PMT16-00869 City of Menifee Permit No.: PMT16-00869
29714 HAUN RD. Type: Residential Re-Roof
�ACCEL/_> MENIFEE, CA 92586
MENIFEE Date Issued: 0 312 3/201 6
PERMIT
Site Address: . 28880 AVENIDA ESTRELLA, MENIFEE, Parcel Number: 341-112-016
CA 92587 Construction Cost: $2,197.71
Existing Use: Proposed Use:
Description of TEAR OFF EXISTING SHINGLES, REROOF W/OWENS CORNING FROSTED OAK COOL ROOF
Work:
Owner Contractor
RODOLFO NAJERA DIAZ RODOLFO NAJERA DIAZ
28860 AVENIDA ESTRELLA 2860 AVENIDA ESTRELLA
MENIFEE, CA 92587 MENIFEE, CA 92587
Applicant Phone: 9513316130
RODOLFO NAJERA DIAZ License Number: 000000
28860 AVENIDA ESTRELLA
MENIFEE,CA 92587
Phone: 9513316130
Fee Description OQtt Amount($1
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
$130.90
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.rpl 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 perjury that 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 ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class License No. By my signature below I acknowledge that,except for my personal residence
Expires Signature in which I 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 DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
❑I hereby affirm under penalty of perjury one of the following declarations:I 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.IeRinfo_ca.Rov/mIaw.htmL
this permit is issued.
Policy# Date
❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which ❑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 I have provided is correct.I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# Expires erthe above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date`� 7
dollars($100)or less
ERTY OVVER OR AUTHORIZED�yC
❑I 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 California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide.
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes ❑No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the intended use of the building by the applicant or future building
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction(S AQ D)modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES f o guide Quality Management District(SCAQMD)7 See permitting checklist
for guidelines
CONSTRUCTION LENDING AGENCY ❑Yes ❑No
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 of a school?
(Section 3097 Civil Code) ❑Yes ❑No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements underthe State of
I hereby affirm under penalty of perjury that I am exempt from the
Contractors License Law for the reason(s)indicated below by the hazardous
Health al Safety Code,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Dyes ❑No
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER 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 RENOVATION,REPAIR AND PAINTING IRRPI
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 licensure 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 he 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($500). managers who do the paint-disturbing work themselves or through their
❑1,as owner of the property,or my employee with wages as theirsole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.epa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
❑1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY •ERM IT/PLAN CHECK APPLICATION
Menifee
DATE 3/ '2Z I I Ip PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL ^ ESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL[' O MECHANICAL
O NEW O PLUMBING �E-ROOF-NUMBEROFSQUARES ,50c)
DESCRIPTION OF WORK
PROJECTADDRESS -�IbU(fo ' rAJ42,Ptiid-a- 1q
ASSESSOR'SPARCEL``��NUMBER y, )Lt- 1lZ-O6lo LOT TRACT
OWNER NAME 'Kbd0Ifiy) NCI•''�rR, bIOLZ /�,� a
ADDRESS �I��� / v �i�(l� 5 ) (R, YYI��) t'LC-, I Z7$
PHONE - 1�J� �3 �' �p I�j� EMAIL
APPLICANT NAME ROdO HO t J 0- Gti- �)"i-GL-2-�
ADDRESS kj;U 0 A, W OLCc nvf,�ia I I ati e, C�I, ' 9g25-Z0--' 1--7
PHONE GPI 331 lP l3D EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES O NO
BUSINESS NAME
ADDRESS
PHONE EMAIL -.
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ 21 q1 �� I SOFT �rjCQ LSQFT
APPLICANT'S SIGNATURE ;' 6D Ild i n z DATE
DEPARTMENT DISTRIBUTION D CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN !/ SMIP
INVOICE 'j ^`O PAIDAMOUNT
AMOUNT I I O CASH OCHECK# O CREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT QCASH CCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES D NO DLNUMBER NOTARIZED LETTER O YES 0 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
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ycnewamericanMortgage Account Statement
F U N D I N G
For Return Service Only If you have questions or concerns about your statement,
P.O.Box 1705B1 contact us at 1-800-893-5304 or TTY/TDD 1-844-249-9633
Austin,TX 78717-0031 between the hours of Monday through Friday 7:00 am and 9:00
pm CT and Saturday 10:00 am to 2:00 pm CT or visit us
0-612-01144-0000230-001-1-000-001-000-000 www.newamericenfunding.com
IIII�III���III III rrlII I IIIll lrlrlr�
Statement Date 12/31/15
ARIVEL NAJERA DIAZ RODOLFO NAJERA DIAZ Loan Number 3000115900
28860 AVENIDA ESTRELLA Next Payment Due Date 02/01/2016
MENIFEE CA 92587-9757 City of Menifee Loan Due Date 02/01/16
Building & Safety Dept, Amount Due $1,233.16
MAR 2 3 2016 If payment is received after 02/16/2016,$34.17late fee will be charged.
Property Address: 28860 AVENIDA ESTRELLA
Received MENIFEE CA 92587
Account Information Explanation of.Amount Due
Outstanding Principal Balance $181,381.39 principal $268.47
Escrow Balance $1.283.71 Interest $585.71
Interest Rate 3.875% Escrow(Taxes and Insurance) $378.98
Pre a ent Penalty NO Regular Monthly Payment $1,233.16
Special Notices Past Due Payments $0.00
Total Amount Due $1,233.16
Help us go GREEN! You can sign up to receive your monthly Past Payments Breakdown
statement via email. Visit ourwebsiteYear
www.newamericanfunding.com to sign up today! PMon h to
t Paid Date
Principal $267.61 $267.61
Interest $586.57 $798.70
Escrow(Taxes&Insurance) $378.98 $1,281.68
Fees and Charges $0.00 $0.00
Total $1,233.16 $2,347.99
tMTl1p- 008&9
Important News
You can pay by mail or phone at no cost by using our automated phone service at 1-800-893-5304 or visit our website at
www.newamericanfunding.com.
If you receive a paper statement in the mail, your 1098 information for 2015 will be included with your January statement 201 B. If you are not
scheduled to get a paper statement or receive one electronically, your 1098 information will be mailed to you by January 30th.Additionally,
the information can also be found by going to www.newamericanfunding.com and logging into your account online after January 10,2016.
Transaction Activity (12/0912015 - 12131/2015)
DATE DESCRIPTION CHARGES PAYMENTS
12/21/15 Int on Escrow 1.53 0.00
12131/15 Payment Received 1233.16 1233.16
12131/15 Int on Escrow -OSD 0.00
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