PMT16-03797 City of Menifee Permit No.: PMT16-03797
29714 HAUN RD. Type: Commercial Mechanical
<A-CCELA—> MENIFEE, CA 92586
MENIFEE Date Issued: 1112812016
P E R M I T
Site Address: 29995 EVANS RD, MENIFEE, CA 92586 Parcel Number; 338-121-046
Construction Cost: $20,000.00
Existing Use: Proposed Use:
Description of HVAC REPLACEMENT OF ONE 5 TON, ROOF MOUNTED,ONE WALL MOUNTED HVAC UNIT
Work: VIATHIN KAY CENICEROS SENIOR CENTER MAIN BUILDING
Owner Contractor
CITY OF MENIFEE CALIFORNIA PROFESSIONAL ENGINEERING INC
29714 HAUN RD 929 OTTERBEIN AVE UNIT E
MENIFEE, CA 92586 LA PUENTE,CA 91748
Applicant Phone:6268101338
VAN NGUYEN License Number:793907
CALIFORNIA PROFESSIONAL ENGINEERING INC
929 OTTERBEIN AVE UNIT E
LA PUENTE, CA 91748
Fee Description Qty Amount
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.Bk1g_Permh-Template.rpt Page 1 of 1
CITY OF MENIFEE
L LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I 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).
Cha pter9(com m encing with section 7000)of Division 3 of the Business and ci I a in exem pt from licensure under the Contractor's State Ucense Law for
C
PProfessions Code and my license is In full force and effect. the following reason:
ILIC '—) By my signature below I acknowledge that,except for my personal residence
License Class Licen�_e No. :J�6)
(Lxpires Signature % — in which I must have resided for at least one year prior to completion of
74�; U improvements covered by this permit.I cannot legally sell a structure that I
FKER'S C MPENSATION DECLARATION have built as an owner-builder if it has not been constructed in Its entirety by
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.leginfo.ca..gov/calaw.htmi.
Policy# Date
ci 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 ci 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 am: 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# 'yp Expires enter the above Identified property for inspection purposes.
s
h
c
b
P
n
C
P
0
h
e
h
a
u
a
0
I
I
is
v
is
I
c
t
m
h
r'r
I
e
e
P
P
I
c
1,
e
Y
b
cy
c
K
a
e
e
r
v
n
a
e
r
t
I
e
n
E
n
r
r
0
s
m
(This section need not to be completed is the permit is for
dollars($100)or less one huddred 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 emplay any persons in any manner so as to become subject to the TY BUSINESS LICENSE#
worker's compensation lam of California,and agree that If I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
C e,I shall forthwit se provisions. Will the applicant or future building occupant handle hazardous material or a
'xI
A licant Date mixture containing a hazardous material equal to or greater that the
(amounts s �cffiecl on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ci Yes IFNI
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 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 forguidell es
CONSTRUCTION LENDING AGENCY a Yes NC
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) 0 Yes QXo
OWNER BUILDER DECLARATIONS I have mad 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&Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)Indicated below by the hazardous m7erill!ro - g.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes QIN
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 K 12116PERTY OWN&OR AUTHDAIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement -"�ZENOVATION,REPAIR AND PAINTING IRRIP)
that he or she Is licensed pursuant to the provisions of the Contractor's State
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-certffied 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
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( )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 Vicense Law does not apply to an owner of a m An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,th rough 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 project because:
ci 1,as owner of the property a m 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 you r project does not comply with EPA RRP rule please fll I out the RRP
Acknowledgement.
& SAFETY PERM IT/PLAN CHECK APPLICATION
1 - 4,Men'r
ITee
DATE PERMIT/PLAN CHECK NUMBERPPTTI(v-0��74171
TYPE: OCOMMERCIAL []RESIDENTIAL F]MULTI-FAMILY [IMOBILEHOME OPOOL/SPA [:]SIGN
SUBTYPE: []ADDITION [Z]ALTERATION [-]DEMOLITION [—]ELECTRICAL FIMECHANICAL
E]NEW F]PLUMBING FIRE-ROOF-NUMBEROFSCLUARES_
DESCRIPTION OF WORK Replacement of one,5-ton HVAC(roof mounted)unit and one wall mounted HVAC unit within
Kay Ceniceros Senior Center main building
PROLIECTADDRESS 29995 Evans Road, MenifeeCA92586
ASSESSOR'S PARCEL NUMBER 338-121-046 LOT TRACT 13706-1
OWNERNAME CityofMenifee
ADDRESS 29714 Haun Road,MenifeeCA92586
PHONE (951)672-6777 EMAIL mcornelo@cityofmenifee.us
APPLICANT NAME City of Menifee: Finance Department
ADDRESS 29714 Haun Road,Menifee CA 92586
PHONE (951)672-6777 EMAIL moornejo@cityofmenifee.us
CONTRACTOR'S NAME Van Nguyen OWNERBUILDER? DYESZNO
BUSINESSNAME CALIFORNIA PROFESSIONAL ENGINEERING INC
ADDRESS 929 OTTERBEIN AVE UNITE,LA PUENTE,CA91748
PHONE (626)810-1338 EMAIL eric@roadwayengineering.com
CONTRACTOR'S STATE LIC NUMBER 793907 LICENSE CLASSIFICATION C-10,C-20
VALUATION$ - )(3 Y SOFT LSQFT
APPLICANT'S SIGNATURE DATE
RM-1 0 , � �'
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAIDAMOUNT
AMOUNT I I I I OCASH OCHECK# Q CREDIT CARD VISA/MC
PLAN CHECK FEES AIDAMOUNT
PI I 1 0 CASH OCHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERII [ED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 ND��
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.citycfmenifee.us Inspection Request Line 951-246-6213
STATE OF CALIFORNIA
CERTIFICATE OF COMPLIANCE, PRESCRIPTIVE HVAC ALTERATIONS
CEC-MECH-IC-ALT-HVAC(Revised 07/10) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE MECH-IC-ALT-E[VAC
Prescriptive RVAC Alterations (Page I of 3)
Project Name: -H Q)kc Date:
a t A—apt.
