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PMT16-00124 City of Menifee Permit No.: PMT16-00124 29714 HAUN RD. 't7�CCELA7 MENIFEE, CA 92586 Type: Mobile Home MENIFEE Date Issued: 07/29/2016 PERMIT Site Address: 25870 GARBANI RD, MENIFEE, CA Parcel Number: 358-240-038 92584 Construction Cost: $120,000.00 Existing Use: Proposed Use: Description of SITE PREP FOR INSTALLATION OF NEW MANUFACTURED HOME 2187 SO FT Work: PER037217CA A,PER037217CA B,PER037217CA C, RAD1517362, RAD1517363, RAD1517364 Owner Contractor CRAIG WATTS GREAT OAKS ENTERPRISES INC 820 BROOKLYN AVE P O BOX 391306 PLACENTIA, CA 92870 ANZA,CA 92539 Applicant Phone:9517634009 JAMES SHERIDAN License Number: 885346 GREAT OAKS ENTERPRISES INC P O BOX 391306 ANZA, CA 92539 Fee Description OQt Amount ISI Manufactured Residential Site Prep 1 196.00 Permit Fee 1 27.00 $223.00 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_Bldg_Permit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects I hereby affirm under penalty of perjurythat I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and effect. the following reason: License Class — License No. �g 3 Y to By my signature below 1 acknowledge that,except for my personal residence Expires )0 1'1 Signature in which 1 must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATH)i have built as an owner-builder if it has not been constructed In its entirety by D I hereby affirm under penalty of perjury one of the following declarations:l licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure for workers 7044 of the Business and Professions Code,is available upon request when compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which www,leeinfa.ca.eov/calaw.html. this permit is issued. Policy# Date PROPERTY OWNER OR AUTHORIZED AGENT ❑I have and will maintain workers compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which D By my signature below I certify to each of the following:i am the property this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this number are: application and the information 1 have provided is correct.I agree to comply with all applicable city and county ordinances and state laws relating to Carrier building construction.I authorize representatives of this city or county to Policy# Expires enter the above identified property for inspection purposes. (This section need not to he completed is the permit is for one-hundred Date dollar 100)or less PROPERTY OWNER OR AUTHORIZED AGENT certify that in the performance of the work for which this permit is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# workers compensation laws of aliforma,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workerscm tion provisions of Section 3700 of the labor Code,I sh forthwith 5 I th those provisions. Will the applicant or future building occupant handle hazardous material or a (_(� mixture containing a hazardous material equal to or greater that the Applicant --r/ Date amounts spec d on the Hazardous Materials Information Guide? WARNING: IL RE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes 0 UNLAWFUL,AND SHALL SUBIECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelinS�' CONSTRUCTION LENDING AGENCY D Yes EffJo I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boundary�fa school? (Section 3097 Civil Code) o Yes OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of Contractors License Law for the reason(s)indicated below by the California Health al Safety[ode,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable ftem(s)(Section 7031.5 bazar ous material rep Business and Professions Code).Any city or county that requires a permit to czyes o (y )^ Date 6 b construct,alter,Improve,demolish or repair any structure,prior to its PROPE TY OW ER OR AUTHORIZED AGENT 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 Contractors State EPA REN ION,REPAIR AND PAINTING IRRPj License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Business and Professions Code)or that he or she is exempt from Ifcensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their o I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.epa.Rov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because: D I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK Y' Menifee 45: �7r DATE `S /Co PERMIT/PLAN CHECK NUMBER (�b TYPE: O COMMERCIAL e-1ESIDENTIAL O MULTI-FAMILY C'lMOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUM��BING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 7`IE-to I'gqblAA)LtfAC-r" eE7) �-- mri— IV Loco J copocAc, PROJECTADDRESS 25 6,qW-g lai AD ASSESSOR'S PARCEL NUMBER S5f3 rq LOT TRACT OWNER NAME I I AS ADDRESS PHONE (rf$/) g-3Y- Z03s EMAIL R£ATOAICSCo.