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PMT17-02883 City of Menifee Permit No.: PMT17-02883 29714 HAUN RD. 4gMDl L/� MENIFEE,CA 92586 Type: Sign-Permanent MENIFEE Date Issued: 08/15/2017 PERMIT Site Address: 29787 ANTELOPE RD, MENIFEE., CA Parcel Number: 340-020-065 92584 Construction Cost: $1,500.00 Existing Use: Proposed Use: Description of INSTALL 2ILLUMINATED CHANNEL LETTER SIGNS"FOOD MART—CAR WASH" Work: Owner Contractor MENIFEE LAKES PLAZA, LLC THE SIGNS AND SERVICES COMPANY 3636 BIRCH STREET,#200 10980 BOATMAN AVENUE NEWPORT BEACH, CA 92660 STANTON, CA 90680 Applicant Phone: 7147618200 RYAN YBARRA License Number:624675 THE SIGNS AND SERVICES COMPANY 10980 BOATMAN AVENUE STANTON, CA 90680 Fee Description QtV Amount(EI Sign Permit 2 190.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Building 1 9.50 $227.50 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 Menitee.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_Bldg_Perrnit_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 I 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 ❑I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. �i r rJt+ the following reason: License Class C 9 b S License No. Z 7 1� J -1 By my signature below I acknowledge that,except for my personal residence Expires �� 31 - 19 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 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 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,for the performance of work for which this permit is Issued. www.leginfo-ca.gov/calaw.html. Policy Jf Date have 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 ❑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 Carrier evfLh LIT 0) with all applicable city and county ordinances and state laws relating to (� building construction.I authorize representatives of this city or county to Policy#ZtrWt-J-L1 03U0 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 ❑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 p worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. qq Will the applicant or future building occupant handle hazardous material or a Applicant N Date Ll�� f�(�— mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide. WARNING: AILURE fOo SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes elpIft 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 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 for guidelines CONSTRUCTION LENDING AGENCY ❑Yes Wo I hereby affirm that underthe 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 gmo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD 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 al Safety Code,Section 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ` t�L� Business and Professions Code).Any city or county that requires a permit to � ��� Date U-1 S"'T construct,alter,improve,demolish or repair any structure,prior to its plI[0PfRTY^NER 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(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 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 sale 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 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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL 1) RESIDENTIAL 0 MULTI-FAMILY t) MOBILE HOME " POOL/SPA JbSIGN SUBTYPE: O ADDITION C)ALTERATION O DEMOLITION ELECTRICAL O MECHANICAL 16 NEW O PLUMBING :1 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK. h fiw i t Z ll-t I %\V V, PROJECTADDRESS .yg tk 13/ I Cl M f^44 c LA Ict S Z Sb ASSESSOR'S PARCEL NUMBER :!'1�!•Q�- 1..1'J'J LOT TRACT Cit �Qx QS OWNER NAME 4 ADDRESS r0.C '�"'. Fit w. •n-Y y J PHONE C(-P To) -7 CV9 -2 4'M` 4 EMAIL / APPLICANT NAME F'-(uv\ T �J �f r/� Received ADDRESS (I O 443 v V us,(rr v% \ erne S Jry rwo, c t) D PHONE 9 I �� 26 7 6 EMAIL 1—YUnI^'%, sir-1l Yv".