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PMT16-01659 City of Menifee Permit No. PMT16-01659 29714 HAUN RD. ',A_CCELh� MENIFEE, CA 92586 Type: Mobile Home MENIFEE Date Issued: 05/27/2016 PERMIT Site Address: 26251 WHEAT ST, MENIFEE, CA 92585 Parcel Number: 330-180-044 Construction Cost: $21,358.00 Existing Use: Proposed Use: Description of MANUFACTURED HOME SITE 2928 SO FT Work: SERIAL WS FLE220CA16-036792A, FLE220C16-36792B, FLE220CA16-36792C, FLE220CA16-36792D HUD VS PFS1166600, PFS1166601, PFS1166602, PFS1166603 Owner Contractor CLAUDIA MARTINEZ DAVID GOODWIN MASONRY 26251 WHEAT ST 798 HARDING MENIFEE,CA 92585 HEMET, CA 92543 Applicant Phone:9513235719 DAVE GOODWIN License Number:633914 DAVID GOODWIN MASONRY 798 HARDING HEMET, CA 92543 Fee Description gtv Amount($1 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 BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION lddkMenifee mbbl- DATE G PERMIT/PLAN CHECK NUMBER M I 0 b ,561 TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL (VNEW O PLUMBING O RE-ROOF-N UMBER 99OF SQUARES DESCRIPTION OF WORK L 1 -c w U ✓2� / ,-L Z 't ' J PROJECTADDRESS PzRis Z 5 J dt A , C aZS 5- ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME rr A V ADDRESS U'I--CC 1 vikZA -5u;l V/n� 1 �A . C7 S PHONE rr-I J 0„'ZI - o-ls EMAIL •r" APPLICANT NAME D01,U, _/ v� n J 0✓1 �� 2�" �"� .-t ADDRESS c r-7 n' -5 • 01 � 3 PHONE (°IS11 �St - 130� EMAIL V� ;�, ;h n , nor-H'h�, (. %.,�) p CONTRACTOR'S NAME OWNER BUILDER? O YES 0 BUSINESSNAME fDAuti. ADDRESS U - '/ i,G s '�• .{I;c.'�' ��S l9� PHONE (clsI YZ `j3ef EMAIL / n r,r,) � . 1 G•G0 CONTRACTOR'S STATE LIC NUMBER L33 11 l LICENSE CLASSIFICATION VALUATION$4`Z^1 .155SOFT 1CM191 LSO FT Ap, APPLICANT'SSIGNATURE DATE -4,7 "f OTY STAFF USE ONLY --F-7 DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS UCENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE n.»,� PAID AMOUNT O O AMOUNT OyYI OCASH CHECK# CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES 0 NO City of tMenif ee Building&Safety Department 29714 Haun Rd, Menifee, CA 92526 951-672-6777 ww+w.citvof;nerijPe.us Inspection Request Line 951-246-6213 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 o 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 & L�n:/ense No. By By my signature below I acknowledge that,except for my personal residence Expires j Z-3 1 l Signature n,f'-� YY/ 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 o 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 worker's 7044 of the Business and Professions Code,is available upon request when compensation,issued by the Director of Industrial Relations as provided for this appliation is submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which www.lezinfo.ca.epv/alaw.html. this permit is issued. Polity# 1 `. 6 Date w^` PROPERTY OWNER OR AUTHORIZED AGENT ' 1 have and will maintain worker's compensation insurance,as required by � section 3700 of the Labor Code,for the performance of the work for which t(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 owner's behalf.I have read this number are: f' (/'�JLn/� application and the information I have provided is correct.I agree to comply Carrier '-l. Co kti�> t KS> I� with all applicable city and county ordinances and state laws relating to 4t � building construction.I authorize representatives of this city or county to Policy# l'4 635 3q)— Expires ?,—f—I] enter the above identified property for inspection purposes. n / (This section need not to be completed is the permit is for one-hundred *17 fiy eff Date dollars($100)or less PRdPERTy OWN€R OR AUTHORIZED AGENT o I certify that in the performance of the work for which this permit is issued, q I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# APPLA(Y �0%l workers compensation laws of California,and agree that If I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compens�alion