PMT18-05249 City of Menifee Permit No.: PMT18-05249
11w
29714 HAUN RD.
7 MENIFEE, CA 92586 Type: Residential Mechanical
MENIFEE MENIFEE Date Issued: 10/26/2018
PERMIT
Site Address: 28543 DELPHINUS DR, MENIFEE, CA Parcel Number: 339-272-015
92586 Construction Cost: $12,226.00
Existing Use: Proposed Use:
Description of REMOVE AND REPLACE 4 TON COMPLETE SPLIT SYSTEM FAU IN ATTIC 80K BTUS
Work: REPLACEMENT-SAME SIZE AND LOCATION
Owner Contractor
GREG MILLER A R S AMERICAN RESIDENTIAL SERVICES OF
28543 DELPHINUS DRIVE CALIFORNIA INC
MENIFEE, CA 92586 965 RIDGE LAKE BLVD.#201
Applicant Phone: 9512769744
A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNI) License Number: 765074
965 RIDGE LAKE BLVD.#201
MEMPHIS, CA 38120
Phone: 9512769744
Fee Description Q�t r Amount($)
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_Bidg_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 Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class CIO C20 CIAO License No. 7lOS 01 IJ By my signature below I acknowledge that,except for my personal residence
Expires 4" a" 9 Signature �( U 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 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
this permit is issued. wnron.leginfo.ca.gov/czlam!,ntml.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
o I have and will maintain worker's compensation insurance,as required by
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 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 1 L q building construction.I authorize representatives of this city or county to
Policy# 'Vo Dq Expires 1 `— 1 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, —7
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 worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with tho provisions. Will the applicant or future building occupant handle hazardous material or a
fi�_�5_ mixture containing a hazardous material equal to or greater that the
Applicant Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECUR ORKER'S CO ENSATION COVERAGE IS ❑Yes No
WARNING:FAILURE TO SE=
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 VNo
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) ❑Yes %�,No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and 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 Health&Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5
Business and Professions Code).Any city or county that requires a permit to Wes ❑No
` Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNEfj R AUTHQSI D AGEN
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(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
❑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 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:
❑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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: I �i'" PERMIT/PLAN CHECK NUMBER
GRADING/ PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: COMMERCIAL RESIDENTIAL MULTI-FAMILY MOBILE HOME POOL/SPA `::: SIGN
SUBTYPE: ADDITION ALTERATION DEMOLITION ELECTRICAL 'MECHANICAL
NEW PLUMBING C) RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS YES NO
PROJECTADDRESS � L2� L ZIP
ASSESSOR'S PARCEL NUMBER ✓ ' G (Z•V LOT TRACT
OWNER NAME
ADDRESS
PHONE �St� ���"-� � EMAIL
APPLICANT NAME
ADDRESS -:� -517 V/E fS1 t LJL
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? YES NO
BUSINESS NAME Z 'n
ADDRESS ��F�
PHONE ( OL) (p(p0 --(!} (o7 S EMAIL
CONTRACTOR'S STATE LIC NUMBER 7 C.p 5Q-7 4 LICENSE CLASSIFICATION
VALUATION $ ) Z j z_z LP SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE
'OTYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY. CITY OF MENENIIFFEEEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENG ERING FIRE nn (/le_
INVOICE TOTAL .lam GREEN SMIP
OWNER BUILDER VERIFIED YES NO DRIVERS LICENSE# NOTARIZED LETTER YES NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
GtYr op
www.Cityofinenifee.CssltY Of Menifee
Building Dept.
ENIFE
OCT 26 2018 `4
Received
CERTIFICATE OF COMPLIANCE CF1R-ALT-0
Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 1 of
Project Name: MILLER,GREG Date Prepared: 2018-10-
A. General Information IMAM
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
CF1R-ALT-02 document for each dwelling unit.
01 Project Name MILLER,GREG 02 Date Prepared 2018-10-26
03 Project Location 28543 DELPHINUS DR. 04 Building Type Single family
05 CA City Sun City 06 Dwelling Unit Name MILLER,GREG
07 Zip Code 92586 08
Dwelling Unit Conditioned Building Dept.
