PMT17-02704 City of Menifee Permit No.: PMT17-02704
29714 HAUN RD. Type: Residential Mechanical
�ACCEL/4� MENIFEE, CA 92586
MENIFEE Date Issued: 08/02/2017
PERMIT
Site Address: 27413 EL RANCHO,MENIFEE,CA 92586 Parcel Number: 336-141-001
Construction Cost: $5,000.00
Existing Use: Proposed Use:
Description of REMOVE AND REPLACE HVAC-SAME SIZE&LOCATION SPLIT SYSTEM 14 SEER REMOVE AND
Work: REPLACE 40G WATER HEATER,40,000 BTU
Owner Contractor
ANNA BONDS RICHARD LEE SHERMAN PLUMBING
27413 EL RANCHO 30623 JEDEDIAH RD
MENIFEE,CA 92586 TEMECULA, CA 92592
Applicant Phone:9512276516
RICHARD SHERMAN License Number:673354
RICHARD LEE SHERMAN PLUMBING
30623 JEDEDIAH RD
TEMECULA, CA 92592
Fee Description Qtv Amount f$1
Residential Water Heater 1 83.00
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
General Plan Maintenance Fee-Plumbing 1 4.15
$411.26
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 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
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjurythat I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter-9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractoes State License Law for
(Expires
Professions Code and my license is in full force and effect. the following reason:
License Class 1.> License No. �- By my signature below I acknowledge that,except for my personal residence
Signature in which I 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 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.html.
,-Policy# Date
- ❑I Lave and will maintain worker's compensa lion 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 worker's compensation Insurance carrier and policy owner or authorized 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
" with all applicable city and county ordinances and state laws relating to
Carrier �(/
Z�� l building construction.I authorize representatives of this city or county to
s Policy# a �a��a Expires �i r enter the above identified property for inspection purposes.
This section need not to be completed is the permit is for one-hundred Date
r dollars($300)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 emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
worker's compensation laws of California,and agree that If I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers co pensation provisions of Section 3700 of the Labor
Code,I shal fort wi romp ith those provisions. WIII the applicant or future building occupant handle hazardous material or a
q-rZ, mixture containing a hazardous material equal to or greater that the
Applican Dale amounts�specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE''WORKER'S COMPENSATION[OVERAGE IS ❑Yes "1'"0
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 for guidelin
CONSTRUCTION LENDING AGENCY o Yes o
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 forthe performance of the work which this permit is issued outer boufi ary of a school?
(Section 3097 Civil Code) ❑Yes "7
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guldeand 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
Contractor's License Law for the reason(s)indicated below by the Health al Safety Code,Section 25505 and 25534 concerning
u
h rdous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 s ❑No
Business and Professions Code).Any city or wunty that requires a permit to Ye Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contracto/s St It EPA RENOVATION,REPAIR AND PAINTING(RRPI
License Law(Chapter 9(commencing with Section 7000)of Division 3 of th g compensation for most work that disturbs paint In a pre-1978 The ER
Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from licensur
and the basis for the alleged exemption.Any violation of Section 7031.5- receip
an Applicant for a permit subjects the applicant to a civil penalty of not more QS re�Ence or childcare facility to be RRP-certified firms and comply with
_ r practices.This includes rental property owners and property
than($500). .. � 4;Nerswho do the paint-disturbing work themselves or through their
NIJ
❑I,as owner of the property,or my employee with wages as their-sole I loyees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is��'' I-@ r3`Fmw.epa.govilead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions " f'3-800-424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a map
❑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 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.
i
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
L
�./lenifee
DATE �— Z 1 / PERMIT/PLAN CHECK NUMBER TW _l0
TYPE: O COMMERCIAL nSIDENTIAL 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 —" Ott C__
PROJECTADDRESS 13 E ( 7 Ite
ASSESSOR'S PARCEL NUMBER 33to -"I-oo I LOT TRACT
OWNER NAME Of y\, l4 / -%D
ADDRESS �(�[ (ems<I���'� C- LC)
9 PHONE �'� /) 3t'7 — E�'C6 (d /� EMAIL
APPLICANT NAME �E�"�Y'S
ADDRESS
PHONEQJ�;_) EMAIL
CONTRACTOR'S NAME ` (jL... J 4—YN �� OWNER BUILDER? O YES O NO
BUSINESS NAME
ADDRESS gb
PHONJ�/� �Z�I �Sl� EMAIL
CONTRACTOR'S STATE LIC NUMBER [�—]�3 LICENSE CLASSIFICATION
VALUATION$ !S�617 C) L SO FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I • SMIP
INVOICE U �V PAIDAMOUNT
AMOUNT. O CASH O CHECK# O CREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menif e, CA 9258%fil eq
in9 gf`Menif Dept.
Iva,nJ.cit lofinenifee.Lis Inspection Request Line 951-245-6213
F-A- BP Cl— 1- w ,t AUG 0 Z 2017
��1 G;r 1� �[w '' Deceived
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 01116 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations-HVAC CZ 2,and 8-15 (Page 1 of 1)
Site Address: Enforcement Agency: Date Prepared: Permit#:
Z 7 Q A
Equipment Type Equipment Efficiency New Ducting or Lineset: Conditioned Z Thermostat
Required R-value Floor Area(ft)
❑Packaged ❑Evaporator Coil FUE COP R-6 (CZI-10,12&13)Ducts Served by system 0-Setback
Pm 11 _Condensing Unit ❑R-81 (CZ 11,14-16)Ducts �OJ ftz (ljnot already
split System ❑Compressor l`f` SEER HSPF ❑2 R-2.8 Lineset° present must
❑Mini Split ❑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, CF1R-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R-MCH-01-E,MCH-20-H,MCH-(23 or 24)2-H,MCH-25-1-12
Compressor,TXV,Lineset, CF3R-MCH-20-H,MCH-(23 or 24)-H2,MCH-25-H2
Air Handier/Furnace'(Can include new ducting)
Installer Requirement:Duct leakage(515%,or 510%to outside,or seal all accessible leaks),Air Flow 2 300 CFM/ton,Refrigerant Charge.
Exempted from duct leakage testing if: ����
111.Duct system registered with HERS provider as previously sealed,or fd2.There is less than 40 linear feet of duct in unconditioned space,or
❑3.Existing duct systems are constructed,insulated orsealed with asbestos(list manufacture date of building
❑2.New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ductsa CFIR-ALT-02-E
including Mini Split CF2R-MCH-01-E,MCH-20-H,MCH-22-H,MCH-(23 or 24)-H2,MCH-25-H2
CF3R-MCH-20-H,MCH-22-H,MCH-(23 or 24)-H2,MCH-25-HI
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 z 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 Ductsa 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,Lineset,Furnace' 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:111. 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' I CF1R-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 ft 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
a All New Ducts Is when at least 7S%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,hoots,air handler,coil,plenums,duct material)
R-2.8(r thick insulation)for linesets 1r'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.
Responsible Designer Name: Responsible Designer Signature: Date Signed: License:
Company: Address: City/State/Zp: Phone: Bull ding & Safety ept.
For assistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300
AUG 0 2 2017
Received
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