provisions of Section 3700 of the Labor Code,1 shall fort Ith com IV fh those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant z_ Date z �' 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 o Yes A. UNLAWFUL,AND SHALL SUBJECT AN 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 forguidelines CONSTRUCTION LENDING AGENCY o Yes "o 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 bounilary of a school? (Section 3097 Civil Code) ❑Yes rWNo 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 California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous mate' I/porting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ri'6 No �j- 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 PROP TY O f 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 RENOVATION,REPAIR AND PAINTING(RRP) 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 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 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 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. No EPA Lea-��Certified Firm is required far this project because: o 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. a RECORDED AT THE REQUEST OF DOC#2016-0156386 �. CHICAGO TITLE-INLAND EMPIRE 04/20/2016 09:41 AM Fees: $28.00 Page 1 of 2 RECORDING REQUESTED BY: Recorded in Official Records Trinity Escrow, Inc. County of Riverside Order No.7101600468-03 Peter Aldana Escrow No.22054-TL Assessor-County Clerk-Recorder Parcel Neo.330-180-044-9 e / kel ' t7qI& — I c-/ I "This document was electronically submitted AND VaMN RECORDED MAII.TO: to the County.of Riverside for recording" CLAUDIA M.MARTINEZ Reeeipted by:MARIA VICTORIA#411 P.O.BOX 2207 SUN CITY,CA 92585 SPACE ABOVE TEES LINE FORRECORDER'S USE GRANT DEED Qj�� THE UNDERSIGNED GRANTOR(S)DECLARES)THAT DOCUMENTARY TRANSFER TAX IS SR&TI1911 and CITY S�/'/ El computed on full value of property conveyed,or �V ❑ computed on full valueless liens or encumbrances remaining at the time of sale. ❑ unincorporated area: U� -IV Menifee,and FOR A VALUABLE CONSIDERATION,receipt of which is hereby acknowledged,Claudia M.Martinez hereby GRANT(S)to Claudia M.Martinez,a single woman the following described real property in the County of Riverside,State of California: Parcel 4, in the City of Menifee,County of Riverside,State of California As shown b R*all U$jon file in Book 78, Page(s)24,of Parcel Maps,Records of Riverside County,California. Building More commonly known as:26251 Wheat Street,Menifee,CA 92585 MAY 27 .2016 Date January 28,2016 Borrower's Signature Fi e c e iv e d Claudia M.Martinez A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. STATE OF CALIFORNIA COUNTY OF SZi v,' }S.S. n On ) A, -4 D1� I6,before me, (Y1P�T4X C, R.USH nee 01olte personally appear laudia M. Martinez who proved to me on the basis of satisfactory evidence to be the eison(f)whose name(6)is/arrsubscribed to the within instrument and acknowledged to me that la/she/tblgr executed the same inLjjLs/her/tlir authorized capacity(ifs), and that by kis/her/W signature(f) on the instrument the persona), or the entity upon behalf of which the person acted,executed the instrument 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 eal. C•RUSH / COMt C Signa Sea MOLVIY PIN2IC•rALWIII1IMJ1 IxVHtMIIII iY IyCa�lt E1g1;16NRt.tl,20}l Mail Tax Statements to:SAME AS ABOVE or Address Noted Below DOC#2016-0155386 Page 2 of 2 NOTARY CLARITY UNDER THE PROVISIONS OF GOVERNMENT COSE 27361.7,1 CERTIFY UNDER THE PENALTY OF PERJURY THATTHE NOTARY SEAL ON THE DOCUMENT TO WHICH THIS STATEMENT IS ATTACHED READS AS FOLLOWS: Name of Notary: Notary Identification Number: C; " L1 (, County Where Bond Is Filed: Date Commission Exp: /ten✓ /Oj C / a;4 1 1 Manufacturer No: DATE: / / ?