PMT16-03370 City of Menifee Permit No.: PMT16-03370
29714 HAUN RD. Type: Residential Mechanical
<A-CCELA-'? MENIFEE,CA 92586
MENIFEE Date Issued: 1011312016
P E R M I T
Site Address: 28243 W WORCESTER RD, MENIFEE, Parcel Number: 339-092-011
CA 92586 Construction Cost: $8,000.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, REPLACE 88,000 BTU FURNACE AND 3 TON, 16 SEER A/C UNIT
Work:
Owner Contractor
BARBARA RUCH COOL AIR SOLUTIONS INC
28243 W WORCESTER ROAD 41162 SANDALWOOD CIR STE 101
MENIFEE, CA 92586 MURRIETA, CA 92562
Applicant Phone:9516762665
JANE RECKTENWALD License Number: 874502
COOL AIR SOLUTIONS INC
41162 SANDALWOOD CIR STE 101
MURRIETA, CA 92562
Fee Description 0tv Amount
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
Air Handling/Condensing Units SFR 1 133.00
Building Permit Issuance 27.00
GREEN FEE 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 carded 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.Bldg2emnit-Template.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 a in under provisions of with a licensed contractor(s)pursua nt to the Contractors State License Law).
Chapter!)(corm menCing 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 and my license is in full force and effect. the following reason:
LicenseClass License No. lg-1 LtGCF,). By my signature below I acknowledge that,except for my personal residence
Expires'Ll;O Signature in which I must have resided for at least one year priorto completion of
improvements covered by this permit.I cannot lega Ilysell a structure that I
WORKERS 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 7D44 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.leginfo.ca.gov/�law.htmi.
Policy# Date
-Aef'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 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
F_ AtcvL& with all applicable city and county ordinances and state laws relating to
Carrier + L�L building construction.I authorize representatives of this city or county to
Policy It 6 1 Expires enter the above identil��operty for inspection purposes.
(This section need not to be completed Is the permit is for one-hundred Date Lo-L7,-Lp
dollars($100)or less PROPERTYOWNE"R THORIZEDAGENT
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 become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensat!p"rovisions of Section 3700 of the Labor
Code,I shall forthwi ions. Will the applicant or future building occupant handle hazardous material or a
Applicant_ Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECUA4RIKER'S COMPENSATION COVERAGE IS a Yes 'Wo
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or firture 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)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATrORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY 0 Yes
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 b dary of a school?
(Section 3097 Civil Code) ci Yes Wo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist I understand my requirements undertbe State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&Saf"I e,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazard I
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ciYes
Business and Professions Code).Any city or county that requires a perm it to Date
construct,alter,improve,demolish or repair any structure,prior to its F�K� —
issuance,a Iso requires the appfica nt for the permit to file a signed statement PROPE RTY OWNER OU_VHORIZED 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 a nd 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
a n 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
a 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPXs Renovation Program visit:
compensation,will do( )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 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 req uired for this project because:
n 1,as owner of the property a in exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contrzictoes 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
Am�sh k7 "
DATE 10-13-16 PERMIT/PLAN CHECK NUMBER PLAM�,0 -0_222-6-70
TYPE: 0 COMMERCIAL VRESIDENTIAL () MULTI-FAMILY 0 MOBILE HOME C) POOL/SPA J SIGN
SUBTYPE: OADDITION ., ALTERATION -1DEMOLITION OELECTRICAL VMECHANICAL
0 NEW () PLUMBING ' RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Replace 88,000 btu furnace & 3 ton (16 seer) A/C unit.
PROJECTADDREss 28243 W Worcester Rd AG15OU
ASSESSOR'S PARCELNUMBER 339-092-011 LOT TRACT ',nI180
Q'y 2'—M 7 lWoopt.
OWNER NAME Barbara Ruch Building a sa
ADDRESS 28243 W Worcester Rd OCT 13 2916
PHONE 951-288-0689 EMAIL _.'�ni ff�rq
k4%;,U V
APPLICANTNAME Jane Recktenwald
ADDRESS
PHONE 714-336-6159 EMAIL
CONTRACTOR'S NAME C,'001 Air SojUtwonS InC OWNER BUILDER? -DYES VNO
BUSINESS NAME
ADDRESS 41162 Sandalwood Cir Ste 101 Murrieta, CA 92562
PHONE 951-676-2665 EMAIL
CONTRACTOR'S STATE LIC NUMBER 874502 LICENSE CLASSIFICATION C20
VALUATION$ 8,000.00 SQ FT LSQFT
APPLICANT'S SIGNATURE DATE.
