PMT17-01267 City of Menifee Permit No.: PMT17-01267
29714 HAUN RD.
'ACCELA> MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE Date Issued:
04/2412017
PERMIT
Site Address: 30279 MARNE WAY, MENIFEE, CA 92584 Parcel Number: 364-124-003
Construction Cost: $10,689.90
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT-3 TON, 16 SEER
Work:
Owner Contractor
RICK BELL AIR FORCE ONE HEATING AND AIR INC
30279 MARNE WAY 31566 RAILROAD CANYON ROAD
MENIFEE, CA 92584 #682
Applicant Phone: 9512440916
CHARLIE DIERINGER License Number: 955952
AIR FORCE ONE HEATING AND AIR INC
31566 RAILROAD CANYON ROAD
#682
CANYON LAKE, CA 92587
Fee Description Qtv Amount($)
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 requidng the correction of errors in the plans and
specifications or from preventing building 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
0
CITY OF MENIFEE
LICENSED DECLARATION property who builds or Improves thereon,and who contracts for
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State Ucenn
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑1 am exempt from Iicensure under the Contractor's State License Lav/
Professions Code and my license is in full force and effect the following reason: /.
License Class License S "+
No. S By my signature below I acknowledge that,except for m g p y personal residences
Expires —?il — J Signature in which I must have resided for at least one year prior to completion of
WORK ' MPENSATION DECLARATION 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
-AMMUWaffirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
ve 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
by Section 3700 of the Labor Code,for the performance of work for which this application is submitted or at the fallowing wehsite:
this permit is issued. www.Igginfo.ca.9ov/calaw.htmL
Policyq Date
J 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 ❑By my signature below I certifyto each ofthe following:I am the property
this permit is issued.My worker's compensation insurance carrier and policy owner orauthorized 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
[* 1 C ' , q� with all applicable city and county ordinances and state laws relating to
Carrier rc�r� }y ry� yLw,.S
building construction.I authorize representatives of this city or county to
7
Policy N 5`'`7 Gl J Z 1&7( Expires ' - ' /O-36•//7 enter the above identified property for inspection purposes.
(This section need notto be completed is the permit is for one-hundred
dollars($100)or less Date
PROPERTY OWNER OR AUTHORIZED AGENT
❑I certify that In the persons in any
the work for which this permit is issued,
15hall not emolov any persons in any mannerso as to become subject to the CITY BUSINESS LICENSE R
worker's compensation laws of California,and agree that if I should become
subject to the worker's compensation provisions of Section 3700 of the Labor HAZARDOUS MATERIAL DECLARATION
Code,I shall forthwith comply with those provisions. 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 SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes f�(No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES X
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000J,IN Will the intended use of the building by the applicant or future building
ADDITION TO 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 permitting checklist
forguidellnes
CONSTRUCTION LENDING AGENCY ❑Yes Js(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 Xf 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
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.
Business and Professions Code).Any city or county that requires a permit to Aes ❑No�--> /J
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 AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt from Iicensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
and 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 permit 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 or through their
o I,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.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
property who,through employees'or personal effort,builds or improves the o An EPA Lead-Safe Certified Renovator will he responsible for this project
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
completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.:
not built or Improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
o I,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.
