PMT17-03089 City of Menifee Permit No.: PMT17-03089
29714 HAUN RD.
�-% C LAl " MENIFEE,CA 92586 Type: Residential Mechanical
MENIFEE Date Issued: 08/31/2017
PERMIT
Site Address: 26625 N FORK WAY, MENIFEE, CA Parcel Number: 338-321-026
92586 Construction Cost: $3,500.00
Existing Use: Proposed Use:
Description of HVAC REPLACEMENT A/C CONDENSER ONLY,3-TON
Work:
Owner Contractor
ROBERT&AMY PINTER BEAR CREEK HEATING AND AIR CONDITIONING
26625 N FORK WAY INC
MENIFEE,CA 92586 24069 CHATENAY LANE
Applicant Phone: 9516002882
VALERIE DUNGAN License Number: 779461
BEAR CREEK HEATING AND AIR CONDITIONING INC
24069 CHATENAY LANE
MURRIETA, CA92562
Fee Description Qtv Amount 1E1
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 6.65
$167.65
The issuance of this permit shall not prevent the building official from thereafter requinng 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 forthe 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).
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for
ProfessW,MPENSATQN
Code is in full force and effect the following reason:
LicenseLic nl Ja. By my signature below I acknowledge that,except for my personal residence
Expiresnature 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
WORKEECLARATIO 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.legInfo.cai.gov/caIaw.html.permit is issued.
Policy N Date
have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
�ect`ion 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 compensatio 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 �'� r building construction.I authorize representatives of this city or county to
ft5 /
PolicyfQ Expires L� enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
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 p
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker' compensation provisions of Secti7 of th abor
Code,I shall f rt o ply v/yth those provi on 3
sions. 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 spa
VIP Pifiied on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION CO ERAGE IS ❑Yes 1916
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 guidelines
CONSTRUCTION LENDING AGENCY ❑Yes D'V
1 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 bo ndary of a school?
(Section 3097 Civil Code) D Yes Dy0
OWNER BUILDER DECLARATIONS 1 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 Sta of
California Health&Safety Code,Section 25505 and 25534 conce ing
Contractor's License Law for the reason(s)indicated below by the h ardo m 4 I reporting.
checkmark(s)I have placed next to the applicable items)(Section 7031.5 yes N
Business and Professions Code).Any city or county that requires a permit to / Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERtfOWhltR 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRP)
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
❑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.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 ❑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.
kMenifee
DATE PERMIT/PLAN CHECK NUMBER 9w vi—o✓otp�
TYPE: 0 COMMERCIAL X ESIDENTIAL O MULTI-FAMILY 0 MOBILE HOME C7 POOL/SPA ?SIGN
SUBTYPE: 0ADDITION 0ALTERATION :%DEMOLITION 0ELECTRICAL -,X6ECHANICAL
(" NEW O PLUMBING 0 RE-R OF-NUMBER OF SQUARES
DESCRIPTION OF WORK C. NI
PROJECT ADDRESS l(/ U 7
ASSESSOR'S PARCEL NUMBER
/..]_. "M /��1nLOT TRACT
OWNER NAME _ k l y r l
ADDRESS 0/ 6 6QtY
PHONE (Q( /) EMAIL BUild n l Of Menifee
APPLICANT NAME (e rI P ✓v,� ✓\ 6( V1
ADDRESS 2a• Y° Gt c o ✓J
PHONE EMAIL Receive
CONTRACTOR'S NAME OWNER BUILDER? O YES 0
BUSINESS NAME
ADDRESS (} �_T��
PHONE 1 j� (/w p 6 �(� /// EJMAIL 6^1G!r (YJ� eX A9, t'0
CONTRACTOR'S STATE LIC NUMBER l (a / LICENSE CLASSIFICATION
VALUATION$ 3 S 00 SO FT V L SQ FT
APPLICANT'S SIGNATURE DATE
WAFFUSEONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP
INVOICE I� PAIDAMOUNT n
AMOUNT I� CASH OCHECKH OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH OaECK# COCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER C3 YES C; NO
City of Menifee Building&SOfety OepOr tment 29714 Haan Rd. PAenifee, CA 92596 951-572-5777
wvw✓.cityof nenifee.us inspection Request Line 951-246-6215
City Menitee
Building &t
d Safety Dept.
AUG 3 1 201
PMM . 0,3MqReceived
CERTIFICATE OF COMPLIANCE CFiR-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 1 of 3)
Project Name: Pinter Data Prepared: 2017-08-31
A.General Information
MR-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit.When multiple dwelling units must be documented,use one
MR-ALT-02 document for each dwelling unit.
01 Project Name Pinter 02 Date Prepared 2017-08-31
03 Project Location 26625 N Fork Way 04 Building Type Single family
05 CA City Menifee 06 Dwelling Unit Name Pinter
07 Zip Code 92586 08 Dwelling Unit Conditioned 2977
Floor Area(ft2)
Number of Space
09 Climate Zone 10 10 Conditioning(SC)Systems in 3
this Dwelling Unit:
B.Space Conditioning(SC)System Information
01 02 03 04 05 06 07 08 D9 10
Is the SC Installing
SC System SC System CFA served system refrigerant Installing new SC Installing Installing Installing
Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new
Name Served System(ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type
System 1 Upstairs 1400 Yes Yes Yes No No No Altered space
conditioning system
C.Extension of Existing Duct System,Greater Than 40 Feet(SectIon1S0.2(b)1DIjb)
This section does not apply to this project.
