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PMT13-03125 City of Menifee Permit No.: PMT13-03126 29714 HAUN RD. `-/1,CCIF= .J MENIFEE, CA 92586 Type: Residential Addition c°""" ggot.., MENIFEE Date Issued; 05/02/2014 PERMIT Site Address: 28648 ERIDANUS DR, MENIFEE, CA Parcel Number: 339-272-024 92586 Construction Cost: $158,050.08 Existing Use: 1 &2 Family Residence Proposed Use: Description of ADDITION 1476sf, PATIO 116sf, DECK 296sf, EXIST. 1519sf, GARAGE 639 Work: SEE PT13-3125$727.03 PAYMENT ON 11/14/2013 Owner Contractor MICHAEL MORALES 28648 ERIDANUS DR MENIFEE, CA 92586 Applicant MICHAEL MORALES License Number: 28648 ERIDANUS DR MENIFEE, 92586 Phone: 9516720795 Fee Description Qtty Amount Receptacle, Switch, Outlet&Fixture 144 839.OQ Plumbing Fixtures and Vents, fixtures 14 171.00 Piping/ROplping �irrgte Family,Reaidential 1 10�04 Sewer ...<1 150.00 Forced-Air or Gravity Type Furnace or Burner 1 1gg;Qp _i Air Handling/Condensing Units SFR 1 133.00 SLnlding Permit Issuance 1 27 QQ Additional Plan Review Building 780 780.00 GREEN FEE 1 TOO SMIP RESIDENTIAL 1 16.00 $2,427.00 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 building operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee. Except as otherwise staled,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 DECLARATION I hereby affirm under penalty or perjury that I am licensed under provisions of as owner of the property an exclusively contracting with licensed Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions Professions Code and my license is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a property License Class License No. who builds or improves thereon, and who contracts for the projects with a Expires Signature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ I am exempt from licensure under the Contractors'State License Law for the ❑ I hereby affirm under penalty of perjury one of the following declarations: following reason: I have and will maintain a certificate of consent of self-insure for workers' By my signature below I acknowledge that, except for my personal residence in compensation,issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of Section 3700 of the Labor Code, for the performance of work for which this improvements covered by this permit, I cannot legally sell a structure that I have permit is issued. built as an owner-building if it has not been constructed in its entirety by licensed Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the ❑ 1 have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available un-request when this application is section 3700 of the Labor Code, for the performance of the work for which this submitted follo ' 'E afl :I .le info.ca. ov/c aw.html. permit is issued.My workers'compensation insurance carrier and policy number are: Prope y�or Authorized Agent Date Carrier Expires Policy# ❑ By my Signature below, I certify to each of the following: I am the property Name of Agent Phone# owner or authorized to act on the property owner's behalf. I have read this (This section need not be completed if the permit is for application and the information I have provided is correct. I agree to comply one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to enter the above- 0 1 certify that in the performance of the work for which this permit is issued,I identified property fort ha ins do urp ses. shall not employ any persons in any manner so as to become subject to the 2 / workers'compensation laws of California, and agree that if I should become �- subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Property Owner or Authorized