PMT14-00795 I
City of Menifee Permit No.: PMT14-00795
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential New
c""""'"sulr"1, MENIFEE Date Issued: 1 013 1/2 01 4
PERMIT
Site Address: 25560 BETH DR, MENIFEE, CA 92584 Parcel Number: 358-234-020
Construction Cost: $363,479.86
Existing Use: Proposed Use: 1 &2 Family Residence
Description of NSFR 2986/804
Work: LOT 64
TR 29636
Owner Contractor
CAPITAL PACIFIC REAL ESTATE, INC. CAPITAL PACIFIC REAL ESTATE INC
4100 MCARTHUR BLVD STE 300 4100 MACARTHUR BLVD ST 300
NEWPORT BEACH, CA 92660 NEWPORT BEACH, CA 92660
Applicant Phone: 9496229010
MARK MULLIN License Number: 937067
CAPITAL PACIFIC REAL ESTATE INC
4100 MACARTHUR BLVD ST 300
NEWPORT BEACH, CA 92660
Fee Description Q$ Amount I$1
Receptacle, Switch, Outlet&Fixture 157 896.00
t
Gas System 1 116.00
Residential Water Heater 1 83.00
Forced-Air or Gravity-Type Furnace or Burner - 1 1`49.00
Building Permit Issuance 1 27.00
R E"
SMIP RESIDENTIAL 1 37.00
Ca o _P r aF e HE,
New Construction Plan Check 1 1,086.81
$4,839.82
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_Permit_Template.rpt
Page 1 of 1
City Of Menifee
LICENSED DECLARATION
::reby 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 8 License Np; who builds or improves thereon, and who contracts for the projects with a
Expires 9 ZOfs Signature licensed contractor(s)pursuantto the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from icensure under the Contractors'State License Law for the
❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason:
1 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, 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
IR` I have and will maintain workers' compensation insurance, as required by Business V,Professions Code,is avallable upon request when this application is
section 3700 of the Labor Code, for the performance of the work for which this submitte f a the foil Web site:http://www.loginfo,ca,gov/calaw.html,
permit is issued.My workers'compensation insurance carrier and policy number are: 64A) r�
Carrier 31—A7 _ djZn�io�1.�7Orj 1/J5 , FUND Property ut oriz�lre Agent Date
Expires Policy#
[i'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-
❑ I certify that in the performance of the work for which this permit is issued, I identified p rty fo the inspection purposes.
shall not employ any persons in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become 26-
subject to the workers'compensation provisio o Sectio 3700 of the Labor
Vie,I shall forthwith comply with those prov' o Property Owner or Authorized Agent
r� Q ( � Date
Date; 10"3! ��T Applicant; City Business License# t2e�°"-'1 LTI.
A
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 El NO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
I hereby affirm that under the penalty of perjury there is a construction lending
INFORMATION GUIDE?
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 OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address v FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
El NO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
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
provisions of the Contractor's State License Law (Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or ❑YES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensors 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, SECTION 25505, 25533 AND 25534 CONCERNING
El I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
ipensation, will do ( ) all of or ( ) porting of the work, and the structure is PROPERTY OWNER ORAUTHORIZED AGENT
intended or offered for sale.(Section 7044, Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
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).
CITE' OF IVIENIFEE PLCIC No:
29714 Haun Road
Data. Data:
Menifee, CA 92586
Phone: (951)672-6777 Amount `7r ant
Fax:(951)679-3843 Ck#: Sk
Building Combination Permit
To Be Completed By Applicant
Legal D^scriplwn: R 2R lo3Co (.tjp- ?fanning Case j0 I3-d3 3 r' I`'3Q,S
Propeei Address: assessor's Parcel Number. r 1.
aSs�o 2 39"l -r Afoao
P rojerb,tenant!lame- Unit m: Floor#:
Name Prone No. Fax No.