dh1WnY',VeA_cSt F
kg
Project Address: Climate Zone: Eff6d",
M�&*^s kd. 10 wnv 2 8 7016
NOTE. Thisform may be used onlyfor single zone constant volume systems, Thisform shall not be usedy6r—hewly constructed
buildings, additions, or VA V multi-zone systems.
Select one"Existing Building Project Type"and complete the corresponding steps listed in the'Rsefflwoluum
below. Note:After installation ofHVA C units andlor ducts, the Installation and the applicable Acceptance Forms are required to be
submittedfor verification by thefteld inspector and a copy shall be made available to building owner.
Existing Building Project Type(select one): Complete Steps:
0 New or Replacement HYAC unit 1,4,5 and 6(ffcriterla is met), 7(When economizer is installed)
LI New or Replacement ducts 1,4,5 and 6(Ifcriteria is met)
13 New Space Conditioning System(HVA C and ducts) 1,2,3,4,5 and 6(Ifcriteria is met), 7(When economizer is installed),8(DCT9
0 Step 1—Ducts and HVAC Equipment
Equipment Type,Efficiency Floor Area Distribution Type Duct Insulation Thermostat Configuration
and Capacity Served' and,Location' R-Value� Type, (Central,Split Package)
1.Indicate Equipment Type;Air Handler,Condenser,Heat Pump,Evap.Cooling,Boiler,Electric Resistance,etc.&HVAC Capacity;or Ducts
(new or replaced).
2.If the Fluor Area Served(per duct system)exceeds 5,000 square ficut,skip Steps 5 and 6.
3.Indicate Type and Location(Ducts on roof,ducts in conditioned space,ducts in attic,etc.)
4.Newly installed or replaced duct insulation:R-8 in unconditioned space or in buried concrete slab;R-4.2 in indirectly conditioned space;and R-0
for conditioned space.
S.Existing non-setback thermostats shall be replaced with setback thermostats for all altered units,and all newly installed space conditiolo 9
systems requiring a thermostat shall be equipped with a setback thermostat, Setback thermostats shall meet the requirements of Section 1 12(c)
0 Step 2—Mechanical Ventilation Calculations
Both options(Am and Occupancy Basis)shall be completed to determine the minimum mechanical ventilation rates and Column I must be the
greater of either Column E or H.
AREA BASIS OCCUPANCY BASIS
A B C D E F G H I
Zone/ Type of Use Condition CFM' Min Num of CFM Min Design Vent.CFM
System Am(ft-) Per ft- CFM2 People2 per CFM` Luger of
CxD Person FxG E or H
�2-0 Cx) 15
15
15
AREA BASIS
1. Minimum ventilation rate(CFM/ft2)for the Type of Use in the Table below.
2. The conditioned floor am of the space multiplied by the applicable minimum ventilation rate from Table 4-1 CFM/ft2 Column below.
For additional ventilation rates,see Table 4-3 and use the values listed in the Required Ventilation Column in the Nonresidential
Compliance Manual. This provides dilution for the building-bome contaminants like off-gassing of paints and carpets.
OCCUPANCY BASIS
2.For spaces with fixed seating such as a theater or auditorium,the expected number of occupants is the number of fixed seats.
3.The expected number of occupants or people multiplied by 15 cfin per person.