Agent D fe City Business License# Date; Applicant; WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING ($100,000), IN ADDITION TO THE COST OF COMPENSATION, OYES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑NO EQUAL TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? I hereby affirm that under the penalty of perjury there is a construction lending agency for the performance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY THE 3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address ❑NO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR GUIDE LINES OWNER BUILDER DECLARATIONS PRINT NAME: I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the reason(s)indicated below by the checkmark(s)I have placed ❑YES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable item(s)(Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A Any city or county that requires a permit to construct, alter, improve, demolish, ❑NO SCHOOL? or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the I HAVE READ THE HAZARDOUS MATERIAL provisions of the Contractor's State License Law(Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or OYES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from Iicensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE, SECOUS MATERIAL, 25533REPOP'�WGD 25534 CONCERNING ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do( )all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; X The Contractor's State License Law does not apply to an owner of a property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). MENIFEE PT13-3125 P(5�v(fssC NOV. 25, 2013 Ckj [DO NOT PAY— THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: MENIFEE PLAN CHECK NO.: PT13-3125 PREPARED BY: ALI SADRE, S.E. DATE: NOV. 25, 2013 BUILDING ADDRESS: 28648 ERIDANUS DRIVE BUILDING OCCUPANCY: R3/U TYPE OF CONSTRUCTION: V-B BUILDING AREA Valuation Reg. VALUE ($) PORTION ( Sq. Ft.) Multiplier Mod. living add 1476 patio add 116 deck add 296 remodel 600 Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code mnf Manual Input Bldg. Permit Fee by Ordinance W I � Plan Check Fee by Ordinance $975.00 Type of Review: ❑ Complete Review ❑ Structural Only ❑Repetitive Fee ❑ Other — J Repeats Hourly 6.5 Hrs. @ EsGil Fee $120.00 $780.00 ' Based on hourly rate Comments: Sheet 1 of 1 PERMIT: 2 ADDRESS: APPLICANT: AfecAwry— PHONE NUMBER: CITY OF MENIFEE BUILDING&SAFETY FEE SCHEDULE MECHANICAL,ELECTRICAL&PLUMBING PERMIT FEES CITY TOTAL ELECTRICAL PERMITS Residential Appliance,up to 1 HP 0 Non-Residential Appliances,up to 1 HP 0 Power Apparatus(less than 100 HP,KW,KVA;or KVAR) 0 Power Apparatus(300+HP,KW,KVA,or KVAR) 0 Solar,Residential or Small Commercial 0 Temporary Power Pole 0 Services,Switchboards,Control Centers&Panels(up to 400 amps) SFR 0 Non-SFR 0 Services,Switchboards,Control Centers&Panels(400+amps) 0 Receptacle,Switch,Outlet&Fixture(first one) 0 Receptacle,Switch,Outlet&Fixture(ea additional) 0 Pole or Platform Mounted Fixtures(first one) 0 Pole or Platform Mounted Fixtures(ea additional) 0 Swimming Pool/In-Ground Spa 0 Meter Reset 0 Misc.Permit,Flat Fee,or Hourly as determined by staff 0 TOTA $0.00 $0.00 CITY TOTAL PLUMBING PERMITS. Plumbing Fixtures and Vents,fixtures 1-3(total cost) 0 Plumbing Fixtures and Vents(ea additional) 0 Grease Interceptor 0 Gas System 0 Piping/Repiping Single Family Residential 0 Multi Family Residential(first dwelling unit) 0 Multi Family Residential(ea additional unit) 0 Water Heater 0 Solar Water Heating System 0 Sewer 0 Misc.Permit,Flat Fee,or Hourly as determined by staff 0 TOTAL $0.00 $0.00 CITY TOTAL MECHANICAL PERMITS Forced-Air or