Registration Number:217-A020300395A-DM-000 0000000-0000 Registration Date/Time: 2017-08-31 09:35:58 HERS Provider.CaICERTS
CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-08-31 09:35:11
schema Version:rev 10/16
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 2 of 3)
D.Altered Space Conditioning System(Sections 1SO.2(b)SE and F)
01 02 03 04 05 06 07 OR 09 10 11 12
Heating Cooling
System Heating Altered Heating Minimum Altered Cooling Minimum Required New or
Identification System Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Replaced New Duct
or Name Type Components Type Value System Type Components Type Value Type Duct Length R-Value
System 1 Central
No heating This field or This field or Outdoor This field or Thisfleldor
furnace e s component section is not section is not Central lit Outdoor
SEER 14 Setback section is not section is not
altered applicable applicable AC unit applicable applicable
Required Documentation:
CF2R-MCH-01{.Space Conditioning Systems
-Duct Insulation repuiremem for new portions ofsuppiµair and miumair ducts or plenums:R6(CZ 1-10,U and Vu and Ra(a 11 and 14.16)
MR and DeIRWCH-20-14-Duct leakage Test required when heating or cooling components are installed in ducted systems,or when more than 40 it of duct length Is replaced
-Leakage rate compliance:<=15%or c 10%leakage to outside,or seal all accessible kala.
CRR and CFM-MCH-2 H RefrigenM Charge verificed.r required when refrigerant containing components are Installed or altered(applicable in CZ 2,9-15).
MR and CFSR-MCH-23 Airflow Rate =300 CFM per ton required when MCH-251s required.
Exceptions,
Duct systems regimretl arm HERS provider as previously sealed are exempt from MCH-10 Duct Leakage Testing requirements.
Hsatinganly systems and Air Handler Furnace changes do not require verification of Air Flow MCH-23,or Refrigerant Charge MCH-25.
-Eaating dud systems constructed,insulated or sealed with asbestos are exempt from MCH-20 Duct Leakage Testing requirements.
E.Entirely New or Complete Replacement Duct System,with or without Equipment Changeout(Sections 150.2(b)1Diia and 1SO.2(b)IE,F)
This section does not apply to this project.
F.Entirely New or Complete Replacement Space Conditioning System(Section 1SO.2(b)1C)
This section does not apply to this project.
Registration Number:217-A020300395A-OW-000-000000D-0000 Registration Date/Time: 2017-0831 09:35:58 HERS Provider:CWCERTS
CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.W6 Report Genemted:2017-08-31 09:35:21
Schema Version:rev 10/16
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Aherations to Space Conditioning Systems(formerly CF-3R-ALT-HVAC) (Page 3 of 3(
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documentation Author signature:
Dungan,Barry
Company: Signature Date:
Bear Creek Heating and Air Conditioning Inc 2017-08-31 09:35:58
Address: CEA/HERS CertiRatlon ldentif don(napplhable):
24069 Chatenay,Lane
City/StateZip: Phone:
Murrieta CA 92562 951-600-2982
Responsible Person's Declaration statement
I certify the fallowing under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certffcate of Compliance is true and correct.
2. 1 am eligible under Were 3 of the Basin.and Professions Cocks eo accept responsibility for the building design or system design Identified on this Certificate of Compliance(responsible designer).
3. 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
repulraments of Title 24,Part I and Part 6 of the California Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance danomanes,worksheets,
calculations,plans and specifications submitted to the enforcement agenry for approval with this building permit applloatloo.
5. 1 w111 ensure that a registered copy of this Certificate of Compilence shall be made•variable with the building pernit(s)issued for His builda,and matle.00ale to the enforement agenry for all aPPli.W.
Inspections.I understand that a registered copy of Has Canifiate of Compliance is required to be Included with the documentation the builder provides to Me building owner at occupancy
Responsible Designer Name: Reaponsibie Da,q m r Signature:
Dungan,Barry 1pAfl VMarstal
Coure"ry Dec.Sigurd:
Bear Creek Heating and Air Conditioning Inc 2017-08-31 09:35:68
Address: do..:
24069 Chatenay Lane 779461
Clty/Slate/Ap: Phone:
Murrill CA 92562 951-600-2892
Easy to Verify ❑e r ❑a
at CaICERTB.mm
DiglMlysgnedby CacERM This M'pitelsgnetwe isp avidcdin order tosetve the contents/Mice regisNreddowmenr.andiron way implies
Regisoatron Pmwder mpwuiG'14y(or rheaauraryo/Main/wmadon. ❑e ..
Registration Number:217-A020300395A-000-000-Of10000D-0000 Registration Date/Time: 2017408-31 0935:58 HERS ProNder:C.ICER15
CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Gemerated:2017-08-31 09:35:21
Schema Version:rev 10/16