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PMT16-01660 City of Menifee Permit No.: PMT16-01660 29714 HAUN RD. Type: Mobile Home -inCCEL/47 MENIFEE, CA 92586 MENIFEE Date Issued: 06127/2016 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 NEW MANUFACTURED HOME PERMANENT FOUNDATION 2928 SO FT Work: FLE220CA16-36792A, FLE220CA16-36792B, FLE220CA16-36792C, FLE220CA16-36792D HUD WS PFS1166600, PFS11666-01, PFS11666-02, PFS1166603 Owner Contractor CLAUDIA MARTINEZ' DAVID GOODWIN MASONRY 26251 WHEAT ST 798 HARDING MENIFEE, CA 92585 HEMET, CA 92543 Applicant Phone: 9513235719 License Number:633914 Fee Description 01t l Amount(SI Manufactured Permanent Foundation 1 240.72 Permit Fee 1 27.00 $267.72 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_eldg_Permit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and O I am exemptfrom licensure underthe Contractor's State License taw for Professions Code and my license is in full force and effect. the following reason: License Class & Uc se No. By my signature below I acknowledge that,except for my personal residence Expires I --3 `( -3_ in which I must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legallysell 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:) licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure forworkers 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,forthe performance ofwork forwhich www.Ieginfo.ca.gov/calaw.htmI this permit is issued. Policy# � �I��" PROPERTY OWNER OR AUTHORIZED AGENT Date 'dI have and will maintain workers 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 owners behalf.I have read this number are: [ application and the information I have provided is correct.I agree to comply Carrier -T-64-t- Cavnp. t KS, with all applicable city and county ordinances and state laws relating to �} 7 building construction.I authorize representatives of this city or county to Policy# 11135 3 f c,'/j+ Expires — f— u enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred �y 1 Fl�t.✓� Date dollars($100j or less PR PER OWN R OR AUTHORIZED AGENT D I certify that in the performance of the work for which this permit is issued, //I1 1 shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#�'.-A workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensa�lion provisions of Section 3700 of the Labor Code,I shall fort ith tom y lrfh those provisions. Will the applicant or future building occupant handle hazardous material or a r / mixture containing a hazardous material equal to or greater that the AZZApplicant e_ Date jr `/�/b amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes V`No 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 forthe construction or madifiration 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 oYes 9/i No I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility he within 1000 feet of the lending agency for the performance of the work which this permit is issued outer b oun ary of a school? (Section 3097 Civil Code) ❑Yes o OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous mated I @porting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 gl(es No Business and Professions Code).Any city or county that requires a permitto Date "/� I construct,alter,improve,demolish or repair any structure,prior to its PROP RTY O t 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 forthe 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 D 1,as owner of the property,or my employee with wages as their sale 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.gov/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 D 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 forthe purpose of sale. No-EPA Lead-Safe Certified Firm is required for this project because: ri - o I,as owner ofthe 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 Menifee DATE ^ ( PERMIT/PLAN CHECK NUMBER TYPE: OCOMMERCIAL O RESIDENTIAL 0 MULTI-FAMILY WMOBILE HOME O POOL/SPA O SIGN SUBTYPE: 0 ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL t3 NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK KGI y {,,,,I U ✓2t l iz� v n. nt, �2f , ' PROJECTADDRESS r5 Z S IG-iN to • I`LIS- ASSESSOR'S PARCEL NUMBER 33p - ( ,9�tf4 LOT TRACT OWNERNAMEE `1YU A 4& /I'C.'L_ ADDRESS U Z-,-7 l U4zA _5wi 04v A • c7 PHONE IGsh�l - 031s EMAIL APPLICANT NAME PI U� vV)n J O✓I _� o� &)I -C ADDRESS c-f hy q ry S Y,m r, � �.A , 2 J PHONE �J �l �S y - 130 EMAIL vt )rm 4 5oi r �A6 on, c A 1w I�� CONTRACTOR'S NAME (�� F., J p O� OWNER BUILDER? 0 YES "0 BUSINESSNAME j\u1_ n hSo;%r� ADDRESS d �L � -�`• Y,{(ic�' C�• �ZS'�� PHONE ��51 '�'L �l3o�! EMAIL o u .n s r-r� 0.60 CONTRACTOR'S STATE LIC NUMBER 03 1 i ( LICENSE CLASSIFICATION VALUATION$ s!