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS UCENSE NUMBER
BUILDING PLANNING ENGINEERING F)RE I GREEN SMIP
INVOICE
1?6-2-
AMOUNT�*�jt�) PAIDAMOUNT In 0 CASH OCHECK 4 CCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT CASH 0 CHECK If C)CREDITCARD VISA/MC
OWNER BUILDER VERIFIED C;YES 0 NO DLNUMBER NOTARIZED LE17ER 0 YES 0 NO
City of Ivienifee Building 0 Safety Depot tment 29,714 Hoon Rd. iv;enifee, CAI 52586 95.i-6,-2-6777
www.Cif Yoftrienijee.us Inspection Poquest Line 951-2 46-62.13
#11,11-1 r-MIA 1 I%Jl,41;0 - F1 V M" CALIFORNIA ENERGY COMMISSION �
C kLT-04-E Revised 03/1 1 CFIR-ALT-04-E
ATE OF COMPLIANCE (Page I of 1)
Alterations-HVAC CZ 2,and a-15(formerly CF-IR-ALT-HVAC)
Di el?repaiea�3P—e—rnrut�:
Site Address: Enforcement ency: it red-:
28243 W Worceste Rd 1 13-16
New Ducting,Plenums,Lineset: Conditioned Thermostat
EquipmentType— — Equipment E iclency Required R-value Floor Area(sq ft) —K75—etback
0 Packaged LI Evaporator Coil MysLAFUE COP 11 R-6 (CZ 2,8-13)Ducting Served by system (if not already
i
System [01 Condensing unit Cl R-91 (CZ 11,14,15)Ducting 1,108 sqft
present,must
IdSplit System [3 Compressor 16 SEER _HSPF El R-6(all M)Plenums be installed)
0 Mini Split 0 Lineset EER 0 R-5 or R7.5)Unesee
11 Furnace 0 TXV
--- bVion this
HERS VERIFICAMON jUMMARY Installer determines work to be completed and matc�es n one of the options bell(WIYAP
form is allowed to be filled out by hand. For final inspection Ifnr,2WIk6Uk9)& 2co y eff o;site.
Ell.HVAC Changeout/Repair Required Compliance Documents to be lett on site for Final: OLT J 3 20
All Equipment, CFIR-ALT-02-E 2
Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23or24)2�HERS,MEC 5-HERS -
Compressor,TXV,Lineset, CF3R: MECH-20-HERS,MECH-(23or24)-HERS2,MECH-25-HERVEO)C e IV e
Air Handler/Furnace2(Can include new ucting)
Installer Requirement:Duct leakage L�.15%,or<i0%to outside,or seal all accessible leaks),Air Flovv;�300 CFM/ton,Refrijerant Charge
Exempted from duct leakage testing if:
0 1.Duct system registered with HERS provider as previously sealed,or El 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 Ne ucts3 CF111-ALT-02-E -22-HERS,MECH-(23 or 24)-HERS2,MECH-25-HERS2
including Mini Split CF2R: MECH-01,MECH-20-HERS,MECH
CF3R: MECH-20-HERS,MECH-22-HERS,MECH-(23or24)-HERS2,MECH-25-HERS2
Mini Splits require CFIR-ALT-02-E,CF2R-MECH-01,and (CF2R-CF3R)MECH-25-KERS
Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/CFM),Air Flow�t 350 CFM/ton tor alternative),Retrigerant Charge
D 3.All New Ducts with Replacement Required Compliance Documents to be left on site tor Final:
All New DUCtS3 and one or more of the following CF111-ALT-02-E 24)-HERS,MECH-25-HERS
replaced:Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23 or
Compressor,TXV,Lineset,Furnace 2 CF3R: MECH-20-HERSMECH-(23or24)-HERS,MECH-25-HERS
Installer Requirement:Duct leakage 5 6%,Air Flow�!35U LI-M/ton(or alternative),Refrigerant Charge
Exempted from duct leakage testing If:D 1. Existing duct systems are constructed,insulated or sealed with asbestos
0 4.New Ducting over 40 feet I Required Compliance Documents to be left on site tor Fin :
New ductIng but less than All New DuctS3 I CFIR-ALT-02-E,CFZR: Mk:LH-ZU-HERS,CF3R: MECH-ZU-HERS
Installer Required to;Duct leakage L�_15%or,:5_10%to outside or,or seat all accessible leaks)
0 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.
*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 handier,coil,plenums,duct material)
*R-5 W'thick insulation)for linesets I"and less. R-7.5(1.5"thick insulation)for linesets over I inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2Ys",2.5-3T-2Y.",3.5 to 4T-27/.",ST-4%"
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. Thatthe energy features and performance specifications,materials,components,and manufactured devices forthe building design or
cle wa I be een el
S in I s' tw floors Dc
n Charge verificatio n M ECH_25
cc nslSt of reused parts from the
in�ri.�rn�te,
system design Identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the CCR.
5. The building design features or system design features identified on this Certificate fCo' Ph rice are consistent with the Information
provided an other applicable compliance documents,worksheets,calculations plar,and cifications submitted to the enforcement
""L�uo" ..�"k3'
agency 0,r approval with this buildin permit ap lication.
DateSigned: Ucense:
Responsible Designer Name: Responsible Designer Signature: in-vi-16
Jnnt- RFlnktPnw;;Id City/State/Zip; Phone:
Company: Address:
Cool Ai 41162 Sandalwood Cir Ste#101 rri
nn
For assistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300