li
Menifee
DATE - 1 -7 PERMIT/PLAN CHECK NUMBER lo'I
TYPE: O COMMERCIAL ASIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL XMECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK - c - -(V/' L
lll� 5 4 _ L
PROJECTADDRESS ��-( ,I., e VJ!E
ASSESSOR'S PARCEL NUMBER (JW'� �p��+ LOT lyl— TRACT �� 1
OWNER NAME R r_ 3�L
ADDRESS SU.�- c- Iz
PHONE '76ry -7 2 ( 6 3 EMAIL
C APPLICANT NAME r , E�
ADDRESS / �4 , e i 914
PHONE n1 �- Zt?L{- pCj(6 EMAILrv,l
CONTRACTOR'S NAME �.r ,� i i OWNER BUILDER? O YES O
BUSINESS NAME ;r ct c �� a.�..o� .�' we
ADDRESS 3(S L' `� �. C'a..., ,,, 9,C1
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER 55595- LICENSE CLASSIFICATION C ^ ZO
VALUATION$ !f/b 41,9 S SQ FT L SO FT
APPLICANT'S SIGNATURE C/= DATE GI^Zc( -I
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MEyN�IIFEEE� lE BUUNN*S UgNSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP -, oy5 %
INVOICE 2.� Q PAID AMOUNT O
AMOUNT `JYJ` •' OCASH OCHECKk CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCASH 0CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES C NO
City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CFIR-ALT-04E Revised 01116 City of aiia a CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE Du1 ing CF111-ALT-04-E
Alterations-HVAC CZ 2,and 8-15 APR. 2 4 2017 (Pagel of 1)
Site Address: Enforcement ency- Date Prepared: P ' • O 1 —�
dLZ W 1 w
Equipment Type Equipment Efficiency New Ducting or lineseC Conditioned i Thermostat
Required R-value Floor Area(ft)
❑Packaged ❑Evaporator Coil ❑R-6 (CZ2-10,12&13)Ducts Served by system XSetback
System ❑Condensing Unit AFUE COP 0R-8' (¢II,14-16)Ducts =-I440 fte Wriotalready
Split System ❑Compressor SEER HSPF ❑2 R-2.8 Uneset4 present mast
❑Mini Split ❑Uneset EER he installed)
❑Furnace ❑TXV
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 final inspection all forms are to be registered(no hand filled forms allowed)and a copy left on site.
)LI.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
All Equipment, CF1R-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R-MCH-01-E,MCH-20-H,MCH-(23 or 24)kH,MCH-25-H'
Compressor,TXV,Uneset, CF3R-MCH-2D-H,MCH-(23 or 24)-H� MCH-25-1-12
Air Handler/Fumacez(Can include new ducting)
Installer Requirement:Duct leakage L515%,or 510%to outside,or seal all accessible leaks),Air Flow?300 CFM/ton,Refrigerant Charge.
Exempted from duct leakage testing if:
❑1.Duct system registered with HERS provider as previously sealed,or 0 2.There is less than 40 linear feet of duct in unconditioned space,or
❑3.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building_J,
❑2.New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ductsr CF111-ALT-02-E
including Mini Split CF2R-MCH-01-E,MCH-20-H,MCH-22-H,MCH-(23 or 24)-Hz,MCH-25-H2
CF3R-MCH-20-H,MCH-22-1-1,MCH-(23 or 24)-H2,MCH-25-1-12
Mini Splits require CFIR-ALT-02-E,CF2R-MCH-01-E,and(CF2.R-MR)MCH-25-H
Installer Requirement Duct leakage 55%,Fan Efficacy(0.58W/CFM),Air Flow>_350 CFM/ton(or alternative),Refrigerant Charge
❑3.All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New Ducts'and one or more of the following CF1R-ALT-02-E
replaced:Condenser Unit,Evaporator Coil, CF2R-MCH-01-E,MCH-20.H,MCH-(23 or 24)-H,MCH-25-H
Compressor,TXV,Uneset,Fumacer CF3R-MCH-20-H,MCH-(23 or 24)-H,MCH-25-H
Installer Requirement:Duct leakage<5%,Air Flow>:350 CFM/ton(or alternative),Refrigerant Charge
Exempted from duct leakage testing if:01. Existing duct systems are constructed,insulated or sealed with asbestos
❑4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts' CF111-ALT-02-E,CF2R-MCH-20-H,CF3R-MCH-20-H
Installer Required to:Duct Leakage L515%or,510%to outside or,or seal all accessible leaks)
❑ EXCEPTION:Existing duct systems constructed,insulated or sealed with asbestos.
'All new ducting requires R-8 insulation when more than 40 fit installed in CZs 11&14.16 and R-6 in CZs 1-10,12&13,and R-6 insulation 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 MCH-(23 or 24),or Refrigerant Charge verification MCH-25
3 All New Ducts is when at least 75%of the duct system is new duct material,and up to 25%may consist of reused parts from the dwelling unit's
existing duct system(e.g.,registers,grilles,boots,air handler,coil,plenums,duct material)
4 R-2.8 W'thick insulation)for linesets 1"and less.
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 Title 24,Part 1 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.
Rest
ue eN m :ex cr RWP0rslbleD erinm: D`et' ne
1-(Z 55 .2—mpanx: Address: i#inq CIry/SmW'zip: Plane:
c,w Lm jl 2'IV- Dq!
For assistance or questions regarding the Energy Standards,contactthe Energy Hotline at:1-800-772-3300