PMT17-03071 City of Menifee Permit No.: PMT17-03071
29714 HAUN RD.
F/ACCEL/7 MENIFEE,CA 92586 Type: Sign -Permanent
MENIFEE Date Issued:
08/29/2017
PERMIT
Site Address: 28115 BRADLEY RD., Suite#4, MENIFEE, Parcel Number: 337-302-015
CA 92586 Construction Cost: $2,000.00
Existing Use: Proposed Use:
Description of INSTALL ONE ILLUMINATED CHANNEL LETTER SIGN"CITY OF MENIFEE POLICE DEPT"
Work:
Owner Contractor .. ,
DONALD HOBBS PROMOTIONAL SIGNS INC
2324 WALMAR LANE 3301 S SUSAN ST
SAN DIEGO, CA 92109 SANTA ANA, CA 92704
Applicant Phone:7145405454
TONY RECTOR License Number:636512
PROMOTIONAL SIGNS INC
3301 S SUSAN ST
SANTA ANA, CA 92704
Fee Description Qtty Amount(SI
Sign Permit 1 190.00
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 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_Bldg_Pennit_Templatexpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
1 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 Ilcensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class C -LA Ai! License No. 43(0 T 12— By my signature below I acknowledge that,except for my personal residence
Expires O 1 Signature LctlV bA_ in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION 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 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
this permit is issued. www.leginfo.ca.gov/calaw.html.
Policy# 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 owner's behalf.I have read this
number are: %A&.A* application and the information I have provided is correct.I agree to comply
Carrier V.15'4 Sou 131 SOYl A*.Cl1 CA with all applicable city and county ordinances and state laws relating to
r building construction.I authorize representatives of this city or county to
Policy#W S`� J31%4&pires ci 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 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 fort ith comp y wtth t ose provisions.Date Will the applicant or future building occupant handle hazardous material or a
t l' mixture containing a hazardous material equal to or greater that the
Applicant amounts specified on the Hazardous Materials Information Gulde7
WARNING: TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes ❑No
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($500,000),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 ❑No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 10W 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 ❑No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
1 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 nyes in No
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,priorto its PROPERTY OWNER 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 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 orthrough their
❑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.goy/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 ekclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Cade: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
I-.
�. Men ifee
DATE N201MPERMIT/PLAN CHECK NUMBER 1
TYPE: ❑COMMERCIAL ❑RESIDENTIAL MULTI-FAMILY ❑MOBILEHOME POOL/SPA SIGN
SUBTYPE: []ADDITION []ALTERATION []DEMOLITION ❑ELECTRICAL []MECHANICAL
NEW ❑PLUMBING [I RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK L,
PROJECTADDRESS �41 r110
ASSESSOR'S PARCEL NUMBER B1�k1M'0 �rAhYY �P
'5,- ,�jQ�-p1�3 LOT TRACT
PROPERTY OWNER'S NAME IM 2 9 2017
ADDRESS
PHONE W I I IGJ --tq.. EMAIL
APPLICANT NAME
ADDRESS H (AIYA ° G
PHONE EMAIL f
CONTRACTOR'S NAME OWNER BUILDER? ❑YESJNNO
BUSINESS NAME i(
ADDRESS `336
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER I2 Q LICENSE CLASSIFICATION
VALUATION$ -I CW"Otl— SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE
OTY STAFF USE ONLY
DEPARTMENT U15TRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP k
INVOICE ^ pgID AMOUNT ,>AMOUNT Q y •g CASH f?CHECK# 0 CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 0CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityo(menifee.us Inspection Request Line 951-246-6213
Show Receipt Detail Page 1 of 2
RECEIPT
City of Menifee
MENIFEE
29714 HAUN RD.
Menifee, CA 92586
Application:PMT17-03071
Application Type:Permits/Sign/Permanent/NA
Address:28115 BRADLEY RD, Suite#4 MENIFEE, CA 92586
Receipt No. 50'1e17
Payment Method Ref Number Amount Paid Payment Date Cashier ID Received Comments
Other $227.50 08/29/2017 EAGUILAR PAID WITH JOURNAL
ENTRY
Owner info.: DONALD HOBBS
2324 WALMAR LANE
SAN DIEGO, CA 92109
Work INSTALL ONE ILLUMINATED CHANNEL LETTER SIGN"CITY OF MENIFEE
Description: POLICE DEPT'
https:Hay.accela.com/portlets/fee/receiptV iew.do?mode=view&autoPrint--false&receiptnbr... 8/29/2017
STATE OF CALIFORNIA
SIGN LIGHTING
CEC-NRCC.LTS-01-E Revised 08116 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lightin (Page 1 of 5)
ProjeR Nime; Date P repered:
A.General Information
Project Address: ' BUlldinp &$BfBfy Deft.
