PMT16-03348 City of Menifee Perrnit No. PMT16-03348
29714 HAUN RD. Type: Residential Mechanical
5A- -I-A.> MENIFEE,CA 92586
G-��SA, MENIFEE Date Issued: 10/13/2016
P E R M I T
Site Address: 28288 VIA CASCADITA, MENIFEE, CA Parcel Number: 336-323-003
92585 Construction Cost: $12,655.00
Existing Use: Proposed Use:
Description of REPLACE 80,000 BTU FURNACE, 3 TON(14 SEER)A/C UNIT&COIL
Work:
Omer Contractor
MARJORIE MOORE PEACH HOME SERVICES INC
28288 VIA CASCADITA 532 MALLOY COURT
MENIFEE, CA 92585 CORONA,CA 92880
Applicant Phone: 7144628174
JANE RECKTENWALD License Number.989511
PEACH HOME SERVICES INC
532 MALLOY COURT
CORONA,CA 92880
Fee Description P!Y 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_Bldg_Pemit-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 I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapterg(commencing with section 7000)of Division 3 of the Business and u 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_91,0el-5 LQ License No. By my signature below I acknowledge that,except for my personal residence
Expires 1—_5kA7b 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
WORKER'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 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 370CI of the Labor Code,for the performance of work for which
this permit Is issued. wmiw.Ieoinfo.ca.gov/calaw.htm1.
Policy 11 Date
o 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 n 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 provilded is correct.I agree to comply
Carrier Af-' V'au+ �&(&'w;ry with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy#ILVA-1- —Expires 1a—k_t`,P enter the above identified prope for inspection purposes.
(This section need not to be completed is the permit Is for one-hundred
dollars($100)or less _.) Date
PROPERTY OWNER OR AU*
,'�AGENT
ci 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#
workees compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compe4ion provisions of Section 3700 of the Labor
Code,I shall forthwith com 11 h th provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date to—\23A� mixture containing a hazardous material equal to orgreater thatthe
k—Y amounts specified on the Hazardous Materials Information Guide?
AARNING-FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS 0yes _71"o
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or futu re building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN
ADDITION M 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 perm itting checklist
forguidelines
CONSTRUC11ON LENDING AGENCY a Yes .9,610
I 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) o Yes b-No
OWNER BUILDER DECLARATIONS I have mad 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 underthe State of
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting. 12
Business and Professions Code).Any city or county that requires a permit to Dyes �'Zft
construct,alter,improve,demolish or repair any structure,prior to its Date
Issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNER OR AUTHOk_W AGENT
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 licensure
a nd the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-1978
an Applicant for a Perm it subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified firms and comply with
than($500). required practices.This includes rental property owners and Property
managers who do the paint-disturbing work themselves orthrough their
ci 1,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( I portion of the work,and the structure is www.epa.gov/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 im proves 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 sa le. ci No EPA Lead-Safe Certified Firm is required for this project because:
ci 1,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.
BUILDI NG & SAFETY PERMiT/PLAN CHECK APPLICATION NO.-
DATE 10-10-16 PERMIT/PLAN CHECK NUMBERWTI(0-0-!5'�
TYPE. OCOMMERCIAL VRESIDENTIAL 0MULTI-FAMILY 0MOBILEHOME U POOL/SPA 0 SIGN
SUBTYPE: OADDITION OALTERATION ODEMOUTION 'DELECrRICAL DMECHANICAL
ONEW VIPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
Replace 80,000 btu furnace, 3 ton (14 seer) A/C unit & oil
PROJECTAIDDRESS 28288 Via Cascadita Romoland, CA 92585
ASSESSOR'S PARCEL NUMBER 336-323-003 LOT Aq L� TRACT
OWNER NAME Marlorwe Moore
of Menifea
ADDREss 28288 S/ia Cascadita Romoland, CA 9250,1ntyg & Satiety Dept.