Type of Use CFM per ft' Type of Use CFM per ftz
Auto repair workshops 1.50 High-rise residential Ventilation Rates
Specified by the CBC
Barber shops OAO Hotel guest rooms(less than 500 R2) 30 cfnVgaest room
Bars,cocktail lounges,and 0.20 Hotel guest mom(500 ft?or greater) 0.15
casinos
Beauty shops -0.40 Retail stores 0.20
Coin-operaied dry cleaning 0.30 All Othersi 0.15
2008 Nonresidential Compliance Form July 2010
STATE OF CALIFORNIA
CERTIFICATE OF COMPLIANCE, PRESCRIPTIVE HVAC ALTERATIONS
CEC-MECH-1C-ALT-HVAC(ReAsed 07110) CALIFORNIA ENERGY COMMISSION ---
CERTIFICATE OF COMPLIANCE MECHIC-ALT-HVAC
Prescriptive HVAC Alterations (Page 2 of 3)
ProjectName:
Commercial dry cleaning 0.45
1.For additional ventilation rates,see Table 4-3 in the Nonresidential Compliance Manual
Installation Certificate requirement. The installing contractor shall complete and sign an Installation Certificate(MECH-INST)
to certify that th e installed H VA Cfeatu res,materials, compon ents, or man ufactured devices(th e installation)conforms to all
applicable codes and regulations, and the installation is consistent with any requiredplans and specifications approved by the
enforcement agency
Certificate ofAcceptance requirement.After completing the installation, all required acceptance testing shall be completed
and all applicable Certificate of Accemanceforms are required to befiffed out completely,signed,and made available to the
enforcement agency atfinal inspection. Copies of the completed,signed Certificate ofAcceptanceforms shall also be made
available to the building owner.
U Step 3-MECH-2A-Outdoor Air Acceptance—77,is test is requiredfor newly installed or replacement HVACSystems(HVAC
equipment and ducts)to verify minimum outside air isprovided in accordance with Section 125 ofthe Energy Standards.
0 Step 4—MECH-3A- Constant Volume,Single Zone Unitary A/C and HP Controls Acceptance-Tus test is required
for nm or replaced constant volume,single-zone unitivy air conditioners and heatpumps to verify controlsfunction,including.,therniostat
installation andprogramming,supplyfian,heating,cooling,and damper operation in accordance with Section 125 of the Energy Standards.
11 Step 5-MECH4A-Air Distribution Systems Acceptance-This test is required when the am or altered system is a jja�
zone, constant volume system servin 5,00W or less,and 25%or more of the duel surface area is located in the outdoors, unconditioned space,
or a ventilated attic in accordance with Section 125 ofthe Energy Standards.
11 Step 6-MECH4-FtERS-Air Distribution System Leakage Diagnostic-This test is required to be completed by a HERS
Rater when the new or altered system meets the criteria in Step 5 to verify duct leakage in accordance with Section 125 ofthe Energy Standards.
Th e HERS Ra ter shall register the MECH-4-HERS Form with an approved HERS Provider.
13 Step 7-MECH-5A-Economizer Testing Acceptance-This tat is requiredfor newly installed or replacement HIIAC equipment
when an economizer is installed in accordance with Section 125 ofthe Energy Standardy.
L3 Step 8-MEECH-6A-Demand Control Ventilation Systems(DCV)Acceptance- This test is requiredfor ninviv installed
DCVsystems or replacement ofHVAC equipment with thefollowing characteristics to verify controls and sensorsfunction in accordance with 125
of the Energy Standards. : A. They haw an air economLrer;and B. 77:ey serve a space urith a design occupant density,or a maximum occupant
loadfactorfor egresspurposes greater than or equal to 25 peopleper 10OOf?(40 squarefootperperson);and C. They are either.-
i.Single zone systems with any controls;or
ii.Multiple zone systems with Direct Digital Controls(DDQ to the zone level.
Documentation Author's Declaration Statement
e I certify that this Certificate of Compliance documentation is accurate and XontIllete.
Name: \A� Signet.
Company: Date:
C — I � )� .1(, -
Address: If Applicable
CEA#
CEPE#
City/State/Zin\_,,.� _,j PhonZ,
Principal Mechanical Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the mechanical
design.
• This Certificate of Compliance identifies the mechanical features and performance specifications required for compliance with
Title 24,Parts I and 6 of the California Code of Regulations.
• The design features represented on this Certificate of Compliance are consistent with the information provided to document this
design on the other applicable compliance forms,workshects,calculations,plans and specifications submitted to the
enforcement agency for approval with this building permit application.
2008 Nonresidential Compliance Form July 2010
STATE OF CALIFORNIA
CERTIFICATE OF COMPLIANCE, PRESCRIPTIVE HVAC ALTERATIONS
CEC-MECH-1C-ALT-HVAC(Re-Ased 07/10) CALIFORNIA ENERGY COMMISSION
CERT]FICATE OF COMIPLUNCE MECH-IC-ALT-RVAC
Prescriptive HVAC Alterations (Page 3 of 3)
Project Name: Da L, �2—A 46
Name: Signatur%l
Company Name N I I Date: �A
Address: License#
9-1)q 1 -1 q��
City/StatdZip: Phone:
2008 Nonresidential Compliance Form July2010