PMT16-01035 City of Menifee Permit No.: PMT16-01035
29714 HAUN RD. Type: Sign-Permanent
<A-CCEU/ MENIFEE, CA 92586
MENIFEE Date Issued: 0410 7/2.01 6
PERMIT
Site Address: 26015 NEWPORT RD,MENIFEE, CA Parcel Number: 360-011-025
92585 Construction Cost: $12,000.00
Existing Use: Proposed Use:
Description of REIMAGE SIGNS ON 4 FUEL DISPENSERS, REPLACE CANOPY FASCIA WITH NEW FASCIA AND 2
Work: CHEVRON WORDMARK SIGNS AND 2 CHEVRON LOGO SIGNS, REPLACE 2 EXISTING MONUMENT
SIGN INSERTS
Owner Contractor
SUN CITY FUELS COMPANY DONCO&SONS INC
12707 HIGH BLUFF DRIVE 4582 E EISENHOWER CIR
SAN DIEGO, CA 92130 ANAHEIM, CA 92807
Applicant Phone:7142540099
EDDIE VIDALES License Number:435516
DONCO&SONS INC
4582 E EISENHOWER CIR
ANAHEIM,CA 92807
Phone:7144883971
Fee Description OQt( Amount($)
Sign Permit 3 190.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 9.50
$227.50
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 carded on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise staled,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_Pennit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuantto 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 G to,45 License No. LF 35-br) By my signature below I acknowledge that,except for my personal residence
Expires 2 lr 1 Signature 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 DECLARATI 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 thata ropy of the applicable law,Section
have and will maintain a certificate of consent of self-Insure for worker's 7044 of the Business and Professions Cade,is available upon requestwhen
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 ,„�„�,.Ieeinfo.ca.eov/calaw.html.
this permit is issued.
Policy# Date
ave and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which O 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 owner's behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
Carrier SC with all applicable city and county ordinances and state laws relating to
G - 2a (, building construction.I authorize representatives of this city or county to
Policy# t 13g gLF— Expires V � ) 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 shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
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 forthwith comply with those provisions. / / Will the applicant or future building occupant handle hazardous material or a
Applicant Date ItZOq mixture containing a hazardous material equal to or greater that the
amounts spofted on the Hazardous Materials Information Guide?
WARNING:WLURETO SEA EWORKER'S COMPENSATION COVERAGE IS Dye AD
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND OVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require 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 forguideliness
CONSTRUCTION LENDING AGENCY ❑Yes uwl
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 WK-
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that am exempt from the permitting checklist.I understand my requirements underthe State of
Contractors License Law for the reason(s)indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning
h ardous material reporting.
checkmark(s)1 have placed next to the applicable item(s)(Section 7031.5 �j� ❑No / 1/
Business and Professions Code).Any city or county that requires a permitto Date I/
construct,alter,improve,demolish or repair any structure,prior to its pR0 R AUTHORIZED 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 IRRP)
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.eoa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-BOG-424-LEAD(5323).
Code;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 RRP
Acknowledgement
PERMIT/PLANBUILDING & SAFETY . . � .'
,Menifee
DATE - PERMIT/PLAN CHECK NUMBER I
TYPE: ACOMMERCIAL RESIDENTIAL C MULTI-FAMILY ^. MOBILE HOME O POOL/SPA - IGN
SUBTYPE: O ADDITION ALTERATION C)DEMOLITION C ELECTRICAL C MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
0trPLOme CA,,A 1 Menitee t.
gupdin9 &
PROJECFADDRESS �7' V
ASSESSOR'S PARCEL NUMBER ,�_p�- ,�• LOT TRACT APR
OWNERNAME SJN G S
ADDRESS J F012 . 1 SAI?4 0AIErnO SIQ
PHONE qjI�2(4(p y &AA EMAIL —
APPLICANT NAME EI>t>l
ADDRESS q'S Z • t` —1
PHONE EMAIL ( L. 4�
CONTRACTOR'S NAME L,. OWNER BUILDER? O YES ;KU0
I
BUSINESS NAME
ADDRESS � . e( t,Q_ C a.\AwntuC&
PHONE EMAIL L 0 CD •L ►M
CONTRACTOR'S STATE LIC NUMBER ({3S(.1 too LICENSE CLASSIFICATION C1 O
VALUATION$ 000 SQ FT 1 C7 L SQ FT
APPLICANT'S SIGNATURE DATE ^
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION k CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SIP M
INVOICE PAID AMOUNT r)
AMOUNT ✓v )CASH i;CHECK# CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH <)CHECK# )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 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
STATE OF CALIFORNIA
SIGN LIGHTING
CEC-NRCC-LTS-01-E Rwsed 06114 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 1 of 5)
NajeRName: OaW Prepared: t
Project Address:
2-&olc�
Location of Sign B�Autdoor Signs ❑Indoor Signs
Phase of Sign Construction ❑New Signs .sign Alterations
Type of Lighting Control ❑New Lighting Controls ❑Replaced Lighting Controls �!*ot Installing Lighting Controls
This Certificate of Compliance includes the following components(check all that apply)
❑Mandatory Measures(Lighting Controls) ❑Maximum Allowed Lighting Power 04ecific Lighting Sources
1.Mandatory Sign Lighting Controls
NOTES:
1. The same responsible person may install both the sign lighting power and the sign lighting controls, or a different responsible
person may install the sign lighting controls than the responsible person installing the sign lighting power.
