PMT17-03661 City of Menifee Permit No.: PMT17-03661
29714 HAUN RD.
<ACCEL/� MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE Date Issued:
10/12/2017
PERMIT
Site Address: 29315 SUMMERSET DR, MENIFEE, CA Parcel Number: 338-291-011
92586 Construction Cost: $6,500.00
Existing Use: Proposed Use:
Description of REMOVE AND REPLACE HVAC - SAME SIZE(3 TON), SAME LOCATION
Work:
Owner Contractor
FRANK GREEN BEAR CREEK HEATING AND AIR CONDITIONING
34284 CANYON RIM DRIVE INC
24069 CHATENAY LANE
Applicant Phone:9516002882
BARRY DUNGAN License Number: 779461
BEAR CREEK HEATING AND AIR CONDITIONING INC
24069 CHATENAY LANE
MURRIETA, CA 92562
Fee Description ON Amount IS)
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
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 ❑I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. t the following reason:
License Class se u" a No. By my signature below I acknowledge that,except for my personal residence
Expires Signature in which i must have resided for at least one year priorto 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 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.Iegimfo.ca.gov/caIaw.htmI.
this permit is issued.
Policy p 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 carrier 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
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy It 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 s II not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If
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,lsh I o with wmpl ith th visiom-- Will the applicantor future building occupanthandle hazardous material or
mixture containing a hazardous material equal to or greater that the
Applicant Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS D Yes ? to
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 guide!Hgos
CONSTRUCTION LENDING AGENCY ❑Yes bgRo
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 for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) o Yes XW
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
Contractors License Law for the reason(s)indicated below by the hazardous mate(rah orting.
checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 ��"�°°%� ❑Now
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 PROPERTY OWNER OR AIffHORIZE 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(RRPI
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
D 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.epa.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 Contractors State License Law does not apply to an owner of a D 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. D No EPA Lead-Safe Certified Firm is required for this project because:
D I,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.
APPLICATION
DATE: PERMIT/PLAN CHECK NUMBER I I I I I - D ?>Q l49 I
TYPE: 0 COMMERCIAL .GrRESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA OSIGN
SUBTYPE: 0 ADDITION k?ALTERATION 0 DEMOLITION 0 ELECTRICAL 0 MECHANICAL
' NEW O PLUMBING 0 RE-ROOF NUMBER OF SQUARES`
DESCRIPTION OF WORK I�\'
PROJECFADDRESS ZG` cz� J � ZIP
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME
ADDRESS 3yZ y� cj�y�
PHONE 2yy-_ 13 EMAIL
APPLICANTcNAME (,�E(• t„T �/ `�. I
ADDRESS L ' ��.! C� C�
PHONE EMAIL
CONTRACTOR'S NAME \�_ OWNER BUILDER? O YE O
BUSINESS NAME r( l
ADDRESS
PHONE g�,-- EMAIL �nf
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION \Z Q
VALUATION$ SQ L SQ FT
APPLICANT'S SIGNATURE DATE EO I�—I
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF ME EEBUSINESS LICENSENUMBER
BUILDING PLANNING ENGINEERING FIRE
PERMIT FEE , �� SMIP GREEN
PLAN CHECK FEE INVOICE TOTAL
OWNER BUILDER VERIFIED 0 YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER r.2 YES 0 NO
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CERTIFICATE OF COMPLIANCE CFSR-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF-IR-AO-HVAC) (Page 1 of 3)
Project Name: Green Date Prepared: 2017-10-12
A.General Information q
CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit.When multiple dwelling units must be documented,use one J
MR-ALT-02 document for each dwelling unit.
01 Project Name Green 02 Date Prepared 2017-10-12
03 Project Location 29315 Summerset Dr 04 Buiidinglrype Single family
05 CA City Menifee 06 Dwelling Unit Name Green
. y Q .aCJ I 'O I 1
07 Zip Cade 92586JO BigDwelling Unit Conditioned1252
Floor Area(ft
Number of Space
09 Climate Zom 10 10 Conditioning(SC)Systems in 1
this Dwelling Unit:
B.Space Conditioning(SC)System Information
01 02 03 04 05 D6 07 08 09 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 morethan40 enthelynew, entirelynew
Name Served System(fit") system? componerrt? components? feetofducts? ductsystem? SC system? Alteration Type
System 1 entire home 1252 yes yes yes No No No Altered space
conditioning system
C.Extension of Existing Duct System,Greater Than 40 Feet(Section1S0.Z(b)1Dilb)
This section tices not apply to this project. 6r
Registration Number:217-A020353425A-000-000-00000D0-0000 Registration Date/nme: 2017-10-1200:1223 HERS Provider.CaICERTS
CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Genereted:2017-10-12 0912:36
Schema Version:rev 10/16
City of Menhe
Building & Safety Dept.
