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Home My WebLink AboutGRAHAM AVE W 200_15-00000389tree N - u - Jc 1 RIVERSIDE COUNTY FIRE DEPARTMENT OFFICE OF THE FIRE MARSHAL CITY OP cr CITY OF LAKE ELSINORE 130 S. Main St. Lake Elsinore, California 92530 L- - KE ES I NODE 951) 674 -3124 Ext. 250 Dbloom @Lake- Elsinore.Org =Vi=m DREAM E/ RFME PERMIT PERMIT NO: 15- 00000389 JOB ADDRESS 200 W GRAHAM AVE DESCRIPTION OF WORK . : FIRE SERVICES OWNER CONTRACTOR SEYEDGAVADI, MAHBOUBEH DATE: 3/09/15 OWNER A.P.# . . . . . . 374 - 261 -002 1 SQUARE FOOTAGE . . OCCUPANCY . . . : DWELLINGS, LODGING HOUSES GARAGE SQ FT . . CONSTRUCTION . . . TYPE V- NON RATED FIRE SPRNKLR . . . VALUATION . . . . ZONE NA 0 0 FIRE SERVICES QTY UNIT CHG 1.00 X 454.0000 LE FIRE MISC ITEM CHARGE 454.00 FEE SUMMARY PERMIT FEES FIRE SERVICES CHARGES PAID DUE 454.00 454.00 .00 TOTAL 454.00 454.00 .00 SPECIAL NOTES & CONDITIONS REPLACING 4 DISPENSERS ONLY AT AM /PM City of Lake Elsinore Fire Services Division Post In COnspiCUOIIS place on the job You must furnish PERMIT NUMBER and the JOB ADDRESS for each respective inspection: Approved plans must be on job at all times: Inspection request (951) 674 -3124 ext. 250 JI. I am my license 2. I,as owner and the 3. I,as owner please read and initial Licensed under the provisions of I3usiness and professional Code Section 7000 et seq. and is in fill force. of the property,or my employees w /wages as the sole compensation will do the work structure is not intended or offered for sale. of the property,am exclusively contracting with licensed contractors to construct the a certificate of consent to selfinsure or a certificate of Workers Compensation Insurance copy thereof. not employ any person in any manner so as to become sub lect to Workers Compensation in the performanc of the work for which this permit is issued. become sub'ect to Workers Compensation after making this certification, forthwith coin; ly with such provisions or this permit shall he deemed revoked. project. y. 4. I have or a certified 5. I shall Laws Note: If you should you mostCodeApprovalsDateInspector Sprinkler System Start Time Finish Time 21\ -7.0 `6C- 'i... —?flc • ' -cc j SK01 UG Thrust 13lock Prepour 1' ' i -- SK02 Underground Rough /Hydro S 0 Underground Flush yyCLW( rV Vcr •J t tn. t-evyt) ,' r ill ,. SI<05 Weld Inspection tq SK06 Overhead Rough /Hydro Ty \' L,. i'i v.X4 v,A> \ 443`V iaC[f/' 'Er.' , ' SK99 Overhead Final SK08 High Pile Storage (FPF.) SK09 In -Rack Sprinklers SK10 Hose Racks e 2 40 IS" SK03 Title 19- Verification SK07 13e11/Main Drain /CMTC SifIli5< \S e...C,,:.e 2.- ,atjoo1e, (23 Fa 041 \l /ir W, r' Hydrant System Date Inspector t,.•.ere .. <A-n.1t. n,4-,4t. <ileA d.. sSr,.,y.rt - =RYW HS01 U.G. Thrust Block Pre -Pour 31`a4115< 4fe re-,2,1 safakJ s,5..z ,, a- Valactii 1 HS02 Underground Rough /Hydro 1 1503 Underground Flush 1 -1S99 Final /Signs /CMTC Knox System Date Inspector KSO 1 Knox Rapid Entry Fire Alarm Systems Date Inspector FA01 Fire Alarm Wiring Insp. FA02 Fire Alarm Func[ion'fcst FA Fire Alain 24 Fir Battery FA9999 Fire Alain Fi nal FA05 Sprinkler Monitoring Fuel Storgae Tanks Date Inspector FT01 Underground Tank (S) F T02 Aboveground Tank (5) - FT03 Fuel Dispensers Only 424\t& G .