA
ALTERATIONS - HVAC City of Menifee
CEC-CFIR-ALT-04-E Revised 06114 ii In 815'BfBt Dept. CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFIR-ALT-04E
Alterations-HVAC CZ 2,and 8-15(formerly CF-1R-ALT-HVAC) I:�A.`( (Page 1 of 1)
Site Address: E+tfgrF9utbnL A¢eR Y: Date Prepared:
Z V2ut G'l.rCI d'
Equipment Type Equipment Efficiency New Ducting,Plenums,Lineset: Conditioned Thermostat
Required R-value Floor Area(sq ft)
❑Packaged System ❑Evaporator Coil $-R-6 (CZ 2,8-13)Ducting Served by system Setback
Split System ❑Condensing Unit AFUE COP 0 R-81 (CZ 11,14,15)Ducting (��u _sgft (if not already
❑Mini Split ❑Compressor resent must
IL-SEER HSPF ❑R-6(all CZ's)Plenums p
❑Furnace ❑Uneset /2 S. EER ❑R-5 or R7.5)Uneset4 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.
UA.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
All Equipment, CFIR-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23 or24)2-HERS,MECH-25-HERS'
Compressor,TXV,Lineset, CF3R: MECH-20-HERS,MECH-(23 or 24)-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 2 300 CFM/ton,Refrigerant Charge.
Exempted from duct leakage testing if:
M 1.Duct system registered with HERS provider as previously sealed,or 0 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 CF111-ALT-02-E,CF2R-MECH-01,and (CF2R-CF3R)MECH-25-HERS
Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/CFM),Air Flow t 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 Ducts'and one or more of the following CFIR-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<69/,Air Flow 2 350 CFM/ton(or alternative),Refrigerant Charge
Exempted from duct leakage testing if:0 1. Existing duct systems are constructed,insulated or sealed with asbestos
IN 4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts3 CFIR-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
3 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 units existing duct system(e.g.,registers,grilles,boots,air handler,call,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-2`/a",2.5-3T-2%",3.5 to 4T-2%",ST-4%"
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 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.
Responslhle Designer Name: Responsible Igner Sign re: 'ate Signed: License:
la . ( 5-27- 4 1 `677c`(r
Company: -Address: City/State/Zip: Phone:
Ei � lit 3 ✓ C 2 '
For assistan a or questicifis regarding the Energy Standards,contact the Energy Hotl ne at:1-800-772-3300