OCT 1 i 2017
ceed
CERTIFICATE OF COMPLIANCE CF111-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 2 of 3)
D.Altered Space Conditioning System(Sections 150.2(b)SE and F)
01 02 03 04 05 06 07 08 09 30 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 Dutt Length R-Value
Allnew All new This field or This field or
Systeml Central gas heating AFOE 81 Central split coaling SEER 14 Setback section is not section is not
furnace components AC components applicable applicable
Reouirad Documentation:
CF211-M CH-01-E-Space Conditioning Systems
-Dud Insulation ne ulrement for the new portions of wppl,-air and return-air dum or plenums:R6(Q 1-10,12 and 01 and Ra(C211 and 14-36)
CF2R and MR-1001-20-11-Duct Leakage Test required when heating or cooling cumponer4s are installed In ducted systems,or when more than 4Dft of duct length is replaced
-Leakage rate complimm:<=15%or<IMteinew to outside,or seal all a sdble leaks.
CnR and CF3R-MCH-25-H Refrigerant Gorge erifcatign required when refrigerant wmaining components are installed or altered(applicable In Q 2,8-15).
MR and CHR-MCH-23 Airflow Rate>=300 CFM per ton required when MC14-251s requlmd.
Exception;:
-Duct sysmms regimered with HERS pmvldm as previously waled are mrcmM from MCH-20 Dutt taakage Te#ing requirements.
-Heating-only systems and Air Handler Furnace Changes do not require verification of Air Flow MCH-23,or Refrigerant Maw 1,10f-25.
-fading duct systems constructed,insulated or sealed with asbestos are esemyt from MCH-20 Dud Leakage Testing mouiremmm.
E.Entirely New or Complete Replacement Duct System,with or without Equipment Changeout(Sections 150.2(b)lDiia and 150.2(b)SE,F)
This section does not apply to this project.
F.Entirely New or Complete Replacement Space Conditioning System(Section 150.2(b)1C)
This section does not apply to this project.
Registration Number 217-4020353425A-000-000.0000000-0000 Registration Date/Time: 2017-10-1206:12:23 HERS Provider:COURTS
CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-SD-12 09:12:36
Schema Version:rev 10/16
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 3 of 3)
Documentation Author's Declaration Statement
1.1 certify that this Certlflcate of Compliance documentation is accurate and complete.
Coomentation Author Name: Documentation Author Signature: 6p ar7�
Dungan,Barr/ ga�
Company: signature Dam:
Bear Creek Heating and Air Conditioning Inc 2017-10-12 06:12:23
Address: CEA/HERS Certification Identification(If applicable):
24069 Chatenay,Lane
City/State/h, Phone:
Murrieta CA 92562 951-600-2882
Responsible Person's Declaration statement
I certify the following under pmdty of perjury,under the laws of the State of California:
1. The Information proWtled on ties Certificate of Compliance Is true and correct.
2. 1 am eligible under DNI9on 3 of the Business and Professions Code to accept responsibility for the building design or system design Identified on the Certificate of Compliance(responsible designer).
3. That the energy features and performance specifications,materials,mmponents,and manufactured devices br the building design or system design identified an this Continuum of Compliance mMormtothe
requirements of Tide 24,Part 1 and Part 6 of the California Cade of Regulations.
4. The building design failures or witem design features identified an this Certificate of Compliance are mnsinen with the Information provided on other applicable compliance documents worksheets,
escalations,plans and specifications submitted to the enforcement agency for approval with this building pemog application.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made wadable with the building"mills)issued for the building,and made a sellable m the enforcement Money for all applicable
Inspeotions.I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building ownere occuparl
Responsible Designer Name: Responsible Designer Signature: 40 �gM/Dungan,Barry 5AvY"— �
Counter, Date Signed:
Bear Creek Heating and Air Conditioning Inc 2017-10-12 06:12:23
Address: ucenre:
24069 Chatenay Lane 779461
CiN/stabb'ZIP: Phone:
Murrieta CA 92562 951-600-2882
Easy to Verily O
at ICERTS cont
Digilallyagrwlby CafC,ERTs.This tlPgis UonPmv(dervideon bility secue dui caofm inr tietereddowment antlinmway implies
flP.]ISV84an PryVldel RepanSlbdl[yfaldM aCCW9Cya/dMln/0.'metlM. � ..
Registration Number:217-A020353425A-000-000-000OOOD-0000 Registration Datum¢: 2017-104206:12:23 HERS Provider:CaICER`rS
CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-10-12 09:12:36
Schema Version:rev 10/16