PMT16-02349 City of Menifee Permit No.: PMT16-02349
29714 HAUN RD. Type: Residential Mechanical
-cACCELX- MENIFEE,CA 92586
MENIFEE Date Issued:
07/21I2016
PERMIT
Site Address: 29091 DEER CREEK CIR,MENIFEE, CA Parcel Number: 339-332-022
92584 Construction Cost $3,800.00
Existing Use: Proposed Use:
Description of REPLACE HEATING AND A/C SYSTEM-3 TON 60,000 BTU'S
Work:
Owner Contractor
DANIELLE LENARD POLAR EXPRESS HEATING AND AIR
29091 DEER CREEK CIR CONDITIONING
MENIFEE,CA 92584 502 CHANEY STREET STE E
Applicant Phone:8009752654
ANTHONY DIERINGER License Number:995884
POLAR EXPRESS HEATING AND AIR CONDITIONING
502 CHANEY STREET STE E
LAKE ELSINORE. CA 92530
Fee Description Oft Amount f$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_Pepnit Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that am under provisions of with a licensed contractor(s)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 anndf my license is in full force and effect' (�rye,�// the following reason:
License Cl ss t- Q License No. -I ct Rs V ti / By my signature below 1 acknowledge that,except for my personal residence
Expires Signature in which l must have resided for at least one year prior to completion of
improvements covered bythis permit.I cannot legallysell a structure that I
WORKER'S COMPENSATION DECLARAT N 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 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 ,N,A„�,,leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy# Date
D I 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 carder and policy owner or authorized to act on the property owners behalf.I have read this
number arr�e:,._, /1 r',,,I �^ /' application and the Information I have provided is correct 1 agree to comply
Carrier 1 'T'taf U (del l �-YIS- (,Q- with all applicable city and county ordinances and state laws relating to
�1 7 9 building construction.l authorize representatives of this city or county to
Policy# 1a �FCZd Expires (17Z 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
D I certify that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
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 forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material ora
Applicant Date mixture containing a hazardous material equal to or greater that the
amountwecified on the Hazardous Materials Information Guide?
WARNING:FAILURE 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 Coast Air Quality Management District(SCAQMD)7 See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guide[[ es
CONSTRUCTION LENDING AGENCY a Yes W,
I hereby affirm that under the penalty of perjury there is a construction WLII 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) D Yes No
OWNER BUILDER DECLARATIONS I have rea 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
I have placed next to the applicable item(s)(Section permit �jes D No 7 I /6
Business and Professions Code).Any city or county that requires apermit to ✓✓�� Date
construct,alter,improve,demolish or repair any structure,prior to its pROPERTr R OR ED 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 IRRP)
License Law(Chapter9(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 Rill)-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
❑I,as owner of the property,or my employee with wages as their sale 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.epa.r:oy/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-8 0 0 4 24-LEAD(5323).
Code,The Contractors State License Law does not applyto an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible forthis 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 rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION �A
JUL 2 1 2016
Menifee
DATE 7-2I—� PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL X RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL X MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 'e I(iI,C /C V'^�,p
"
PROJECT ADDRESS d�"LV ��iiQG1 '1 �
ASSESSOR'S PARCEL NUMBER (( O3J-1 3 a D;i1 TRACT LS�O�I I
OWNER NAME Ou {Ql T, F �, ,
ADDRESS oq 2 t L 1 '
PHONE q5-(" ;7�/'�_ ; .S] EMAIL
6
APPLICANT NA^ME r I1 L1,,0 n
ADDRESS J ` Ofiv
�+
PHONE 5I`"1 9- EMAIL d' to ncV �C� ffr0
CONTRACTOR'S NAME OWNER BUILDER? O YES O
AV I
BUSINESS NAME filar E,6resy IN w4 `r CaJkewnq
ADDRESS C Y Q e S• Ore. C d
PHONE (300� q75`, Z65`"'' EMAIL iCP6b tv lkreklmrS5com -oo
CONTRACTOR'S,j STATES LICC NUMBER qJ 8�� /] LICENSE CLASSIFICATION C�� 0
VALUATION}J'YT�jVw SOFT 1oRo LSO FT J
APPLICANT'S SIGNATURE DATE
EWAFF USE ONLY
DEPARTMENT DISTRIBUTION 1 CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GRLEN SMIP
INVOICE PAID AMOUNT
AMOUNT 0 CASH O CHECK# O CREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD 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 951-246-6213
STATE OF CALIFORNIA ^Ity of Menifee
I
ALTERATIONS - HVAC building & Safe' Dept.
CEC-CFIR-ALT-04-E Revised 06114 LIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFIR-ALT-04-E
Alterations-HVAC CZ 2,and 8-15(formerly CF-IR-ALT-HVAC) (Page 1 of 1)
Site Address. ( Enforcement - ate Prepared: Permit#:
I l�(i r•
Equipment Type Equipment Efficiency New Ducting,Plenums,Lineset., Conditioned Thermostat
Required R-value Floor Area(sq ft)
❑Packaged System vaporator Coil �� AFUE COP ❑R-6 (CZ 2,8-13)Ducting Se ed b ystem ❑Setback
❑Split system ondensing Unit 1 ( ) g q (if not already
❑R-8 CZ1$14,15 Ductin sgft
Mini Split ❑Compressor SEER HSPF present must
Furnace ❑Lineset ❑R-6(all CZ's)Plenums be installed)
L3 TXV EER ❑R-5 or R7.5)Lineset'
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, CFIR-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23 or 24)a-HERS,MECH-25-HERS'
Compressor,TXV,Lineset, 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 t 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 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' CF1R-ALT-02-E
including Mini Split CF211: MECH-01,MECH-2D-HERS,MECH-22-HERS,MECH-(23 or24)-HERS',MECH-25-HERS'
CF3R: MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS',MECH-25-HERS'
Mini Splits require CFIR-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 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,Lineset,Furnace CF3R: MECH-20-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 I Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts' CFIR-ALT-02-E,CF2R: MECH-20-HERS,CF3R: MECH-20-HERS
Installer Required to:Duct leakage Ls 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
'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-2s/",2.5-3T-2%%",3.5 to 4T-2%",ST-4'b"
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 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 COL
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 sibleD igner Name: Responsible Design signatur Date Sgned: Ikeme:
el Arl ff� eft / ✓p7/�-a1-t1 C- ynrn�q�7�rys�
Company: i r+�� ,ie.r,i• �1'1. Fa (i � IN/statej tive A-92 Phpn_ e: -_J - _' /
For assistancelPtorr questions regarding the Ener Standards,contact the Energy Hotline at:1-800-772-3300 �7