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PMT16-02362 City of Menifee Permit No.: PPATi6-02362 29714 HAUN RD. 4lkCCEL/� MENIFEE,CA 92586 Type: Commercial Electrical MENIFEE Date Issued: 07/22/2016 PERMIT Site Address: 28995 NEWPORT RD. MENIFEE, CA Parcel Plumber: 364-030-004 92584 Construction Cost: $1,000.00 Existing Use: Proposed Use: Description of GENERATOR FOR RITE-AID NEW COMM Work: Owner Contractor FOOTHILL ARCH LLC PARKCREST CONSTRUCTION INC 2910 S ARCHIBALD AVE#A350 2910 S ARCHIBALD AVENUE ONTARIO, CA 91761 A-350 Applicant Phone:9099301201 RICHARD FITZSIMONS License Number: 600254 PARKCREST CONSTRUCTION INC 2910 S ARCHIBALD AVENUE A-350 ONTARIO, CA 91761 Fee Description gty Amount($) Power Apparatus 1 150.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Electrical 1 7.50 $185.50 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 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_Templale.rpl 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 contractors)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//^I Z License No. -i��OZ �L� By my signature below I acknowledge that,except for my personal residence ExpiresMA l j� Signature _� In which I must have resided for at least one year prior to completion of Improvements covered bythis 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 ,,v,,v,,v,leeinfo.ca.eov/calaw.html. this permit is issued. Policy ff Date ❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT 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 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 Carrier /'� 70/ Cd—.-07with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy fr ��7 9 S t{O Expires Z. 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 o I certify that in the performance of the work for which this permit is issued, I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE q 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 forthwi .co�pl ith se pr isions. Will the applicant or future building occupant handle hazardous material or a Applicant / // Date 22 mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO E ORKER'S COMPENSATION COVERAGE IS ❑Yes No UNLAWFUL,AND SHALL SUEU AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN WIII the intended use of the building by the applicant or future building ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South IN SECTION 37136 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist for guidelines CONSTRUCTION LENDING AGENCY ❑Yes i.. PINO I hereby affirm that under the penalty of perjury there is a construction WIII 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 AzNo 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 Contractors License Law for the reason(s)Indicated below by the California Health&Safety Code,Se ion 25505 and 25534 concerning hazardol�s material repo g.j checkmark(s)I have placed next to the applicable items)(Section 7031.5 ,.L'-1..,1 AA /) Business and Professions Code).Any city or county that requires a permit to oyes o % ? Date construct,alter,improve,demolish or repair any structure,prior to its i issuance,also requires the applicant forthe permit to file a signed statement PROPERTY OCN R OR//AAL�ffT DRIZED AGENT that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION.BEPAIRAND PAINTING(FIRM 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 apre-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($500). managers who do the paint-disturbing work themselves or through their ❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project propertywho,through employees'or personal effort,builds or Improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or Improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required forthis project because: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. DATE Z / PERMIT/PLAN CHECK NUMBER f milu., TYPE: COMMERCIAL CU RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION @ ALTERATION O DEMOLITION 0 ELECTRICAL C MECHANICAL O NEW O PLUMBING ORE-ROOF APPLICATION NAME DESCRIPTION OF WORK PROIECTADDREss ' Q ASSESSOR'S PARCEL NUMBER ,'3{ola LOT TRACT OWNER NAME ADDRESS PHONE gQ�/ {dam/" S'Q CJZj EMAIL APPLICANT NAME ADDRESS PHONE 7� �Sd� ( JL> EMAIL CONTRACTOR'S NAME g Lt"' NER BUILDER? O YES O NO BUSINESS NAME ADDRESS PHONE ��� S��S C�. EMAIL CONTRACTOR'S STATE LIC NUMBER �n �� � L/ LICENSE CLASSIFICATION VALUATION$ n SQ FT L SO FT APPLICANT'S SIGNATURE / - _ - _ DATE 2 _ ..CITY STAFtUSE.ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE SMIP GREEN INVOICE pglD AMOUNT AMOUNT OCASH v'CHECKN 0CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH CCHECKt1 C)CREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO LICENSE NUMBER NOTARIZED LETTER O YES O NO it",at n,enlfee Building g .Safety 1)cpuio;)ent_9714 Houn Rd. Menifee, CA 92586 951-672-5777 wI,vw.cityoimelliree-us Inspection Request Une 951-246-6213 office Copy qV CONDITIONS OF APPROVAL NAME: RITE-AID PLAN CHECK No: PMT15-02844 ADDRESS: 28995 NEWPORT RD DESCRIPTION: NCOM DATE: 7/21/16 1. Generator Permit for"moisture controP, hours of operation shall be per City Ordinance: Q§ 8.01.010 HOURS OF CONSTRUCTION. Any construction within the city located within one-fourth mile from an occupied residence shall be permitted Monday through Saturday, except nationally recognized holidays, 6:30 a.m.to 7:00 p.m. There