PMT15-03074 City of Menifee Permit No.: PMT15-03074
29714 HAUN RD.
MENIFEE,CA 92586 Type: Residential Demolition
MENIFEE Date Issued: 1010812015
PERMIT
Site Address: 25606 PAPILLON CT, MENIFEE, CA Parcel Number: 329-380-041
92585 Construction Cost: $4,310.00
Existing Use: Proposed Use:
Description of DEMO SLAB FOUNDATION
Work: TR 29495-7
LOT 24
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 II, LLC License Number. 1002375
MENIFEE,CA
Fee Description gty Amount($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 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 Pernit Template.rpt Page 1 of 1
City Of Menifee
le.,,�X-80 :i,'i ❑ fam exempt roti111censure under the Contractors!¢Iate License Law farihe
following rearmnt
I hereby affirm under penalty or perjury that I am licensed under provisions of
Chapter 9(commencing with section 7000)of Division 3 of the Bustness end fay my signature below I acknowledge that,except for my personal residence In
Prates i s"Code d my license Is In full_force and effect /( which 1 must have resided for at least one year prior to completion of
lleLL
e��lse Improventimts covered by this permiti I cannot leg@illy sell a structure that I have
built as an owner-building if it has not been constructed In its entrely by licensed
contractors.I understand that a copy of the applicable Ia v,,Section 7044 of the
r V((b Pi G `>ri' rD GAR tON` business and Professions'God a,Is available upon request when this application is
-" "- submltted of at the following Web site;
'❑ C hereby affirm under penalty, of perjury one of the.following declarations: ntto:l/yiviw leginlo ca.eovlcalaw.himl.
I have and will maintain a certificate of consent of self-insure for workers"
.compensation;Issued by the Director of Industrial Ra7atlons as provided for by Date
Section 3700 of the Labor Cade,for the performance of work for which this
permit is Issued. Properly Owner or Authorized Agent
R.By`my Signature below, I certify to;each of the following: I am the property
�9.(7 I have avid will maintain workers'compensation Insurance, as required by owner or authorized to act on the property owner's behalf. I have read this
�seLfian 3700 of 1hG.Labor Cade, for the performance of the work far which this wtq�allltoli an theappti stile city form Hon andcount) have ordinances ncevkIed s a and state I)agree a comply
dI
permit Is issued,My workers'compensagon insurance carrier and policy number are: y )' laws relating W building
„—m��T- " _6 cohstfilt; .I aullholize representatives of this city or countyto enter the above.
torrrm l'Le-, W -F-ns �n Identifted-propertyfortheInspectionpurposes.
`l IotildZio lS a,`�� 4IZC7l� Date
Prdpedy OwoerorAuthoiized Agent
(Thfs,section need not be,completed Ifthe permit is for oily Business Ucensek
.ono-Hundred dollars($100)orless)
FIAZARDOUS MATERIAL DECLARATION
❑ I certify that In the performance of the work for which this permit Is Issued,I
.snail not embidy any perso05 in any manner so as to becomas a to.(he Will the applicant or'future building occupant handle hazardous material or a
WoYke,a compensation IeWs of California,and agree that If I shouiri become mixture canfaining a-Hazardous material equal to or greater that the
subJeet to the workers'compensation provisions of Secgan 3700 of ti a Labor amounts sp'ecllied on the Hazardous Materials Infoiraton Guide?
Code,I$halt rodhwith cram with those provisions. pYES ONO
_
x m i" f �Cj ZOl
Will lhe'Inten'detl use of the building by the applicant or fuWPe building
occupant requires permit for the construction of rnodification from South
'WARNING, 'ILURE TiO SECURE WORKERS' Coast Alr Quality Management District(SCAQMD)2 See permitting checklist
COMPENISA fON OVERAGE IS UNLAWFUL AND SHALL forguldeilpe's
SUBJECT AN EMPLOYER TO .CRIMINAL PENALTIES AND DYES O.NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,60b),-IN ADDITION TO THE COST OF'COMPENSATION;. Will Ole proposed building or modified fac101y be within 1000 feelof the outer
DAMAGES AS PROVIDED FOR IN SECTION 3766 OF'THE bounday0fieschool7
LABOR'CODE,INTEREST,AND ATTORNEYS FEES OYEs n NO
CONSTRUGTION.LENDING AGENCY 1 have read the Hazardous Material Information Guide and the SCAQMD
I hefeti'y affirm that underI-he penally of perjury there Is a construction lending permining'checkgst.I understand my requirements under the State of
agency for the performance of the work which this permit Is Issued(Section California Health&Safety Code,Section 255,05 and 25534 concerning
3097 CWIICode) hazardous material reporting.
OWNER BUILDER DECLARATIONS OYES O NO
1 bereby:affirm :under penally ofpaqury that I am exempt from the Contractor's Date
License Law for the reasonts)Indicated below by the checkrnark(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 construct,-alter,improve,demolish, 'EPA RENOVATION.REPAIR AND PAINTING(RRP)
of 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-Renovalion,Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's State License Law(Chapter 9(commencing with recefVing compensation for most work that disturbs paint In a preA978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with
she is, exempt from Iicensure 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 Prugrem vislt:
www.epa.gov/lead or contact the National Lead Information Center at
❑ I, as owner of the properly, or my employees with wages as their 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 Professions Code;
The Contractor's State Ucense Law does not apply to an owner of a property ❑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 O 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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
4�•
Men 1-fee
m
DATE 10/01/2015 PERMIT/PLAN CHECK NUMBER 5 -Q
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY [-]MOBILE HOME ❑POOL/SPA [-]SIGN
SUBTYPE: ❑ADDITION []ALTERATION ❑✓ DEMOLITION []ELECTRICAL El MECHANICAL
[]NEW ❑PLUMBING [-IRE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Demolish existing concrete slab for Lot No: of Tract No.29495-7
PROIECTADDRESS 2 (��(p 2.�LC� �L-L-r-(- �J/} /�
ASSESSOR'S PARCEL NUMBER 32st V y 0 "�"T V LOT L'+ TRACT /�"I qq,5--7
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-enterprises.com
CONTRACTOR'S NAME Mendoza Grading&Paving, Inc. OWNER BUILDER? ❑YES❑NO
BUSINESS NAME Mendoza Grading&Paving, Inc.
ADDRESS 11259 Juniper Avenue, Fontana,CA 92337
PHONE (909)822-0738 EMAIL everett@mendozapaving.com
CONTRACTOR'S STATE LIC NUMBER 1002375 LICENSE CLASSIFICATION C-12
VALUATION$ $4,310.00 SO T 2155 L SO FT
APPLICANT'S SIGNATURIf'- DATE 10/01/2015
CfTYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GR SMIP X
INVOICE PAIDAMOUNT
AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-612-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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