PMT16-03666 City of Menifee Permit No.: PMT16-03666
29714 HAUN RD. Type: Residential Mechanical
<A—CCEUA—> MENIFEE, CA 92586
MENIFEE Date Issued: 11110/2016
P E R M I T
Site Address: 28349 KING APACHE CIR,MENIFEE, CA Parcel Number: 388-020-010
92584 Construction Cost: $900.00
Existing Use: Proposed Use:
Description of REPLACE EVAP COIL ONLY
Work:
Owner Contractor
JIM SPURBECK M D HEATING&AIR
28349 KING APACHE CIRCLE 16984 MOCKINGBIRD CYN RD
MENIFEE, CA 925134 RIVERSIDE, CA 92504
Applicant Phone:9516605699
PATRICIA DE LA TORRE License Number:921800
M D HEATING&AIR
16984 MOCKINGBIRD CYN RD
RIVERSIDE,CA 92504
Fee Description Ply. Amount 1$1
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 6.65
$167.66
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.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
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractors)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 Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License 0__T_ By my signature below I acknowledge that,except for my personal residence
ExpiresNtOt& Slin.t.r, 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
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.m.govJmIaw.htmL
Policy# 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 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 ownees 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 Date
dollars($1.00)or less PROPERTY OWNER OR AUTHORIZED AGENT
certify that in the performance of the work for which this permit is issued,
all 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 workees compensation provisions of Section 3700 of the Labor
Code,I shall fort it comply 'h th se provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date 1,D I I iiii, mixture containing a hazardous material equal to or greaterthat the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION CJVERAIG;IS oYes oNo
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 TOONE 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 Qua lity Management District(SCAQM D)?See permitting checklist
I N SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORN EYS FEES for guidelines
CONSTRUCTION LENDING AGEN o Yes o No
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 o No
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
Contractor's License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable itemls)(Section 7031.5 oYes o No
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT
issuance,also requires the applicant for the permitto file a signed statement
that he or she Is licensed pursuant to the provisions of the Contractoes state EPA RENOVATION,REPAIR AND PAINTING flRRPJ
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
a 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 I I all of or I 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(532,3).
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 required for this project bemuse:
o 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.
Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: COMMERCIAL OESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME POOL/SPA 0 SIGN
SUBTYPE: �ADDITION f,ALTERATION DEMOLITION () ELECTRICAL XMECHANICAL
ONEW OPUUMBING RE-ROOF-N UMBER OF SQUARES
DESCRIPTION OF WORK 1A C,e, CO C%=LA
PROJECT ADDRESS lie)
ASSESSOR'S PARCEL NUMBER -Zee -crll�_0 ('6 LOT TRACT Bulld�ing 06'=ty )opt.
OWNER NAME NOV I o 2016
ADDRESS i<I vi ci a c3i e, d
PHONE a q v 1111 EMAIL
APPLICANT NAME MD av\� Ail- eafri'rrz.. De LC&TD ff f,
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME beA44v) A j-r- OWNERBUILQER? ')YESrNO
BUSINESS NAME _�(,vw_r-5, cle cA clzs-�y
ADDRESS 6 q 3
PHONE 41 EMAIL A Lea fy i�) a n A Q fr- ya boo. ��k"
CONTRACTOR'S STATE LIC NUMBER 0 0 LICENSE CLASSIFICATION (2 7- 0
VALUATION $ SC,FT L SO Fr
APPLICANrs SIGNATURE DATE
22111m, CITY OF MENIFEE BUSINESS LICENSE NUMBER
DEPARTMENT DISTRIBUTION
BUILDING PLANNING ENGINEERING FIRE GREEN smip
INVOICE D JDAMOUNT
AMOUNT I - CASH 0CHECK# 0 CREDIT CARD VISA/MC
PLAN CHECK FEES 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 No DL NUMBER NOTARIZED LETTER r, YES 0 NO—
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofmenJfee.us Inspection Request Line 951-246-6213
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CF1R-ALT-04-E(Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF111-ALT-01�4�E
Alterations-HVAC CZ 2,and 8-15(formerly CF-IR-ALT-HVAC) (Page 1 of 1)
Site Address: t e c�r, Enforcement Agency: Dqe Prqpared: Permitti:
v,j- 3q ki ,14 Apzit� V_k�%;CA It 1%C)liv Itp-0&6L#6
-) ' ii New Ducting,Plenums,Lineset: Conditioned Thermostat
EquipmentType Equipment Efficiency Required R-value Floor Area(,q ft)
El Packaged System Evaporator Coll COP 0 R-6 (CZ 2,8-13)Ducting Sewed by system El Setback
MA Split System 0 Condensing Unit —AFUE — 0 R-81 (CZ 11,.14,15)Ducting IV&o sqft (if not already
0 Mini Split Cl Compressor �ILI SEER _HSPF 11 R4i(all CZ5)Plenums present,must
(3 Furnace 0 Uneset 0 R-5 or R7.5)Lineset' be installed)
0 TXV EER _L J
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 c%I ZV�6to;
�4-HVAC Changeout/Repair Required Compliance Documents to be left on site for Final; Bullding & Sallisty D pt.
All Equipment, CFIR-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23or24)2�HERSMECH-25-HERS2 NOV 10 2016
Compressor,TXV,Lineset, CF3R: MECH-20-HERS,MECH-(23or24)-HERS',MECH-25-HEFtS2
Air Handler/Furnace2(Can include new ducting) A
Installer Requirement:Duct leakage(S-15%,or<10%to outside,or seal all accessible leaks),Air Flow�300 CFM/ton,Refrlger�
Exempted from duct leakage testing if:
0 1.Duct system registered with HERS provider as previously sealed,or 0 2.There is less than 40 Rnear feet of duct in unconditioned space,or
13 3.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-2G-HERSMECH-22-HERS,MECH-(23or24)-HERS2,MECH-25-HERS2
CF3R: MECH-20-HERS,MECH-22-HERSMECH-(23or24)-HERS',MECH-25-HERS2
Mini Splits require CFIR-ALT-02-E,CF2R-MECH-01,and (CF2R-CF3R)MECH-25-HERS
Installer Requirement:Duct leakage<6%,Fan E cacy(.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 CF1RALT-02-E
replaced:Condenser Unit,Evaporator Call, CF2R: MECH-01,MECH-20-HERSMECH-(23or24)-HERSMECH-25-HERS
Compressor,TXV,Uneset,Furnace4 CF3R: MECH-20-HERSMECH-(23or24)-HERS,MECH-25-HERS
Installer Requirement:Duct leakage:S 6%,Air Flow 2t 350 CFMAon(or alternative),Refrigerant Charge
Exempted from duct leakage testing if:0 1. Exiiiag duct systems are constructed,insulated or sealed with asbestos
0 4.New Ducting over 40 feet Re; !red Compliance Documents to be left on site for Final:
New clucting but less than All New DuctO CFIR-ALT-02-E,CF2R: MECH-20-HERS,CF3R: MECH-20-HERS
Installer Required to:Duct leakage L<15%or,L10%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-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 unit's existing duct system(e.g.,registers,grilles,boots,air handier,coil,plenums,duct material)
4 R-5 W'thick insulation)for linesets V 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-2Ys",2.5-3T-2W,3.5 to 4T-2Y.",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. 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 1-itle 24,Part I 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.
R�ponsible De,lsnerp; 11-pomble]�J 'JI't ned:
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For assistaole or questions regarding the Energy.9tanclards,confact the En irgil'Intline at-1 8011772
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