shall be no construction permitted on Sunday or nationally recognized holidays unless approval is obtained from the City Building Official or City Engineer. (Ord. 2010-83,passed 11-16-2010) 2. Operation of generator shall not exceed 14 days from the date of Permit. CITY OF MENIFEE BUILDING AND SAFETY DEPARTMENT PLAN APPROVAL Craig Carlson REVIEWED B 42g Senior Inspector DATE City of Menifee 951-723-7359 'Approval of these plans shall not be construed to be a permit for,or an approval of,any violation of any provisions of the federal,state or city regulations and ordinances. This set of approved plans must be kept on the jobsite until completion. Air Resources Board v ¢ F Mary D. Nichols, Chairman 1001 1 Street•P.O.Box 2815 Edmund G.Brown Jr. Matthew Rodriquez Sacramento,California 95812•www.arb.ca.gov Governor Secretary for Environmental Pr000fice Rpyortable State Equipment Registration CITY OF MENIFEE BUILDING AND SAFETY DEPARTMENT PLAN APPROVAL Registration No: 144406 RE\i%MV6yr Ope to Sunstate Equipment Co.,LLC DATE Mailing Address: °- ` ' 5 E.Washington Street 'Approval of these plans shall not be construed to be a�e�l�ii JVr,1Nn85034 approvgno anydioscnpiiofrany provisions of the federal,state or city regulations and ordinances. This set of approved plans must be kept on the jo1bsiteCalilmetplp6Mble internal combustion engine,compression ignition,isuzu, model Bl-41RKIX,Serial No:435564,(Unit Number:90500),rated at 173 bhp and diesel fueled. U.S.EPA Engine Family Name: 8=L05.21XB Conditions: see attached South Coast Air Quality Management Home District: District r�enrction Discount: No inspection discount claimed AU *- � OU( cESOO Expiration Date:4uly 31,2017 ghaay>Itf� 144406 07/31/17 MichaelJ.Tollstrup Chief,Project Assessment Branch Stationary Source Division 144406 07/31/17 The energy challenge lacing calllomia is rear, teary caliromian creeds to take immodieto action to reduce energy consumption. For a list of simple ways you can reduce demand and cut your energy costs,see our wehsite:hllo'awww arh ca.aov. California Environmental Protection Agency Printed on Recycled Paper Statewide Portable Equipment Registration The following operating conditions apply for registration#144406 Engine Serial# : 435564 General Requirements 1. The engine shall be properly maintained and kept in good operating condition at all times. 2. The registration identification sticker shall be affixed in a visible location on the registered portable engine at all times.The metal placard shall be securely affixed on a vertical surface of the portable engine in a location that is readily visible from a distance.A legible copy of the registration certificate and operating conditions shall be kept on site with the portable engine and shall be made accessible to the Air Resources Board or district representative upon request. 3. Engine fuel shall meet standards for California motor vehicle fuels as set forth in Chapter 5, Division 3,Title 13,of the California Code of Regulations,or shall have been verified through the In-Use Strategies to Control Emissions From Diesel Engines verification procedure per Title 13 of the California Code of Regulations commencing with section 2700. 4. The engine and any replacement engine shall not reside at the same location for more than 12 consecutive months. 5. The operation of this engine shall not cause a public nuisance. 6. The engine shall be equipped with operational and properly maintained non-resettable hour time meter. 7. For each rental engine or an engine used in a third party rental transaction,the owner shall provide each person who rents the portable engine with a copy of the registration certificate, including operating conditions,as part of the rental agreement. 8. The operator of a portable engine or equipment unit shall obtain district authorization prior to operation at any specific location where the Statewide registration is not valid. 9. This registration is not valid for operation of generators used to provide power into the grid,except during an emergency event or other unforeseen event that affects grid stability. 10. This registration is not valid for operation of generators used to provide primary or supplemental power to a building, facility,stationary source,or stationary equipment except during the following scenarios:unforeseen interruptions of power from the serving utility; maintenance and repair operations;and electrical upgrade operations that do not exceed 60 calendar days. 11. This registration is not valid for operation within the boundaries of the California Outer Continental Shelf and State Territorial Waters. 12. The portable engine shall not be operated under both statewide registration and a district permit at any specific location. 13. This registration is not valid for operation of an engine that powers an equipment unit that has been determined by the Air Resources Board to qualify as part of a stationary source permitted by a district. 