�j CONTRACTOR'S NAME n S sx- 'cA C v OWNER BUILDER? O YES :%NO BUSINESS NAME p t�,� W ADDRESS b T 0 A-4t`--✓1�1 �V C S�FLI�'" ()n O o PHONE W o f EMAIL CONTRACTOR'S STATE LIC NUMBER 2 y L 7,_ LICENSE CLASSIFICATION C J U VALUATION$ 1 1 () \,) SO FT L SO FT C, T APPLICANT'S SIGNATURE DATE O J qw DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP X INVOICEIaglenI PAID AMOUNT 0 AMOUNT � •� CASH OCHECK# 1)CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 1 0CASH OCHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES Q NO (i)i 01`Pd-'L E'P :iuiicv lC _-f.ciE 9 Ga(x•rin1eG( 5 e:ray.cii:yloi'nlenijee.us 1,'1Sji8CYi0n 2Goes,line 9_1 5-52113 STAT=OF CALIFORNIA SIGN LIGHTING CSC.NRI.C-LTS-0i-EIRevl5ed M16I CALIcORNIA ENERGY COMI:SSION CERTIFICATE OF COMPLIANCE NRCC-1-TS-01-E Sign Lighting (Page 1 of 5) rm>,n a.rc CHEVRON - MENIFEE LAKES PLAZA c'- "D 8114 rCd4yrdf Menifee �U'Iulnll cc balliaty Dept. A.General information Allelgrim Project Address: 29787 ANTELOPE RD. Location of Sian Outdoor Suns ❑Indoor Signs Phase of Sign Construction New Signs Sign Alterations Type of Li htin Contrc: New Lighting Controls Replaced Lighting Contorts Not Insta:;inn Lighting Controls This Certificate of Compliance includes the following components(check all that apply): ❑Mandatory treasure!(Lighting Controls) ❑M:iximum Allowed Lighting Pourer j Sp_cific Lighting Sourc.s 1. Mandatory Sign Lighting Controls NOTES; 1. The some responsible person may install both the sign liahting power and the sign lighting controls, or a different responsible person may install the sign lighting controls than the responsible person installing the sign fightino power. 2. The A4ondatory keeasures (sign lighting controls) are required for compliance with the sign lighting Standards, If the person responsible far 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 hove the sign lighting controls installed. 3. !f more than one person has responsibility for compliance, each responsible person shall prepare and sign a Certificate of Compliance and on Installation Certificate applicable to the portion of construction for;vhich 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 (e.g. a C-10 contractor may complete parts 1a and Ib an one compliance document and a C-45 contractor may complete parts 2a and 2b on a separate compliance document—the Responsible Designer shelf submit the two compliance documents together forMe some complete instalfation . I have responsibility for installing the sign lighting controls: ❑Yes,1 have responsibility fcr the sign lighting controls,and will ®No,I do not have responsibility for installing the sign lighting controls, complete parts la and lb of this compliance document Someone else will complete parts la and 1b of this com0mce document. Ia.Check Yes or No for al:of the following statements: 1 There are existing sign lighting controls that comply with the applicable provisions of§110.9 End §130.3 ❑Yes M No There are no existing sign lighting controls and I will be installing sign lighting controls that comply with the applicable 2 provisions of§1109 End §130.3 M Yes ❑ No There are existing sign lighting controls:hat do not comply with the applicable provisions of§110.9 and §130.3 and I will be 3 installing sign lighting controls that comply with the applicable Provisions of §110.9 and 9130.3 ❑Yes ® Ida CA Building Energy Efficiency Standards-2016 h7onresidentizl Compliance August 2016 STATE Cc CALIFORNIA SIGN LIGHTING CEC-NRCC-1-TS-01-EiRevLad 06116) CALWORNIA ENERGY COMMIS&ION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 2 of 5) N'.t CHEVRON - MENZFEE LAKES PLAZA 8/14/2017 Sb.Mandatary 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 li hting 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 isi n lighting control) note blocl<can be located: 1 §130.3(a)1.All indoor sign lighting is controlled with an automatic time-switch control or astronomical time- Y I N NA switch control. Q 0 0 §130.3(a)ZA. All outdoor sign lighting is controlled vAth a photocontrol in addition to an automatic time- Y 114 NA 2 switch control, or an astronomical time-switch control. • 10 0 EXCEPTION to Section 130.3(a)2A: Outdoor signs in tunnels, and signs in large permanently covered outdoor Y 14A areas that are intended to be continuously lit,24 hours per day and 365 days per year. O §130.3(a)23. 