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PMT16-04259 OFF City of Menifee Permit No.: PMT16-04259 29714 HAUN RD. Type: Mobile Home '5ACCIECA-> MENIFEE,CA92586 MENIFEE Date Issued: 0310312017 P E R M I T Site Addiess: 32525 BRADLEY RD,MENIFEE,CA Parcel Number: 360-340-002 92584 Construction Cost: $10,000.00 Existing Use: Proposed Use: Description of INSTALL MOBILE HOME AS SECOND UNIT Work: Owner Contractor JEREMIAH RAXTER GREAT OAKS ENTERPRISES INC 32525 BRADLEY ROAD P 0 BOX 391300 MENIFEE, CA 92584 ANIZA, CA 92539 Applicant Phone:9517634009 JAMES SHERIDAN License Number:885346 GREAT OAKS ENTERPRISES INC P 0 BOX 391306 ANZA, CA 92539 Phone:9518342035 Fee Description QtV Amount Manufactured Install 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. CONDITIONS Condition Comment 1 OUTSTANDING PLNG FEES AA�_Bldg_Perrnit-Templatexpt Page I of 1 CITY Cl� MENIFEE LICENSED DECLARATION propertywho builds or improves thereon,and who contracts for the projects I herebyaffirm under penalty of perjurythat I am underpicivisions of with a licensed contmctor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and a 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 Clam—/�-I License No et_s.5 ell. By my signature below I acknowledge that,except for my personal residence Expires JOAZI in which I must have resided for at least one year prior to completion of - T-7 1,V— Signatur All improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATIOI tgr� have built as an owner-builder if it has not been constructed in its entirely 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 workees 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 this permit Is Issued. www.legmfo.ca.gov/calaw.htmI. Policy# Date ci I have and will maintain workees compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which o By my signature below I certify to each of the following:I am the property this permit is issued.My workees compensation insurance carrier and policy owner or authorized to act on the property owner's 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 enter the above identified property for inspection purposes. (This section need not to be completed is the permit Is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ",e fy that In the performance of the work for which this permit is Issued, 17 n I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 0 worker's compensation laws of California,and agree that if I should become subject to the worker's compensation provisions of Section 3700 of the Labor HAZARDOUS MATERIAL DECLARATION Code,I shall forthwit:h 7coVpb those provisions. Will the applicant or future building occupant handle hazardous material or a API)Ilcant Date 3-S-)-7 mixture containing a hazardous material equal to or greater that the amounts spec':ed on the Hazardous Materials Information Guide? WARNING:&I I R SECURE-WORKER'S COMPENSATION COVERAGE IS 0 Yes ;;fic' UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future build Ing AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South IN SECTION 3706 OF THE LABOR CODE,INTEREST�AND ATTORNEYS FEES CoastAi.r Quality Management District(SCAQMD)?See permitting checklist for guidelines CONSTRUCTION LENDING AGENCY o Yes 2_16� 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) n Yes a-M-6 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 permitring checklist.I understand my requirements under the State of Contractor's License Law for the reason(s)indicated below by the California Health&SafeAy Code,Section 5505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 azar usmatelal p ing. a No Businessand Professions Code).Any city or county that requires a permitto s jt'�t construct,alter,improve,demolish or repair any structure,prior to its MOPE TY OWNER OR AUTHORIZED AGENT Date 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 Contractor's State F=-�--11-110N.REPAIR AND PAINTING IRRP License Law JChapter 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 ci 1,as owner of the propeft or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do I )all of or( )portion of the work,and the structure is www.epa.goy/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 Contractor's State License Law does not apply to an owner of