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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