/2o16 SIGNATURE: AMBER HUMPHRIES/CHICAGO TITLE 2015-0298379 07/08/2015 03:14 PM Fee: $ 31.00 Page 1 of 3 Recorded in Official Records • County of Riverside • Peter Aldana Assessor-County Clerk-Recorder `r 'III fll"7�11711�1�11+1�117Cl�lfl��t'I,I�II II R I A Exam: `J Page DA PCOR Mlsc Long RFD 1st Pg Add Pg Cert CC SIZE NCOR SMF NCHG T: -T Recording requested by: + l( e2 Space above reserved for use by Recorder's Office When recorded,mail to: Document prepared by- -Name: — - •Name:� 1nR a ti t t04i Q� Name ^ /-171 Address: 1 • pt7`�,(-} (��(� / Address < / City/State/Zip:1In _ 44 I CIt q�_r)96 City/State/Zip I Property Tax Pareet/Account Number:J3� _ CJ 'a�her aU�h er Q' uitclaim Deed This Quitclaim Deed is made on 1 i n P 5A 2015 between T:ru)1J�l F. MCkv4lnP�7 Grantor,of-3_ City of , State of l f 1 and 1 Grantee,of ( U41ca+ SA City of 17 State of CGl 1 0'r n 1 G- For valuable consideration,the Grantor hereby quitclaims and transfers all right,title,and interest held by the Grantor in the following described real estate and improvements to the Grantee,and.his or her heirs and assigns,to have an&hold forever o ted at W 5 1- he0, City of t State of CQ r6a creel �i qs shown by parse► Map 13947 0n +(�e I 0 haoK `l$ Pa� ParCe I f`A �na S 33�- � 8�- �o monly ..I�i �QU Q 6a51 U� eat S� Stan C1•�y 1 Cal,,�'or r» q'a5 Subject to all easements,rights of way,protective covenants,and mineral reservations of record,if any. Taxes for the tax year of a O 15 shall be prorated between the Grantor and Grantee as of the date of recording of this deed. 9uitclalm Deed Pg.1(11-12) DOC#2015-0298379 Page 2 of 3 Dated: Signature o rantor 1,3 -f'Z—. EtU,,v, MaT�r,-V�Qr+_ �� Name of Grantor , Signature of Witness#1 Printed Name of Witness#1 Signature of Witness#2 Printed Name of Witness 42 State of County of On ,the Grantor, personally came before me and,being duly swom,did state and prove that he/she is the person described in the above document and-that he/she signed the above document in my presence. Notary Signature Notary Public, In and for the County of State of My commission expires: Seal Send all tax statements to Grantee. 9ultclalm Deed Pg.2(11-12) DOC#2015-0298379 Page 3 of 3. CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT I I I FAnotary public or other officer completing this certificate verifies only the identity of the individual who signed ocument to which this certificate is attached,and not the truthfulness,accuracy,or validity of that ment. I (STATE OF CALIFORNIA } ! 1 COUNTYQO,F ';On before me, D�1 G / y Q!l 4 Notary iPublic, / ' Date (hero insert name and tide of the officer) 1 1 r ' (personally appeared �� 2 • lw Z I I i jwho proved to me on the basis of satisfactory evidence to be the person whose nameO)is/are Isubscnbed to the within instrument and acknowledged to me that he/slw/they executed the same juthis/her/fir authorized capacity(ie ,and that by his/ir signatus)on the instrument !the person(s),or the entity upon behalf of which the personjA acted, executed the instrument. . ` II certify under PENALTY OF PERJURY under the laws of the State of California that the 9 s foregoing paragraph is true and correct. WITNESS my hand and official seal. SONIA NALLAN Comniisslon#2021617 z ,:o Notary Public-California i z ' Santa Clara County My Comm.Expires May 21,2017 i i Isigna (Seal) OPTIONAL I IDescriptiori of Attached Docum I � ;Title or Type of Document: ; umber of Pages: {Document Date: Other. e Troy Matthews From: Abby Durham <abby@horizonmh.com> Sent: Friday, May 20,2016 9:57 AM To: Troy Matthews Subject: Martinez-Serial numbers Attachments: Fleetwood expire 2017 foundation plan.pdf 1 Serial FLE220CA16-36792A FLE220CA16-36792B FLE220CA16-36792C FLE220CA1 --36792D OHUD Factory Contact Gabriel Aguilar (951)356-6567 Edgar 760-475-3586 Dustin 951-543-3175 Abby Cell 951-956-6217 Thank you, Abby Durham Construction Coordinator Horizon Manufactured Homes Inc. Abby@ horizonhomecenter.com Office:951-537-6850 Direct:951-537-6853 Fax:951-926-2664 1