PMT15-01061 i
City of Menifee Permit No.: PMT16-01061
29714 HAUN RD.
1'�-\CCELA—. MENIFEE, CA 92588 Type: Mobile Home
s.muurs tmk'. MENIFEE Date Issued: 04/24/2015
PERMIT
Site Address: 25170 MALONE AVE, MENIFEE, CA Parcel Number: 327-400-002
92585 Construction Cost: $79,000.00
Existing Use: Proposed Use:
Description of PERMANENT FOUNDATION FOR MANUFACTURE HOME 1822 SQ FT
Work:
Owner Contractor _
VALENTINO MOCA
25170 MALONE AVE
MENIFEE, CA 92585
Applicant License Number:
ROBERT NICORICI
3849 HALLADAY AVE
RIVERSIDE, CA 92503
Phone: 9517081150
Fee Description QtY Amount
Manufactufgd Permanentoundalonx __M _! ?a ;s1, h qr4 42402
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 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,orwhere 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
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
,del 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 b this permit, cannot legally sell a structure that 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 Profession 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 e fo dG+ing Web site:http://www leginfo ca gov/calaw htm1.
permit is issued.My workers'compensation insurance carrier and policy number are: 1. 2 y�
Carrier Hropert ner or Author" Agent Date
Expires Policy#
y 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 property for the'nspection 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 became �� _ 7. Zee.�(
subject to the workers'compensation provisions of Section 3700 of the Labor property Ow r or Authorized Agent Date
Code,I shall forthwith comply with those provisions.
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 HANDLEA HAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES 'Z(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
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address 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 AYES 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, WO 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 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 V1,110 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL 4tEPORI'ING.
compensation, will do ( ) all of or ( ) porting of the work, and the structure is PROPERTY OWNER OR aliTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code; \/K�+'
The Contractor's Slate License Law does not apply to an owner of a property X ---� 1�—
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale. If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
i
BUILDING & SAFETY PERMIT/PLAN CHECK AP41CATION,
ty
`Menifee
DATE 4 1Is I IS PERMIT/PLAN CHECK NUMBER Fm-fIS 0R) (0
TYPE: COMMERCIAL RESIDENTIAL I MULTI-FAMILY .._ MOBILE HOME POOL/SPA SIGN
SUBTYPE: -/ADDITION ALTERATION DEMOLITION -' ELECTRICAL MECHANICAL
XNEW ''_' PLUMBING :% RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 'K EPLacf MfN'- 0-f AN O(. L� Ho r3i Le WiTI4
rI rT -FoLk N t)►1;l
PROJECT ADDRESS 2.9 A, Lo l\l A l/
ASSESSOR'S PARCEL NUMBER .3V+-L}00 — Od Z LOT 2- TRACT 4gfJ O
OWNER NAME VALi NTri No (motOCA
ADDRESS 38 Lt kkl-t Ar t� A / AL,/LT L) C.5l61E CA 72.733
PHONE g5-1 3 115-0 EMAIL 1r Lir-ih 6mA4L •CoH
APPLICANT NAME } ,swa T- a �(
ADDRESS 3p� �/ �7Hacc cRr qZ �pq,
PHONE 4S-� i � b I 0 EMAIL TEL'C4- IN (T Mf;'1l' Cof-(
CONTRACTOR'S NAME OWNER BUILDER? XYES NO
BUSINESS NAME -
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ 1 A 0 a SO FT L SQ FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE
AMOUNT PAIDAMOUNTCASH ''.`CHECK# { CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT -CASH 'CHECK# 0CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 3 YES <, NO DL NUMBER NOTARIZED LETTER YES NO
City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92586 951-672-6777
www.cityo,'meni/ee.us lnspection RecIvest Llne 951-246-5213
l0 01
L�
N
345 �
57
2G!8"
4
20
�0r
i
Q•
I I
Power of Attorney
Let this serve as an authorization letter for Robert Nicorici to pull permits At the City of Menifee for
25170 Malone Ave,Menifee.
Sincerely,
Valentino Moca
State of California, County of Riverside,
On 4/22/15 before me,Anna I. Rodriguez, Notary Public, personally appeared Valentino Moca,who
proved to me on the basis of satisfactory evidence to be the personKwhose name i y re ubscribed
to the within instrument and acknowledged to me that ee he/they executed the same it hj.D/her their
'authorized capacit s , and that by 0h /their signatur#on the instrument the perso or the
entity upon behalf of which the person( acted,executed the instrument. I certify under P NALTY OF
PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
WITNESS my and official seal.
