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PMT16-01704 City of Menifee Permit No.: PMT16-01704 29714 HAUN RD. �ACCELAk�. MENIFEE, CA 92586 Type: Sign-Permanent MENIFEE Date Issued: 06/0212016 PERMIT Site Address: 30043 HAUN RD, MENIFEE, CA 92585 Parcel Number: 360-060-053 Construction Cost: $2,000.00 Existing Use: Proposed Use: Description of INSTALL 2 SETS OF CHANNEL LETTER SIGNS"JIMMY JOHN'S" Work: Owner Contractor RICH DEVELOPMENT SIGNATURE SIGNS 1000 N WESTERN AVE,#200 1952 ALONDRA CT SAN PEDRO, CA 90732 ONTARIO, CA 91764 Applicant Phone: 9099875105 ROBERT HUNT License Number:737465 SIGNATURE SIGNS 1952 ALONDRA CT ONTARIO,CA 91764 Fee Description City Amount fSl Sign Permit 2 190.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Building 1 9.50 $227.60 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 slated,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_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 1 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 o 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 !''��License No. / /7!�s By my signature below I acknowledge that,except for my personal residence Expires 4�—2U 7 Signature l� 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 1 WORKER'S COMPENSATION DECLARATION have built as an owner-builder ifit has not been constructed in its entirety by o I hereby affirm under penalty of perjury one of the following declarations:I licensed contactors.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 www.leeinfo.ca.eov/calaw.lstml. this permit is issued. Policy If Date PROPERTY OWNER OR AUTHORIZED AGENT o I have and will maintain workers compensation insurance,as required by section 3700 of the labor Code,forthe performance ofthe work forwhich o 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 Cartier with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# Expires 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 certify that in the performance of the work for which this permit is issued, I sh t emnlnv 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,Ishall forthw omply �hthose revisions. Will the applicant or future building occupant handle hazardous material or Applicant Date mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes o No UNLAWFUL,AND SHALL SUBIECTAN 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)7 See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY o Yes o No 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 school? (Section 3097 Civil Code) o Yes o No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of California Health al Safety Cade,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable items)(Section 7031.5 oyes o No Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR 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 IRRPI 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 o 1,as owner of the property,or my employeewith wages as theirsole 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 1-800-424-LEAD(5323). Code,The Contractors State License Law does not apply to an owner of a o 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. o No EPA Lead-Safe Certified Firm is required for this project because: a 1,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. BUILDING i SAFETY PERMIT/PLAN CHECK APPLICATION ,,11�4,,.-LMenifee DATE Z " PERMIT/PLAN CHECK NUMBER U' onv4 TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA ASIGN SUBTYPE: O ADDITION C ALTERATION O DEMOLITION ELECTRICAL O MECHANICAL C NEW O PLUM/�BING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 2 (rPt n2 E r t v / /0 iv rcitv,/oj E3ujIdjrM & Safety De . PROJECTADDRESS QO to Rd . q JUN 0 2 2016 ASSESSOR'S PARCEL NUMBER ?,lM • t)LOO- M3 LOT TRACT ReGeived OWNER NAME � Ue- O,/� 57 ADDRESS `'�"'�� �� PHONE EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME 0 /eI' Ut, OWNER BUILDER? O YES 0 NO BUSINESS NAME /V?-<- 5' ADDRESS 9 f Z ldvwo�rl v o / 0C PHONE �09 S� 7 030 2- EMAIL 6 ,7 J ` k O/.LGO CONTRACTOR'S STATE LIC NUMBER 737y`c LICENSE CLASSIFICATION VALUATION$ 2 opo-, SQ FT L SQ FT APPLICANT'S SIGNATURE DATE -CITY STAFF USE ONLY Z �� DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP X INVOICE ^^^^ t DAMOUNTAMOUNT '� OCASH OCHECK# UCREDITCARD VISA/MC PLAN CHECK FEESD AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES 0 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 ► IS CEC-NRCC-LTS-at-E(Revised 09/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting City of Men e 1 of 5) Pmlect Name: Date P.,.red: A. General Information { l Project Address: Rprpivpd Location of Sign la Outdoor Signs ❑Indoor Signs Phase of Sign Construction la New Signs ❑Sign Alterations Type of Lighting Control ❑New Lighting Controls ❑Replaced Lighting Controls la Not Installing Lighting Controls This Certificate of Compliance includes the following components(check all that apply) ❑Mandatory Measures(Lighting Controls) ©Maximum Allowed Lighting Power ©Specific 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 far 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. Ia.Statements of Responsibility Any person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E shall complete Part Ia.Check Yes or. No for all of the following statements: 1 I have responsibility for installing the sign lighting controls O Yes,complete parts la and 1b of this form O No,complete part 1a of this form 2 There are no existing sign lighting controls and I will be installing compliant sign lighting controls O Yes O No 3 There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls o Yes O 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 