2. The Mandatory Measures (sign lighting controls) are required for compliance with the sign lighting Standards. If the person
responsible for installing the sign lighting power is not also responsible for the sign lighting controls, then the owner of the sign,
general contractor,or architect shall be responsible to have the sign lighting controls installed.
3. If more than one person has responsibility for compliance, each responsible person shall prepare and sign a Certificate of
Compliance and an Installation Certificate applicable to the portion of construction for which they are responsible;alternatively,
the person with chief responsibility for construction shall prepare and sign the Certificate of Compliance Declaration Statement
for the entire construction.
la. Statements of Responsibility:Any person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E
shall complete Part la.Check Yes or No for all of the following statements:
1 1 have responsibility for installing the sign lighting controls
❑Yes,complete parts la and lb of this form 9yo,complete part 1a of this form
2 There are no existing sign lighting controls and I will be installing compliant sign lighting controls
❑Yes No
3 There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls
Yes ❑No ,
There are existing sign lighting controls that do not comply with the applicable provision of§110.9 and§130.3 and I will be
4 installing compliant sign lighting controls ft
❑Yes o mod
There are existing sign lighting controls that do not comply with the applicable provision of§110.9 and§130.3 and someone
5 else will be responsible to install compliant sign lighting controls
Yes ❑ No
City Of Menifee
Building Dept
APR 0 5 2016
Received
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
SIGN LIGHTING t .
CEC-NRCC-LTS-Oi-E Revised 015/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 2 Of 5)
ProfeR Name: Date Prepared: J
1b.Mandatory Sign Lighting Controls
If the person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E is responsible for complying with
the sign lighting control requirements,that person shall answer all of the following questions:
If there are construction documents,indicate where on the building plans the
mandatory measures(sign lighting control)note black can be located:
1 §130.3(a)l.All indoor sign lighting is controlled with an automatic time-switch control or astronomical time- Y N A
switch control. ❑ ❑
§130.3(a)7A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time- Y N NA
2 switch control,or an astronomical time-switch control. ❑ Xi ❑
EXCEPTION to Section 130.3(a)2A:Outdoor signs in tunnels,and signs in large permanently covered outdoor Y N
areas that are intended to be continuously lit,24 hours per day and 365 days per year. ❑
§130,3(a)2B. All outdoor sign lighting that is ON both day and night is controlled with a dimmer that provides
the ability to automatically reduce sign lighting power by a minimum of 65 percent during nighttime hours. TYN
3Signs that are illuminated at night and for mare than 1 hour during daylight hours shall be considered ON both
t.4 day and night.
` EXCEPTION to Section 130.3(a)2B:Outdoor signs in tunnels and large covered areas that are intended to be Y NA
illuminated both day and night. ❑
§130.3(a)3. Demand Responsive Electronic Message Center Control.An Electronic Message Center(EMC) y N N/A
having a new connected lighting power load greater than 15 kW has a control installed that is capable of ❑ ❑
s•. 4 reducing the lighting power by a minimum of 30 percent when receiving a demand response signal.
EXCEPTION to Section 130.3(a)3:Lighting for EMCs that is not permitted by a health or life safety statute, Y NA
ordinance,or regulation to be reduced by 30 percent. ❑
Field Inspector Notes:
brri
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
SIGN LIGHTING J
CEC-NRCC-LTS-01-E Revised 06114 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 3 of 5)
Poled Na.: pare P.'a :
2 Maximum Allowed Lighting Power Method of Compliance
Certificate of Compliance and Field Inspection Energy Checklist
Complete this part if there are signs using the maximum allowed lighting power method of compliance.(Complete part 3 of
this Certificate of Compliance if there are signs using the Specific lighting sources method of compliance)
A B C D E F G H I J
Symbol OPTIONAL—Energy Complies Filed inspector
Or Code Description of the Sign Verified Label(see Allotted Watts Design Watts YEN Check that sign
Instructions below) complies
c w
4§ 1
v =A
m c - °1 ry r4 a x = � a
earn a , o _ � o � m .a
a �w 6 I- 3 0
✓ ✓
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
A Symbol or code used on the plans(when plans are required)and other documents.
B A description of the sign,or location of sign on the building;and the location of sign on construction documents.
OPTIONAL-Check this box only if this sign has a permanent,pre-printed,factory-installed,ENERGY VERIFIED label,confirming that the
sign complies with the Section 140.8 of the California 2013 Title 24,Part 6 Standards,using the Maximum Allowed Lighting Power
method of compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by
C Underwriters Laboratories(UL)or other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards
Institute in accordance with ISO/IEC 17011.Surveillance by the Accredited Certification Body shall be an ongoing annual inspection
program carried out by a Type A Inspection body in accordance with ISO/EC 17020.For signs with such an ENERGY VERIFIED label,
columns'D'through Tare not required to be filled out.Note:Using an ENERGY VERIFIED label Is an optional method to validate
compliance.An ENERGY VERIFIED label is not needed for compliance.
