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PMT14-03236 I City of Menifee Permit No.: PMT14-03236 29714 HAUN RD. MENIFEE, CA 92586 Type: Residential New MENIFEE Date Issued: 04/16/2016 PERMIT a Site Address: 33911 SWEETWATER CANYON RD, Parcel Number: 384-080-013 MENIFEE, CA 92584 Construction Cost: $428,390.61 ` Existing use: 1 &2 Family Residence Proposed Use: 1 &2 Family Residence Description of NSFR AS-BUILT NO INSPECTIONS AFTER SLAB APPROVAL Work: 3709/770 Owner Contractor Applicant License Number: KANGSAN TRUST 21704 DUNN ST WILDOMAR, CA 92595 Fee Description 2yt Amount M Receptacle, Switch, Outlet& Fixture 146 841.00 �P�uming�f u�res a�tl eti s��XtUres � f „_-� "wF� 7 � _; 86,Op Gas System 1 116.00 Residential Water Heater 1 83.00 arced •or Gta I De tlprla� "Q B ri r �1 1�,0,�„0,, Air Handling/Condensing Units SFR 1 133.00 Administrative Fee 1,811 1,811.40 GREEN FEE 1 18.00 RESIOE TI t" w a$ 1 �" ' New Construction Permit Fee 1 1,961.40 $6,815.80 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 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_Templatespt 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 ❑ 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 3ssu of the Labor Code, for.the performance of work for which this improvements covered b this permit, I cannot legally sell a structure that I have permit is issued. P Y P 9 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 ❑ 1 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 submitte rat the following b site:hftp;//www.leainfo.ca.00vlcalaw.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# - Lf`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($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 property for the inspection purposes, shall not emolov any persons In any manner so as to become subject to the workers'compensation laws of California, and agree that if I should become - t- - --- �'-V--- subject to the workers'compensation provisions of Section 3700 of the Labor Property Owner or Authorized Agent Code, I shall forthwith comply with those provisions. P rtY g 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, []YES 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 Lender's Civil Code)der's Name APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address 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 ❑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 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($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING. compensation, will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). APPLICATIONBUILDING SAFETY PERMIT/PLAN CHECK f "Menifee DATE PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL *RESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION 'ALTERATION O DEMOLITION O ELECTRICAL OMECHANICAL O NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 0,( Ol J ejtj bL O VK PROJECT ADDRESS '43a(( P_O( '✓' ( �v- ASSESSOR'S PARCEL NUMBER ?794- -060-0(?J LOT TRACT � OWNER NAME j t, -Fvu '^b :33� ( ( _5eka CI LO 14o;fe' ADDRESS Z(-7©�' "h f W FW c) wLAY' CA//''��Q Z�.c PHONE v751 - 6C(I - Da8 2 EMAIL SCvto _ NA60 L1.Qj L _fcswl APPLICANT NAME Se la nn '' 4o -FytL5+r_e ADDRESS �Q SCO(T Pd #P� MUYU'I a CA Gj2�6� PHONE (2 - 6a t � e' >q g2 EMAIL -,EhC4_ CLO 0 kC+, ML\iA - ✓Owl CONTRACTOR'S NAME Iv 1 A OWNER BUILDER? *YES O NO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ SQ FT �©� �dl , L SQ FT APPLICANT'S SIGNATURE �� r ��'r t3« DATE Z 12 �20( CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT AMOUNT CASH `%CHECK# 11CREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT CASH CCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES G' NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityo fineni fee.us Inspection Request Line 951-246-6213 Peres Union High School District 1i1 "rA-:aumiwoy;fln7gmnNu¢r Mvparnq4,£rCu�cm9iarra",y a, SCHOOL FACILITIES FEES 155 t as¢Fourth � PURSD APPI,ICA'TIC.DM 3199 Late: 10/'l.0!2007 st�c Penis,Calffonna 92570-2124 Building Dept.Permit# BRS061091 Main Nuaatr Project Address. 3391 I Sw ater f anyosl.ILoad 951-943dr369 lMlenlfee;, CA Supeintcadant's Office Fax 951-94-5378 `dTract#(s): I'iMl 4979 APN: 384-080-013 Lot (s): 3 Business Applicarnfs Name: Stephen Durand Applicant°s Phone-9949--244-41.28 FAX 951-9434159 j Personnel Applicant's Address: 33911. Sweetwater Caaayou Road OfficeMertifee CA FAX 9st-94�a3-9asz 'I'yve Develoynieat, SMIMohtle6C'oude Wt? C FD _ ❑ Commercial ercial Adlt Replacement Senior Rate Apt.Building L] I Number of Units/Lots: I Total Squat-e Feet": 3709 of "If final building perasnia is over 20 feet unaore or less than this uumbet;supplicant most andiust the lee paid Tmiaws accordingly. Joan D.Cooky ! I certify that the above information is true. Joe E.tDaaughei9.y William F.ldaulstunrn Eric J A.Twym Date: Ja Applicant: -- —._-- -- Carolyn A.Twyreoan CEWFI 'ICATICIN➢ TO TIIE IIP—R . NYT o I3utLDIN G SAFVTI' Dasuiot This certifies that theschool inanities fees iffT05cd 1>Ea ono to(X)Ca9iforain Govennnent Code Section Supesaon u7an¢ 53080;()Pro-legal aaithority in the amount of$1,35 tinT53709 square fW,or $5,007.15(total Dennis D.Murray sunount off fees),and have been paid to the District for the above-lized properfics,and that building permits for this squame footage in this proposed deve➢opmeRut nnnny now be isstmd by youur,uriidncaion. - ,� Prepared Isy: Date: Io/la/zl�tl7 � -,-- Approved.Fay:_ ,��-- .�.--�.�'OL.-_=,✓ �� _, Business Se ices Inept. { Menifee Union School District 30205 Menifee Road, Menifee CA, 92584 CERTIFICATE OF COMPLIANCE PAYMENT OF SCHOOL FACILITY FEES Date: 1 011 0/2 0 0 7 Certificate#: 07/08 - 1041 Developer/Applicant: Stephen Durand Telephone#: 949-422-4128 Bldg. Dept. Plan Check#: BRS061091 Address: 33911 Sweetwater Canyon Road Location of Project: Menifee Tract/Lot#: Parcel#: 384-080-013 RESIDENTIAL SPACE Number of Square Feet CFD 94-1 x 1.92 Total: $0.00 Approved 04124107 3,709 x 3.68 Total: $13,649.12 COMMERCIAL & INDUSTRIAL SPACE Approved 2114106 x 0.3024 Total: $0.00 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 County 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 Governmen Code. Additionally, this notice �advises that the protest thereof must occur within 90 calendar days thereaft DEVEL E /AP I LICANT This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Section 65995. Menifee U.S.D. agrees that building permits for this square footage in the proposed development may now be issued by your jurisdiction. Bruce H. Shaw T Director of Facilities Certificate of Compliance Template 07-08