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PMT16-02775 City of Menifee Permit No.: PMT1 6-02775 29714 HAUN RD. Type: Commercial Electrical '5A-CCF-LA-> MENIFEE, CA92586 MENIFEE Date Issued: 1010312016 P E R M I T Site Address: 21740 MENIFEE RD,MENIFEE, CA 92584 Parcel Number: 372-090-006 Construction Cost: $15,000.00 Existing Use: Proposed Use: Description of INSTALLATION OF 1)NEW 2417 MICROWAVE DISH, 1)ODU BEHIND THE DISH&1) 1/2'LINE TO Work: EXISTING TOWER,T-MOBILE SITE IE25778A Owner Contractor LD ACQUISITION COMPANY 9 TOTAL TELCO SPECIALISTS INC 1700 E WALNUT AVE#400 602 W SOUTHERN AVENUE EL SEGUNDO,CA 90245 ORANGE, CA 92865 Applicant Phone:7144848266 . CA License Number: 720587 Phone:9493361550 Fee Description 0tv Amount Building Permit Issuance 1 27.00 Inspections not specified 129 129.07 Additional Plan Review Electrical 158 157.50 GREEN FEE 1 1.00 General Plan Maintenance Fee-Building 1 6A5 $321.02 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_I31dg_Permjt-TeMp1ate.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 I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapterg(commencing with section 7000)of Division 3 of the Business and a I am exempt from licensure under the Contractoes State License Law for Professions C d d my license i.s in full force and effect. the following reason: 0 eg —7 u e� 7 License Clan 4�2 29-7 By my signature below I acknowledge that,except for my personal residence Signature I A in which I must have resided for at least one year prior to completion of Expires 43�4& improvements covered by this permit.I cannot legally sell a structure that I -NSATION DECLARATIONV have built as an owner-builder if it has not been constructed in its entirety by a 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 worker's 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,forthe performance of work forwhich www.leginfo.ca.gov/caIaw.htmL this permit is issued. Policy# PROPERTY OWNER OR AUTHORIZED AGENT Date Yhave and will maintain worker's compensation insurance,as required by stction 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 workees 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 with all applicable city and county ordinances and state laws relating to Carrier 014 ge e, 6 ot"cd I[A r, building construction.I authorize representatives of this city or county to Policy# .A 10-007 7-7 i'�L)S Expires 1-7 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 employ a ny persons in a ny man ner so as to become subject to the CITY BUSINESS LICENSE# worker's 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 rth Hh ly th ose provisions. Will the applicant or future building occupant handle hazardous material or a mixture containing a hazardous material equal to argreaterthatthe Applicant Date amounts specified on the Hazardous Materials Information Guide? WARNING:�AILUREOIO SECURE W4KER`S COMPENSATION COVE GEIS Dyes 1�60 UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL FINES UP TOONE 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)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY o Yes y"'. I hereby affirm that under the pena Ity 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) o Yes V. OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contraictor's License Law for the reason(s)indicated below by the h rdaus material repopmIg checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ZYes n No Business and Professions Code).Any city or county that requires a permit to SMI Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OW ENT 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 Contractor's 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 ficensure receiving compensation for most work