1 of The following operating conditions apply for registration# 144406 Engine Serial # :435564 22. When this engine is sold,the new owner shall submit a change of ownership application within 30 days of the change in ownership. If an application is not received within 30 days of the ownership change,the existing registration is not valid for the new owner until the application has been filed and all applicable fees have been paid. 23. The owner of a registered portable engine shall notify the Executive Officer in writing within five days of replacing the registered portable engine with an identical replacement. The notification shall include company name,the responsible official,phone number, registration number, make,model, rated brake horsepower, and serial number of the identical replacement,description of the mechanical breakdown,and applicable fees. Fleet Average Requirements 24. Except for low-use engines and engines used exclusively in emergency applications, for engines less than 175 bhp,a weighted fleet average PM emission factor of 0.3 g/bhp-hr shall be met by January 1,2013,0.18 g/bhp-hr shall be met by January 1,2017, and 0.04 g/bhp-hr shall be met by January 1,2020. Changes in the fleet, including engine additions and deletions,shall not result in noncompliance with this standard. 25. The weighted fleet average PM emission factor shall be calculated by taking the summation of the emission factor for each engine in the fleet multiplied by the bhp rating for each engine and then dividing that summation by the summation of the bhp ratings for all the engines in the fleet. 26. The weighted fleet average PM emission factor calculation shall use the test results from nonroad emission standard certification,test results from a verified emission control strategy as defined in Title 13 of the Califomia Code of Regulations Section 93116.2,or the test results from a SCR system. All test results shall be made available to the Air Resources Board upon request. 27. Where equipment uses grid power for more than 200 hours in lieu of operating a portable diesel engine for a given project,the time period grid power is used may be used to reduce each affected engine's emission factor.The emission factor for each affected portable engine shall be reduced proportionally by the percentage of time the equipment uses grid power. 28. The weighted fleet average PM emission factor shall include all portable engines, including those permitted or registered with a local air district,that are owned and managed by an individual operational entity, such as a business, business unit within a corporation,or individual city or state department under the control of a Responsible Official. Engines that are owned by different business entities that are under the common control of only one Responsible Official shall be treated as a single fleet. 3of5 The following operating conditions apply for registration # 144406 Engine Serial# : 435564 14. Except for engines owned by a rental business,the owner/operator of this engine shall contact the local air district prior to operation at an agricultural source. 15. For each rental engine or an engine used in a third party rental transaction,a written copy of the rental agreement or a completed Form 10 must be kept onsite at all times. Emission Limitations 16. No air contaminant shall be discharged into the atmosphere for a period or periods aggregating more than 3 minutes in any one hour which is as dark or darker than Ringelmann I or equivalent to 20%opacity. Recordkeeping 17. For a rental engine or an engine that is part of a third party rental transaction,the rental business shall provide a written log for recordkeeping purposes which is to be kept with the rental engine at all times.The rental business shall keep records of the registration number of the engine;date of the start and end of the rental transaction; and written(signed)acknowledgment by each renter of having received the registration certificate and operating conditions. The written log shall be maintained on an annual basis and previous annual logs shall be maintained at a central location for a minimum of five years,and made accessible to the Air Resources Board or districts upon request. 18. While the engine is out on rent,the rental customer shall record no less than once a month the specific location of the engine(i.e. street address and city; or county and UTM coordinates;or other location indicator) in the written log provided by the owner. 19. For non-rental engines, the operator shall record the registration number and specific location of the engine (i.e. street address and city; or county and UTM coordinates:or other location indicator)no less than once a month. 20. All records shall be maintained at a central place of business for a minimum of five years,and made accessible to the Air Resources Board or district representative upon request. Reporting& Notification 21. Within 5 days of a rental transaction exceeding 9 months in duration,a rental business or the owner of a registered engine involved in a third party rental shall submit written notification of the rental transaction to the district in which the rental business is located.The notification shall include the engine registration number,the rental customer telephone number and mailing address,and estimated location of the registered engine. 