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 cower by a minimum of 65%during nighttime hours.Signs that Y N NA 3 are illuminated at night and for more than 1 hour during daylight hours shall be considered ON both day and d 0 night. EXCEPTION to Section 136.5(a)28:Outdoor signs in tunnels and large covered areas that are intended to be Y NA illuminated both day and night. j O • §130.3(a)3, demand Responsive Electronic t+4essage Center Control.An Electronic Wessage Center(EMC) A N N / having a new connected lighting paver load greater than 15 ItW has a control installed that is capable of Y Y N 4 reducing t�htingpower by.a minimum of 39%when receivinga demand response signal. EXCEP'nCh'to Section 130.3(a)3:Lighting for Eh9Cs that is not permitted by a health or life safety statute, 1' NA ordinance,or regulation to be reduced by 30%. O A Field Inspector Notes: CA Building Energy Efficiency Standards, 201.6:donresidential Compliance August 2016 BThTE OF CALtFORN.A SIGN LIGHTING 'CEC-NRGGLTS.C3-EtRevtt3tl 08+78} CALIFORNIA E`JERGY'COk4Mt3S13N �� CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 4 of 5) Pt9"9 r+v me CHEVRON-MENIFEE LAKES PLAZA Dace nrnsre:: 8114/2017 2b.Specific Lighting Source fliethod 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 ENERGY Specific light source used for Symbol VERIFIED compliance Field Inspector or Description label Shaft include only lighting Check that Sign Code technologies listed below Complies (see � instructions (List all that apply) belo:v) A WALL SIGN ® A, B, C, D7 g WALL SIGN A, B, C, D7 ❑ L-7 A Symbol or code used cn the plans(when plans are required)and other documents. B ( A narrative description of the sign,or location of sign on the buildin ;and the location of sign on construction documents OPTIONAL-Check this box only if this sign has a permanent,pre-printed,factory-insis'led E�:ERGY VERIFIED label,confirming that this sign complies with the Section 140.8 of the California 2016 Title 24,Part 6 Standards,using the Spucific Lighting Sou-ca Method of Compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marrs authorized by Underrrtere Laboratories C (ULI.or other Product Certification Body accredited to ISO/IEC Guide 65 by the American flational Standards Institute in accordance with I54JIEC 17011.Surveillance by the Accredited Certification Body shall b>_ an ongoing annual inspection program carried out by e Type A Inspection body in accordance with 150FIEC 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 net aLu&c!for compliance. Specific Light Source Compliance Method. The signs)identified above use only the following lighting technologies: List all applicable numbers ll through 4)that apply in column D above for each role. 1 High prrssurr sodium lamps Metal halide lamps that are pulse start or ceramic served by a ballast that has a minimum efficiency of 68%or greater. 2 Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage when tested according to ANSI C32.6-205. Wietal halide lamps that are pulse start that are 320 watts or smaller, are not 250 watt or 175 watt lamps,and are 3 served by a ballast that has a-minimum efficiency of BD%. 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. ""eon or mid cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 7556 when D 4 the transformer cr power supply rated output current is less thin 50 mA.The ratio of the output attage to the input wattage is at 10D%tutong load. Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 65%when 5 the transformer or power supply rated output current is 50 mA cr greater.The ratio of the outp;Jt::=attage to the input wattage is at =%tubing load. 6 Fluorescent lighting systems meeting one of the following requirements:A.)Use only lamps v:ith a minimum color rendering index (CRiI of SD:or B.)Use only elect,onic ballasts with a fundamental output frequerc•rot less than 20 kHz. 7 Light emitting diodes(LEDs) ,with a power supply having an efficiency of S0%or greater. Sirgle voltage external power supplies that are designed to convert 120 volt AC Input into lower vc!Yage DC or AC output,and have a 8 nameplate output power fess 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; rew base sockets(E24JE26) E This Page doubles as a NOd inspection checklist. Field Inspector Notes: CA Building Energy Efficiency Standards-20I5 Nonresidential Compliance August 201E STATE OF CALIFORNA SIGN LIGHTING `rA GEC-uRCO-LTS-Gt EiRevis6tl P5t6f CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-L TS-D1-E Sign Lighting (Rage 3 of Sj CHEVRON - MENIFEE LAKES PLAZA "iPi"'P' 8/14/2017 2. MandatM Sian Ui;hting Measures 1 have responsibility for installing the sign lighting ®Yes,I have responsibility,for the sign fighting,and will complete (71 No,I do not have responsibility for install ag the sign hi;htirg.Someone parts 2a and 2b of this comp'iance document else will complete pads 2a and 2b of this compliance document. 