Gravity-Type Furnace or Burner 1 149 Suspended/Recessed Wall/Floor Mounted Heater 0 Air Handling/Condensing Units SFR 1 133 Non-SFR 0 Hood Served by Mechanical Exhaust p Boilers,Compressors,and Absorption Systems p Misc.Permit,Flat Fee,or Hourly as determined by staff p TOTA $0.00 $0.00 PERMIT FEE RECEIPT 5 - ENHFE tj Case # PT13-3125 Date Printed: 04/18/2014 CITY OF MENIFEE - FEES RECEIPT Permit Summary Case Number: PT13-3125 Status: Created Permit Number: Date Started: 11/14/2013 Permit Type: Addition to Single Family Residence Property: 28648 ERIDANUS DR SUN CITY, CA 92586(339-272-024) Lot Number: 22 Contacts Contact Type: Applicant Full Name: MICHAEL A MORALES Address: 28648 ERIDANUS DR MENIFEE,CA 92586 Email: aguirre2222@sbcglobal.net Contact Type: Property Owner Full Name: MICHAEL A MORALES Address: 28648 ERIDANUS DR MENIFEE, CA 92586 Permit Fees Fee Information Account Amount Plan Check Fee 100-3410 $780.00 Misc Fixed 100-3410 $133.00 Permit Processing 100-3410 $27.00 Permit Preparation and Issuance 100-3410 $472.57 Plan Check Fee 100-3410 $727.03 SMIP Fee-Category 1 Permits-Valuation Greater Than 5000 100-2290 $12.00 Green Fee-Valuation Over 100000 100-2291 $5.00 Payment Information Transaction ID Transaction Date Payment Type Amount Plan Check Fee 7790 11/14/2013 Check $727.03 Paid By:MICHAEL A MORALES-Notes:136 AMOUNT PAID $727.03 BALANCE DUE $1,429.57 0411812014-8:23:40 AM-Generated by:ccarlson 1/1 cruioPerris Union High School District "Ox•mnixxgTogetherThroaghEducatia:"SCHOOL FACILITIES FEES 155 East Fourth PUHSD APPLICATION: 3838 Date: 4/22/2014 Street Building Dept. Permit#: PT13-3125 Perris,California 92570-2124 Project Address: 28648 ERIDANUS Main Number MENIFEE, CA 951-943-6369 Tract#(s): 20821 APN: 339-272-024 Lot#(s): 22 MB 213/091 superintendent's Applicant's Name: MICHAEL MORALES Office PP Applicant's Phone: 951-672-0795 Fax 951-940-5378 Applicant's Address: 28648 ERIDANUS Business Office MENIFEE, CA Fax 951-940-5301 Type Development: Personnel SPll/D1o6ile/Condo D Office Commercial ❑ Fax 951-943-9852 Adlt Replacement El Senhor Rate ❑ Apt.Building ❑ Number of Units/Lots: 1 Total Square Feet**: 1476 "If final building permit is over 20 feet more or less than this number,applicant must adjust the fee paid accordingly. I certify that the above information is true. �� ' Board Dater 22— � Applicant: of Trustees Joan D.Cooley CERTIFICATION TO THE DEPARTMENT OF BUILDING SAFETY William E.Hulstrom Eric J.Kroencke This certifies that the school facilities fees imposed persuant to(X)California Government Cade Section 53080;O Pre-legal Carolyn A.Twyman authority in the amount of $0.90 times 1476 square feet,or $1,322.50(total amount of fees),and have been paid to Randy J.Williams the District for the above-listed properties,and that building permits for this square footage in this proposed development may now be issued by yourjurisdiction. NOTICE OF 90-DAY PERIOD FOR PROTEST OF FEES: Pursuant to section 66020 of the California Government Code and other applicable law,you have a period of ninety(90)day from the date of payment of school fees,mitigation payments or District other extractions to protest the validity thereof. This ninety(90)day period commences upon such payment of performance of Superintendent any other requirement,as provided in Section 66020, Any such protest must be in writing and received by the Board of Dr,Jonathan L. Trustees of the Perris Union High School District within ninety(90)calendar days of the date of the CDC above. Greenberg EFFECTIVE PERIOD OF CERTIFICATE OF COMPLIANCE: This COC is valid for a period of ninety(90)days from the date of