D The sign area in square feet.
E List"I"if the sign is internally illuminated. List"E"if the sign is externally illuminated.
F Allowed watts per square foot. Enter 12 if the sign is listed as"I"in column E.Enter 2.3 if sign is listed as"E"in column E.
G Multiply the square footage in column D times the allowed Lighting Power Density(LPD=watts)in column F.
H Show the total installed watts in the sign,as determined according to the applicable provisions of§330(c).
Enter Y if the number in column H is less than or equal to the number in column G. Otherwise,the sign does not comply.
J This page doubles as a field inspection checklist.
Field Inspector Notes:
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
SIGN LIGHTING
CEC-NRCC-LTS-01-E Revised 06I14 CALFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 4 of 5)
Pmja Name: Date Prepared:
3.Specific Lighting Source Method of Compliance
Certificate of Compliance and Field Inspection Energy Checklist
Complete this part if there are signs using the Specific lighting source method of compliance. (Complete part 2 of this Certificate
of Compliance if there are signs using the maximum allowed lighting power method of compliance)
A B C D E
OPTIONAL Specific light source used for
Symbol ENERGY VERIFIED compliance Field Inspector
Check that
or Description label Shall include only lighting
Code (see instructions technologies listed below Complies
below) List all that apply
❑ 7 ❑
G o ❑ ❑
n Pu u .xt • cu - ❑ 7 ❑
C L2Lc L% L D.l.ua- L-L ❑ ❑
A Symbol or code used on the plans(when plans are required)and other documents.
B A narrative description of the sign,or location of sign on the building;and the location of sign on construction documents
C OPTIONAL-Check this box only if this sign has a permanent,pre-printed,factory-installed ENERGY VERIFIED label,confirming that this sign
complies with the Section 140.8 of the California 2013 Title 24,Part 6 Standards,using the Specific Lighting Source Method of Compliance. The
only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories(UL)or
other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards Institute in accordance with ISO/IEC
17011.Surveillance by the Accredited Certification Body shall be an ongoing annual inspection program carried out by a Type A Inspection body
in accordance with ISO/IEC 17020.For signs with such an ENERGY VERIFIED label,column'D'is not required to be filled out.Note:Using an
ENERGY VERIFIED label is an optional method to validate compliance.An ENERGY VERIFIED label is not needed for compliance.
Specific Light Source Compliance Method. The sign(s)identified above use only the following lighting technologies:
List all applicable numbers(1 through 9)that apply in column D above for each row.
1 High pressure sodium lamps
Metal halide lamps that are pulse start or ceramic served by a ballast that has a minimum efficiency of 88 percent or
2 greater.Ballast efficiency is the measured output wattage to the lamp divided bythe measured operating input wattage
when tested according to ANSI C82.6-2005.
Metal halide lamps that are pulse start that are 320 watts or smaller,are not 250 watt or 175 watt lamps,and are served by
3 a ballast that has a minimum efficiency of 80 percent.
Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage when tested
according to ANSI C82.6-2005.
Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 75 percent
D 4 when the transformer or power supply rated output current is less than 50 mA.The ratio of the output wattage to the input wattage is at
100 percent tubing load.
Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 68 percent
5 when the transformer or power supply rated output current is 50 mA or greater.The ratio of the output wattage to the input wattage is at
100 percent tubing load.
6 Fluorescent lighting systems meeting one of the following requirements:A.Use only lamps with a minimum color rendering index(CRI)of
80;or B.Use only electronic ballasts with a fundamental output frequency not less than 20 kHz.
7 Light emitting diodes(LEDs)with a power supply having an efficiency of 80 percent or greater;
Single voltage external power supplies that are designed to convert 120 volt AC input into lower voltage DC or AC output,and have a
8 nameplate output power less than or equal to 250 watts,shall comply with the applicable requirements of the Appliance Efficiency
Regulations(Title 20).
g Compact fluorescent lamps that do not contain a medium screw base sockets(E24/E26).
E This page doubles as a field inspection checklist.
Field Inspector Notes:
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
SIGN LIGHTING W
CEC-NRCC-LTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 5 of 5)
Plpiett Name: Date Prepared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documentation Author
Company: Signature Date:
L'( l
Address: CEA/HERB Certifiation identifl ation(if applicable):
GN/Stste/Lp: Phone:
4 v7 7/Y - ���771
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. 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 completed signed 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 completed signed copy of this
Certificate of Compliance is required to be included with the documentation the builder provides to the buildi owner at occupancy.
Responsible Designer Name: Responsible Designer Signal
Company: ` l Date Signed: —� r
Address4%—�3 2 ` ' r iicense: LC
L iC cell/ki Lc -3
Cry/state/ZI : Phone: --i
C �U
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014