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PMT15-00198 City of Menefee Permit No.: PMT16-00198 29714 HAUN RD. Type: Mobile Home G LAry MENIFEE, CA 92586 MENIFEE Date Issued: 0 210412 01 6 1 PERMIT Site Address: 27550 MONROE AVE, MENIFEE 92585 Parcel Number: 329-232-013 Construction Cost: $0.00 Existing Use: Proposed Use: Description of PERMANENT FOUNDATION OF MOBILE HOME; Work: SERIAL#CAHK0127172lA997432A; INSIGNIA RAD1178682; 56'X 13'4" SERIAL#CAHK01271721A997432B; INSIGNIA RAD1178683; 52'X 13'4" Owner Contractor GLEN& MARY PIPKIN 28000 HWY 74 MENIFEE, CA 92570 Applicant License Number: GLEN &MARY PIPKIN 28000 HWY 74 MENIFEE, CA 92570 Phone: 9516740110 Fee Description Ply Amount IS1 Permit Fee 1 27.00 $267.72 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,orwhere the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA BIdg_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 ❑ 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 ❑ lam 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 1 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 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:htto'//www.leuinfo.qg.clov/calaw.html. permit is issued.My workers'compensation insurance carrier and policy number are: Property Owner 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- El I 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 �/J� - workers' compensation laws of California, and agree that if I should become / CG(/u� � > .ZI4/ /S subject to the workers'compensation provisions of Section 3700 of the Labor properly O er or Auth zed Agent Da Code,I shall forthwith comply with those provisions. 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, ❑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 3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE Lender's Name ❑YES 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 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 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 AYES 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL F EPORYING. compensation,will do( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION r M e n i f e e DATE / 7 —/ PERMIT/PLAN CHECK NUMBER TYPE: COMMERCIAL 0 RESIDENTIAL ') MULTI-FAMILY O MOBILE HOME POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL C% MECHANICAL 0 NEW 0 PLUMBING C) RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 7 w ILAq -7 PROJECT ADDRESS 2 TtS ASSESSOR'S PARCEL NUMBER 32q-Z'3 2 - 01, 3 LOT TRACT OWNER NAME ADDRESS aZcfx9O PHONE //I EMAIL ItY of Menjf,, UI ding & Safety Dept. APPLICANT NAME ADDRESS JAN 19 1015 PHONE EMAIL Received CONTRACTOR'S NAME OWNER BUILDER? () YE$ ONO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ SO FT L SO FT APPLICANT'S SIGNATURE G- DATE z22 y I S CffYSTAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE �` _ PAIDAMOUNT AMOUNT �P -) CASH �)CHECKp 'J{REDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT C''CASH O CHECK# :)CREDIT CARD VISA/MC . OWNER BUILDER VERIFIED O YES <) NO DL NUMBER NOTARIZED LETTER '.:)' YES 0 NO City of Menifee Building & Safety Department 29714 Houn Rd. Mdnif_=e, CA 92536 951-572-6777 svww.citvofMenlfee.LiS Inspection Request Line 951-2d6-6213 2yn . �7z i STATE OF CALIFORNIA-BUSINESS,CONSUMER SERVICES,AND HOUSING AGENCY EDMUND G.BROWN JR.Governor DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT %)SING Division of Codes and Standards Z'O ADO On © 011'9 11 u Z � � �rr W Title Search 3°tip,°aF Date Printed : 01/28/2015 