_ 2 SOFT �L`1ry� LSQPPFT APPLICANT'S SIGNATURE / DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT 0 AMOUNT • 0CASH 0CHECK# CREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECKN 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER 0 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 RECORDEDAT THE REQUEST OF DOC#2016-0155386 �. CHICAGOTITLE-INLANDEMPIRE 04/20/2016 09:41 AM Fees: $28.00 Page 1 of 2 RECORDING REQUESTED BY: Recorded in Official Records Trinity Escrow,Inc. County of Riverside Order No.7101600468-CB Peter Aldana Escrow No.22054 TL Assessor-County Clerk-Recorder Parcel No.330-180-044-9 —rlm%W-& — t q y **This document was electronically submitted AND WHEN RECORDED MAELTO: to the County.of Riverside for recording" CLAUDIA M.MARTINEZ Receipted by:MARIA VICTORIA#411 P.0.BOX 2207 SUN CITY,CA 92585 SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED TBE UNDERSIGNED GRANTOR(S)DECLARE(S)THAT DOCUMENTARY TRANSFER TAX IS SR&T11911 and CITY Slb-K ❑ computed on full value of property conveyed,or ❑ computed on full value less liens or encumbrances remaining at the time of sale. ❑ unincorporated area: Menifee,and FOR A VALUABLE CONSIDERATION,receipt of which is hereby acknowledged,Claudia M.Martinez hereby GRANT(S)to Claudia M Martinez,a single woman the following described real property in the County of Riverside,State of California: Parcel 4, in the City of Menifee,County of Page(s)24,of Parcel Maps,Records ofRiversidemCounty,tCatifomia.e of California,As shown ba�g &ralitok$ton file in Book 78, More commonly known as:26251 Wheat Street,Menifee,CA 92585 MAY 2 •2016 Date January 28,2016 Borrower's Signature Fi e c e Iva d Ncu ld;a 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 Ri✓ee S.S. On lb,before me, PQ714A li. K081n nac oIoIrG personally appear laudia K Martinez who proved to me on the basis of satisfactory evidence to be the eison(f whose name(E)We=subscribed to the within instrument and acknowledged to me that WshehbW executed the same in4d�lherht a$ • authorized capacity(iEs), and that by hk/her/05ir signature(t) on the instrument the person(q), or the entity upon behalf of which the person(4)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 keal. ��C•� / C01 02042408 Signa Sea 10111 IlyGaiMl.E>4iIpW}t.2f,2BiJ Mail Tax Statements to:SAME AS ABOVE or Address Noted Below oY.®SuuW lmwma4 MnYn OUWYf.P�Nn wMGVMYN91+ DOC#2016-0155386 Page 2 of 2 NOTARY CLARITY UNDER THE PROVISIONS OF GOVERNMENT COSE 27361.7,[CERTIFY UNDER THE PENALTY OF PERJURY THAT THE NOTARY SEAL ON THE DOCUMENT TO WHICH THIS STATEMENT IS ATTACHED READS AS FOLLOWS: Name of Notary: Notary Identification Number: County Where Bond Is Filed: Date Commission Exp: — [ Manufacturer No: DATE: / / �/2016 SIGNATURE: AMBER HUMPHRIES/CHICAGO TITLE 2015-0298379 07/09/2015 03:14 P17 Fee; $ 31.00 Page 1 of 3 Recorded in Official Records County of Riverside Peter Aldana Assessor-County Clerk-Recorder 'III 157'�I I�Y�I�h'YRa(Y0. l�f I I�t�lli7 'I II R I p Exam: `j Page DA PCOR Misc Long RFD 1st Ps Adtl Ps Cert cc SIZE NCOR SMF NCHG T: -( Recording requested by: l neZ Space above reserved for use by Recorder's Office When recorded,mail to: y� I Document prepared by: , -- - •Name:C 10(14 b''fl ti t Cr+�-i-lYI� Name ^ _I,r r1 e 7 Q 0.16d'. �o 1 Address C� -Address: c } 1 (� �j / r C / City/State/Zip: Janl h— CN CU5�j6 City/State(Zip l q 86 7 Property Tax Parcel/Account Number:J O q ' C I n } rQ 'tcl,m�l��lrans �er/ a+her aU3h er Quitclaim Deed This Quitclaim Deed is made on 1 t 11\P 5r l +h nt 0 1 5 ,between Fr ll y t C) E jno r' .t n P�7 Grantor,of City of 9--lan State of a 1 Y l C , and fZ713rantee,of City of 11 State of CL111 Y' n i cL 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,an his or her heirs and assigns,to have and'hold forever o ted at p( 5 W 1. �1 e a S ' , City of 1 State of CQ r-\*10, �rc�l �I qs sho r, by p�fce► Ma.p 139L1 '7t. on l e i n 1�JOOK r1$ pa�e PV4 6P. PQr'Ce I Ma s ; reeol �¢ iverside ©�n , CQ b iF ' an �� Ap�i �# 33�- t ��- Oaf-I Co +mon1y ..IfiW � .6 as� 5 Coa51 Wf�ea � !9., 5un City , CavNornlo- CIQ5 Subject to all easements,rights of way,protective covenants,and mineral reservations of record,if any. Taxes for the tax year of a©15 shall be prorated between the Grantor and Grantee as of the date of recording of this deed. 9uitclolm Deed Pg.i(11-12) DOC#2015-0298379 Page 2 of 3 Dated: �Gur,l'�ttie - - - - � • �1r,��- Signature ot t3f-antor Name of Grantor Signature of Witness#1 Printed Name of Witness#1 Signature of Witness#2 Printed Name of Witness#2 State of County of On ,the Grantor, personally came before me and,being duly sworn,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. Quitclaim Deed Pg2(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 orgy the identity of the individual who signed document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that ument. ' ISTATE OF CALIFORNIA } (COUNTY OF !On before me, ' D��G ��lla� Notary IPtil7hc, ; Date (here insert n®e and title ofthe oT=) 1 I (personally appeared I I ' jwho proved to me on the basis of satisfactory evidence to be the persono whose nameN is/are jsubs¢ibed to the within instrument and acknowledged to me that he/dw/they executed the same i jut hisfi=Aheir authorized capacity(i9g),and that by his/l ear-signatt�n eTs)on the i nstnunent (the person(s),or the entity upon behalf of which the personp) acted, executed the instrument. 11 certify under PI?NALTY OF PERJURY under the laws of the State of California that the n s Iforegoing paragraph is true and correct. WITNESS my hand and official seal. SONIA NALLAN Commission#2021617 z QMY Notary Public-California i Santa Clara County Comm.Expires May 21,2017 i I ISIgm - (Seal) OPTIONAL I IDescriptiori of Attached Docum I � !Title or Type of Document: umber of Pages: ' 10ocurrent Data: 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 1 Attachments: Fleetwood expire 2017 foundation plan.pdf / 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 i