PMT16-03012 City of Menifee Permit No. PMT16-03012
29714 HAUN RD- Type: Residential Mechanical
<A—CCELA-l' MENIFEE,CA 92586
MENIFEE Date Issued: 09112/2016
P E R M I T
SiteAddress: 29467 WINDING BROOK DR, MENIFEE, Parcel Number: 340-240-081
CA 92584 Construction Cost: $7,850-00
Existing Use: Proposed Use:
Description of INSTALLATION OF NEW HVAC EQUIPMENT
Work:
Owner Contractor
RICHARD&MARGE FOREMAN BOUCHEYS HEAT&AIR COND
29467 WINDING BROOK DR 1637 EAST VALLEY PKWY#279
MENIFEE, CA 92584 ESCONDIDO, CA 92027
Applicant Phone:6198439207
GREG BOUCHEY License Number:723013
BOUCHEY'S HEAT&AIR COND
1637 EAST VALLEY PKWY#279
ESCONDIDO,CA 92027
Fee Description aty Amount
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_B1dg2ernri1-TernpIate.rpt Page I 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 I am under provisions of With a licensed contmctor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and ci I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class_C_?_6 Lice No. 2-10 V'1> By my signature below I acknowledge that,except for my personal residence
Expires c:;-:'5 9_) Signature in which I in ust ham resided for at least one yea r prior to completion of
improvements covered by this permit.I ca nnot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION U 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 worker's 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
this permit is issued. www.Ieginfo.ca.gov/calaw.htmL
Policy# Date
a I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which a By my signature below I certify to each of the foliming: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
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# Expires enter the above identified property for Inspection purposes.
(This section need not to be completed is the permit Is for one-hundred
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT Date
o 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#
worker's compensation laws of California,and agree that if I should became HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall f hwith Tm with those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applican, 70 Date C�—In'_—((ti amounts specified on the Hazardous Materials Information Guide?
WARNING:FA21RI?TO SEC EW "'S COMPENSATION COVERAGE IS ciYes 'IR7No
UNLAWFUL,AND SHALL SU ECT N EMI LOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
r
M OTI
AND CIVIL FINES UP TO ON N DRED THOUSAND DOLLARS($100,000),IN
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST�AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist
for guidelines
CONSTRUCTION LENDING AGENCY o Yes Eitft
I hereby affirm that under the pena Ity 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) ayes "a
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
California Health&Safety Code,Section 25505 and 25534 concerning
Contractoes License Law for the reason(s)Indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Secrion 7031.5 aves 0140
Business and Professions Code).Any city or county that requires a permit to n:b � 0 LAd 6� —Date '[-I? I(,
construct,alter,improve,demolish or repair anystructure,priorto its PROPERTY"Elt OR A CAIZ 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 Contractor's 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 ficensure receiving compensation for most work that disturbs paint in a pre-1978
a nd the basis for the a lleged exemption.Any violation of Section 7031.5 by residence or childcaire facility to be RRP-certified firms and comply With
an Applicant for a permit subjects the applicant to a civil pena Ity of not more required practices.This includes renta I property owners a nd property
than($500). managers who do the paint-disturbing work themselves or through their
a 1,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( I all of or( )portion of the work,and the structure is www.epa.goy/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 Contractor's State License Law does not apply to an owner of a a 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. ci No EPA Lead-Safe Certified Firm is required for this pmject because:
o 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractoes 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
DATE 9 -q-k(.0 PERMIT/PLAN CHECK NUMBERP hu (D V;oa
TYPE: OCOMMERCIAL )W6ESIDENTIAL 0MULTI-FAMILY OMOBILEHOME OPOOL/SPA CISIGN
SUBTYPE: OADDITION OALTERATION ODEMOLITION CIELECTRICAL >rMECHANICAL
ONEW O- PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 0-1P (U-01A) 4 U P�C- e 04Y i P IT fl�+ C)
PROJECT ADDRESS 2-94(.o-+ W�mA;Nc� &C-jv-- Dcoio�p—
ASSESSOR'S PARCEL NUMBER LOT (0$5 TRACT
OWNERNAME �) '�CV- A(-,5�e m Avj
ADDRESS 2-q4(a-+ V- u e- (N-r,;Fe-e Ctri- ct?-S84
PHONE EMAIL
APPLICANT NAME AS- 6plocd)
ADDRESS
PHONE EMAIL
coNTRAcroR'S NAME (N(f!� Q>ouckp. OWNER UILDER >CYESONO
BUSINESSNAME Zaxke�,6- 'AA It f�-
ADDRESS JAjk:e� CO3 qZ,02 I-
PHONE ( EMAIL 6r!!5boCjc kp�(ZA) qA�pe2 Corr\
U(ct) b45 — 926-f-
CONTRACTOR'S STATE LIC NUMBER 2-'b 0 t"� LICENSE CLASSIFICATION C- 2-0
VALUATION $ b SO ' 00 SO FT -z 14 oo — LSQFT
APPL &LA DATE -C� -
A
�S T�FF US E OML Y
DVARTMENT DIN I RIBLI I IUN MIP OF MENIFELBUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN S
INVOICE 1% 1%:3 PAID AMOUNT
AMOUNT 1 0 CASH CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 No DLNUMBER NOTARIZED LET-TER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
STATE OF CALIFORNIA City of Manifee iW
ALTERATIONS - HVAC Building & Safety Dept.
