PMT14-02746 City of Menifee Permit No.: PMT14-02746
29714 HAUN RD.MENIFEE, CA Type: Residential New
f .'
MENIFEE Date Issued: 1 0131/2 01 4
PERMIT
Site Address: 25586 BETH DR, MENIFEE, CA 92584 Parcel Number: 358-234-019
Construction Cost: $423,116.96
Existing Use: Proposed Use: 1 &2 Family Residence
Description of NSFR TR 29636
Work: 3608/593
LOT 63
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 Qtty Amount S
Receptacle, Switch, Outlet&Fixture 163 926.00
Gas System 1 116.00
Residential Water Heater 1 83.00
e
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
Building Permit Issuance 1 27.00
SMIP RESIDENTIAL 1 56.00
Ne •• . '. atip ' i ee 9
New Construction Plan Check 1 1,265.12
$5,343.46
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 slated, 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_Sidg_Permil_Template,rpt Page 1 of 1
City Of Menifee
L_I_CENSED 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 Fi License N 9 706 who builds or improves thereon, and who contracts for the projects with a
Expires 0/ 2415- Signature licensed contractor(s)pursuantto 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
LF'- 1 have and will maintain workers' compensation insurance, as required by Business a fi 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 submitte f a�the foil g Web site:httpi//www.leciinfo.ca.gov/calaw.html.
permit is issued.My workers'compensation insurance carrier and policy number
/� Property Owner or Authorized Agent Carrier .STf ��M,lY1 �i70n1 INS , �UNA p y g. Date
Expires "c3-7 -1 Policy# �.
d"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-
El I certify that in the performance of the work for which this permit is issued,I identified �rty to/,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 provislocip o Sectiou 3700 of the Labor property Owner or Authorized Agent ' l Date
�a` -'� Applicant;
ie,I shall forthwith comply with those prov fo /p�(
Date; City Business License# og
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 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
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 w FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
❑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 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 ($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
El I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
ipensation, will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER ORAUTHORIZED AGENT
intended or offered for sale. (Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENIFEE PLC-No
29714 Haun Road Date: Date: {1y
Menifee, CA 92586 1010
1
Phone: (951)672-6777 Ama C Amount:
Fax:(951)679-3843 ck ii: Ck x:
Building Combination Permitrn 1 55co
To Be Completed By Applicant
Legal Description: R_ 2.4Iv3(oL&r h3 Planning Casa p, 20 R-.3 37 Rt R
Propsry Address: Assessor's Parcel Number.
Projec67enmd darns Unit,:: Floor it:
L'A�0£2 Rai
Name: Prone No. Fax No.
GP I�G 9` - Z2goIa Y Lo q
Owne , r'19—G22— 40fZ
Owner Property Acdrass: Unit Tlum:xr 7Faxtla
f'IloO HCCod77-tr2 Dc-up'. Sr o-w /3 42yo6o
Email Address:
HAft. rlvr..t,tt.l
Name: Phone iio
Appticanl Adtlress: Unit tlumhar
Email Address-
a
Name:
Phone No. Fax No.
Connector Address City State Zip Code
Goncra_(or s Uity Husinass Llceng9 N�
Cont.acWr'g C�'r• re of Caliform:a Lic=_nse No Classitica;Rn:
0a.a r•+4 -l3'106.7 P
Plumherof squares:
Square Fao!age 2ir 4Q S.�JIGC/ (p�
Description of Work: Cost Of Wo:k:$ 2 - 1
Applicant's Signature OaL IJ
O -13-1
To Be Completed 8y City Staff Only - - -
Indica:e As R-Received or MIA-Mot Appl.cabie
5 Cnnplgles aah of!ally aimensipnad•drawn to gala plan;:vMch indlide' 1 set Or docunenis whim Ind.da
❑ Tula Sheet ❑ Elevations ❑ Electrical Plan ❑ Gen TecWSoils Report(on cd only)
❑ Plat l Site Plan ❑ Root Plan ❑ M_chanical Plan ❑ Title 24 Energy(on 8 Y,x 11)
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Sirurtural Calculations
❑ Floor Plan ❑ Single Line diagram for epee sluices over 4^,0 AMP
❑ Slntctural Flaring Plan 3 Deals ❑ Shoring Plan ❑ Saund Report-Rasidential
Class Code: Indicate Now constuction Alteration' Addition' lJegna.'M1l=lhcE;
Wor.<T/po Repair' Retro�it' °2viScn to E655'rg parrill Requi.,.dP YES NO
Proposed Building Use(s) Existing Buiiding Use(s)
d Buildings' ` 5 Units k Stories Will the Byldinq Have a Bas:ntan!v
y of tip
Bldg Coda O•-,-.-peon,/Group Irzaicata it Z--
In,:�r_at� Y'ES or MO Indicate all Jea-lerh Haz. ana
At Pro'ecl eni-M,retl
f�.anSL U`J.loq S� Ihal apply: �nastal Zone
Completion
lYp:(s) CoIO R Noise Zone
a:uired? YES or IO
'! Listed on Fli Staric P.esuu•ces In re:Y,or/
Cl fY PLANNItig STAFF ONLY
APPROVALS Comal Cornmiss Arch R�viev,Board Landeia:A Comm Planning Comn: Zocing A.;:-,ini;tra•�r
Fee Ecmpt City r^roject r-lac V=hick Charger Landn;ar'rt Seismic P.e!rafit 'Ff41"" "' ad9
II
Jfnaal
Expedda Pr:jeri(31 Child Caro Ciry Poojncl Creel Buddin
9 Ldndmar:i AI(or::a)-,
_ Ffr.it if;Ilse pnly
I�
1
rH•:H% '/rl'.1 :riH:,=l Pelri tn:roc env orrr-n, .+........ ..., '