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PMT17-02050 City of Menifee Permit No.: PMT17-02050 29714 HAUN RD. Type: Residential Mechanical 'ACCEL/-> MENIFEE,CA 92586 yp MENIFEE Date Issued: 06/21/2017 PERMIT Site Address: 26650 AMHURST ST, MENIFEE, CA Parcel Number: 335-220-012 92586 Construction Cost: $13,000.00 Existing Use: Proposed Use: Description of HVAC PACKAGE UNIT CHANGE OUT AND COMPLETE RE-DUCT Work: 'INSPECTOR PLEASE COLLECT HERS RATING FORMS AT INSPECTION' Owner Contractor CAROL RATLIFF LOTSHAW AIR CONDITIONING COMPANY INC 26650 AMHURST CT 1492 PALMYRITA AVENUE MENIFEE,CA 92586 RIVERSIDE, CA 92507 Applicant Phone:9517816513 RICHARD DOUTHIT License Number:995221 LOTSHAW AIR CONDITIONING COMPANY INC 1492 PALMYRITA AVENUE RIVERSIDE, CA 92507 Fee Description QQt Amount I$I Forced-Air or Gravity-Type Fumace 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 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_aldg_Pennit Template.rpt Page 1 of 1 i CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and a am exempt from licensure under the Contractors State License Law for Professions Code and rm-yllicense is in full force and effect. the following reason: License Class ;)10 a lo. By my signature below I acknowledge that,except for my personal residence Explras -31 b Lg Signature F in which I most 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 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 I and will maintain a certificate of consent of self-insure for workers 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 www,.IeRinfo.ca.gov/caIaw.htmI.permit is issued. n 1 Policy # W Date 0I have nd will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 1700 of the Labor Code,for the performance of the work for which D By my signature below I certify to each of the following:I am the property this per it is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.1 have read this numbe are: application and the Information I have provided is correct.I agree to comply I with all applicable city and county ordinances and state laws relating to Carrier v'1 1 1 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($100)or less PROPERTY OWNER OR AUTHORIZED AGENT 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# workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor , / de,Is will comply sslith tho rovisions. Will the applicant or future building occupant handle hazardous material or eoil ! Date mixture contai ing a hazardous material equal to or greater that the amounts sp ified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKE ' COMPENSATION COVE GE IS 0 Yes o 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 forguidelines CONSTRUCTION LENDING AGENCY ❑Yes M4 I hereby affirm that under the penalty of perjurythere 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 V<0 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 Contactors License Law for the reason(s)indicated below by the azardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Y Business and Professions Code).Any city or county that requires a permit to f LSCL�� Date construct,alter,improve,demolish or repair any structure,priorto its �� Issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWN ER OR AtOOFUZED AS ENT that he or she Is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRPJ License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contactors Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs palnt 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 ❑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.eoa.eov/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 Contactors State License Law does not apply to an owner of a ❑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. ❑No EPA Lead-Safe Certified Firm is required for this project bemuse: 0 I,as owner of the property am exclusively contacting with licensed contactors to construct the project(Section 7044,Business and Professions Code:The Contactors State License Law does not apply to an owner of a If your project does not comply with EPA RAP rule please fill out the RRP Acknowledgement BUILDING & SAFETY PERMIT/PLAN APPLICATION ',Menifee DATE �j PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL. dRESIDEENTIAL 0 MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION yFALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Cn l a m PROJECTADDRESS V' ] Y'Od ^ Q ASSESSOR'S PARCEL NUMBER orl 01 O��/1 �Q` TRACT C O� OWNER NAME 0.ro a ADDRESS a. (a50 r PHONE (�'S1_Mk L613 EMAIL L1 APPLICANT NAME L \ C O InX ( {mil n '-R) 1 � ADDRESS PHONE j I��` 65I3 EMAIL 1`� CONTRACTOR'S NAME cAW 1 r Ca ciBmq OWNER BUILDER? OYES P'fJ0 BUSINESS NAME ADDRESS pp �1M r L PHONE �5� �O '-��j� `� EMAIL CONTRACTOR'S STATE 2LIC NUMBER �� 5�a l LICENSE CLASSIFICATION C cA VALUATION$ I J dc) d S L SO FT APPLICANT'S SIGNATUR - - > > DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE PAID AMOUNT 0 AMOUNT OCASH OCHECK# CREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH 0 CHECK It O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER 0 YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 STATE OF CALIFORNIA ALTERATIONS -HVAC CEC-CFIR-ALT-04-E Revised 01116 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE Building 8 Safet De t. CF1R-ALT-oa-E Alterations-HVAC CZ 2,and 8-15 (Page 1 of i) Site Address: Enforcement AR cv: Dat er "red: Permit#: a 1��0 n ,I�u r � -- rn 177- a N pr Lineset: Con Rio d Equipment Type Equipment Efficiency 2 Thermostat ,Required R-value Floor Area(ft) Packaged ❑Evaporator Coll AFUE COP R-6 (QI-10,12&13)Ducts Serve by system 0 Setback System ❑Condensing Unit ❑R-8' (CZ11,14-16)Ducts (If not already ❑Split System ❑Compressor LSEER HSPF 0>R-2.8 Uneset' present,must ❑Mini Split ❑Uneset be installed) 0 umace ❑TXV EER 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 Riled forms allowed)and a copy left on site. 1.HVAC Changeout/Repair Required Compliance Documents to be left an site for Final: All Equipment, CFIR-ALT-02-E Condenser Unit,Evaporator Coil, CF2R-MCH-01-E,MCH-20-H,MCH-(23 or 24)2-H,MCH-25-H2 Compressor,TXV,Uneset, CF3R-MCH-20-H,MCH-(23 or 24)-H2,MCH-25-HI Air Handler/Furnace2(Can indude new ducting) Installer Requirement:Duct leakage L15%,or 510%to outside,or seal all accessible leaks),Air Flow 2 300 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 ❑2.New HVAC System Required Compliance Documents to be left an site for Final: All new equipment and All New Ducts" CFIR-ALT-02-E including Mini Split CF2R-MCH-01-E,MCH-20-H,MCH-22-H,MCH-(23 or 24)-H',MCH-25-1-12 CF3R-MCH-20-H,MCH-22-H,MCH-(23 or 24)-H2,MCH-25-H2 Mini Splits require CFiR-ALT-02-E,CF2R-MCH-01-E,and(CF2R-CF3R)MCH-25-H WIn Iler Requirement Duct leakage<5%,Fan Efficacy(0.58W/CFM),Air Flow 2!350 CFM/ton(or alternative),Refrigerant Charge 3.All New Ducts with Replacement I Required Compliance Documents to be left an site for Final: All New Ducts'and one or more of the following CFIR-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,Lineset,Fumace2 CF3R-MCH-20-H,MCH-(23 or 24)-H,MCH-25-H Installer Requirement:Duct leakage<5%,Air Flow a 350 CFM/ton(or alternative),Refrigerant Charge Exempted from duct leakage testing if:0 1. Existing duct systems are constructed,insulated or sealed with asbestos 0 4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final: New ducting but less than All New Ducts' I CFiR-ALT-02-E,CF2R-MCH-20-H,CF3R-MCH-20-H Installer Required to:Duct leakage(515%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. 2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MCH-(23 or 24),or Refrigerant Charge verification MCH-25 2 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) R-2.8(1"thick insulation)for linesets 1"and less. Contractor(Documentation Author's/Responsible Designer's Declaration Statement) I certify the following under penalty of pedury,underthe 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. 5. 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. Responsible Designer Name: Responsible Designer Signature: Date Signed: License: Company: Address: - .. Stete/Lp: CQ�Sn� one:) .) I ..;l- �LT`�f`)Cl,' L? r1 C- " G /.1/ NCI' l ` 2 lL For assistance or questions regarding the Eneirgy Standards,contact the Energy Hotline at:1 7724300 C A - AlE