CEC-CFIR-ALT-04-E(Revised 06114) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE Sp 12 2016 CF1R-ALT-04E
Alterations-HVAC CZ 2,and 9-15(formerly CF-IR-ALT-HVAC) (Page 1 of 1)
r%n . 14
Site Address: WMeRfAlAcy: Date Prepared:
11446+ W�Iikv-!b -cx;v r 01 U e- New Ducting,Plenums,Lineset: Conditioned Wig
EquipmentType Equipment Efficlency Required R-value Floor Area(sq ft) Thermostat
[I Packaged System KEvaporatorCoil. ri COP [3 R-6 ((.Z Z B-13)Ducting Sewed by system 0 Setback
JKSpIit System fi(Condensing Unit _BG�%UE — D R-81 (CZ 11,14,15)Ducting -2�AOO qft (if not already
0 Mini Split 0 Compressor _L4_SEER HSPF 11 R-6(all CZs)Plenums present must
11 Furnace 0 Uneset 0 R-5 or R7.5)Uneset' be installed)
11 TXV EER I I I
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 fina inspection all forms are to be registered(no hand filled forms allowed)and a copy left on site.
XHVAC Changeout/Repair Required Compliance Documents to be left an site for Final:
All Equipment, CFIR-ALT-02-E
Condenser Unit,Evaporator Coll, CF2R: MECH-01,MECH-2G-HERS,MECH-(23or24)kHERSMECH-25-HERS'
Compressor,TXV,Uneset, CF3R: MECH-20-HERSMECH-(23or24)-HER9,MECH-25-HERS2
Air Handier/Furnace'(Can include new clucting)
Installer Requirement:Duct leakage(:LIS%,or<10%to outside,or sea]all accessible leaks),Air Flow 2�300 CFM/ton,Refrigerant Charge.
Exempted from duct leakage testing if,
111.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
113.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building
0 2.New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts3 CFlR-ALT-02-E
including Mini Split CF2R: MECH-01,MECH-20-HERS,MECH-22-HERSMECH-(23or24)-HERS2,MECH-25-HERS2
CF3R: MECH-20-HERSMECH-22-HERSMECH-(23or24)-HERS2,MECH-25-HERS2
Mini Splits require CF1R-ALT-02-E,CF2R-MECH-01,and (CF2R-CF3R)MECH-25-HERS
Installer Requirement:Duct leakage:5 6%,Fan Efficacy(.58W/CFM),Air Flow 2�350 CFM/ton(or alternative),Refrigerant Charge
0 3.All New Ducts with Replacement I Required Compliance Documents to be left on site for Final:
All New Ducts3 and one or more of the following CF1R-ALT-02-E
replaced:Condenser Unit,Evaporator Coll, CF2R: MECH-01,MECH-20-HERSMECH-(23or24)-HERSMECH-25-HERS
Compressor,TXV,Lineset,Furnace 2 CF3R: MECH-20-HERS,MECH-(23or24)-HERS,MECH-25-HERS
Installer Requirement:Duct leakage<6%,Air Flow�:350 CFM/ton(cralternative),Refrigerant Charge
Exempted from duct leakage testing if:0 1. Existing duct systems are constructed,insulated or sealed with asbestos
0 4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New clucting but less than All New DuCtS3 CFlR-ALT-02-E,CF2R: MECH-2G-HERSCF3R; MECH-2D-HERS
Installer Required to:Duct leakage(�_15%or,:E_10%to outside or,or seal all accessible leaks)
0 EXCEPTION:Existing duct systems constructed,insulated or sealed with asbestos.
I All new ducting R-8 required when more than 40 ft installed and R-15 when less than 40 fit Installed. This includes In walls,between floors etc.
2 Heating only systems and Air Handier/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 unit's existing duct system(e.g.,registers,grilles,boots,air handier,call,plenums,duct material)
4 R-5 It"thick insulation)for linesets I"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%",2.5-3T-23A",3.5 to 4T-2Y",5T-4n"
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 forthe 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 perforrnance 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,worksheet5,calculations,plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Respo Is Designs I e: ResponslWoligner it.r.-
nel a;fJr-k1P14 I M"- Phone:
Address: cttylstte/Zip-
?
For assistance or questions regarding the Energy Stairdards,contad the Energy Hotline at:2-800-772-3300