Floor Area(ft2) 1800
Number of Space
09 Climate Zone 10 30 Conditioning(SC)Systems in 1
this Dwelling Unit:
B. Space Conditioning(SC)System Information
•
01 02 03 04 05 06 07 08 09 10
Is the SC Installing a
SC System SC System CFA served system a 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 Ty Altered space
pe
System 1 Location 1 1800 Yes Yes Yes No No No conditioning system
C. Extension of Existing Duct System,Greater Than 40 Feet(Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number:418-A020084531A-000-000-0000000-0000 Registration Date/Time:2018-10-26 09:15:46 HERS Provider:CHEERS
CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2018.0.001 Report Generated:2018-10-26 09:15:46
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CERTIFICATE OF COMPLIANCE CF111-ALT-024
Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 2 of 3)
D.Altered Space Conditioning System (Sections 150.2(b)1E and F)
01 02 03 04 05 06 07 08 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
All new All new This field or This field or
AC
System 1 Central gas heating AFUE 0.8 Central split cooling SEER 14 Setback section is not section is not
furnace components components applicable applicable
Required Documentation:
CF2R-MCH-01-E-Space Conditioning Systems
-Duct insulation requirement for the new portions of supply-air and return-air ducts or plenums:R6(CZ 1-10,12 and 13)and R8(CZ 11 and 14-16)
CF2R and CF3R-MCH-20-H-Duct Leakage Test required when heating or cooling components are installed in ducted systems,or when more than 40 ft of duct length is replaced
-Leakage rate compliance:<=15 percent or<=10 percent leakage to outside,or seal all accessible leaks.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered(applicable in CZ 2,8-15).
CF2R and CF3R-MCH-23 Airflow Rate>=300 CFM per ton required when MCH-25 is required.
Exceptions:
Duct systems registered with HERS provider as previously sealed are exempt from MCH-20 Duct Leakage Testing requirements.
Heating-only systems and Air Handler Furnace changes do not require verification of Air Flow MCH-23,or Refrigerant Charge MCH-25.
-Existing duct systems constructed,insulated or sealed with asbestos are exempt from MCH-20 Duct Leakage Testing requirements. r,
E. Entirely New or Complete Replacement Duct System,with or without Equipment Changeout(Sections 150.2(b)1Diia and 150.2(b)1E, 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. City Of Menifee
Building nent
OCT 2 S' 2018
Received
Registration Number:418-A020084531A-000-000-0000000-0000 Registration Date/Time:2018-10-26 09:15:46 HERS Provider:CHEERS
CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2018.0.001 Report Generated:2018-10-26 09:15:46
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CERTIFICATE OF COMPLIANCE
CF1R-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 Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
Christina Calhoun C3"Stz ca.Uwu.w
Company: Signature Date:
Rightime Home Services 2018-10-26
Address: CEA/HERS Certification Identification(if applicable):
965 Ridge lake Blvd,Suite 201
City/State/Zip: Phone:
Memphis TN 38120 951-276-9744
Responsible Person'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 Business and Professions Code to 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
requirements of Title 24,Part 1 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 documents,worksheets,
calculations,plans and specifications submitted to the enforcement agency for approval with this building permit application.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s)issued for the building,and made available to the enforcement agency for all applicable
inspections.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 owner at occupancy.
Responsible Designer Name: Responsible Designer Signature:
Christina Calhoun Uwi/tt Calhoun,
Company: Date Signed:
Rightime Home Services 2018-10-26
Address: License: City 01 Menitee
965 Ridge lake Blvd,Suite 201 765074 Building Dept.
City/State/Zip: Phone:
Memphis TN 38120 951-276-9744 OCT 2 201e:
Received
Digitally signed by CHEERST". This digital signature is provided in order to secure the content of this registered
document, and in no way implies Registration Provider responsibility for the accuracy of the information.
Registration Number:418-A020084531A-000-000-0000000-0000 Registration Date/Time:2018-10-26 09:15:46 HERS Provider:CHEERS
CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2018.0.001 Report Generated:2018-10-26 09:15:46
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