Signature
ANNA I. RODRIGUEZ
NA*
COMM,#2004702 '�nn
A NOTARY PUBLIC-CALIFORNIA UI
ORANGE COUNTY
.. MY COMM,ENP,JAB N.7T0,207
Q�g1NG
STATEOF.AALIFORNIA, _ ,NwFtBEE,BU51NEBb Ti371fi5pCfl21A[!{�IANb1 E15��7pAGEh1CY
DEPARTMENT cI AN_4 Qf�t6L &AGENT
. .'�MkMJF�KfC1'C�R£D� ' G�R.12�S
OGRAI4Y",. ,. . . ,. .,...�.. , . .,
IS
MANUFACTURER CERTIFICATE OF.QRIGIN,
❑ CHECK IF THIS IS A DUPLICATE-MCD-ENTER ORIGINAL MCO NO,
MANUM URED14QME QRM"TIFAMjYMANUFArTTRgOHO SINr
NUMBER OF
C SFD(SING)_E FAMILY DWELLING) ❑ MFMH(MULTIFAMILY MANUFACTURED HOUSING) TRANSPORTABLE SECTIONS 2
OCCUPANCY GROUP -
..FAC
Fleetwood Homes,Inc. A T 7RER I N9E"NUMBER
'MANUFACTURER ADDRESS: '
NIF 1200756,
SUGGESTED RETAIL PRICE:
7 Jurupa Ave. Riverside CA 92504
MANUPADTURER TRADE NAME; CN StDte
MODEL NAME ANIJA�NyUM9ER: DATE OF MANUFACTURE
NAMED
DEALER a TRANSP " t L 22r668 Q3/04/2b15
220PX24503Y
NAME O DEALER 4R TRANSFEREE{OWNERSHIP TRAPY^�)<ERRED TO1: CALIfORNIA DEALER NUMBER OR DATE OF TR:AN3FER;
. 1wC T 6FEREE DESIGNATION;,
> D8A6ER,ORTRMOPEEROAPPRES$;,. >.. 03P24A2®1�5
IM 141LI AVME,BS-#2os COSTA 0E3A
Ct7D .
nV4LNTORY CRE#COR ADDRESs: ..
s C.
see
1 FLG220C#15;3S1244 PFS 1145190 1. .
2,
2 FLES20CSS-$SI ±EH PFS E i 19i B1& $ t5IQO
Meeffea CA 9565
AESTIPWT7ANfOR',GND:DBSORIBEOA.BOV,E;. {alb
NAME &Greet C ,... . .
3g a
wruty under pemq of-pequry ender dre iawe of yra gt le of Callfomla that the eooue facts ere true arW.cerreet,
Erleauetl on ...05t'P�4fZ4'15 - Rive
at t'�Bde -
RiVeMide CA
(oe) (CRY) ^'" '
yw* rq»+ ..,,,<::. .�✓ .:✓ (County) (State)
SIGNATURE OF AU1HORIZ9DAMNT: °y+� "�.•• '`,,. .+ -" ..
ORIGML(WNX)........ .PORWARD 70.TME-IN4ENTORY GREDROR,•UN4E EREIS.NON*Ex.,.w'pb9'M"FOR4ypRD TQSHE.PUROHASER D6ALER•flR TRANSFER
DOPY 1{±NHITE) FORWARD TO THE DEPARTMENT AT P 0.BOX�B,SHgCRAMENTO,CA DSB72•t02B,WYPHIN PFVE(8)DAYS pF RELEASE. EE}'COPY L40W) DEDVERTOTHETRANSPORTER TO ACCOMPA THE UNIT T ITS DESTINATION.
COPY B'(GOLDENR40) TORE RETAINED BYTHE MANUFACTURER.