a a An EPA Lead-Safe Certified Renovator will be responsible forthis 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 forthis project because: ci 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contmactor's 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 PERMIT/PLAN CHECK APPLICATION I Wen'fee DATE PERMIT/PLAN CHECK NUMBER TYPE: OCOMMERCIAL ORESIDENTIAL OMULTI-FAMILY elgO-BILEHOME OPOOL/SPA OSIGN SUBTYPE: OADDITION OALTERATION ODEMOLITION OELECTRiCAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK :1�-SrACC� CWAt—VFACrVzsz) PROJECTADDRESS —5zsz,-�, i5 R014D ASSESSOR'S PARCEL NUMBER LOT TRACT "'y OWNER NAME BuIldi,I'1"=,0, , -e ADDRESS 2D nn.� PHONE (9,ef V-2-0 3 s— EMAIL RD, 4 U LUJU APPLICANITNAME 5;Hirelnq^�, Received— ADDRESS ?Q, 'j�o-,c 3�1(3o L *z(,\-, r-,4 - PHONE (7SI) S-*3y- ?,D3 5- EMAIL CONTRACTOWS NAME ECM:r AJ& OWNER BUILDER? 0 YES O� BUSINESS NAME ADDRESS vio Sri (3 0 6 /&oj M, C4- PHONE 9-7 2,() EMAIL CONTRACTOR'S STATE LIC NUMBER &9S3LfG LICENSE CLASSIFICATION VALUATION$ 10,0W n Aii SO.FT /,!5"1 Z- L SO FT APPLICANT'S SIGNATURE DATE I-Z -2-0 1 � I , .1 DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE I PAID AMOUNT AMOUNT I I OCASH OCHECK# 0 CREDIT CARD VISAIMC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECKN 0 CREDIT CARD VISAIMC A/ML [OWNER BUILDER VERIFIED 0 YES 0 No DLNUMBER NOTARIZED LEITER 0 YES 0 N�O�_ City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofmenifee.us Inspection Request Line 951-246-6213 County of Riverside DEPARTMENT OF ENVIRONMENTAL HEALTH www.rivcoeh.org ff LAND USE APPLICATION OFFICE USE ONLY PE CORC FEE: 3880 Lemon Street-Suite 200-Riverside-CA-92501-(951)955-8980 ISO, 62-2 ZI 0 El 47-950 Arabia Street-Suite A-Indio CA 92201-(760)863-7570 V&P, � — -EFHS ON# 1 ! LMS I �, C1 APN: E, TIRF LOT 4 LOT# 2, _Cj TRIPM ' 'j-'E OF�'Ee %,fly UT F SECTION A Name OWNER: Address lcz� 52ADI'- city -gk3 Phone CompanyName L�'z A nt/Contractor AGENT/ Ci zip 2539 CONTRACTOR: Mailing Address �3cll300 Phone 3 Email --Tz-i Site Address 2. 62,S' 12'Z�41 PROPERTY INFO: . 1/1 Water A encYfWell V,2- 'A �— ;- DATE: APPLICANTS SIGNATURE: SECTION 6 Below-For Office Use Only CHECK BOX IF REQUIRED if any boxis checked,this a ication shall be considered denied unfit the i imation is rovlded� Floor Plan andfor Plumbing Layout Required El Holding Tank Agreements Kequimu 0 Special Feasibility Boring Report Required []Certificate of Existing OWTS Required(C-42) 0 Detailed Contour Plot Plan Required(11 to 5 foot intervals) 0 WQCB Clearance Required 7, mtolls Percolation Re It uired SITE ECT REMARKS: EVALUATION INS E,IS 1411TALS/DATE: VO, SE 10 C W BDIRMS# -�T Tr ITS t3-NEW 0 REPAIR I REP 'STING 171 PUMP S'ils Percolation/Boring Report By:, Date: Ucense# 7 C-42 Certifica"On By: Tested Depth: Max. trench depth: Septic tank cap.:: Soil Rate*., I Line(s)'. !t'Ft o rea:: Total Linear Ft: -F �W; �gl,plssflc Chambers Sq.ft.Running foct Rock below drmain line: in. or Sidewall Allowance; Ft.Rock/ Leach Linesibed special design for slope: 11 MIA 0 Overburden Factor. Pit Total D th::: Max ilowable depth: Pit Diameter No.pits: Depth below inlet(bi): CONSTRUCTIO NSTALLATION RtMAKNO: SECTION D OWTS as indicated on the accompanied plot plan using the requirements set forth in This Application is IS Approved Li Denied regarding the design of the� Section C above.6 construction is permitted in the required rese.-,ld 100%Expansion area. Date: -ERSSIgnature: �,YELLOW-Mdg.MPL P1W-APP11=t EPO42(REV 7116) V,)?-[( I�VAJJ)ot�kot-L MUSk bp raA,41' U'u. PAOV- 4D zc�vvn_� County of Riverside DEPARTMENT OF ENVIRONMENTAL HEALTH www.rivcoeh.org OWTS INSPECTION CARD APN: 360 340 - 002- ON No.: so,[( 0 EHS No.: I 6c) 86L4 SiteAddress: 3oq5AS 'BT�adtw , rzoma( , M,01A 1-pp-e— To Schedule anqnspection Please Call (951) 955-8980 CWTS Components Date Re-inspection Inspector �pticT n� of Inspection Date Initials— SeptiGT-aRk_�nrnent _Swmer-�I Final lnspdT� TO BEPOSTED A TJOBSITEINPLAIN VIEW EPO-54(REV 9/Z) Government Code 27361.7 1 Certify Under Penalty of Pedury That The Notary Seal On The Document To Which This Statement is Attached Reads As Follows: Name of Notary: -RE� Zz- e A ) Commission No: Date Commission Expires: County: By Date: 1111111111111111111 IN 2 of 2 f 2 �Wft �W:1/15=62:14MW