that disturbs paint in a pre-1978 a nd the basis for the a Ileged exemption.Any Violation of Section 7031.5 by residence or childca re facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil pena Ity of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves orthrough their o 1,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 Contractor's State License Law does not apply to an owner of a ci An EPA Lead-Safe Certified Renovator will he 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: ci 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractoes 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 & SAFETY PERMIT/PLAN CHECK APPLICATION UtIw1mg &. Safety Dept. 'fee AUG 2 4 2016 DATE Riarpived PERMIT/PLAN CHECK NUMBER Owq1to- CQ-7-75 TYPE: E]COMMERCIAL FIRESIDENTIAL [71MULTI-FAMILY []MOBILEHOME [7]POOL/SPAEIS,GN SUBTYPE: E]ADDITION []ALTERATION [—]DEMOLITION []ELECTRICAL [:]MECHANICAL ONEW []PLUMBING [_]RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK T-mobile(1)new 24"Microwave Dish, (1)ODU behind the dish,and(1) 1/2"line tolhe existing tower. (T-Mobile site number IE25778A) PROJECTADDRESS 21740 Menifee Road., Menifee, CA92584 ASSESSOR'S PARCEL NUMBER 372-090-006 LOT TRACT PROPERTY OWNER'S NAME Bell Mountain Communications(Landmark Dividend LLC) ADDRESS 2141 Rosecrans Avenue I Suite 2100, El Segundo, CA90245 PHONE (310)361-5716 EMAIL ebachoC&Iandmarkdividend.com APPLICANTNAME Luzine Rawls(Coastal Business Group, Inc.) ADDRESS 24310 Moulton Pkwy, SufteO#1009 Laguna Hills, CA 92637-3306 PHONE 949.336.1550 EMAIL Irawls@coastalbusinessgroup.net CONTRACTOR'S NAME N/A OWNERBUILDER_ [:]YES[:]NO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ 15,000 SO FT L SO FT APPLICANT'S SIGNATURE DATE CITYSTAFFUSEONLY DEPARTMENT DISTRIBUTION 6`0 CITY OF MENIFEE BUsINE55 ULENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICIE AMOU T PAIDAMOUNT 0 CASH 0 CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# OCREDITCARD VISA/MC_ OWNER BUILDER VERIFIED OYES -0 NO DLNUMBER NOTARIZEDLE17ER 0 YES 0 NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-572-5777 www.citVofmenifee.us Inspection Request Line 951-246-6213 NENIGY6 FROM ZERO TO INFINIGY the solutions are endless 1033 WATERVLIEr SHAKER RD,ALBANY,NY 12205 August 3,2016 City of Menifee Luzine Rawls Building & Saiety Dept. Coastal Business Group,Inc. AUG 2 4 2016 243 10 Moulton Parkway Suite 0#1009 Laguna Hills, CA 9263 7-3306 Received RE: T-Mobile Project Mount Evaluation T-Mobile Site Number: IE25778A T-Mobile Site Name: MENIFEE Site Address: 21740 Menifee Road,Menifee, CA 92584 Building Code: 2012 IBC/2013 California Building Code Design Standard: ANSI/TIA-222-G Result: Pass Notes: 64.5% Dear Mr.Rawls: At your request Infinigy Engineering, PLLC has reviewed the existing and/or proposed tower mounted equipment supports at the above referenced site for adequacy to support the existing and proposed loads for the referenced project. This evaluation is based on a review of the information from the Structural Analysis Report (dated 05/20/15) provided by All States Engineering & Surveying and Construction Drawings(dated 07113/16)provided by Infinigy Engineering,PLLC. This evaluation assumes that all structural members and connections are in good condition,have not been altered from the manufacturees original design, and have been installed per the manufacturer's 40 requirements.Prior to installation of any new appurtenances, the contractor shall inspect the condition of all relevant members and connections and shall tighten all connections. The contractor is responsible for the means and methods of construction and shall notify Infinigy Engineerin& PLLC immediately if any field conditions differ from those listed above. Should there be any questions,please do not hesitate to contact us(518)690-0790. 