GA In1r_, tjr{q_ (rZ2gofo Y fro 999-Gza- 40lL
Oviner Z Address. Unit Number
L1f00 HAc Zip Code
+at rr2 DwD. 3 cw 4 42tobo
Email Address:
HAQIL rlr/W1tJ q AvNyz Cr
Name: Phone No.
Fax No
Applicant Address: Unit f!unbar IZip Ccda
Email Address
T
Name: ?,lone No. ra.<Na.
Conlraaor Address Ciry, State Zip Coda
C:on[raotor's Qor tt614,41 License NO Contractor's C �la!e or Caliipmia License No. ClasslFcat. n
�t 9 6`3'toro-t
Momher of Squares: pQ ♦� p0 yy
square Foa!ags ra l.A TJ &,&
Description of Wars: Cos;of 4'{ork:8
Applicants Signatory Date:
10-13-1
To Be Completed BY City Staff Only
Indicate As P-Receivsd or MIA-Mot Applicable
5 Comolatcs sets.r F,II cn:ans�enad,drawn to sale plans a:h;ch includ± .1 1 syt of dwunen:i wnicn mdode
❑ 6t1e She==-t Cl Elevations ❑ Electrical Plan
❑ Goo Tacft'Seils Report(on cd only)
❑ Plot/Site Plan ❑ Poor Plan ❑ hlachanical Plan ❑ Title 24 Energy(on a V,x 11)
❑ Foundation Plan ❑ Structural Calculations
❑ Cross section ❑ Plumbing Plan Sin Line die[II_Single gram for alyc sanrices over 4•30 AMP
❑ Floor Plan ❑ Structural Framing PWl3 Det43 ❑ Sharing Pfan ❑ Sound Report-Residar,tial
Clara Coda' Indirate Now Construction Aa=n!icn' Addition' 1.[zansR.fstSods
Work Type' Repair' Retrol' Ptvi;;cn to Ea's5rg Parril, RequimV YES NO
Proposed Building Usa(s) ExlsGng Building Use(s):
#Buildings e f:Units, ij
Will rho Btyldirg Have a Basement?
Y d it
Bldg Code Qcc;pano/Group IcJAI Prjlc�t Intlmata S or NOIndicaL allMisled
ao-taco.Haz.Zone
Cunsruc!ion Sc thal apply: oastal Zone
C oi;a Zone
R� S or l O
- on Historic Resources L�ren'v�rr
CITY PLAAfNIMG STAFF ONLY
APPROVALS Costal Comrniss Arch P.rvir:r Bwrd Landmark Cnrnnl Planniny Comm �•.ning AJr inist:a�s
aE<amo! Oily Pr.Jjxt Clcc Vehirlc Cnar< Land:na;R s:•o::a:c,:e e'u,
r" Tr Seismic Ps,lror t UfScbl`::,rn„I
Erp=•Jae Pr.jecry sj CHIJ Care City Prolecl Green Ep!Idin : -g ,an;imarY. Asar'-vaa Hasn t
_ For it v;Us,Onb/
i
( „_I Ca./P,n,.,.a I .at-.r, -n.,r. Am.. r- -
1
rHnti : 'f n:i -np rFl P:elr, iI
CITE' OF MENIFEE PLCKtie: P ; r .
29714 Haun Road iy��D I6
Dalz: Date:
Menifee, CA 92586
Phone: 951 672-6777 , Amount` ;f Q nt
Fax:(951)679-3843 �^W`I Ck F- C Ck 8:
Building Combination Permit
To Be Completed By Applicant
Legal Description: lcL\ Planning Case, Pzota- 7-3 u Ft xf j'8,s I .4 gas•i
Property Address: 7 r� Assessor's Parcel Number.
L �i �r8' a3H'-bZd
Prt>jecl/Tanant rlamz: Unit p: Floor 9:
Plama: Prone Plo. Fax Pip.
