PMT15-03054 City of Menifee Permit No.: PMT15-03054
29714 HAUN RD.
<�CCEL—A MENIFEE, CA 92586 Type: Residential Demolition
MENIFEE Date Issued: 10/0812015
PERMIT
Site Address: 25656 SOLELL CIR, MENIFEE, CA 92585 Parcel Number: 329-380-021
Construction Cost: $4,310.00
Existing Use: Proposed Use:
Description of DEMO SLAB FOUNDATION
Work: TR 29495-7
LOT 4
Owner Contractor
STRATA CVE, LLC MENDOZA GRADING& PAVING INC
4370 LA JOLLA DRIVE, STE 960 11259 JUNIPER AVENUE
SAN DIEGO, CA 92122 FONTANA, CA 92337
Applicant Phone:9098220738
FH ll, LLC License Number: 1002375
MENIFEE,CA
Fee Description gly Amount t$1
Building Permit Issuance 1 _ 27.00
Demolition Permit 1 140.00
GREEN FEE -- — ---- -- — 1 — -- 1.00�
$168.00
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee. Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire, and fees paid shall be
forfeited.
AA_Bidg_Permit_Template.rpt Page 1 of 1
City Of Menifee
I','-�';LI NSA Jab +GlfA di(21" 9>'•5 ❑ 1am exempt from llcensure udder the Contractors!State License Law for the
hereby affirm under Penalty or perjury that 1 am licensed under provisions of following reason:
Chapter 9(commencing.with section 7000)of Division 3 of the Business and By my signature below I acjmowledge that,except for my personal residence In
ProfessT113 gods d myllcenseis lrn Tull;forceand effect. L1/_ which I must have resided for at least one year prior to completion of
fh ads , Lt`(o,"gf sa Nb S� 1 Ko Improvements covered by this permit;I cannot legally sell a structure that I have
�( -" gd�t.� bruit as an owner-buliding if it has not been constructed In its entirely by licensed
contractors. I understand that a copy of the applicable law,Sgefion 7044 of the
tt VJbR9'�� 9.T10W DEl^iA T N Business and Professions bode Is available upon request when this application is
U);,-'y'�a.-.><v=-• - •"- - submitted cr at the following Web$le:
❑ 1 hereby affirm under penal of of penury one of the,following declarations: ntto•lMri�wleoinfo ca aovlalaw htmh
I have end will maintain a cedificate-of consent of self-Insure for workers'
compensation)Issued by the Director of Industrial Rdefions as provided-forby Date
Sectlon:370o of the Labor Code,for the_performance of work for which this
permit is Issued. Propefty Owner crAuthin#ed Agent
cz(-�411 d.By my Signature below, I oertify to each of the following: I am the property
XI have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owners behalf. I have read this
ton 3700 of the Labor Code,for the performance of.the work for which this applicalloh sand the Information I have provided is correcF l agree to comply
permit Is Issued:My workers'pompensadon Insurance carrier and pollcy numberere: with all applicable city and county ordinances and state laws relating to building
-T'• cofiWatiion.I aulhonze representatives of this city or county to enter the above-
I'+'y afF7_ C`AtY1P�•n 5 Identified properlyforlhe Inspection purposes.
ef�� `� ��llzb l5 lPtxm,�ll LI � zc�(� Date
"� - (•• -, •• - prapartyownerorAuthodiedAgent
(This:section need r4 be,complewd if the permit is for (;fly Business License fk
.one-hundred dollars($100)or less)
❑ I certify that1n""'the perfgrinadce-of the work far which this permit ls Issued,l HAZARDOUS MATERIAL DECLARATION
shall of a" to an Per sons In any manner so as to become subject to the Will the applicant or"future"building occupant handle hazardous material or
workers'compensat pn taws of California,and agree that If l should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions.of Becfion 3700 of the Labor .amounts sgs6ffied on the Hazardous Materials Information Guide?