9�,.Of ESS1011, JO. Sincerely, Joseph R.Johnston,P.E. 8 0 Department Manager—Structural 0 4 201 19 structural@infinigy.com C101 California P.E.License Number: 83098 6' OF C'1%0� ST/MG V?,OFESSIO HA NO. 62543 INFINIGY6 121,07 OF CAL0 �VOGPC �Wbo� Infinigy Engineering, PLLC I E25778A Mount MG IE25778A Aug 3, 2016 at 6:12 PM 474-000 IE25778kr3d jjs�-s PIS SHP, t2 Compmy Infinigy Engineering, PLLC Aug 3,2016 Designer MG 6:10PM INFINIGY8 Job Number 474-000 Checked By- Model Name IE25778A Member Primary Data Latel I J dint i Joint K Joint Rotale(cleo) Sectron/Shape Type Des ion List Material Deslan Rules 1 Mi N 1 N2 Main Horizontal Beam Pipe A53 Gr. B Typical M7 N3 N4 4x4 Beam Tube A500 Gr.46 Typical 3 M3 N15 Nil Mount Pipes Beam Pipe A53 Gr. B Typical 4 M4 N13 Ng Mount Pipes Beam Pipe A53 Gr. B Typical 5 M5 N14 NIO Mount Pipes Beam Pipe A53 Gr. B Typical 6 M6 N16 N12 Mount Pipes Beam Pipe A53 Gr. B Typical 7 MWA N18 N17 Main Horizontal Beam Pipe A53 Gr. B Typical Material Takeoff Material Size Pieces Lenothfirill Weiqh&Kl 1 Hot Rolled Steel 500 Gr-46 �tSS4"x2l 1 48 0 5 3 A 3 B PIPE 2.0 4 288 0 4 A53 Gr. B PIPE 3.0 2 168 0 5 Total HR Steel 7 504 .2 Basic Load Cases BLC Description Cateqory X Gravity Y Gravity Z Gravity Joint Point Distribut... rea(Me...Surface(... I Self Weight DL -1 9 2 Wind Load AZI 000 01-1 9 1 3 Wind Load AZI 090 01-2 9 1 4 SerVice Live 01-3 1 5 Service Live Eccentric Left OL4 1 6 Service Live Eccentric R! ht 01-5 1 7 BLC 2 Transient Area Loads None 6 8 BLC 3 Transient Area Loads None 6 Load C�mbinations Description Sol..PD..SR..BLC Fact...BLCFact...BLC Fact..BLC Fact...BLC Fact...BLC Fact..BLC Fact...BLC Fad...BLC Fact..13LC Fact... I I 1AD Yesl Y DL 1.4 2 1.213+1.6..Yesl y DL 1.2 OL1 1.6 3 1.2D+1.6..Yes y DL 1,2 OL2 1.6 4 1.2D+1.6... Yes y DL 1.2 01-1 -1.6 5 1.2D+1.6... Yes y DL 1.2 OL2 -1.6 6 1.213+1.0-Yes y DL 1.2 OL1 .17601-3 1.6 7 1.2D+1.0..Yes y DL 1.2 OL2 .176 DO 1.6 8 1.2D+1A.Yes y DL 1.2 OL1 -.176 01-3 1.6 9 1.2D+1A.Yes y DL 1.2 OL2-.176 OL31 1,6 10 1.2D+1A.Yes y DL 1.2 01-1 .17601-41 1.6 11 1.213+1.0..Yes y IDL 1.2 OL2 .176 OL41 1.6 12 1.2D+1A.Yes y DL 1.2 01-1 -.176 OA 1.6 13 1.2D+1.0..Yes y DL 1.2 OL2-.176 OL4 1.61 U2D Yes Y DL 1.2 01-1 .176 01-5 1*6 2D+10 Yes y DL 1.2 OL2 .176 01-5 1.6 1.2D 1.0 Yes y EIL 1.2 01-1 -.176 01-5 1.6 I 2D 1 Yes y DL 1.2 OL2-.176 01-5 1.6 RISA-31D Version 14.0.1 IKA...\...\T-Mobile MW\IE25778A\Sbuctural Calculations\IE25778A.r3d] Page 1 CompwY Infinigy Enloneering, PLLC Aug 3,2016 Designer MG &.1013M INFINIGY8 Job Number 474-000 Checked By_ Model Name IE25778A Envelope Joint Reactions Joint X 1161 LC Y PbI LC Z[Ibl LC MX[k-ftl LC MY[k-ft] LC KE Ilk- LC i N4 max 1 11174..631 280:4M 112 1114�2 4GI 1 2 1 -1:975 2 5922 2.052 11 6331 5 5R 835 2 _ 461 4 916 min 574 .408 12 5 Totals: max 11574.6331 3 1 980.835 1 12 11462.4081 2 1 #4 min 1-1574.6331 5 1 580.835 1 2 1-1462.4081 4 1 Envelope AISC 14th(360-10):LRFD Steel Code Checks Member Shape Code C...Locrinl LC Shear... Loclinl Dir LC phrPnc nblt)hi*Pnt rlbI DhrMn Y-.. phi*Mn z-.. Clb Eqn 1 M7 HSS4x4x3 .645 48 3 .276 48 v 1111100151.1..- 106812 12.662 1 12.662 11--.11-11-1 b 2 M1 PIPE 3.0 .628 72 12 .106 72 4 130165.191 65205 5.749 5.749 1... H1-1b 3 M5 PIPE 2.0 .283 36 4 .020 36 !&ON!...7 32130 1.872 1.872 1... H1-1b 4 M3 PIPE 2.0 .238 36 4 MO 36 ;� 32130 1.872 1.872 1... H1-1b 5 M6 PIPE 2.0 .221 36 4 .018 5 20866.733 32130 1.872 1.872 1... 1-11-1b 6 M4 PIPE 2.0 .176 36 4 .023 §6 4 20866.733 32130 1.872 1.872 1...... H - 7 WA I PIPE 3.0 .004 12 3 .002 12 3 53823.6441 65205 5.749 5.749 1... H1-1h RISA-31D Version 14.0.1 [K:\...\...\T-Mobile MW\IE25778A\Structural Calculations\]E25778A.r3d] Page 2