2n. 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 2b of this Certificate of Compliance if there are signs using the Specific Li lighting ht Sources method of compliance). A B C D E F G H I 1 OPTIONAL- Symbol or Energy Verified Field Coda Description of the Sign Label(see A.iotted WattsDaslgn Complies InspectorWatts yjN Check that Instructions below) Sign Complies o V, Q w X _ O a c V ( e 3 ./ I U ✓ A WALL SIGN 0 31.23 I 12 409.99 120 Y ❑ g WALL SIGN 0 12.01 I 12 144,12 120 V ❑ ci 0 D ❑ � D D ❑ o I ❑ ❑ 0 ❑ ❑ D ❑ ❑ D ❑ ❑ D D A Symbol or code us_d on the pans fwhen plans ar rir aired)-no other documents. B A descri !ion of the si n,or IOCE iDn of sin on the building;and the location of sian cr;comtrucVi n documents. OPTIONAL-Check this boa only if this sign has a permanent,pre-printed, factor;-installed,ENERGY VERIFIED label,confirming that the sign complies with the Section 140.8 of the California 2016 Title 24,Part 6 Standards,using the Maximum�Ilowed Lighting Power method of compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks C out`-prized by Undcnvriters Laboratories(UL)or other Product Certificztion Body accredited to tSOjtEC 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 ISC/!EC 17020.For suns with such an ENERGY VERIFIED fatal,columns'O'through T are not required to be filled out.Nose:Using an ENERGY VERIFIED label is an optional method to validate compliance.An ENERGY VERIFIED label is not needed for compliance. D I The sign area in square feet. E List"1' if the sign is internally illuminated. List"E"if the si n 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 lou:dply the square footage in column D times the allowed Lighting Power Density(LPD=watts)in cc'umn F. H Sho:�the total insta0ed watts in the sign,as determined according to the as liraCe provisions of§130 c). I Enter Y if the numtrer in column H.is less than orequal to the number in column,G. Other,4;F% the sign does not comply. 1 Ths pane daub!ss as afield Inspection checklist. Field Inspector Notes: CA Building Ene:gy Efficie-cV Stardards-2016 Nonresidential Compliance August 2016 STATE OF CALIFCRNiA SIGN LIGHTING CEC•N2CC-LT5.67-Et Revised 4Q.i111 r;,_=ORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE N R CC-LT5.01-E Sign Lighting (Page 5 of 5I M°, CHEVRON - MENIFEE LAKES PLAZA crc e..,pmed: 8/14/2017 DOCUMENTATION AUTHOR'S DECLARATION ST.,TEWENT 1. 1 certify that this Certificate of Compliance documentation is eccurate and compete. aacnmcntaticn Futtfnr Kame; A tDvcumLniai cl hb4Par$iLna;fxe; ��. ) ComPanY: V't 'rj ,-� t Si^.n�tuic Dale +, Address VCEA Certdicxmn dentifiear.n(t appllcab:e): V Wck% `tX�tLfYY1 Pl /f_. CitYl4taie/Ztq: i Paone' } RESP01,15;PLE PERSOfi'S DECLARATION STATENIEN7 1 certify the folio.ving under penalty of perjury,under the laws of the State of California: 1. The information provided or,this CiAificatu of Compliance is true and correct. 2. l am eligible tinder Division 3 of the Business end Professions Code to accept responsibility fer the buddins design or system design identified on this Certificate of Compliance(responsible designer). 3. The energy features and performance srieci ications,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 i and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Cer-iffwte of Compliance are consistent with the information provided on other applicable comdiarce documents,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval Yvith this building permit application. S. 1 will ensure that a completed signed copy of this Certificate of Compliance shall b made available with the building permitlsj issued for the building,and made available to the enforcement agency for all applicable inspect ns.I understand Y t a completed signed copy of this lunge Certificate of Corr is required to be included ivith the documentation the er p4vde5.'tC1T1h building owner at occupancy. nespanslt4e nesar.ar Game Respa , n+s1g g u Company, Dot"S bed Address: Ban X"Aaq lrccnse Cily)Stafel�p; F lane CA Building Energy Efficiency Standards-2016 Nor-asidermal Compliance August 2016