K
Location of Sign B Outdoor igns ❑Indoor Signs AUG Z 9 ZO17
Phase of Sign Construction ew Signs ❑Sign Alterations
Type of Lighting Control ew Lighting Controls ❑Replaced Lighting Controls ❑Not Installing Lighting Controls
This Certificate of Compliance includes the fall wing components(check all that apply):
❑Mandatory Measures(Lighting Controls) 'fNaximum Allowed Lighting Power- ecific Lighting Sources '
1.Mandatory Sign Lighting Controls
NOTES:
I. The some responsible person may install both the sign lighting power and the sign lighting controls, or a different responsible
person may install the sign lighting controls than the responsible person installing the sign lighting power.
2. The Mandatory Measures (sign lighting controls) are required for compliance with the sign lighting Standards. If the person
responsible for 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 have the sign lighting controls installed.
3. If more than one person has responsibility for compliance, each responsible person shall prepare and sign a Certificate of
Compliance and an Installation Certificate applicable to the portion of construction for which 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 la and 1b on one compliance document and a C-45
contractor may complete parts 1a and 2b on a separate compliance document—the Responsible Designer shall submit the two
compliance documents together for the some complete installation).
I have responsibility for installing the sign lighting controls:
❑ Yes,I have responsibility for the sign lighting controls,and ff No,I do not have responsibility for installing the sign lighting controls.
will complete parts is and lb of this compliance document Someone else will complete parts la and lb of this compliance document.
la.Check Yes or No for all of the following statements:
1 There are existing sign lighting controls that comply with the applicable provisions of§110.9 and§130.3
❑Yes No
There are no existing sign lighting controls and I will be installing sign lighting controls that comply with the applicable
2 provisions of§110.9 and§130.3
Yes ❑ No
There are existing sign lighting controls that do not comply with the applicable provisions of§110.9 and§130.3 and I will be
3 installing sign lighting controls aht comply with the ap li able provisions of §110.9 and§130.3
❑Yes No
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance August 2016
STATE OF CALIFORNIA
SIGN LIGHTING
CEC-NRCC-LTS-01-E Revised 08118 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTSg01E
Sign Lighting (Page 2
Project Name:
Date Prepared:
1b.Mandatory 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 lighting 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(sign lighting control)note block can be located:
1 §130.3(a)1.All indoor sign lighting is.controlled With an automatic time-switch control or astronomical time- EN
switch control
§330.3(a)2A. All outdoor sign lighting is controlled with a phot'ocontrol in addition to an automatic time r NA
switch control,or an astronomical time-switch control. ❑
EXCEPTION to Section 130.3(a)2A:Outdoor signs in tunnels,and signs in large permanently covered outdoor Y
areas that are intended to be continuously lit,24 hours per day and 365 days per year. ❑
§330.3(a)2B. 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 power by a minimum of 65%during nighttime hours.Signs that Y N N
3 are illuminated at night and for more than 1 hour during daylight hours shall be considered ON both day and ❑ ❑
night.
EXCEPTION to Section 130.3(a)2B:Outdoor signs in tunnels and large covered areas that are intended to be Y NA
illuminated both day and night. ❑
§330.3(a)3. Demand Responsive Electronic Message Center Control.An Electronic Message Center(EMC)
having a new connected lighting power load greater than 15 kW has a control installed that is capable of Y N N/
4 reducing the lighting power by a minimum of 30%when receiving a demand response signal. ❑ ❑
EXCEPTION to Section 130.3(a)3:Lighting for EMCs that is not permitted by a health or life safety statute, y
ordinance,or regulation to be reduced by 30%. ❑
Field Inspector Notes:
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance August 2016
STATE OF CALIFORNIA
SIGN LIGHTING
CEC-NRCC-LT8-01-E Revised 08116 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 3 of 5)
Project Name: pate Prepared:
2.Mandatory Sign Lighting Measures
I have responsibility for installing the sign lighting
❑ Yes,I have responsibility for the sign lighting,and will complete ❑ No,I do not have responsibility for installing the sign lighting.Someone
parts 2a and 2b of this compliance document else will complete parts 2a and 2b of this compliance document.
2a.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 Lighting Sources method of compliance).
A B C D E F G H I J
OPTIONAL—
Field
Energy Verified
Symbol or Code Description of the Sign Label(see Allotted Watts Design Complies Inspector
instructions Watts Y/N Checkthat
below) Sign Complies
pCp N }' g II o - .a
O
p U
MI
H
L I Z e ❑ ❑
.111" Itue 46y, ❑
A Symbol or code used on the plans(when plans are required)and other documents.
