PMT14-01943 i
I
City of Menifee Permit No.: PMT14-01943
29714 HAUN RD, Type: Residential New
MENIFEE, CA 92586
%Mk." MENIFEE Date issued: 09/04/2014
PERMIT
i
Site Address: 25529 BETH DR, MENIFEE, CA 92584 Parcel Number: 358-232-002
Construction Cost: $415,370.26
Existing Use: Proposed Use: 1 &2 Family Residence
Description of NSFR
Work: 3490/717
LOT10
TR 29636
Owner Contractor
CPRE, INC. CAPITAL PACIFIC REAL ESTATE INC
4100 MACARTHUR BLVD#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 ,f01ty Amount 1$1
,.NI eS,i0 s�CAIerp� . .
Receptacle, Switch, Outlet& Fixture 171 966.00
Gas System 1 116.00
Pi /Re i in ;. In9leyFales�id��l�a ,,, 3'Q
Residential Water Heater 1 83.00
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
A s a ng/Cndehsmg�UnSSR
Bur�llding Permd Issuance 1 27 00
SMIP RESIDENTIAL 1 54 00
New Construction Plan Check 1 1,241.96
$5,327.66
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 Permil_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 ❑ I, 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
❑ 1 am exempt from licensure under the Contractors'State License Law for the
❑ 1 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 3ssu of the Labor Code, for the performance of work for which this im improvements covered b this permit, I cannot legally sell a structure that I have
permit is issued. P Y P g y
Policy# built as an owner-building if it has not been constructed in its entirety by licensed
contractors. I understand that a copy of the applicable law, Section 7044 of the
❑ I have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http://www.leainfo.ca.gov/calaw.html,
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier Property Owner or Authorized Agent
Date
Expires Policy#
Name of Agent Phone# ❑ By my Signature below, I certify to each of the following: I am the property
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($1D0)or less) with all applicable city and county ordinances and slate 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 for 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
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 Date
Date; Applicant; City Business License#
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, DYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A
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
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 DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
[INO 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 DYES 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 DYES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPOW�ING.
compensation,will do( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale,(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale. If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENIFEE PLCKNo: P � ,0
29714 Haun Road Dau: as f� Date:
Menifee, CA 92586
Phone: (951)672-6777 Am°dOWE Amount
Fax:(951)679-3843 Ck#; Ck x:
Building Combination Permit G,1'155�
To Be Completed By Applicant
Legal Description: Q 1-9 ?tanning Casa' ppiv lei- 233 r3S ,1 Rt; ,} t;4 .1
fi3(e -
Property Addra_ss: Assessor's Parcel Number.
9S52tv, D¢ , lca Io 3S$- 3-ZoaZ
Projert(Tenpnt Marne:^ ^' ^'n Unit Floor#:
Nam-: [.•/+G .+� Prtone.No. Fax No,
GP ING, q4z- 'f�'z-gvlo Y LD 4°t9-42Z- r?olz
Property Address': Unit riumher Zip Coda
oiwner "1100 HACAan-,V7- N-Vi1, yr3 O'N" l3 `i 2lebo
Email Address;
Name: Phone lk o. - Fax Nc,
Applicant Address: Unit Number Zip Cede
s
Email Address•
MAddress:
?hone No. Fax Na.
Convector C!C/ State Zip Cad_
osrnass Liens=N°. Contractor's Ci• Slane or California license M1oS 0k oSquare FaN9 u
Cost of Work:$415 3 0. a Description of roc: N l� F
Applicants Signature Date; l-a4_.��
_ .-. ..:..:-... .., ., ... _ ..•Tq'Ba Cbmplet^d By City Sta`(Only .
Indic-ate As P.-Received or WA-Nat Applicable
5 C.e,.l -s aala of f=_.Ir C raeuicnad C vn'o sa a pia-.wh._h to �.'+. 1 »r of doc.,n r- wnien induda
❑ Tida Shut ❑ Elevan.ans ❑ E!=,Viral Pun ❑ Gan T3Ch1S615 Report(on cd only)
❑ ❑Pl Tide 2.:Energy(on B '/.x III
n:!Srt�Plan ❑ P.00f Plan ❑ Alechanica'Plan ❑ S!ructural C3lcula:i°ns
❑ Foundation Plan ❑ Crass Sectian ❑ Pturnbing Plan ❑ Single Lira diagram for el__ sarsices over 400 A`dP
❑ Floor Plan ❑ Strctural Framing Plot 3 Delala ❑ Sharing Plan ❑ Sound Raport-Rasidantial
Clans Code: Indicabo `1°w Cons(rudion Alteration.' Addi'ion' 1,!•:an.^i Al::hods
Work Typo' Repair' RatroT,t• '3wh;cn to Ecsting Per-iC Rzqu!r ad? YES NO
Prapn,ed B_hldi n•q Use(s). Existing Building Use(s)'
✓:Duil!lungs_ 9 Un:Cs: %Srionas. :Yid the Balding Have a Basern=_n'.n
Y c: .I
Bldg. Coda 0-r i�a�ry Group h^rlca!e irJ cats d Y'ES or AIO Irdica�e III
3�o-tach.Hex _ono
Al Pr>.^ct .S.nrklered Ihet apt%!/- '-owtal Zone
Cors Vu_lion
Cornpl^_II00: T C010 YES or
IO Poise Zone
Raaui,,d? -ista_d on Hi;'.oric Res'°urras In'aenS)ri '
CITY PLAAIPIh4G STAFF 0`ILY
APPi'.UV:,L S: Costal CQnlr1l35 Arch.R-rvi•_w Board Landr^,anti Cnmm Planning Comm 72nmq 4.'.minis7a ar
r-ay Te. '1 - Ve C'
Fe,.a.Erm°;, .-' i r.>jec! Ecc. hick narger Land:rs:F S=_ismic P.a.:n>fit „�I
Ezaedda Pruj---ii3) Child Carc City PmjeZ, 13,A ling Landmar}.
Only
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