Decal#: LAZ7938 Use Code: SFD Manufacturer: HALLMARK-SOUTHWEST CORP Original Price Code: AWN Tradename: WINCHESTER IV Rating Year: Model: 27-1721A Tax Type: LPT Manufactured Date: 05/26/1999 Last ILT Amount: Registration Exp: Date ILT Fee Paid: First Sold On: 06/07/1999 ILT Exemption: NONE Serial Number HUD Label/Insignia Length Width CAHKO127172IA997432A RAD1178682 56' 13'4" CAHKO127172I A997432B RAD 1178683 52' 13'4" Record Conditions: PPF Exempt -An application for title or registration change is pending with the department. For information regarding this application,please call 1-800-952-8356 and request to speak with a customer representative. Registered Owner: GLEN A PIPKIN AND MARY HELEN PIPKIN TRUST DTD 120106 28000 STATE HWY 74 PERRIS,CA 92570 Last Title Date: Pending Title Last Reg Card: Pending Reg Card Sale/Transfer Into: Price$10,000.00 Transferred on 12/15/2014 Sims Address: 27550 MONROE AVE ROMOLAND,CA 92585 Silos County: RIVERSIDE *** END OF TITLE SEARCH *** i RECORDING REQUESTED BY DOC # 2007-0444598 GLEN PIPKIN & MARY PIPKIN 07/09/2007 0 I of I Fee:7.00 Page of 1 �I Recorded in Official Records AND WHEN RECORDED MAIL TO: County of Riverside Larry W. Ward Name:GLEN PIPKIN & MARY PIPKIN Assessor, County Clerk & Recorder Address: 2 8 0 0 0 HWY 7 4 I Iliill I{IIIII Ilt IIII IIlIIiI iilil IIIII III lilil lilt fll City& State: PERRIS, CA Zip: 92570 S R U I PAGE SIZE DA I MISC I LONG RFD COPY M A L 1 466 1 426 PCOR COR SMF NCHG ASSESSORS PARCEL NO. 32 92 32 013—1 O GRANT DEED 606 The undersigned Grantor(s)declare(s) under penalty of perjury that the following is true and correct: Documentary transfer tax is $ 0 . 00 . 0 Computed on full value of property conveyed, or 0 Computed on full value less value of liens and encumbrances remaining at time of sale. 0 Unincorporated area: ® City of PERRIS and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, GLEN A. PIPKIN AND MARY H. PIPKIN, HUSBAND AND WIFE AS JOINT TENATS hereby GRANT(S)to GLEN A. PIPKIN AND MARY HELEN PIPKIN, CO—TRUSTEES, OF THE GLEN A. AND MARY HELEN PIPKIN TRUST DATED DECEMBER 1, 2006 the following described real property in the County of RIVERSIDE State of California: LOT 190 OF ROMOLA TOWNSITE, AS SHOWN IN MAP ON FILE IN BOOK 13, PAGES 8 AND 9 OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIF. THIS DEED IS BEING RECORDED TO CORRECT AN ERRONEOUS TRANSFER OF TITLE WHICH OCCURRED BY QUITCALIM DEED RECORDED DECEMBER 8, 2006 AS DOCUMENT NO. 2006-0904638, RATHER THAN J DEED Dated JULY 6, 2007 Ee� ACKNOWLEDGMENT GLEN A. PIPKIfq State of California �?ait�3 =a ' Countyof RIVERSIDE MARY H. PION On JULY 6, 2007 beforeme, DEBRA K. DAVIS, A NOTARY PUBLIC (HERE INSERT NAME AND TITLE OF THE OFFICER) personally appeared GLEN A. PIPKIN & MARY H. PIPKIN personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s)whose name(s) jsPare subscribed to the within instrument and acknowledged to me that he/she/they executed the same in bia/ber/their authorized DEBI DA"S capacity(ies), and that by hWhedtheir signature(s) on the instrument the person(s), CCW O' 29 or the entity upon behalf of which the person(s) acted, executed the instrument. NOTARY PU61X-CAIIFORt+IU WITNESS my hand and official seal. R $t �10 Signature (SEAL) Title Order No. ---- Escrow, Loan, or Attorney File No. ---- MAIL TAX STATEMENTS TO: SAME AS ABOVE NAME ADDRESS CITY,STATE,ZIP NONJC-om Rev.07101r2006 GRANT DEED Maven Dean,S Essential Fwrns TM PIPKIN, GLEN & MARY I � I I V � V I V � � I I I I GL,,LciY f�l�iEN