O Yes (E) No There are existing sign lighting controls that do not comply with the applicable provision of§310.9 and§130.3 and someone 5 else will be responsible to install compliant sign lighting controls O Yes O No CA Building Energy Efficiency Standards-2013 Nonresidential Compliance August 2015 STATE OF CALIFORNIA SIGN LIGHTING CEC-NRCC-LTS-81-E(Revised 08/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LT5-03=E Sign Lighting (Page 2 of 5) Pro)¢tt Name: Date Prepared /��z � v 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 block can be located: 1 §130.3(a)1.All indoor sign lighting is controlled with an automatic time-switch control or astronomical time- Y N NA switch control. O O G §130.3(a)2A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time- Y N NA switch control,or an astronomical time-switch control. G O O 2 EXCEPTION to Section 130.3(a)2A:Outdoor signs in tunnels,and signs in large permanently covered outdoor Y NA areas that are intended to be continuously lit,24 hours per day and 365 days per year. O G §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. Y N NA 3 Signs that are illuminated at night and for more than 1 hour during daylight hours shall be considered ON both O O G day and night. EXCEPTION to Section 130.3(a)2B:Outdoor signs in tunnels and large covered areas that are intend4beyNA illuminated both day and night.§130.3(a)3. Demand Responsive Electronic Message Center Control.An Electronic Message Cente NA having a new connected lighting power load greater than 15 kW has a control installed that is capa G 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 stNA ordinance,or regulation to be reduced by 30 percent. G Field Inspector Notes: CA Building Energy Efficiency Standards-2013 Nonresidential Compliance August 2015 STATE OF CALIFORNIA SIGN LIGHTING CEC-NRCC-LTS-Ot-E(Reviud 08115) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting T (Page 3 of 5) ProjeR Name: J r � 1n Date Preparetl: 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 Field Symbol OPTIONAL—Energy Design Complies Inspector or Description of the Sign Verified Label(see Allotted Watts Watts Y/N Check that Code instructions below) sign complies ;K c !a, C d N (e1 a X = a a C a 3 c w _ < a 3 E A Led Channel Letters ❑ F 0.o0 0 O ❑ B Led Channel Letters ❑ 2 O 7.,`-0 0.00 0 O ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ 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/IEC 17020.For signs with such an ENERGY VERIFIED label, columns'D'through Tore 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§130(c). I 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 August 2015 r STATE OF CALIFORNIA SIGN LIGHTING cEa NRCC-LTS-01-E Revised 08/15 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting / (Page 4 of 5) Pm7 `0: ♦ oaaereparea � 4an 0 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 ofthis 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 ld Inspector Symbol ENERGYVERIFIED compliance Fieckthat Sign or Description label Shall include only lighting Check that Sign Code (see instructions technologies listed below Complies below) List all that apply A LED Channel Letter Sign ❑ 7 ❑ B LED Channel Letter Sign ❑ 1 7 ❑ ❑ ❑ A Symbol or code used on the plans(when plans are required)and other documents. B A narrative description ofthe 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 Speck 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 by the 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 :ballast has 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 ofthe 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 1 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 ofthe Appliance Efficiency Regulations(Title 20). 9 Compact fluorescent lamps that do not contain a medium screw base sockets(E24/E26). E I This page doubles as a field inspection checklist. Field Inspector Notes: CA Building Energy Efficiency Standards-2013 Nonresidential Compliance August 2015 STATE OF CALIFORNIA _ SIGN LIGHTING cEC NRCC-LTS-01-E Revised 00115 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 5 of 5) Prelaat Name: t pate Prepared: /��r I D f1 O 4 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name:Robert Hunt Documentation Author Signature: company:Signature Signs Signature Date: IJ' ap�J — /� Address:1952 Alondra Ct. CEA CertiOration Iden0Dration(Waapplitabble): city/State/Zlp:Ontario CA 91764 Phone.9099875105 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 ofthe 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. S. I 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 sig ed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to thp Li ding own at ccupancy. Responsible Designer Name: O/ Responsible Designer Signature: J I.t company' Signature Signs Date signed: 6' ^ / Address: 1952 Alondra Ct ucense: C-45/737465 C' otvnmrelnp' Ontario CA 91764 phone: 909 987 5105 CA Building Energy Efficiency Standards-2013 Nonresidential Compliance August 2015 KL - 011 % W o _ O o o e "o Co C N m LL b W a a9atl`aa°3� c t• vt C Z O • 2 W -°a m o m 0 0 = mUW FZ 0 N '^ N O __cnM o'u of n Cm C C O O 2 C v@i3ec °E Cm dT `1 Mm� plE OIL d 01 in Z Wa �°a�cnO F=mo d N Oyu Vpm a1 QMF as DY 0 � � �Z LL d runnm E=e ZPE41 Q R 4 CIJ �� L o �y a �� O •W Z 2 � � i O co Z U 2 m Q Z n/ of In } _ , 4 1 � C � I V Eli . w r - W a cc `o Y \ v w m Fa a m ui C W i o N " 111 o t W n o N LLii CA o a C T N ~N\ Q N W o o T 2 C7 a W o iL Z a 3 .� a p z W A o j ~ gig >Lj a � v m a cc Sao `a a Cg C O 9oLOUOD° �? t pnj Q d LL t9 tt ¢ ac�oya - 9< 6 N N G Z O W W `e9 a��t a. 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