�+STYAF}Ce0- eN.c APPLICANT NAME J:' Awt r,S S Fi IE21 Dk -j ADDRESS PHONE ( 9-S'L� O �y'Z03 S EMAIL CONTRACTOR'S NAME e) (a7C1 Sz T - OWNER BUILDER? O YES O BUSINESS NAME �1 ADDRESS 0 • 1'0 3 1 AgzA, PHONE (d !il 1\J 83Y-2-o3S EMAIL CONTRACTOR'5 STATE LIC NUMBER F5S'71 C/ LICENSE CLASSIFICATION 1 ?'— VALUATION$ 51 FT L SQ FT APPLICANT'S SIGNATURE DATETYSTAFFUSEONLY i, DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT r AMOUNT OCASH OCHECKN ?CREDIT CARD VISA/MC PLAN.CHECK FEES PAIDAMOUNT 0CASH O CHECK 4 0CREDITCARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER C; YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 SING CpV '9q. :_ . _STATE OF CALIFORNIAHO NUMBER " u d. BUSINESS,TRANSPORTATION ANDDHOUSING AGENCY O uL, a :a DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT O "rN Y r• DIVISION OF CODES AND STANDARDSI - 2� 022 MANUFACTURED HOUSING PROGRAM 4 s IBC• O Oq. r , /ZITS'DNb�' E 191ANUF'ACTURER CERTIFICATE OF ORIGIN— Q CHECK IF THIS IS A DUPLICATE:MGO ENTER ORIGINAL MCO:NO MANUFACTURED HOME ORMULTIFAMILVMANUFACTURED HOUSING "NUMBER OF S'FD'(SINGCE FAMILY OWELCING) ❑ MFMH,(MULTIFAMILY:MANUFACTURED HOUSING) TRANSPORTABLE SECTIONS ' COMMERCIAL MODULAR OCCUPANCY GROUP -MANUFACTURER NAME: - -`- ,- MANUFACTURER LICENSE NUMBER. MANUFACTURER ADDRESS::, -- - SUGGESTED RETAIL PRICE' $tr(?at) `• _. ! CIL). SIdIe (ZIP) - MANUFACTURER TRADE NAME. -MODEL NAME AND/OR NUMBER: DATE'OF'MANUFACTURE: NAME OF DEALER OR TRANSFEREE(OWNERSHIP TRANSFERRED TO): "CALIFORNIA DEALER NUMBER OR " 'DATE OF TRANSFER. <- _TRANSFEREE DESIGNATION:..., - DEALER OR TRANSFEREE ADDRESS': - - Sheet), stsl_ Gt , .. _..:_ (State) - - (zip) INVENTORY CREDITOR NAME: - - - INVENTORY CREDITOR ADDRESS: - : - - - (City) _. __ "'(St afe -. . (Zip) _. SECTION - RI- - - LENGTH WIDTH - WEIGHT -.'MANUFACTURER SEAL NUMBER HCD INSIGNIA OR HUD LABEL NUMBER fINCHES ..015HES .:POUNDS) F " TRANSPORTER NAME " TRANSPORTERADDRESS (StreelJ',U. _ i (City) (Slate) (ZiP) r bESTINATIONFORUNRDESCRIBEDA ,DVC .. . MAMEf . _..-------- . _::;. SIvrL .-:_ __ _.__ C�1..:_ .. ___ i._: __ _. _.._C;_ StatoY r .. „.. .�� .i r or ca se ::.. I certify under penally 0(pepury under Ole lavrs o[Lhe Mate DT Gali(ornta-I(iat the above(acts erellve and correct SIGNATURE DFAUTHORI2EDAGENTL, 7^ - DISTRIBUTION: ORIGINAL(PINK) FORWARD TOTHE'INVENTORYCREDITOR UNLESS THERE IS-NONE-THEN FORWAROTOTHE PURCHASER(DEALER OR TRANSFEREE). -:COPY I(WHITE) FORWARD TO SHE DEPARTMENT'ATRO,6O%:1828,S.ACRAI.ONTO.CA95812tl828.WRHM FIVE,.(5)DAYS OF RELEASE.' -r COPY2 ftl-LOW) DELIVERTO THE TRANSPORTER.TO'ACCOhtPANY THE UNIT TO'ITS DESTINATION ' - I'COPYJ(GOLDENROD) 400ERETA(NEDBYTH'c KtANUFACTUBER - - '- HCD 403.0-Side 1-(Rev.01112)- ` - WHEN RECORDED RETURN TO: N.James Watts 820 Brooklyn Ave Placentia, CA 92870 QUITCLAIM DEED THE GRANTOR(S),Anna L Pond Neil James Watts Bonnie L Baker AS TRUSTEES OF THE LORY 0.WATTS AND WILMA L.WATTS FAMILY TRUST DATED APRIL 23 1996 for and in consideration of:one dollar and other good and valuable consideration conveys and Quitclaims to, N.James Watts and Glenda J.watts The following described real estate, situated in the unincorporated area of County of Riverside State of California,together with all after acquired title of the Grantor(s)therein (legal description): Parcel 3 of Parcel Map#6621as shown by Parcel Map on file in Book 22, Page 20 of Parcel Maps,and Riverside County Records Most commonly known as:25870 Garboni Road,Sun City, CA Tax Parcel Number: 358240030-1 DATED _ 3 DATED l )/� 3 DATED td '� 3 . r - - i � G� , _ iti �a�) Anna L. Pond-Trustee Neil mes Watts-Trustee Bonnie L. Baker-Trustee State of California } }ss County of 0?1:7 } On this day personally appeared before me Anna L Pond and Neil James Watts and Bonnie L Baker, Grantor(s),to me known to be the individual(s)described in and who executed the foregoing instrument,and acknowledged that s/he signed the same as his/her free and voluntary act and deed for the uses and Purposes therein mentioned. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. GIVEN nder my hand and official seal this day of M 2013_ N IC in and for the State of Califomia, I rn9aY M commission expires MUNAWAR ARIF LAKHANI COMM. #2004648 z Notary Public•California a z Orange County Comm.Ex nes Jan.19,2017 /1122/2015 Prir l Subject: FW: serial number for Watts From: Abby Durham (Abby@horizonhomecenter.com) To: greatoaksconst@yahoo.com; Date: Saturday, October 17, 2015 10:30 AM Good morning Jim, Here is the serial number for Watts (located in Menifee). 1 know you need it for permit purposes. EPER037217CAAB- Watts Please a me know if you need anything else. Thank you very much. Please have a nice day. Best regards, Abby Durham- Construction Coordinator Abby horizonhomecenter.com Office: 951-537-6850 Direct: 951-537-6853 Fax: 951-926-2664 Cdfae'f " ofl t HS 7100 W. Florida Ave. Hemet, CA 92545 httpsJ/us-mg6.mail.yahoo.mm/nedlaunch?.rand=lkhs6vcj7gj7l#6493055861 113