ProperGD IIJG, q{q- 22*rrote Y 2+0 9rt9-G72- 401Z
Owner Address: Unit Number Zip.Code
Owner �'IloO IiPCn2Tt-t✓Z [�.ur,. Sri £uv ovl- 13 g2/obp
Email Addresv \
HAeX, r-tvr-c4N ORuNlJ�+- c_orr
Name: Phone No. Fax Pie.
Applicant Address; Unil Ptumoer Zip Coda
Email A ddressr
Name: Phone rip. Fax Mot
Contractor Address:
City State Zip Cody
'onCractor's by Cauai4 s4s Llcensc Ho. Cant asto,'s G'31ts ts ul Caflfom;a License Na. Classildii n:
rlum0er of Squwes:
squarx Footage 1 $04 S f
Description of Work: CO V ,y,_` t - Costar 4'/erk:5 O
Applicant's Sfgnatur3 r1fN
Dalai
.. .. ....': ...... . .."To'Be Cemplerd Sy:City Staff Only -
Indicate As R.P.eceived or PVA-Not Appl;able -
a Complates sets of f•.:Ily elm=reicnad,drawn to sale plans which indude.. 1 set e.`dpcmnenm vmica induda
❑ Title Sheaat ❑ Elevations ❑ Electrical Plan
❑ Gen TachlSoils Report(an ed only)
❑ Plot I Site Plan ❑ Roof Plan ❑ M:tcharical Plan ❑ Tide 24 Energy(on 8 V,x 11)
❑ Foundation Plan ❑ Cross Section ❑ Plurnhing Plan ❑ Structural Calculations
❑ Single Lima diagram for eb!c salvices over 400 AMP
❑ Floor Plan ❑ SlmctLral Franarg Plan S Dela9s ❑ Shoring Plan ❑ Sound Repor-Resid?ntlal
Class Code: IndicnDa Now Construction E Alteration' Addition' feeansrkL:`,pds
Work Type• Repair' Retrofit' aavis'.cn to Erslirg la2mil' Regntred? YES NO
Proposed Building Use(s)• Existing Boiling Use(s):
d Building;: k Units; Storias' YAA the B4:dirg Have a Basement?
Y o` rl
Sldg.Code Occupancy Group „ Irdiwta a Indicate all Gaodech.Haz.Zone
Al Pnaiect In.Ica(a Surinatpred YES or NO
Corn CansUucti.an thatearly: coastal Zone
plalion: Type(s)' C of O Nai;a Zone
Required? YES or NO
!istzd on Hisaric Resources in
CITY PI-Ai•INING STAFF ONLY
APPROVALS. Cnsfal Commiss Arch.P.'_vicvr Board Larigmw Comm Plannin4 Cornin Zoning Admimstraw
Fea Ecamae. Cd'I PrnjeU Cleo.Vehiclra Charger Lando,,vy ..I sansmi iaa t:aq
ga Snipe,,rc Rr:!rm i,
ExpaW!=_Prui q[(s) Child Care Cif/Project Grew.5A..fing Lardmart. ate'.:r'aa:e f!rAi:;g
1� For a'laif Use Only
,.:/•I Fcg^:2r:,"1 I :1'`,'.I .\)'n.. I:d v'm•Ir L•:•lNm r,...w
rf i AtI l; YDil F n R H F I noIr:Ile I-oc.\rc ...
City of Menifee
BUILDING & SAFETY DEPARTMENT
tetrvi i 29714 Hann Road
Menifee,CA 92586
Phone: (951) 672-6777-Fax(951)679-3843
wwWAtyofinenifee us
Request for Certificate of Occupancy
Residential — Custom Homes/Tracts/Condo's/Apts.
After all final inspections have been completed by all involved agencies/departments you must
obtain authorized signatures from all the involved agencies/departments on this form. When the
form is completed, return it with the entire final package to the Building and Safety Department for
release of utility meters and issuance of Certificate of Occupancy. All signatures on the forms in
this package must be original signatures (copies or faxes will not be accepted).
