PMT16-03741 City of Menifee Permit No.: PMT16-03741
29714 HAUN RD.
'(�kCCFELA> MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 11/2112016
P E R M I T
Site Address: 27123 MONK ST, MENIFEE, CA 92586 Parcel Number: 335-304-008
Construction Cost: $4,500.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT
Work:
Owner Contractor
JO DEE LOPEZ PRO FLO A/C AND HEATING INC
27123 MONK ST 41447 JOHNSTON AVE
MENIFEE,CA 92586 HEMET, CA 92544
Applicant Phone:9516941300
BRYAN TODD License Number.78G602
PRO FLO A/C AND HEATING INC
41447 JOHNSTON AVE
HEMET, CA 92544
Fee Description Qtv 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 building 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.Bidg_Permit Ternpiate.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).
Chapter9(commencing with section 7000)of Division 3 of the Business and a 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 — ,2-2 By my signature below I acknowledge that,except for my personal residence
License No.
Expires
Signature inwhichl 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 DECLARATI'OON have built as an owner-builder if it has not been constructed In its entirety by
o I hereby affirm under penalty of p;;��llowing 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.leginfo.ca.gov/calaw.htin].
Policy Date
PROPERTY OWNER OR AUTHORIZED AGENT
u I have and will maintain worker's compensation insurance,as required by
section 3700 of the Labor Code,forthe 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 prop"owner's behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier 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 less
PROPERTY OWNER OR AUTHORIZED AGENT
certify that in the Performance of the work for which this permit is issued,
I shall n ot em Ploy a ny persons In any ma n ner so as to become subject to the CITY BUSINESS LICENSE#
worker's compensation laws of C-aliforn ia AcL"gree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the wo1rke!r' ;;rs_a_tion=oN;iis'ions of Section 3700 of the Labor
'5-comp !�_pn pro
Code,I shal rthwn. llpwv�kh th,ci��pvisions. Will the applicant or future building occupant handle hazardous material or a
Date
t mixture containing a hazardous material equal to argreater thatthe
:c:.:n: amounts specified on the Hazardous Materials Information Guide?
ECUR�WBIR�NSATION COVERAGE Is 0 Yes 0
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA e
LTIES 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)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY o Yes
I hereby affirm that under the penalty of perjury there is a construction Will the rprposed 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
OWNER BUILDER DECLARATIONS I have rrd the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&5afe�Y�BrSectlon 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazardous material
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,priarto Its —PROPE R OR AUTHOR6DA6rENf
Issuance,also requires the applicant for the permit to file a signed statement
that he or she is licensed pursuaritto the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING 1RRPJ
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 pa int 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 nut more required practic�.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
o 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( )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 ci 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. o No EPA Lead-Safe Certified Firm is required forthis project 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 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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
" Menifee
Ad�mi kh-b0,
DATE PERMIT/PLAN CHECK NUMBER
TYPE: 0 COMMERCIAL 5"ESIDENTIAL 0 MULTI-FAMILY 0_ MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: 0 ADDITION 0 ALTERATION 0 DEMOLITION 0 ELECTRICAL WAECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 4 Or
PROJECTADDRESS a 7 e2 3 1_V_6&Z- �r� J�i2� 2,&9Z
ASSESSOR'S PARCEL N UMBER LOT TRACT
OWNER.NAME
ADDRESS 02 -7/'13 1Y&,,Je �zz L<
PHONE EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME OWNERBUILDER? OYESONO
BUSINESS NAME 14/L 0/C v
ADDRESS v*e�v f,0
PHONE el�Z :?66 EMAIL
�� (��
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ Z/ SO FT LSQFT
APPLICANT'S DATE--—,,I/;P/
_0TY STAFF USE ONLY
DEPARTMENT DISTRIBUTION LIIY UImtNIFEE BUSIN tFLICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE � GREEN I JOQ SMIP
INVOICE j5E,,Uj. I0 I PAIDAMOUNT
AMOUNT _,",-1 � 0 CASH 0 CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Deportment 29714 Haun Rd. Menifee, CA 92586 951-572-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CF1R-ALT-04-E(Revised 06114) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE City nf Mopiton CF111-ALT-04-E
-HVAC CZ 2,and 8-15(formerly CF-IR-ALT-HVAC) Building & Safety Dept. (Page I of 1)
Alterations
Site Address: EnforcementW:2 I LUIb Date Prepared:
Du I 4&peset: Conditioned
Equipment Type Equip New ctmp onu Thermostat
ment Efficiency Required R_ aMe IF I Ve Floor Area(sq ft)
g%ackaged stem 0.Evaporator I COP (011-1 (CZ 2,8-13)Ducting Sewed by system Wetback
'Pr. Y CoiIm (If not already
t Systam Condensing Unit &LAFUE L3 R-8' (CZ 11,14,15)Ducting qft
•Mini Split U Compressor 44—/S E E R _HSPF 0 R-6(all CZs)Plenums present,must
•Furnace 0 Uneset 13 R-5 or R7.5)LIneset4 be installed)
0 TXV E
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the option,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 an Site.
Cl 1.HVAC epair Required Compliance Documents to be left on site for Final:
,,Chafigeou�o
All Equipment, CFIR-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERSMECH-(23or24)'-HERSMECH-25-HERS2
Compressor,TXV,Uneset, CF3R: MECH-20-HERS,MECH-(23or24)-HERS2,MECH-25-HERS2
Air Handier/Furnace 2(Can include new clucting)
Installer Requirement:Duct leakage(:5_15%,or<10%to outside,or seal all accessible leaks),Air Flow�300 CFM/ton,Refrigerant Charge.
Exempted from duct leakage testing if:
111.Duct system registered with HERS provider as previously seailed,or There is less than 40 linear feet of duct in unconditioned space,or
0 3.Existing duct systems are constructed,insulated or sealed with asbet's(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 CFIR-ALT-02-E
Including Mini Split CF2R: MECH-01,MECH-20-HERSMECH-22-HERS,MECH-(23or24)-HERS2,MECH-25-HERS2
CF3R: MECH-2D-HERS,MECH-22-HERS,MECH-(23or24)-HERS2,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(.SSW/CFM),Air Flow�:350 CFM/ton(or alternative),Refrigerant Charge
0 3.All New Ducts with Replacement mpliance 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-HERSMECH-(23or24)-HERS,MECH-25-HERS
Compressor,TXV,Unese CF3R: MECH-20-HERSMECH-(23or24YHERS,MECH-25-HERS
Installer Requirement:Duct leakage<6%,Air Flowa 350 CFM/ton(or alternative),Refrigerant Charge
Exempted from duct leakage testing ii 0 1. Existing duct systems are constructed,insulated or sealed with asbestos
0 4.New Ducting over 40 feet R qu"red Compliance Documents to be left on site for Final:
New clucting but less than All New DUCtS3 FlR-ALT_02-ECF2R: MECH-20HERS,CF3R; MECH-211-HERS
Installer Required to:Duct leakage(�_15%or,<10%to outside or,or seal all accessible leaks)
0 EXCEPTION:Existing duct systems constructed,insulated or sealed with asbestos.
I All new clucting 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/Fumace 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,boarts,air handier,coil,plenums,duct material)
4 R-5(r 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-25/s",2.5-3T-2%",3.5 to 4T-2w,ST-4y."
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. Thatthe 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 Title 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 pgfflut�jko I
R We D.igner N..e- Datesi ed:/
ponsi eslgnnFS�waz�
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C. P I;Add,e��. I hone-
city/stite/zip;
For assistance or questions regarding the -contact the Energy Hotline at:1-800-772-3300