2of5 The following operating conditions apply for registration # 144406 Engine Serial# : 435564 35. The Responsible Official of a fleet electing to use electrification in determining the fleet average shall notify prior to the start of the project the Executive Officer of the dates, location of the project, and make, model, serial number,district permit or State registration number of the affected engines. In addition, the notification shall clearly identify the electrification activity, including indicating the amount of electricity used and the time period for the project. Inspection Requirements 36. Within 45 days after initial issuance or renewal of a registration,the owner or operator shall contact the home district to arrange for inspection to be completed within one year of the initial registration or renewal date. If the engine is operating in a district other than the home district,the owner or operator may request the home district to arrange an inspection by that other district. 37. For the purposes of scheduling inspections of multiple engines in order to qualify for an inspection fee discount, the owner or operator shall submit,within 45 days of initial registration issuance date or by January 30 of each year for renewals,a letter of intent to the home district that shall include an engine list with registration numbers of those to be inspected. 38. The time for the arranged inspection shall be agreed upon in advance between the district and the company. To the extent that an arranged inspection does not fall within the district's normal workday,the district may charge for the off-hour time. 39. If an arranged inspection does not occur due to unforeseen circumstances,the inspection shall be rescheduled for no later than 90 days from the initially scheduled inspection. 40. If the engine is out of California for one year or more following initial registration or renewal, the engine shall be excused from having the arranged inspection provided that within 45 days after the date of initial registration or renewal,the owner sends a letter to the district containing the registration number and a statement that the registered engine or equipment unit is out of California for the one-year period. Upon the return of the engine to California,the owner shall arrange to have the engine inspected within 30 days. 5 of 5 The following operating conditions apply for registration # 144406 Engine Serial # : 435564 29. If certified non-diesel fueled engines are part of your fleet and have been operating 100 or more hours, they may be included toward determining compliance with the applicable fleet emission standards. A diesel PM emission rate of zero shall be used in the fleet calculations for these engines. If the engine was added to the fleet prior to January 1,2009 , it may be counted twice in the company's fleet average determination toward compliance with the 2013 and 2017 fleet emission standards. 30. Portable diesel-fueled engines certified to Tier 4 nonroad engine standards that are added to a fleet prior to January 1, 2015, may be counted twice in the company's fleet average determination toward compliance with the 2013 and 2017 fleet emission standards. Fleet Recordkeeping 3I. Starting January 1,2012, the responsible official of a fleet shall keep records of annual operating hours for non-diesel fueled portable engines used as part of a company's fleet average, engines affected by the use of electrification, low-use engines,and engines used exclusively in emergency applications. 32. All records pertaining to the fleet average shall be maintained at a central place of business for a minimum of five years,and made accessible to the Air Resources Board or district representative upon request. Fleet Reporting and Notification 33. The Responsible Official of a fleet shall submit to the Air Resources Board by March 1,2013, March 1, 2017, and March 1, 2020 a signed statement of compliance that the fleet standards are being achieved.The Statement of compliance shall include for each engine in the fleet: make, model,serial number, fuel type, PM emission factor(g/bhp-hr),and district permit or State registration number. If compliance with the fleet average includes the use of electrification, the Responsible Official shall provide documentation supporting the credit claimed for electrification. 34. As part of each statement of compliance,the Responsible Official shall, if applicable,certify that all alternative-fueled engines included in the fleet average operated at least 100 hours during the previous 12 months prior to the fleet emission standard becoming effective, for all engines exclusively used in emergency applications, the engines were used only for emergency applications, for all engines using the low-use designation, the engines operated no more than 80 hours for the reporting period,and for all portable diesel-fueled engines equipped with SCR, the engine complies with applicable district or Statewide Portable Equipment Registration Program requirements. 4of5 STATE OF CALIFORNIA ED/CREB/PERS-176(REV 09/15) California Environmental Protection Agency AIR RESOURCES BOARD Statewide Portable Equipment Registration Program FORM 22 - Portable Certified Engine—Monthly Recordkeeping Form (Auto-fill format. Use"Tab"or up/down arrows to enter information. Additional form information is provided on the reverse side.) PERP Registration Forms are available at http7//Nvww.arb.ca.gov/l)ortable/`portable.htm. See the Portable Equipment Registration Program Regulation section 2458 for recoralkeeping requirements. 1. Company Name: Sunstate Equipment Co.,LLC 2. PERP Registration Number: 144406/EQ#90500 3. Location 4. Date ! C ^ Page 1 of 2(reverse side)