Project Name: � � /b9 /' Permit#: y` 00 7 t S
Tract:-- e fie - LLkot#: . P Bldg. #: Unit#:
Address: 7i�S (Pea ��f 1/aL U`��i�l I Y�� ��bE q 2.5 `y q
Custom Home: Yes ( ) No (-�' Model Home: Yes ( ) No
Condo/Apartment: Yes ( ) No ( .Y Tract Repetitive: Yes (-flho ( )
Date A
/7pna re
1. Engineering (951) 672-6777 LAL
2. E.M.W.D (951) 928-3777
3. Fire Prevention (951) 955-4777 G iS
4. Planning (951) 672-6777 q Z8 /S
5. Health Department (Septic Only) A .Iu AIM
6. Finance (951-672-6777
7. Building & Safety (951) 672-6777 LA I vi- 1 S
(Final release of utilities) A;q—
Riverside County Fire Department Fire Protection Planning Section
Riverside Office:2300 Markel St.,Ste.150,Riverside,CA 92501 Ph,(951)955L777 Fax(961)955-888
Palm Desert Office: 77 933 Las Montanas Rd.,#201 Palm Desert,G 92211 4131 Ph.Q60)963 8886 Fax(760)863 7072
Fire Department Clearance/Release
Date: 4/6/2015
To: ccarlsonna cityofinenifee.us; brivera@citvofinenifee.us; mbinnall2cityofinenifee.us
Tract/Parcel Map M 25586 BETH DR, 14-MENI-00746 LOT#63
Permit/Lot#: 25581 BETH DR, 14-MENI-00794 LOT# 12
25560 BETH DR, 14-MENI-00795 LOT#64
Job Site Address: CAPITAL PACIFIC AT CALDER RANCH
Final For Recordation
Release For Building Permit(s)
❑ Shell Final Only(No Tenant)
® Final For Occupancy
❑ Release For Residential Sprinkler Installation
❑ Building Plan Check Fees Paid, Water Requirement Met-if water applicable
❑ Building Plan Check Fees Not Paid
Residential Sprinkler Plan Check Fees Paid
Residential Sprinkler Plan Check Fees Not Paid
❑ Other (Water&Access Inspection)
❑ Fees Not Required
If you should have any questions, please contact the appropriate Riverside County Fire Protection Planning office for
further assistance.
DAVID YOUNG FSI
Print Name of Plan Reviewer/Inspector Approved Release
DAVID YOUNG FSI
Sent By: Print Name
Form C—Revised 3/01/2012
<!ASTERN
t�fUNICIPAL
ATER DISTRICT
-SINCE 1950->-
Board of Directors April 16, 2015
president '.
Randy A,Record Tract: 29636-2 C.O.: 68541/68542
Vice President (_ot(s): 12, 63, 64
David 1.Slawson Reclaimed
Directors XX Water Water XX Sewer
Joseph J.Kuchler,CPA Model Homes
E.Paulc
Ronald W.Sullivan —Landscaping only
GeneraLNanager XX Occupancy
Paul D.Jones 11.N.E.
Treasurer
Joseph 1,Kuchler,CPA
City of Menifee
Chairman of the Board, Building & Safety Department
The,99errapolitan Water 29714 Haun Road
District o carf.R Menifee CA 92586
Randyndy A.Record
ecord ,
Legal Courts,,/ To Whom It May Concern:
Lemieux&O'Neill
You are advised that interruptible domestic service is granted to the partial tract
as indicated by the lots enumerated above. The water and/or sewer systems will
be acceptable by Eastern Municipal Water District for operation and
maintenance upon completion of all tract street improvements, at which time you
will be notified.
Sincerely,
Clara Lotton for Bru&AMel, P.E.
Director of Field Engineering
BM/GI
Cc: Records Management File
Engineering Tract File
Developer
Mailing Address: Post Office Box 8300 Perris,CA 92572-8300 Telephone: (951)928-3777 Fax: (951)928-6177
Location: 2270 Trumble Road Perris,CA 92570 Internet www.en2wd.org