PMT17-02959 City of Menifee Permit No.: PMT17-02959
29714 HAUN RD.
47%CCELA7 MENIFEE, CA 92586 Type: Commercial Electrical
MENIFEE Date Issued: 08/2112017
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 2 BRANCH CIRCUITS(20 AMP)FROM PANEL TO KIOSKS. PANEL LOCATED AT BACK OF
Work: KITCHEN IN PANEL BANK.
Owner Contractor
MCDONALD USA LLC AMBIENT ELECTRIC INC
2363 TELLER RD STE 112
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 Qtt t Amount IEI
Receptacle, Switch,Outlet&Fixture 2 121.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
GREEN FEE 1 0.00
General Plan Maintenance Fee-Electrical 1 6.05
$155.05
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 Pennit_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 underthe Contractors State License Law for
Professions Code and my license is in full force and effect, the following reason:
License Class_C Lic n e II o'J C Z B m signature below I acknowledge that,except for m Y Y g g p y personal residence
Expires r—j�Signature in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATI N improvements covered by this permit.I cannot legally sell a structure that I
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.9ov/calaw.html.
Poli eeeu !90`1 Date
pkhave 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 workers compensation insurance carrier and polity owner or authorized to act on the property owner's behalf.I have read this
number
yyftf_are:
"" pp //�� application and the information I have provided is correct.I agree to comply
1y Carrier dtj T-Xt (Nl(/'♦< with all applicable city and county ordinances and state laws relating to
-a building construction.I authorize representatives of this city or county to
Policy# 74M,f.Y.U (9tq Expires'-31- 19 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 emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers coca ensati n laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to th wor'I s compensation provisions of Section 3700 of the Labor
Code,I shall it ofnply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date —Z mixture containing a hazardous material equal to or greater that the
amounts spec on the Hazardous Materials Information Guide?
WARNING: ILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes o
UNLAWFU' AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN u o i
Will the intended use f the building by the applicant or future building
occupant require us permit for the construction 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 guideline'
CONSTRUCTION LENDING AGENCY aYes Flo
I 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 Noun ry of a school?
(Section 3097 Civil Code) ❑Ves o
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&Sa ty Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ha ous ma W
Business and Professions Code).Any city or county that requires a permit to �D Noconstruct,alter,improve,demolish orrepairany structure,priorto its Dateissuance,also requires the applicant for the permit to file a signed statement PROPERTY ORIZED AGENT
that he or she Is licensed pursuant to the provisions of the Contractors State EPA REND ATION.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 Iicensure receiving compensation far most work that disturbs paint In a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence compenor sation
facility to be work
that
firms and comply with
than
Applicant for a permit subjects the applicant to a Civil penalty of not more required practices.This includes rental property owners and property
than($S00). 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.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 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/PLANCHECKAPPLICATIO
,Menifee
DATE PERMIT/PLAN CHECK NUMBER TM Tt 177 ✓ 15Cl
TYPE: XCOMMERCIAL []RESIDENTIAL MULTI-FAMILY ❑MOBILEHOME POOL/SPA ❑SIGN
SUBTYPE: []ADDITION ❑ALTERATION ❑DEMOLITION WELECTRICAL ❑MECHANICAL
❑NEW ❑PLUMBING ❑RE-ROOF-NUMBERO"Fp SQUARES
DESCRIPTION OF WORK tl f k(( ,Z b(r(,w►G�'1 C(rCLA ITS ( fid
-)o ktcsts r Q r
PROJECTADDRESS NK�IQ//1��
ASSESSOR'S PARCEL NUMBER u ' O�y ��-4' LOT 3 TRACT
PROPERTY OWNER'S NAME
ADDRESS /!� }- kQ •ffee C �4
PHONk �7 �� b� � �b Q EMAIL
APPLICANT NAME a 2
ADDRESS 2 /ik (/' p9ak C
4 S 13 2a
PHONE \ fff1S� (,�z�Oy`LS EMAIL
CONTRACTOR'S NAME (-_4"( Qj JIX• OWNER BUILDER? ❑VES®NO
BUSINESS NAME AMBIMT G
ADDRESS e A 112, "- LAM P-NeV, CA Q1320
G
PHONE D11 . 3Oq-1::M21 EMAIL. a, `1 tGfn LL C,(J
CONTRACTOR'S STATE LIC NUMBER C 512$ LICENSE CLASSIFICATION
VALUATION$ SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION M^ CITY OF MENII:;711ESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE I 05 PAIDAMOUNT
AMOUNT • OCASH ",CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH -1CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES G NO DL NUMBER NOTARIZED LETTER O YES O NO
Cit at Menifee
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 9258ta A& ;&83.d�ptV Dept.
www.cityofinenifee.us Inspection Request Line 951-246-6213
AUG 21 2017
Received
CERTIFICATE OF COMPLIANCE
Certificate Number 20151104-E475735
Report Reference E475735-Al-UL
Issue Date 2015-NOVEMBER-04
Issued to: ZIVELO
7014 E Camelback Rd., Suite 608
Scottsdate AZ 85251
This is to certify that INFORMATION TECHNOLOGY EQUIPMENT INCLUDING
representative samples of ELECTRICAL BUSINESS EQUIPMENT
Kiosk, Models:
EVOLUTION - ZMCD-0001 (Dual sided version)
EVOLUTION - ZMCD-1001 (Single sided version)
City of Menifes EVOLUTION - ZMCD-0002 (Dual sided version)
Building & Smilety Dept.