+y Building Inspections - Date Inspector FT99 T/t Final FS99 Shell Final Misc. Inspections Date Inspector M 0 Spray Booths M102 Suppressionood /De / tackM103HighPile /Rack StorHighStorage MI04 H.P. Vents /Access /Corr. MI05 I-laz -Mat Verification MI06 Other: RIVERSIDE COUNTY FIRE DEPARTMENT OFFICE OF THE FIRE MARSHAL CITY OF CITY OF LAKE ELSINORE LAKE 6LSINORE DREAM EXTREME 130 S. Main St. • Lake Elsinore, California 92530 951) 674 -3124 Ext. 225 • Dbloona(aLake- Elsinore.Org Permit No. PERMIT APPLICATION FORM Project Address: 0..D WW'kLAk (We_ Project Nome: '-kk Car l,J4 1, 4-44,, x. I understand that after the second submittal and after failed inspections that ad itional fees will be required. City & Zip: Lo e- S';Q Applicant Sign: Date: tv.b le 4-S" Contact Information F.-1 S r (10C-c. t? ctr CONTACT PERSON: 1202 5e-YlaciyVAd' Company Name: -ti-misr wask 4. 45, X119 E -mail Address: el' rto re- pc4S(' ie i al rt i i % Phone No: 6 - (09 -bLIa 1 Plan Review Type (Check appropriate items) i4 Commercial Industrial Residential Special Event Other Building Building Tenant Improvement High Fire Area Underground Water Sprinkler System TI Sprinkler System Sprinkler Monitoring Fire Alarm System Hood & Duct Suppression System Other Suppression System Spray Booth Cell Site High Pile /Racks Operating Permit Other: Storage Tank Submittals: xr Dispensers Only Above Ground Underground i sf Submittal Official Use Only Received Date: Reviewed by PC Review Date: Plans: Approved Denied Letter Attached: Yes No Job Card Included: Yes No Called for Pick -Up: Date Picked -Up Date: Date By Applicant Sign Did Submittal Official Use Only Received Date: - Reviewed by Low Plans: Approved ,Denied Called for Pick -Up: 3) D 115 Date Resubmittal Fee Paid Date: Letter Attached: Wes No Picked -Up Date: 3 I I-) I IcC" By: Date PC Review Date: -1• .- t Job Card In lud apr .nt Sign Yes Kilo 3rd Submittal Official Use Only Review Date: 3` `t - Received Date: Reviewed by: Plans: Approved Denied Letter Attached: Called for Pick -Up: Picked -Up Date: Date Date Resubmittal Fee Paid Date: Yes QQNo C By: Job Card Included: I!'1 es No 5Iic rnt Sign ryr. DF Drawer: 1 l5 18 lrecEip? no: 018 oeci 00 WILDIN{ Mars number.'. N CHECK el9 10_06 454.00 VR -201 -R 10 Exhibit 1 Healy Model 900 EVR Nozzle FIGURE 1 -1 Healy Model 900 EVR Nozzle Drawing) VAPOR COLLECTION BOOT FIGURE 1 -2 Healy Model 900 EVR Nozzle Image) NOZZLE SERIAL NUMBER LOCATtON LAY NOZZLE ON SIDE TO SEE INFO) HEALY MODEL 900 SN. XX YY Z WEEK (i.e. 37) YEAR (i.e. 06) SEQUENTIAL NUMBER OR TWO POSITION HOLD OPEN CLIP THREE POSITION HOLD OPEN CUP ARB Approved IOM — Executive Orders VR -201 -M and VR -202 -M (75 Series Hoses) Page 33 Healy Model 75 Series Inverted Coaxial Hoses 1.0 Healy Model No. 75 Series Coaxial Hose 1.1 Healy 75 Series Hoses and Hose Assemblies should be serviced by a Healy Certified Technician. However, GDF Owner / Operator can remove and install hanging hardware nozzle, curb hose, breakaway, flow limiter and whip hose). Hoses should be inspected for kinks, flat spots, abraded outer cover (wire strands visible) and leaking fittings on a weekly basis. Note: The following procedures shall be conducted after installation or repair, with the dispenser authorized and ready to dispense fuel. Field Serviceable Hose Components 1.11 Healy Part No. HB -2 0-ring (Item 1, in Figure below). This o -ring seals the fitting to the nozzle and the adaptor. Liquid gasoline visible on the hose indicates a damaged or improperly installed HB -2 o -ring. Replace the o -ring, if necessary. 