PMT17-02322 City of Menifee Permit No.: PMT17-02322
29714 HAUN RD. Type: Residential Mechanical
'�ACCELA--J' MENIFEE, CA92586
MENIFEE Date Issued: 0 710 512 01 7
PERMIT
Site Address: 28455 CATHEDRAL ST,MENIFEE, CA Parcel Number: 336-413-001
92585 Construction Cost: $7,500.00
Existing Use: Proposed Use:
Description of REMOVE AND REPLACE HVAC-4 TON 15 SEER AMERICAN STANDARD
Work:
Owner Contractor
THOMAS POWERS J D F CONSTRUCTION INC
28455 CATHEDRAL STREET 201 GEMINI AVE
MENIFEE, CA 92585 BREA,CA 92821
Applicant Phone:7145261120
MARK EVANS License Number: 956749
J D F CONSTRUCTION INC
201 GEMINI AVE
BREA, CA 92821
Fee Description Ply Amount 1$)
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 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_Bldg_Permit Template.rpl Page 1 of 1
CITY OF MENIFEE
ICENSED 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 ❑I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class C License No. gr'67gq
(License
J� By my signature below I acknowledge that,except for my personal residence
Expires /7 Signature.s!/N` ' in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION 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
❑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 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.leginfo.ca.gov/calaw,htnil.permit is issued.
Policy# Date
I have and will maintain workers 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 certify to each of the following:I am the property
this permit is Issued.My workers compensation insurance carder and policy owner or authorized to act on the property owners behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
Carrie4l!LS LAA e Y`f k-k t\m) C-ASU I L}\1 with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy#f L�. ow 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
❑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
Code,I shall fo�rth�w Jhl comply 'th tho provisions. //1 �/ Will the applicant or future building occupant handle hazardous material or a
Applicant I A/V I L Date 7/ / mixture containing a hazardous material equal to or greater that the
�'T amoun s specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AN15 CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Duality Management District(SCAOMD)75ee permitting checklist
forguidelines
CONSTRUCTION LENDING AGENCY 0 N No
I hereby affirm that underthe penalty of pedurythere is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer bqundary of a school?
(Section 3097 Civil Code) ❑Yes a No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that 1 am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 l,C�
Business and Professions Code).Any city or county that requires a permit to e� �/✓ /
construct,alter,improve,demolish pr repair any structure,prior to its C_C,�/`�- Date
Issuance,also requires the applicant for the permit to file a signed statWent PROPERTY OWNER OR AUTHORIZE/D/+GENT
that he or she is licensed pursuant to the provisions of the Contractors 9, EPA RENOVATION,REPAIR ANDPAINTING(RRPI
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the�7j a'O
Business and Professions Code)or that he or she is exempt from licensur '9$r The EPA Renovation,Rep 'fond Painting(RRP)Rule requires contractors
g receiving compensate most work that disturbs paint in apre-1978
and the basis for the alleged exemption.Any violation of Section 7031. pY/ 9 (�idence or child re facility be RRP-certlfied firms and comply with
an Applicant for a permit subjects the applicant to a civil penal f not m e
than($S00). �s !red pro es.This includes tal property owners and property
�} ers o do the paint-disturbi work themselves or through their
o I,as owner of the property,or my employee with wages as their �Q,, es.For more Information abou A's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the str g is www.eoa.zov/lead or contact the National ead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions , 1-800-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a °`
property who,through employees'or personal effort,builds or improves the p An EPA Lead-Safe Certified Renovator will be 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 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 because:
❑1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors 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.