EVOLUTION - ZMCD-1002 (Single sided version)
AUG 2 1 2017
Received Have been investigated by UL in accordance with the
Standard(s) indicated on this Certificate.
Standard(s)for Safety: UL60950-1, 2nd Edition, 2011-12-19 (Information
Technology Equipment - Safety - Part 1: General
Requirements)
CAN/CSA C22.2 No. 60950-1-07, 2nd Edition, 2011-12
(Information Technology Equipment - Safety - Part 1:
General Requirements)
,additional Information: See the UL Online Certifications Directory at
for additional information
Only those products bearing the UL Certification Mark should be considered as being covered by UL's O
Certification and Follow-Up Service. 1
Look for the UL Certification Mark on the product.
Bruce Whre ngola,Director RaM American CeeM1fin r,o Pra9rvn ns e
UL LLC
mwg My infoon and documenontim Involving UL Mark aaNk,m am gavided on LeM1eCMLL ULCJUL)or any aWhoramd ficensee a UL For aurada .Pleas
conmda Ioc and
Cunormr Service Rapresenp6ve at
Page 1 of 1
NOTICE OF COMPLETION `
AND
AUTHORIZATION TO APPLY THE UL MARK
Zivelo City of Menitoe 06/05/2015
Building & Safety Dept.
Mr.Jason DeLaet
7014 E Camelback Rd., Suite 608 21 20t l
Scottsdate Az 85251, Us gg�AUGA,U�G�,
Our Reference: File E475735, Vol.X1 Proj, FiJGMbpiwd 4786955854
Your Reference: 37221
Project Scope: Alternate construction of unit and addition of new model single version configuration
EVOLUTION-ZMCD-1001. Report E475735-A1, US/CAN. This cost includes expedite fee
Dear Mr. Jason DeLaet:
Congratulations! UL's investigation of your product(s)has been completed under the above Reference Number and
the product was determined to comply with the applicable requirements. This letter temporarily supplements the UL
Follow-Up Services Procedure and serves as authorization to apply the UL Mark at authorized factories under UL's
Follow-Up Service Program. To provide your manufacturer(s)with the intended authorization to use the UL Mark,
you must send a copy of this notice to each manufacturing location currently authorized under File E475735,Vol. X1.
Records in the Follow-Up Services Procedure covering the product are now being prepared and will be sent in the
near future. Until then,this letter authorizes application of the UL Mark for 90 days from the date indicated above.
Additional requirements related to your responsibilities as the Applicant can be found in the document"Applicant
responsibilities related to Early Authorizations"that can be found at the following web-site:
hrto.//www liLe'
Any information and documentation provided to you involving UL Mark services are provided on behalf of UL LLC
(UL) or any authorized licensee of UL.
We are excited you are now able to apply the UL Mark to your products and appreciate your business. Feel free to
contact me or any of our Customer Service representatives if you have any questions.
Very truly yours, Reviewed by:
Michelle M. Hahnlein Bruce A. Mahrenholz
847-664-3566 847-664-3009
WiSE Project Lead CPO Director
Michelle.M.Hahnlein@ul.com Bruce.A.Mahrenholz@ul.com
O
N13KBECI3-80DB9D
pow
This is an electronically generated letter.Signatures are not required for this document to be valid. Page 1 of 1
ZIVELO Suit East Camelback Road Lvelo.cG 835E
Suite 608 zivelo.com
Scottsdale. Arizona 85251
September2, 2015
McDonald's USA LLC
21 1 1 McDonald's Drive City of Menifee
Building Oak Brook, IL 60523 ding & Safety DePt.
RE: ZIVELO Floor Standing Kiosks
AUG 21 2017
To Whom If May Concern: ReceiVed
ZIVELO's kiosk models ZMCD-0001 (EVOLUTION Dual-Sided Floor Standing) and ZMCD-1001 (EVOLUTION
Single-Sided Floor Standing) are designed to run in conjunction with McDonald's software to meet ADA
reach range compliance requirements. It is our understanding that McDonald's software design is
intended to bring the operational platform down to the bottom portion of the display so that it is in
compliance with the 48" reach range requirement.
Please see attached diagram that visually represents the reach range on the kiosk and a letter from the
software vendor acknowledging this same information for your reference.
Thank you for your consideration of this clarification related to the ZIVELO kiosk installations.
Kind Regards,
Jessica Williams
Director of Special Projects
frVA
r
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Los A, iycics Scottsdale I Uervei i Indianapolis I Htii,aoeipnia i IOIOntO Loncon I Syoney �dl., 1 :,