I
HCD 483.0-Slde1•(Rw,01/12)
f
Trinity Escrow, Inc.
-
12345 Mountain Ave., Suite T, China CA 91710
Tel: (909) 591-1668 •Fax: (909)591-1610
BUYERIBORROWER STATEMENT
Final
Escrow Number: 21153-J$ Title Order Number;
Escrow Officer: Kellie S,Potter Date: 03/30/2015 -11-32:48AM
Closing Date: 0313 0/2 0 1 5
Buyer/Borrower: 25170 Malone Avenue,Trust UTD 110414
Seller: JMS Sales,Inc,
Property: 25170 Malone Avenue,Romotand CA 92585
TOTAL CONSIDERATION 75 994,10
Initial Deposit rec'd from Citizens Business Bank'-Incoming Wire-Resolute A NV Corp/Nest IrB0 10,000.00
22427 Akers Lane Trust UTD 110414
Additional Depositrec'd from Citizens Business Vank-Incoming Wire-Resolute NV Corp/Nest 65,994.10
Lendi FBO 22487 Akers Lane Trust
TOTALS 75,994.10 75,994.10
RECORDING REQUESTED BY: DOC #2015.0080612
Fidelity National Title Company 02/27/2015 05:00 PM Fees: $25.00
Page i of 1 Doc T Tax Paid
` Recorded in Official Records
WHEN RECOWED MAIL DOCUMENT AND County of Riverside y
TAX STATEMENT TO: Peter Adana
Assessor,County Clerk&Recorder
Valentino Moca,Trustee
5120 E.La Palma Avenue#105
Anaheim Hills,CA 92807 'This document was electronically submitted
to the County of Riverside for recording-
Receipted by:MGARCIA '..
APN: 327400-002-6
TITLE ORDER NO.:00026334-991-IE1-BS2
ESCROW NO.: 17551-L
GRANT DEED
The undersigned Grantor(s)declare(s)that the DOCUMENTARY TRANSFER TAX IS:$ 68.20 County
XX computed on the full value of the interest of property conveyed,or
_computed on the full valueless the value of liens or encumbrances remaining therrggo n at the time of sale.
OR transfer is EXEMPT from tax for the following reason: \ �t f/\I o� �dw/',I na
FOR A VALUABLE CONSIDERATION,receipt of which is hereby acknowledged,RALPH G.MORNINGSTAR
HEREBY GRANT(S)to Valentino Moca Trustee of the 25170 Malone Avenue Trust UTD February 2015
All that real property situated in the City of Romoland,County of Riverside,State of California,described as:
PARCEL 2 OF PARCEL MAP 8900 AS PER MAP ON FILE IN BOOK 34, PAGE 64 OF PARCEL MAPS, RECORDS OF
RIVERSIDE COUNTY,CALIFORNIAAPN: 327-400-002-6
Commonly Known As:25170 MALONEAVENUE, Menifee, CA 92585
Dated:February 24,2015
A notary public officer or other officer completing this certificate verifies only the
identity of the individual who signed the document to which this certificate is
attached,and net the truthfulness accuracy or validity of that document
STATE OF CAWfORNIA
"'�1 ^ } �q <
COUNTY OF �VP Yc9�1yC��. } �� o/!�i>�
On etkrk 1lAY4 rri J , Own ,before me, RALPH G.M INGSTAR
(�tiArin 0 . *T�)S-S a,-Notary
Public
personalty appeared� ('A Mpmlr L.r�II.Y6�
who proved to a on the basis of satisfactory evidence to be the persona DANA C.FOSS
whose na e re subscribed to the wittII,n Instrument and acknowledged to 'Q�;v!
Commission#2056433
me that /they executed the same Irf,Lil�Yher/their authorized capaoityji4 QZ z Notary Public-Calilornia
and that b hf herAheir elgnature,(af op the instrument the person{bh, or the z Riverside County g
entity upon behalf of which the person( acted,executed the instrument. M Comm.Riverside
Ides Jan 31,2018+
I certify under PENALTY OF PERJURY under the laws of the State of
California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature.�;b .e ri, lyss (SEAL)
MAIL TAX STATEMENTS AS DIRECTED ABOVE