issuance. Upon application by the applicant,the Board ol'Trustees of Perris Union High School District may determine,in its sole discretion that good cause exists to grant an extension to the foregoing period. The Board may grant an extension for any number of days up to and including thirty(30)days. The applicant may apply for up to three(3)such extensions. At such time as this COC expires,if a building permit has not been issued for the construction of the corresponding dwelling unit,the applicant will be reimbursed all amounts paid,without interest,that were paid to obtain this COC. This COC shall be deenhed to be a separate CDC for each Lm/DU specified above. Date:4/22/2014 Prepared by: C c- Approved b December 9, 2013 Scott A.Mann Mayor Wallace W.Edgerton To Whom It May Concern: Deputy Mayor �—� John V.Denver The following information is provided for the school district to determine mitigation fee % Councilmember amounts: Thomas Fuhrman Councilmember Applicant: Michael Morales Phone: (951) 672-0795 Greg August Application Type: Building Permit for New Addition to Single-Family Residential Councilmember Permit Number: PT 13-3125 Location: 28648 Eridanus Drive, Menifee,CA Assessor's Parcel Number: 339-272-024 Tract/Lot: LOT 22 MB 213/091 TR 20821 Description: Souare Footage: Existing Single-Family Residence to Remain 1,519 sq.ft. Proposed Single-Family Residence with Addition 2,995 sq.ft. PLANNING DEPARTMENT CERTIFICATION STAMP: PRIOR TO THE ISSUANCE OF THE PERMIT REFERENCED ABOVE, applicants are required to submit written evidence from: Perris Union High School District Menifee Union School District to City of Menifee authorizing the issuance of building permits. Ryan Fowler,AAssociate Planner 29714 Haun Road Menifee,CA 92586 Phone 951.672.6777 Fax 951.679.3843 www.cftyofrnen1fee.us PERRIS UNION HIGH SCHOOL DISTRICT RECEIPT 155 E. 4TH STREET Receipt Date: 04/22/2014 PERRIS , CA 925700000 Receipt Number: 1313 Received From: Received B Customer Number: ' Customer Name: MICHAEL MORALES Signature Accounts Receivable (951)9436369 Serace Rlam ef)cscripiraLht Pr ice rice Quauttity Arnow)- DEVELOPER FEES LOT22 MB 213/091 TRACT20821, 1,322.50 1.00 1,322.50 CHECK #164 TOTAL: 1,322.50 Account Information (Internal Only) __ count_ W cru l Nu amber Ac Amou Trans Type C-500-9010-0-0000-0000-8681 90-1172 /673 MICHAEL A. MORALES 0222 164 28648 ERIDANUS DR. - SUN CITY,CA 92586 r7 Date "2L�- -14_ Pay too the order o�f�,�l�Ci\ -Sollars atibank' CITIBANK,N.A. RR.#G73 / EEE.iii 9)I90 SUN CITY alvo P /�.f6'l z SUNCITY,R92E6 �I-� 4' 1: 3222717241: 400 5608 9 7L31i, 0 1 E 4 Menifee Union School District 30205 Menifee Road, Menifee CA, 92584 CERTIFICATE OF COMPLIANCE PAYMENT OF SCHOOL FACILITY FEES Date: 4/18/2014 Certificate#: 13-14 1093 Developer/Applicant: Michael Morales Telephone#: 951-672-0795 Bldg. Dept. Plan Check#: FT 13-3125 Address: 28648 Eridanus Drive; Menifee, CA Location of Project: Menifee Tract/Lot#: Lot 22 MB 213/091 TR 20821 Parcel#: 339-272-024 RESIDENTIAL SPACE Number of Square Feet CFD 94-1 x 1.92 sq ft Total: Effective 1128113 1,476 x $2.30 sq ft. (room additio Total: $3,394.80 COMMERCIAL& INDUSTRIAL SPACE Approved 3111/08/EHective 5110108 x $0.3670 eff 11128112 Total: The above representations as to square footage are true. Developer/Applicant agrees that if it is later determined that such representations are untrue,then this certificate shall automatically terminate and the City shall be notified. NOTICE:THERE IS A 90-DAY PERIOD FOR PROTEST OF FEES. Section 66020 of the Government Code enacted as Assembly Bill 3081,set forth as Chapter 549, Statutes of the State of California, 1996 