B A description of the sign,or location of sign n on the building;and the location of sign on construction documents,—
OPTIONAL-Check this box only if this sign has a permanent,pre-printed,factory-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 Allowed Lighting
Power method of compliance. The only labels that will be recognized'.for this purpose are ENERGY VERIFIED Certification Marks
C authorized by Underwriters Laboratories(UL)or other Product Certification Body accredited to ISO/IEC 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 ISO/IEC 17020.For signs with such
an ENERGY VERIFIED label,columns'D'through'I'are not required to be filled out.Note:Using an ENERGY VERIFIED label is an
optional method to validate compliance.An ENERGY VERIFIED label is not needed for compliance.
D The sign area in square feet.
E List"I'•if the sign is internally illuminated. List"E"if the sign 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 Multipl the square footage in column D times the allowed Lighting Power Density(LPD=watts)in column F.
H Show the total Installed watts in the sign,as determined according to the applicable provisions of§130(c).
I Enter Y If the number in column H is less than or equal to the number in column G. Otherwise,the sign does not comply.
J I This page doubles as a field Inspection checklist.
Field Inspector Notes:
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance August 2016
STATE OF CALIFORNIA
SIGN LIGHTING ,g
CEC-NRCC-LTS-01-E ReNsed 08/18 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE li NRCC-LTS-Ol-E
Sign Lighting (Page 4 of 5)
wolecx wama:
Dare prep.red:
2b.Specific Lighting Source Method 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 Shall include only lighting Check that Sign
Code (see technologies listed below Complies
instructions: (List all that apply) ✓
below)
NG ❑ ❑
z r ❑ ❑
❑ ❑
❑ ❑
A Symbol or code used on the plans(when plans are required)and other documents.
B A narrative description of the sign,or location of sign on the building;and the location of sign on construction documents
OPTIONAL-Check this box only if this sign has a permanent,pre-printed,factory-installed ENERGY VERIFIED label,confirming that this sign
complies with the Section 140.8 of the California 2016 Title 24,Part 6Standards,using the Specific Lighting Source Method of Compliance.
The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories
C (UL)or other Product Certification Body accredited to ISO/IEC 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 ISO/IEC 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 validatelcompliance.An ENERGY VERIFIED label is not needed for
compliance.
Specific Light Source Compliance Method. The sign(s)identified above use only the following lighting technologies:
List all applicable numbers(1 through 9)that apply in column D above for each row.
1 High pressure sodium lamps
Metal halide lamps that are pulse start or ceramic served by a ballast that has a minimum efficiency of 88%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 C82.6-2005.
Metal 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 80%.
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.
D
Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 75%when
4 the transformer or power supply rated output current is less than 50 mA.The ratio of the output wattage to the input wattage is at
100%tubing load.
Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 69%when
5 the transformer or power supply rated output current is 50 mA or greater.The ratio of the output wattage to the input wattage is at
10091tubin load.
6 Fluorescent lighting systems meeting one of the following requirements:A.)Use only lamps with a minimum color rendering index
(CRI)of 80;or B.)Use only electronic ballasts with a fundamental output frequency not less than 20 kHz.
7 Light emitting diodes(LEDs)with a power supply having an efficiency of 80%or greater.
Single voltage external power supplies that are designed to convert 120 volt AC input Into lower voltage DC or AC output,and have a.
8 nameplate output power less than or equal to 250 watts,shall comply with the applicable requirements of the Appliance Efficiency
Regulations(Title 20).
9 Compact fluorescent lamps that do not contain a medium screw base sockets(E24/E26).
E This page doubles as a field inspection checklist.
Field Inspector Notes:
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance August 2016
STATE OF CALIFORNIA
SIGN LIGHTING
CEC-NRCC-LTS-01-E Revised 06116 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting
(Page 5 of S)
Project Name: Date Pre pared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and compete.
Documentation Author Name: Documentation Author Signature:
Company: ' �• Signature Date:
Addres' CEA Certi oatow Identification(if applicable):
City/State/Zp: Phone;'
I e
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design
identified on this Certificate of Compliance(responsible designer).
3. The energy features and performance specifications,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 1 and Part 6 of the California
Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents,worksheets,calculations,plans and specifications submitted to the enforcement
agency for approval with this building permit application.
5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s)issued for
the building,and made available to the enforcement agency for all applicable inspections.I understand that a completed signed copy of
this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at
occupancy.
Responsible Designer Name: Responsible Designer Signature:
Company: Date Signed:
Address
ense:
CltyAtate/Zip
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance - August 2016