1.1.2 Healy Part No. HB -4 Quad Seals (Item 2, in Figure below). These quad seals are used on the end of the hose that attaches to the breakaway assembly (or flow limiter, if equipped). If the symptom is meter creep (gallons dispensed display on dispenser is counting up when the nozzle is not dispensing gasoline), check the HB -4 quad seals at the breakaway (or flow limiter, if equipped) end of the hose for cuts or damage. Replace the seals, if necessary. 1.1.3 Healy Part No. 291 0-ring (Item 3, in Figure below). These o -ring seals are used on the end of the hose that attaches to the nozzle or hose adaptor assembly. If the symptom is meter creep (gallons dispensed display on dispenser is counting up when the nozzle is not dispensing gasoline), check the 291 o -rings at the nozzle or adaptor end of the hose for cuts or damage. Replace the seals, if necessary. Lubricate any o -ring or Quad Seal before installing the hose assembly into an adaptor, breakaway or nozzle assembly to make it easier to install and prevent the seal from getting cut. Motor oil (any weight) is acceptable for lubricating an o -ring or Quad Seal. Rule of Thumb: O -rings to Nozzle and Hose Adaptor Quad Seals to Breakaway (or Flow Limiter) Franklin Fueling Systems 3760 Marsh Road Madison, Wisconsin 53718 USA ARB Approved Installation, Operation and Maintenance Manual Franklin Fueling Systems Website: htto: / /www.franklinfueling.com Email: sales @franklinfueling.com Telephone: 800-225-9787 Fax: 608-838-6433 ARB Approved IOM - Executive Orders VR -201 -M and VR -202 -M (900 Nozzle) Page 16 1.7 900 Series Nozzle Illustration laceable Parts - 900 Series Nozzle Illustration Reference Part Description Healy Part Number 1 900 Mini -Boot Assembly Mini -Boot Clamp 6395B 6409562 3 Face Seal Assembly with Wire 279A 4 Spout Assembly 8155 5 Scuffguard, Assorted Colors Contact Healy Distributor 6 Handle Cover 469 7 Hold Open Clip 6238 (3 position) or 6238 -2 (2 position) 239 -L8RearGuardPin 9 * Spring 6249 10 Handguard 6358 11 Lever Cover 235 -C 12 * Lever Assembly Front Guard Rivet 6130 -4 21913 * 14 Spout Screw & 0-ring Pal Nut 6102A 240SS15 Order Healy Part No. 6238 (Z057) or 6238 6130 -4 Lever Assembly, Z057 or Z058 Hold -Open Clip Kit (Includes Healy Part Numbers: 2 (Z058) Hold -Open Clip, 239 -L Rear Guard Pin, 6249 Spring, 240SS Pal Nut, 219 Front Guard Rivet) VR-202-R -8 Exhibit 2 FIGURE 2-1 Vapor Boot for Healy 900 Nozzle VR -202 -R 21 Exhibit 1 Healy Model 8701VV Breakaway FIGURE 1 -10a DECAL LOCATION BREAKAWAY COUPLING 8701 -VV VAPOR RECOVERY EMERGENCY BREAKAWAY COUPLING FOR FLAMABLE LIQUIDS BREAKS AT NOT MORE THAN 350 LBS. WARNING: SEE INSTRUCTIONS PRIOR TO INSTALLATION LISTED 9M59 GASOLINE SPARE it 4FLOW PIN HEALY SYSTEMS INC. HUDSON, N.H. STRAIGHT THREADS BOTH ENDS P/N 765 REV F VENDOR IC J DECAL SHOWN LARGER FOR READABILITY HEALY Encore 700 S Encore 700 S Os censers Secure your competitive advantage and increase profits with Gilberto Veeder Roofs Encore 700 S - your hest dispenser investment for today and tomorrow. Highly secure, powerful (RIND® electronics build a flexible and innovative platform for your changing forecourt marketing and payment needs. Enjoy peace of mind with a leading foundation that is highly secure Today and upgradeahle to meet the payment security and technology needs of tomorrow. GILBARCO VEEDER —ROOT Encore 700 5 delivers: The industry's proven forecourt merchandising solutions, featur ing Applause' content management to drive