PHONE 951-751-0068 EMAIL OCT I
APPLICANTINAME Jane Reck-tenwald
ADDRESS 'Received
PHONE 714-3a6-6159 EMAIL janereck@att.net
CONTRACTOR'S NAME The Prompt Plumber OWNER BUILDER? 0 YES IYNO
BUSINESS NAME
ADDRESS 532 Malloy Crt Corona, CA 92880
PHONE 714-462-8174 EMAIL
CONTRACTOR'S STATE LIC NUMBER 989511 LICENSE CLASSIFICATION C36 C20
VALUATION$ 12,655-00 LSQ FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP CrrY OF MENIFEE BUSINESS LICENSE NUMBER
INVOICE 1 0 CAS
AMOUN:T���o PAIDAMOUNT
I— I H 0 CHECK OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT CCASH (;CHECK# OCREDITCARD VLWMC
LOWNER BUILDER VERIFIED OYES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO
City qf tv"enife. guildi!1j, & -safevl Depgi�ttnept 2�-7 41futmFfri. Iivis--nifee, C�A ,025 CC, 1_67 _'-?71
'2
CitY of Menifee
Building Dept
OCT 1 12016
Received
CFIR-AIT-M-E
CERTIFICATE OF COMPLIANCE
Alterationsto Spam Conditioning Systems(formerly CF-IR-ALT44VAC) (Page I of3)
Project Namen Marjorie Moore Date Prepared; 2016-09-30
A.Genetral Informatlont
CFIR-ALT-02 Is applicable to multiple$Pace conditioning systems conUmed within a single dwelling unit.When multiple dwEJIIng units must be documented,
use onocnit-ALT-02 document for Each dwelling unit.
01 1prejactNarno Maniorte Moore 02 DaMPrepared 2016-09-30
D3 1projectLocation 2828SVIaCascadIts 04 SuldingType Single fanni�y
05 CA City 5un City 06 Dwelling Unit Name MaTionle Moore
III VpCoda 92585 08 Dwelling Unit Conditioned IODO
FloorArea fftl)
Numberafspam C�TKIldoning
09 r1itnetenne 10 10 [SC)system In this dwellIng I
unit.
S.Space Conditioning(SC)System Information
02 03 04 09 10
7sq 'th'S Iffinalike �-'Iastalllnz
SC System served �e�svem e-L- 'Vilgalm"Ot�-histsllingnevf firsts, Ing jn3la qg
SC System CIA 1 .1
? — " I t,'. -6
Identincationor LocistionorArea Irythissc ducted containing systoon morethan4D entrelynew entirely new
Nema served System(K) system? component? components? fe'lolducts? dua5irstem? SC SYStRol? Alienation Type
yes Yes No No No Altered Spam
System I Location I LOGO yes 00ndulaning system
C.Extension of Existing Duct System,Greater Than AD Feet(SectionIS0,2(b)2011b)
This section does nut apply in this project
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Alterations to Spam Conditioning Systems(formerly CF-IR-ALT44VAC) (Page 2 of 3
D,Altered Space Conditioning System(Sections 150.2(b)IE and F)
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01 Oz 03
Heating Cooling
Swam Heading ,red Heating minimum Altered cooling Minimum Required N�or New Dud
I&Intiffeation ..... �!.Hmiitsl Efficiency Efficiency C.Oling Cociling Efficiency Efficiency Themumbat Replaced
or Nam lvpe componen Type Value SystemTypm Components Type Value Type Duct Length R-Value
Cetitral gas All n. Annea, Thlb field or Thisfteldor
system I heating AFUE ED centralsplit .0fing SEER 14 Setback ,cflonIsmOt section Is nOt
fur.m. components AC cornponeflis applicable applicable
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CFIA�-GI-E-SP.comild.namSyA...Mda and I.
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-unak.,.m ...Oa..s 1VA ar4 log kabw w madd,ar.141 $--�
&MR-Mdi-M-H ufftanant ChaM.V-dicflEan mnaimai whea,nertsmant cnrMaInim; am lanallawl car alurod lWaluible in a 2,O-M
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EEntheiV Now or Complete Replacement Duct Systerv,With or Wit M :hpngcgut(SeCUOn,.Jgq.2(b)-JDjJa and,250.2(b)IE,F)
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This secdon does rot apply to this pmjea.
F.Entirely New or Complete Replacement SP20B.Conditionihii SYSUM(Section 150.2(b)IC)
This section does not apply to this project.
Registration Nuenb�.216,AO3G9S?3AO)OQK)OGDU-O00O WNation Date/rmc; 2GISIMM 19:19:58 HERSI'nnldenCRICERTS
(A Bulkilm Eneargy Efficiency Standards-�Residential Compilarx,a R�portVer,4=201311uvlma Rap.dGemenated:20164MO IMMAS
SchemaVersion:0.555SICID
CERTIFICATE OFCOMPUANCE CFIR-ALT-02-9
Alte6tloffl toSpace ConditionimMstems(fornnedly CF-IR-ALT-HVAC) l(Page 3 of 3
Dercumentation Author's Declaration Statement
1.1 certify that Vdis Certificate of Compliance docurrentatlon Is accurate and wmplete.
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