effective January 1, _ 1997,requires that this school district provide a written notice to the project applicant at the time of payment of school fees, mitigation payments or other exactions. This notice is to advise you that any protest in regard to such amounts or the validity thereof in accordance with Section 66020 of the Government Code and other applicable law, commences with such payment or performance of any other requirement as described in Section 66020 of the Government Code. Additionally,this notice advises that the protest thereof must occur within 90 calendar days thereafter. D VELOP R/APPLICANT q es that the a ve named Developer/A (licant has paid school facility fees in compliance with Government ion 995. Me ifee U.SD. agrees tha wilding permits for this square footage in the proposed nt , y now be issued by yourjuri iC i n. Bruce H. Shaw Director of Facilities COC Template 13-14 J a co r%O, CNJ Z o ti O 1Yk0 0 m p t=4 W wZOW.XQ Q S O¢M 0&OO 54 o � w ❑ > z w qp o i ❑ T 00 Q a m i {I F I � rm`ri3-a3�a5 ... LOR GEOTECHNICAL GROUP, INC. 6121 Quail Valley Court ♦Riverside, California 92507 (951) 653-1760 ♦ Fax(951) 653-1741 7 �FIELD SERVICE TICKET Project No:,3J �hS r � Date: I0 —1-12—i LI Project: .2 RG Client: k/ d- A4,&r F P I /btuy4l Pi � General Contractor: Services Performed Staff Code Reg. Hours Other Hours Grading Water Line B.F. Tests Electrical Line B.F. Tests Sewer B.F. Tests Parking Lot Tests Street Tests Sidewalk / C & G Tests Sample Pickup Other r Testing Hours Passing Failing Remarks: 'le'14� i klf400x i LOR Representative: Client Representative: Billing per current fee schedule or by contract. I i LOR GEOTECHNICAL GROUP, INC. Pi -VG- o3�as 6121 Quail Valley Court •Riverside, California 92507 (951) 653-1760 ♦Fax (951) 653-1741 FIELD REPORT Project No.: C t2 Date: r� '144r Day: M T W Th F S Su A � Client: AIR �'yM/(rd'/144,e l �AP 41CS Weather: Clear )Mist/Foggy Overcast Rain Project 2S(O `L� Ek ibAA)us J)/,L Temperature: . 32-60 60-80 80-95 95 & up Wlnd: Still odrate High Location: M e-w 6C,=G, cA Humidity: Dry oderate Humid Clients Representative: M'2. Jl k(c-( - 1444a4jeJ Site Superintendent/Other: Contractor: Supervisor/Foreman: Equipment at Site: Services Provided: MNSOCfc--170 0 O/- / wtL xi,. a �,4hdiP 4&4/ 6j,P'Px y 60,6edur� THE FOLLOWING WAS NOTED: 0Al S> 4 �� f ods�c yr 7Je_ P�Xgx v F, g�� �A/l � . Y Ri/iC I1/LL/.✓.9 �. n,. - ��ess�-,A '�T! / � � /1 S-- LOR Representative: Copy Received By: Sri �ij`"3� f Page 1 of P�3-o��a5 R e;m o v e your new Pocket C e r t if i c a t e Board for Professional Engineers, Land Surveyors, and Geologist 2535 Capitol Oaks Drive; Suite 300, from E h e r e c e i p t portion and carry Sacramento, CA 95833-2944 it with you at aLL times . 916263-2222 05/28/14 CUT HERE 05/28/14 BOARD FOR PROFESSIONAL ENGINEERS, CUT HER ....^.....1. LAND SURVEYORS, AND GEOLOGISTS �'".�o'`.r , �� I M P R T A N T � ^7 2535 CAPITOL OAKS DRIVE, SUITE 300 UT HERE LL''�� SACRAMENTO, CA 95833-2944 916 263-2222 ,�°� 1. Please include your Certificate Number on any correspondence to this of �� 2. Notify the Board of any name or address change in writing. CERTIFICATE NO. CIVIL ENGINEER EXPIRATION 3. Report any loss of this Certificate immediately in writing to the Board. C 55116 06/30/16 4. Please sign and carry the Pocket Certificate with you. M I C H A E L K E V I N O S M U N 5. Please laminate your Certificate to avoid deterioration. 6121 QUAIL VALLEY CT RIVERSIDE C A 507 MICHAEL KEVIN OSMUN CERTIFICATE NO. EXPIRATION DATE RECEIPT NO. 9ignemra RECEIPT NO. C 55116 os/30/I6 00717139 ® OO]11739 This is your receipt. Please save for your records.