& SAFETY PERM IT/PLAN CHECK APPLICATION
Menifee
DATE 7 �j o PERMIT/PLAN CHECK NUMBER
\
TYPE: O COMMERCIAL Q RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL .O. MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK VAe C w.A CJ V+(`�
Y7ZZ 14viti !tJ 5'k"C f-' Aril COS ,%Aw aieb
PROJECT ADDRESS S� l,A'1F411 L S'!- ';1h 9-7-we
ASSESSOR'S PARCEL NUMBER 33 LOT 22 TRACT 2g2 ICI
OWNER NAME oaj-
ADDRES 2-�(SS� /ll�L n. 0 W72-5kS
PHONE �S�) 672' 363] EMAIL
APPLICANT NAME A W S
ADDRESS S t�GG r✓ 7
PHONE EMAIL
CONTRACTOR'S NAME J D Ji s. OWNER BUILDER? O YES NO
BUSINESS NAME
ADDRESS ( 465 &w /1
PHONE 1t`1 S71.' (/20 uery EMAIL
q
CONTRACTOR'S STATE LIC NUMBER %7Z(9 LICENSE CLASSIFICATION n��v
VALUATION$ 7rOO Sat FT lgoo L SO FT ZO
f J
APPLICANT'S SIGNATURE �" -1 �l/r/� DATE ?/�/�
CnYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION Y1 CIT'OF MENIFEE BUSMP5LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN
INVOICE / I r10 PAIDAMOUNT
AMOUNT 0CASH 0CHECK# 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAMAMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213 City Of Menifee
Building &Safety B8P4.
JUL 0 5 zoo/
STATE OF CALIFORNIA
ALTERATIONS - HVAC M ,
CEGCFIR-ALT-04-E Revised 01/16 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations-HVAC CZ 2,and 8-15 (Page 1 of 1) (N
Site Address: ./ t Enforcement Agency: Date Prepared: Permit#:
J clq)
Equipment Type Equipment EfficiencyNew Ducting or Lineset: Conditioned �
Thermostat
Required R-value Floor Area(ftz)
❑Packaged ❑Evaporator Coil '1'16 . 11 R-6 (CZI-10,12&13)Ducts Served by system Setback
System ❑Condensing Unit J AFUE COP R-8' (CZ 11,14-16)Ducts ft2 (If not already
Split System ❑Compressor /D SEER H5PF ❑2 R-2.8 Uneset4 present,must
11 Mini Split [I Lineset be Installed)
❑Furnace ❑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 filled forms allowed)and a copy left on site.
1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
All Equipment, CF2R- -E
Condenser Unit,Evaporator Coil, CF2R-MCH--MCH-01-E,MCH-20-H,MCH-(23 or 24)'-H,MCH-25-H'
Compressor,TXV,Lineset, CF3R-MCH-20-H,MCH-(23 or 24)-H',MCH-25-H'
Air Handler/Furnace'(Can include new ducting)
Installer Requirement:Duct leakage(515%,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❑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
[12.New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts' CF1R-ALT-02-E
including Mini Split CF2R-MCH-01-E,MCH-20-H,MCH-22-H,MCH-(23 or 24)-H2,MCH-25-H'
CF3R-MCH-20-H,MCH-22-H,MCH-(23 or 24)-H',MCH-25-1-1' ^
Mini Splits require CF1R-ALT-02-E,CF2R-MCH-01-E,and(CF2R-CF3R)MCH-25-H
Installer 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 Required Compliance Documents to be left on site for Final:
All New Ducts'and one or more of the following CF1R-ALT-02-E Q
replaced:Condenser Unit,Evaporator Coil, CF2R-MCH-01-E,MCH-20-H,MCH-(23 or 24)-H,MCH-25-H CD
Compressor,TXV,Lineset,Furnace' CF3R-MCH-20-H,MCH-(23 or 24)-H,MCH-25-H ..
Installer Requirement:Duct leakage<5%,Air Flow>_350 CFM/tan(or alternative),Refrigerant Charge
Exempted from duct leakage testing If:❑1. Existing duct systems are constructed,insulated or sealed with asbestos W c e }
❑4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final: y, J
New ducting but less than All New Ducts' CFiR-ALT-02-E,CF2R-MCH-20-H,CF3R-MCH-20-H Ir
Installer Required to:Duct leakage 15%or,510%to outside or,or seal all accessible leaks) •? e1.
(5
❑ EXCEPTION:Existing duct systems constructed,Insulated or sealed with asbestos. 03
All new ducting requires R-8 insulation when more than 40 It Installed in CZs 11&14-16 and R-6.in CZs 1-10,12 03,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(1"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.
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.
Respons6 Desi¢ner Naame: es nsl leDesi� atur rSlgn : Date d/ Ilcens s�6�
Co any: ��,S I dre �� City/State/Zlp: Phone:
7! dd /.�
For assistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300