in store traffic Enhanced security that minimizes your investment in future requirements Future-ready, established global electronics platform that supports emerging technologies Familiar, quality design - durable conshuction for Tower cost of ownership and ATM -style customer interface for better throughput I E:t ltl it('tpl l,ijlf i' Unlock profits, loc dow sec rfiya Encore 700 S Dispensers Build your business on a future -ready foundation Superior merchandising improves profits. Encore 700 S gives you field-proven tools to inform, persuade, and motivate yaur fuel customers to carne inside your store and buy higher-margin goods, through: Flexible content management options, with the industry leading Applause merchandising system Superior image clarity, resolution and video performance 5.7" color smelt as standard for clear, effective communication 10.4" color upgrade option for maximum impact Platform for growth delights consumers. Encore 700 5 provides u strong foundation for growth with powerful, future ready electronics to support your innovation needs, such as mobile payments, enhanced loyalty, expanded merchandising and other applications: Enhanced applications processor for future growth Enhanced GRIND memory for improved application speed CAT -5 connectivity for ultimate flexibility Encore 700 S Specifications ilat0 y1a xgrfiiiQI Approvals, 0L, cUL Measurement Canada, Weights & Measures, FCC PCI PED 2.x PCI UPT 1.x EMV Co Tilt 40Cto85C A cabinet or keypad heater option rs available to avoid ice accumulation. Prot ss+l Proven design guarantees airtime. You get the best of Gilborco's field - proven Encore S series: Familiar ATM-style customer interface Full range of alhernafive fuel options Industry's most comprehensive warranty Enhanced, upgradeable security protects your investment. You'll benefit from Gilbarco's global EMV leadership and experience, including the largest installed base of EMV fueling pay points in North America. The Payment Card Industry Unattended Payment Terminal (PCI -UPT) and EMV certified platform in Encore 700 S includes sophisticated electronics and physical security technologies as standard features including: FlexPayn' Encrypting PIN Pad (EPP) to protect PIN data FlexPay Secure Cord Reader (SCR) to encrypt card data EMV certification (requires software and EMV Chip & PIN reader upgrade for EMV transactions ") PCI UPT certification Secure Controller to protect the entire electronics platform N0W: Boswt m broom EMV spotiherrons today. The US rl15 sperifinollcrs Iowe not yod lanai mooned by Rsn. Up to 720-MIiz ARM AB Care for enhanced CRIND applications speed Up to 520.MHz DSP Core for high performance audio and video capability Secure processor for data encryption and tamper responsiveness Memory: NAND Flash: 512 MB DDR SRAM: 256 MB eMMC: 468 Component , Options: Complete Encore S Bezel 5 7" QVGA (10,4' VGA upgrade option avoiloble) Door switches to notify the P0S to limit (recess and prevent tampering Key components that self-disable in the event of tampering High Speed Graphic Thermal Printer Ability to integrate site intercom with Applause Media System and Applause TV audio Additional Peripherals available (bar code scanner, cosh acceptor, TRIND'-, and intercom) barco.com RIVERSIDE COUNTY FIRE DEPARTMENT OFFICE OF THE FIRE MARSHAL CITY OF .34.c CITY OF LAKE ELSINORE LAKE LS I N ORE 130 S. Main St. • Lake Elsinore, California 92530 %