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PMT17-02550 City of Menifee Permit No.: PMT17-02550 29714 HAUN RD. Type: Commercial Electrical < -�CCELA? MENIFEE,CA 92586 MENIFEE Date Issued: 0712112017 PERMIT Site Address: 26875 NEWPORT RD,MENIFEE, CA Parcel Number: 360-030-024 92584 Construction Cost: $500.00 Existing Use: Proposed Use: Description of INSTALL A 20A 120 VOLT DEDICATED CIRCUIT FROM PANEL TO KIOSK Work: Owner Contractor MCDONALDS AMBIENT ELECTRIC INC 26875 NEWPORT RD 2363 TELLER RD STE 112 MENIFEE, CA 92584 NEWBURY PARK,CA 91320 Applicant Phone:8183097927 AMBIENT ELECTRIC INC License Number:995928 2363 TELLER RD STE 112 NEWBURY PARK,CA 91320 Phone:8183097927 Fee Description 9ht Amount 151 Services,Switchboards, Control Centers&Panels 1 183.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Electrical 1 9.15 $220.15 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 olhervvise 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 D�IQN property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 70D0)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. p the following reason: License Class ( 10 License Jo. I Z� By my signature below I acknowledge that,except for my personal residence Expires -3( 0 Signature r 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 DECLARA ION have built as an owner-builder if it has not been constructed in its entirety by o 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 ip 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.ler;info.a.¢ov/calaw.html. this permit is issued. Date Policy fl A919— PROPERTY OWNER OR AUTHORIZED AGENT V<have and will maintain worker's compensation insurance,as required by section 3700 ofthe 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 owners behalf.I have read this number are: application and the Information I have provided is correct.I agree to comply �It with all applicable city and county ordinances and state laws relating to Carrier 0(' f1g2Q In/$U 20.rL C2 building construction.I authorize representatives of this city or county to polity q_I Z v2.C2U I q 1 Expires �1 'I 1 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 eflcertlfy that in the performance of the work for which this permit is issued, shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE p workers compensation laws of California,and agree that If I should become HAZARDOUS MATERIAL DECLARATION subject to the w rke s c npensation provisions of Section 3700 of the Labor Code,1 shall fo h Eh wid"hose provisions. —1 . Wi0 he applicant orfuture building occupant handle hazardous material or a Applicant Date — 2 'I 1 mixture containing a hazardous material equal to or greater that the amounts spe ed on the Hazardous Materials Information Guide. WARNING: (LURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes UNLAWFU AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL INES 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)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelin CONSTRUCTION LENDING AGENCY ❑Yes No j I hereby affirm that under the penalty of perjury there is a construction Will the prop ed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer bou ary of a school? (Section 3097 Civil Code) o Yes No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAO,MD I hereby affirm under penalty of perjurythat I am exempt from the permitting checklist.I understand my requirements under the State of California Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)indicated below by the ha rdous material repo ring. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es o No I 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 O R O A ORIZED 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 RENOVA71 N REPAIR AND PAINTING RRP 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 0 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 1-800-424-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 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 yearof 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. SAFETY . • APPLICATION Memee DATE _ '2 1 PERMIT/PLAN CHECK NUMBER1,;M711-0125S-0 TYPE: COMMERCIAL ❑RESIDENTIAL MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ELECTRICAL ❑MECHANICAL [-]NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK - r ,✓ ,,,1 sL 'ZO C � RI c u;4- PROJECTADDRESS 2(0 21 s e µ) o -t' �^� ¢n I Fe 2 � " Z d7� ASSESSOR'S PARCEL NUMBER O ' O '024 LOT TRACT PROPERTY OWNER'S NAME OLv,l�i ADDRESS �I. 1 Ai, w 1'C-- i 1 Fee CA 17- PHONk %(j(15-)\/ ]a6 %o EMAIL APPLICANTNAME ADDRESS b kilt( 'L UEf CA- I �0 PHONE (gOS-) �Z-041 Zr EMAIL '-e jfl)' C_ •V C U P I CONTRACTOR'S NAME C, E OWNER BUILDER? ❑YES❑NO BUSINESS NAME4/4"e /LF13ndfIl C. ADDRESS rr W 0b0rr c -A c, J 3 -2-0 PHONE( bP5) �,�O�L ^ O�1Lf- G EMAIL C � ,' CONTRACTOR'S STATE LIC NUMBER C(9 5' /7- LICENSE CLASSIFICATION C'� VALUATION$ 00 SO,FT L SQ FT -1 APPLICANT'S SIGNATURE DATE 7"2 I L DEPARTMENT DISTRIBUTION C� CITYOFME IFEEBUoSI NESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I' SMIP b �/ INVOICE 220 PAIDAMOUNT AMOUNT OCASH OCHECK JI OCREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 925860QS1-6��6777 �I�ryY o enlfee www.cityofinenifee.us Inspection Request Line 951-245-6218uilding & Safety Dept. JUL 2 9 2017 Received AMBIENT ELECTRIC INC To Whom It May Concern: I Elisha Dan Elder as president of Ambient Electric,Inc.do hereby give my permission for John Ballestero to obtain business licenses and electrical permits on behalf of Ambient Electric Inc. P Elisha D. Elder President Ambient Electric,Inc. t 1 Date �tOO O41. City Q1` fee Bull tty�ti@pt. N�0�vl��` e� ,v J Reed 2363 TELLER RD, PHONE 818-309-7927 R-nBIEnT UNIT112 FAX 805-262-0425 ELECTRIC NEWBURY PARK EMAIL ambientelectricinc@gmail.com CA 91320 WEBSI `E ambientelectric.net LICENSE#995928 SECTION 2 - FLOOR PREPARATION MEW" Y LW FOR ALL KIOSK INSTALLATIONS OPTION 1: Use the base plate mounting template as a template to align the placement of the anchor bolts with either the rotating or non-rotating slots. OPTION 2: Using an erasable marker, draw an outline of the rotating slots from the base stand cover onto the floor. *Please Note: Review electrical section (See Pages 23-29) before proceeding. CL Rotating Slots: For installations where the angle of the kiosk may need to be adjusted over time, the O rotating slots should be used. U Non-Rotating Slots: For permanent installations where the angle of the kiosk will not need to be W adjusted over time, the non-rotating slots should be used. U Using a drill, make four to six holes (total) that correspond to the four to six separate sloLlocations. � The drilled holes need to conform viith the concrete anchor bolt specifications. ry Install anchor bolts,per anchor bolt specifications.(Separately Contained In Package Number 1-See Page 1) V/� Drill 3/8" anchor bolt holes C Holes should be at least 4"- 5" deep Use"Anchor Bolt Installation"tools as necessary :i , Cltlll-EE , ^ FOR POWER + DATA ROUTED Tig0RW*WA;,gTCW DEPARTMENT ,v\ MOUNTING STRUCTURE l N4YIAN APPROVAL 1. Use the base plate mounting template as a drilling template to aely locate tl tr point into the kiosk for power and data. PoweVandidataVIIII nded to enter t the V 2. The conduit stubs should not protrude above the finished floor more than 1.5". 1 xial of ttiv:,,plans Ad nol.oe construed to be a permit for,Oran r 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. 02016 ZIVELo"1 AU dghtsr rod Instaliatfon Guide I McDonald's EVOLUTION I Version 1.5.3 Page 9 ESECTION.2.-.FLOOR PREPARATION t1 tI tl ELU �l1ATl 6Jq A25 WTAK655 /'�._^ -••••.���. ftFRU:H.CCFiS .• � T\ 61 _ / �AnTw •` um Tsw i'f OF MENIFEE BUILDING AND SAFETY DEPARTMENT PLAN APPROVAL LJ rr11 1 1V /DATE 'Approval of these plans shall not be construed to be a permit for,&an approval of,any violation of any provisions of the federal,state or dty regulations and"ordioances. This set of approved plans'mustlie kept on the jobsite until completion. 020162JVEL0'I All nghweservad Installation Guide I McDonald's EVOUITION I Version 1.5.3 Page 10