PMT18-04415 City of Menifee Permit No.: PMT18-04415
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE MENIFEE Date Issued: 09/1012018
PERMIT
Site Address: 29733 BUENA TIERRA, MENIFEE,CA Parcel Number: 336-223-012
92586 Construction Cost: $9,300.00
Existing Use: Proposed Use:
Description of HVAC CHANGE OUT, UPGRADE 4 TON, 75,000 BTU FURNACE
Work:
Owner Contractor
DONALD$MARY MARTIN AIRE-TECH AIR CONDITIONING/HEATING
29733 BUENA TIERRA 18943 COLE AVE.
MENIFEE, CA 92586 PERRIS, CA92570
Applicant Phone:9515291502
TOM PAGE License Number.531800
AIRE-TECH AIR CONDITIONING/HEATING
18943 COLE AVE.
PERRIS, CA92570
Fee Description City 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_PerrnR_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 Contractor's State License Law for
Professions Code and my license is in full force and effect. the fallowing reason:
License Class C- & rL License Now.. ��nl �� � By my signature below I acknowledge that,except for my personal residence
Expires G. -30--Z&DGSignature / 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 u�ir fifer-p I of perjury o eftF following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certif"icu�atteez+ 0 "osu[e for workers 7044 of the Business and Professions Code,is available upon request when
compensation, 1+9birector of Industrial Relations as provided-for this application is submitted or at the following website:
by Section 3700 the Labor Code,for the performance of work for which www.leRinfo.ca.zov/calaw.html.
this-permit is issued.
Policy p Date
PROPERTY OWNER OR AUTHORIZED AGENT
❑I have and will maintain workers compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which in 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
Carrier f lgz�/E�L� with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy ttQl�tG/C Expires 6 g"ac/ — Z4,01 enter the above identified property for inspection purposes.
(This section need not t0 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 emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE g
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 forthwit amply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applica .* — Date 09 /62 '-(�` mixture containing a hazardous material equal to or greater that the
amounts sip ied on the Hazardous Materials Information Guide?
WARNING:FAILURE O CURE WORKER'S COMPENSATION COVERAGE IS ❑Yes >a 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($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District($CAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelln
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 agency for the performance of the work which this permit is issued outer bounf of a school?
(Section 3097 Civil Code) ❑Yes ra'Fla
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
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 Cade,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the haz ous material reportiin
checkmark(sl I have placed next to the applicable item(s)(Section 7031.5 es ❑No /
Business and Professions Code).Any city or county that requires a permit to �- Date 029 %C
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR J dRIZED 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(FIRM
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 000). managers who do the paint-disturbing work themselves or through their
in I,as owner of the property,or my employee with wages as theirsole 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.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).
Cade;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:
❑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 RAP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION r r.; MENIFEE
At to
DATE: PERMIT/PLAN CHECK NUMBER 2S CJ 7
PLANNING CASE NUMBER
TYPE: O COMMERCIAL RESIDENTIAL OMULTl-FAMILY O MOBILE HOME J PlOOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O'1ECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK 091A ceA10j1r100V .V,6 f- dr'o
PROJECTADDRESS ,_Q 3 !jf/E:i//l %lkRR/{ ZIP Z.! II eb
ASSESSOR'S PARCEL NUMBER LOT LOT TRACT lI Q �✓O�
OWNER NAME Vgel r11 /
ADDRESS c2 73 AlV ` ``/ - - C. T"/ Ci! ' G/ R.
PHONE 2571 6 79 - D 5,37 EMAIL
APPLICANTNAME
ADDRESS O G ( e�'
PHONE$"/,�rj cZ� - l Sfjo� EMAIL , 7/g-qr ,•�4 rr{/C /
CONTRACTOR'S NAME OWNER BUILDER? O YES Ie'NO
BUSINESS NAME 7-
ADDRESS g oC-
PHONE(c,S"/ Jj 0 uZ EMAIL
CONTRACTOR'S STATE LIC NUMBERS /SQa LICENSE CLASSIFICATION
VALUATION$ 9,300 -cV SQ FT 170 9' L SQ FT
i
APPLICANT'S SIGNATURE 'c_ - DATE
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE U/
INVOICETOTAL 3a ,CIO GREEN SMIP
OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee,CA 92586 (951)672-6777
www.cityofinenifee.us
NIF
,1"
STATE OF CALIFORNIA - d\vf ,
ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 06114 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFIR-ALT-04-E
Alterations-HVAC CZ 2,and 8-15(formerly CF-IR-ALT-HVAC) eitY Of Menit-ee (Page 1 of 1)
13wilEling Dept.
Site Address: EnforcJCf Date P
3 e rze R AULO+U repared: i iO
New Ducting,Plenums,Lineset: Conditioned
Equipment Type Equipment Efficienry a Floor Area(sq ft) Thermostat
fed❑�Pa�ckaged System Evaporator Coil etback
L splitSstem ondensin Unit AFLIE COP —/" ) Served by system
y g CAR-8 (CZ 11,14,15)Ducting /709 sgft (if not already
❑tv1ini Split ❑Compressor ER HSPF present must
urnace OL eset f7 R-5 or C 5) Plenums
idI xv EER ❑R-5 or R7.5)Lineset be installed)
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
for 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, CFIR-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23 or 24)'-HERS,MECH-25-HERS'
Compressor,TXV,Lineset, CF3R: MECH-20-HERS,MECH-(23 or 24)-HERS',MECH-25-HERS'
Air Handler/Furnace'(Can include new ducting)
Installer Requirement:Duct leakage(c i5go,or<3.0%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--------J
❑2.New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Duct
' CFIR-ALT-02•E
including Mini Split CF2R: MECH-O3,MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS',MECH-25-HERS'
CF3R: MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS',MECH-25•HERS2
Mini Splits require CFIR-ALT-02-E,CF2R-MECH-01,and (CF2R-CF3R)MECH-25-HERS
Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/CFM),Air Flow_350 CFM/ton(or alternative),Refrigerant Charge
❑3.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 CF111-ALT-02-E
replaced:Condenser Unit,Evaporator Coil, CF2R: MECH-01,MECH-20-HERS,MECH-(23 or 24)-HERS,MECH-25-HERS
Compressor,TXV,Lineset,Furna( I CF3R: MECH-20-HERS,MECH-(23 or 24)-HERS,MECH-25•HERS
Installer Requirement:Duct leakage<6%,Air Flow_350 CFM/ton(or alternative),Refrigerant Charge
Exempted from duct leakage testing if:❑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 Ductse I CFIR-ALT-02•E,CF2R: MECH-20-HERS,CF3R: MECH-20-HERS
Installer Required to:Duct leakage(<15%or, 510%to outside or,or seal all accessible leaks)
❑ EXCEPTION:Existing duct systems constructed,insulated or sealed with asbestos.
'All new ducting R-8 required when more than 40 ft installed and R-6 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 MECH-(23 or 24),or Refrigerant Charge verification MECH-25
'All New Ducts is when at least 75 percent of the duct system is new duct material,and up to 25 percent 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-5(1"thick insulation)for linesets 1"and less. R-7.5(1.5"=hick insulation)for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2'/. ,2.5-3T-2'/.",3.5 to 4T-2%",5T-4y.."
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 forthe 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 I and Part 6 of the OCR.
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: Responsib i er Signature: Date Signed: License:
CD e s G�
Company: dress. City/state/Zip: I Phone:
-- � _ c1 v p s
For assistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3 DO