Code,Is hall fodhwlth cram with those provislortts. _ ❑TES U NO
+.d Lo l y�?d�S Will thelntended use of the building by the applicant or future buili ing
occupant require a permit for Ihe.cohatnlctlon.of modirtcatlon front South
'WARNING; :IL, E TO SECURE WdR..ERSs Coast Air Quality Management District(SCAQMD)?�See pennilting checklist
COMPENSA ION - OVEE 1$ UNLAWFUL, AND 'SHALL -forguldeline's
SUBJECT AN EMPLO RAG YE TO .CRIMINAL. PSIN IES..AND AYES O NO
CIVIL FINES UP TO :ONE HUNDRED THOUSANDROLLAIRS
($100,000)JN ADDITION TO THE COST OF:COMPENSATON; Will the proposed building or modified facility be within 1600 feet ofthe outer
DAMAGES AS PROVIDED FOR IN SECTION 3706'OF'THE boundary ofa.sobool7
LABORCOOE,INTEREST,AND,ATTORNEY SO:EES DYES El NO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that underI-he penally of perjury thereIs:a construction lending perml0ing'checklist.I understand my requirements under the State of
agency for the performance of the work which this permit W issued(Section Cellfomia Health&Safety Code,Secttbp 255P5 and 25534 concerning
-3097 Civil code) hazardous:material reporting.
OWNER BUILDER DECLARATIONS AYES ❑NO
I herebyaffinn under penally of,perjury that I am exempt from the Connector's
Date
License.Law for the reasons)Indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT
next to the applicable item(s)(Section 7031 5 Business and Professions Code:
Any city or county that requires a permit to construcl,alter,improve, demolish, EPA.RENOVATION.REPAIR AND PAINTING(RRP)
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 The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
provislons of the Contractor's State License Law(Chapter 9(commencing with re6elVfng compensatian for most Work thatdisturbs paint In a preA978 l
Sectjtm 70.00)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply wlth
she is exempt from licensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing Work themselves or through their
a civil penalty of not more than($500).) employees.For more Information about EPA's Renovation Program visit:
www.'epa.govllead or contact the National Lead Information Center at
❑ I, as owner of the property, or my employees with wages as (heir sole 1-800.424-LEAD(5323).
compensaton,will do( )all of or( )porting of the Work,and the structure Is
not Intended or offered for sale:(Section 7044,Business and Professlone Coda;
The Contractor's State Ucense"Law does not apply to an owner of a properly ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees'or,personal effort, builds or Improves the property,
provided that the Improvements are not Intended or offered for sale.If,however, Certified Firm Name:
the building or Improvement Is sold within one year of completion,the Owner-
Bullder.wlll have the burden of proving that It was not built or Improved for the Firm Certification No.:
purpose of sale).
❑ I, as oWner of the property an exclusively contracting with licensed 0 No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's License Law does not apply to an owner of a property
who builds or Improves thereon, and who contracts for the projects with a
licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
& SAFETY • APPLICATION
t=
4�
Menifee
DATE 10/01/2015 PERMIT/PLAN CHECK NUMBER
TYPE: []COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME POOL/SPA ❑SIGN
SUBTYPE: [-]ADDITION ❑ALTERATION ❑✓ DEMOLITION ❑ELECTRICAL ❑MECHANICAL
❑NEW ❑PLUMBING El RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Demolish existing concrete slab for Lot No.Q+of Tract No,29495-7
PROJECT ADDRESS -Z �O �Qp�,e I C'(l,—vA-C ,,{ �j
ASSESSOR'S PARCEL NUMBER �JZ� V�` UZ f LOT `T TRACT 2G`-t"'I
PROPERTY OWNER'S NAME STRATA CVE, LLC; Strata Equity Group, Inc.
ADDRESS 4370 La Jolla Drive,Suite 960,San Diego,CA 92122
PHONE EMAIL
APPLICANT NAME FH II, LLC
ADDRESS 8300 Utica Ave,Ste 300, Rancho Cucamonga,CA 91730
PHONE (909)354-8000 EMAIL ttucker@frontier-enterpdses.com
CONTRACTOR'S NAME Mendoza Grading&Paving, Inc. OWNER BUILDER? ❑YES d❑NO
BUSINESS NAME Mendoza Grading&Paving, Inc.
ADDRESS 11259 Juniper Avenue, Fontana,CA 92337
PHONE (909)822-0736 EMAIL everett@mendozapaving.com
CONTRACTOR'S STATE LIC NUMBER 1002375 LICENSE CLASSIFICATION C-12
VALUATION$ $4,310.00 SO FT 2155 L SQ FT
APPLICANT'S SIGNATURE DATE 10/01/2015
rCITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN LfOrASH
IP
INVOICE PAIDAMOUNT �1
AMOUNT �yO CASH O CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCHECK# OCREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Sofety Department 29714 Houn Rd. Menifee, CA 91585 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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