PMT17-02886 City of Menifee Permit No.: PMT17-02886
29714 HAUN RD.
<�CC A> MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 08/15/2017
PERMIT
Site Address: 27885 GOLDEN HILL CT, MENIFEE,CA Parcel Number: 336-370-028
92585 Construction Cost: $13,920.00
Existing Use: Proposed Use:
Description of REPLACE HVAC SYSTEM,5-TON A/C,90,000 BTU FURNACE
Work:
Owner Contractor
BOBBY WILLIAMS TOTAL CARE HEATING&AIR INC
27885 GOLDEN HILL COURT 2867 SAMPSON AVENUE
MENIFEE,CA 92585 CORONA, CA 92879
Applicant Phone: 9518088804
STEVEN SCHNIERER License Number: 1005914
TOTAL CARE HEATING&AIR INC
2867 SAMPSON AVENUE
CORONA, CA 92879
Fee Description gtv Amount 19i1
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.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 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 CClla�ss- if ZL License No. I DOS 9 1 r-I By my signature below I acknowledge that,except for my personal residence
Expires 113] —Signature -�,.�,..az 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 www.leRinfo.ca.gov/calaw.html.
this permit is issued.
Policy# Date
-P-Lhave and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
f/sect_ion 3700 of the Labor Code,forthe performance of the work for which my signature below certify to each of the fallowing:I am the property
this permit is issued.My worker's compensation insurance carrier and policy owner 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
Carrier Nvc(�UWrt� with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# ToLJG 7,o701La Expires K a enter the above identified property for inspection purposes.
(This section need not to be completed is the permit Is for one-hundred 2 Date 4J,4f�
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#
worker's 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 forthwith comply with those provisions. Will the applicant orfuture building occupant handle hazardous material or a
Applicant ���� Date 8' )p )-) mixture containing a hazardous material equal to or greater that the
amounts sp�cifred on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes/c�Jp
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 guldeli s
CONSTRUCTION LENDING AGENCY ❑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 agencyforthe performance of the work which this permit is issued outer bou7dary of a school?
(Section 3097 Civil Code) ❑Yes /rRJo
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
Contractors License Law for the reason(s)indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 yes ❑No
Business and Professions Code).Any city or county that requires a permit to �!� � `
.xw— Z Date SC r5 r7
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 Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRP)
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-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($500). managers who do the paint-disturbing work themselves or through their
❑1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( I all of or( )portion of the work,and the structure is www.epa.RqvJlead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
❑1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
DATE l5 \1 PERMIT/PLAN CHECK NUMBER -
TYPE: 0 COMMERCIAL RESIDENTIAL Q
- MULTI-FAMILY 0 MOBILE HOME O POOL/SPA SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION 10 ELECTRICAL XMECHANICAL
O NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK S lro . A I jal t `1a,c+OL7 SAL? w cv-�gc�
Building 8 Safe El11 1 tY Dept,
PROIECTADDRESS Z7$&S Gelciev `ri'-w5 Or- q AUG 15
ASSESSOR'S PARCEL NUMBER LOT LOT TRACT
V
OWNER NAME
ADDRESSCA, gzses-
PHONE q51- (0301. O99 EMAIL
APPLICANT NAME ,
ADDRESS .312zS Lc 6&-,1 Ue. '� u-s tjr-4�. V,��a e. C'A 043G7.
PHONE $t$ 1-75-787(, EMAIL
CONTRACTOR'S NAME OWNER BUILDER? C)Y NO
BUSINESSNAME
ADDRESS Sampson Ave CA R2.8-701
PHONE cisL-lot. TaO4 EMAIL
CONTRACTOR'S STATE LIC NUMBER I0059L't LICENSE CLASSIFICATION G20
VALUATION$ 1 3,R.2o•L0 SO FT L SO FT
APPLICANT'S SIGNATURE �.ti,..;y C> DATE $ 1•. I-I
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP X
INVOICE PAID AMOUNT
AMOUNT • I OCASH C'CHECK# ` CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH 0 CHECK A %CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER YES 0 NO
':i �,ojnlei'em Ecildmg -i Safety Deperr;)eot,,4, 1IZ h.'GI-In Rd. ioe jee, •-A 5o6557 6i2 67i:'
Ne✓ ir.:i yo;`rne;;iree.o's;;'specrion R2cUe .'Line 95 % - 1
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CFiR-ALT-04-E Revised 01/16 CALIFORNIA ENERGY COMMISSION 16
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations-HVAC CZ 2,and 8-15 (Page 1 of 1)
Site ,,�sSss: `` 11 A Enforcement Agen D e P epared: Permit#:
z7S
53 G e�vl N1L'S Q, Ci.;� OAF' Oeraltte 15 t1
Equipment Type Equipment Efficiency New ucting or Lineset: Conditioned 2 Thermostat
Required R-value Floor Area(ft)
❑ Packaged ❑Evaporator Coil }Lp J. AFUE COP R-6 (CZ I-10,11&13)Ducts Served by system .$I Setback
System 8(Condensing Unit 13R-8' (CZ 11,14-16)Ducts ft2 (if not already
Split System ❑Compressor 16 SEER HSPF ❑Z 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)2Z,co eft on site.
1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: 6
All Equipment, CF1R-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R-MCH-01-E,MCH-20-11,MCH-(23 or 24)2-H,MCH-25-H2 AUG 15
Compressor,TXV,Lineset, CF3R-MCH-20-H,MCH-(23 or 24)-H2,MCH-25-H' 201(
Air Handler/Furnace'(Can include new ducting)
Installer Requirement:Duct leakage L15%,or 510%to outside,or seal all accessible leaks),Air Flow a 300 CFM/ton,11,ply6Char e. _
Exempted from duct leakage testing if: ITl COe r.
❑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
113.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 on site for Final:
All new equipment and All New Ducts' CF1R-ALT-02-E
including Mini Split CF2R-MCH-01-E,MCH-20-11,MCH-22-H,MCH-(23 or 24)-H2,MCH-25-1-12
CF3R-MCH-20-H,MCH-22-H,MCH-(23 or 24)-H',MCH-25-1-12
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 a 350 CFM/ton(or alternative),Refrigerant Charge
113.All New Ducts with Replacement I 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,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:0 1. 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' CF1R-ALT-02-E,CF2R-MCH-20-H,CF3R-MCH-20-H
Installer Required to:Duct leakage(5 15%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.
'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 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 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.
R spansible De' n rName: oable Desigpx Signature[ Dat Sig ed: License:
_ cv' t C g i5 -7 kaOSRt4
any: t1 Address' Cky/State/Lip: Phone:
o �n.e tte < 4: 2zv) .Sa t Ce c. CA `1781 451-$Oo 880
For assistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300