PMT15-03177 City of Menifee Permit No.: PMT15-03177
29714 HAUN RD.
�CCELA—. MENIFEE,CA 92586 Type: Commercial Electrical
MENIFEE Date Issued:
10113/2015
PERMIT
Site Address: 30115 ANTELOPE RD, MENIFEE, CA Parcel Number: 364-010-007
92584 Construction Cost: $1.100.00
Existing Use: Proposed Use:
Description of (1)208V DEDICATED CIRCUIT 30AMP FOR FROZEN BEVERAGE DISPENSER
Work:
Owner Contractor
TACO BELL ELECTRONIC PROCESSING TECHNOLOGIES
30115 ANTELOPE RD P O BOX 4339
MENIFEE,CA 92584 OCEANSIDE, CA 92057
Applicant Phone:7604537774
ANTHONY LOVE License Number: 883225
ELECTRONIC PROCESSING TECHNOLOGIES
P O BOX 4339
OCEANSIDE, CA 92057
Fee Description O_yt Amount($l
Non-Residential Appliances,up to 11 HP- _ -- 1 116.00
Receptacle, Switch, Outlet&Fixture 1 116.00
Building Permit Issuance 1 27.00
GREEN FEE 1 0.00
GREEN FEE - - - — -` 1 - - - 1.00
General Plan Maintenance Fee-Electrical 1 11.60
$271.60
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,orwhere the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA_Bldg_Pernit_Template.rpt Page 1 of 1
City Of Menifee
ENSED DECLARATION ❑ lam exempt from licensure under the Contractors State License Law for the
following reason:
I hereby affirm under penalty or perjury that I am licensed under provisions of
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence in
Professions Code and my license is in full force and effect. which I must have resided for at least one year prior to completion of
License Class L l O License No. �_ improvements covered by this permit, I cannot legally sell a structure that I have
Expires �- �1' —[ Signatur built as an owner-building If It has not been constructed in its entirety by licensed
contractors. I understand that a copy of the applicable law, Section 7044 of the
O KERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is
submitted or at the following Web site:
I hereby affirm under penalty of perjury one the following declarations: http;//www.leginfb.ca.gov/mlawhtml.
(section
have and will maintain a certificate of consentt of self-insure for workers'
mpensation,issued by the Director of Industrial Relations as provided for by Date
ection 3700 of the Labor Code, for the performance of work for which this
rmit is issued. Property Owner or Authorized Agent
olicy# ❑ By my Signature below, I certify to each of the following: I am the property
1 have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read this
3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to comply
permit is issued.My workers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to building
construction.I authorize representatives of this city or county to enter the above-
Carrier identified property,for the inspection purposes.
Policy# Expires ///111 Date
Property Owner or Authorized Agent
(This section need not be completed if the permit is for Business License#
one-hundred dollars($100)or less)
HAZARDOUS MATERIAL DECLARATION
I certify that in the performance of the work for which this permit is issued,I
s all not employ any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a
workers'compensation laws of California,and agree that if I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide?
Code,I sh 111 rthwfth comply with those provisions. ❑YES NO
plica Date; (D ' C 7j Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast%r Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHAL for guidel' es
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AN DYES W0
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAR
($100,000), IN ADDITION TO THE COST OF COMPENSATION WIII the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF TH boundary of a school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑YES #O
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section Califpmia Health&Safety Code,Section 25505 and 25534 concerning
3097 Civil Cade) hazardous material reporting.
OWNER BUILDER DECLARATIONS ❑
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
Date
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNEA OR AUTHORIZED AGENT
next to the applicable item(s)(Section 7031.5. Business and Professions Code:
Any city or county that requires a permit to construct, alter, improve, demolish, EPA RENOVATION.REPAIR AND PAINTING(RRP)
or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's State License Law(Chapter 9 (commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with
she Is exempt from ticensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500).) employees.For more information about EPA's Renovation Program visit:
www.epa.govllead or contact the National Lead Information Center at
❑ I, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323).
compensation,will do( )all of or( )porting of the work,and the structure is
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however, Certified Firm Name:
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the purpose of sale). Firm Certification No.:
❑ 1, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's License Law does not apply to an owner of a property
who builds or Improves thereon, and who contracts for the projects with a
licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING i SAFETY PERMIT/PLAN APPLICATION
. p
Menifee
DATE DATE I C4 - L-5-L5 PERMIT/PLAN CHECK NUMBER-aM J�
TYPE: MCOMMERCIAL []RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN
SUBTYPE: [-]ADDITION []ALTERATION []DEMOLITION JgJELEcTRICAL ❑MECHANICAL
❑NEW ❑PLUMBING El RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 208 \1 0 1E0 i CAT C D C t A C 0 .-7(L) 30 R
PROJECTADDRESS b i 5 A I-yr-C L0 i RID
ASSESSOR'S PARCEL NUMBER M - oty-- 7 LOT TRACT
PROPERTY OWNER'S NAME -T t Co (3 it Lt_
ADDRESS 3p� t-fTeLO 0 er
PHONE EMAIL
APPLICANT NAME
`"yNArME �L�CTRpwl�C. RoGESsi/16 l CC ( ( !�c ( fJGL IE
ADDRESS S �. J6ta6DA t.&� �v4 SSS
PHONE -1I00 - 45-3 - -► -11 LIF EMAIL SALtS IF,, E7L6CT-Rz Cs Po ICEcbt-
CONTRACTOR'S NAME Awrvizao Y4
b\/i✓ OWNERBUILDER? ❑YES 0
BUSINESSNAMrrE �L CT ►ttC PReCCSS21L (� IVDLoGC ES
ADDRESS `1 64 A E,Ls LD Y4- MrH.S�SS
PHONE -7610 -4.53 --1Z ZQ�} EMAIL 1L � C-LC-c tea Pka t Cc' • CC1
CONTRACTOR'S STATE LIC NUMBER U 8 3 Z Z 5 LICENSE CLASSIFICATION c O
VALUATION$ lb O — SQ FT ($ao L SQ FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Naun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us inspection Request Line 951-246-6213
Taco Bell
30115 Antelope Road
Menifee, CA 92584
(951) 301-3747
Dedicated 208V/30A/1Phase Circuit
City ot&
Building menifee
Safety Dept.
OCT 13 2015
Frutista Frozen Beverage Received
Dispenser
• Flex Cord Twist
• • 200-210V/30A/1Phase
Back Office
Panel
208V/30A/2P
Breaker
0 0
MC 10/2, Concealed, 60 Feet
L63 Wall V ;i , Cable Length o 0
Wall (�I
00
00
CITY OF MENIFEE DEPARTMENT
BUILDING AND SAFETY
pi.AN APPROVAL
lot
REVIEWED BY DATEconq r
permit for,city
an
*Approval of these plans shall oot cF sionsro!the federal,state or dty
apploval of,any violation of alrl P roved plans must be kept on the
regulations and ordinances. This set oS app
iolisite until completion.
CSLB 4883225 4549Avenida Manessa,Oceanside,CA 92057
Electronic
°""'"`'""° Date 10/12/2015 Drawn By Anthony Love Scale None
Quality Electrical Service - Page 1 of 1
Est.2006 Title Dedicated Circuit Diagram __ _
(760)453-7774 Taco Bell-Menifee Plan# 19532