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PMT16-04262 City of Menifee Permit No.: PMT16-04262 29714 HAUN RD. Type: Mobile Home <A-CCELX. MENIFEE,CA 92586 MENIFEE Date Issued: 03/0312017 P E R M I T Site Address: 32525 BRADLEY RD, MENIFEE, CA Parcel Number: 360-340-002 92584 Construction Cost: $10.000.00 Existing Use: Proposed Use: Description of PERMANENT FOUNDATION FOR MOBILE HOME AS SECOND UNIT Work: Owner Contractor JEREMIAH RAXTER GREAT OAKS ENTERPRISES INC 32525 BRADLEY ROAD P 0 BOX 391306 MENIFEE,CA 92584 ANZA, CA 92539 Applicant Phone:9517634009 JAMES SHERIDAN License Number: 885346 GREAT OAKS ENTERPRISES INC P 0 BOX 391306 ANZA, CA 92539 Fee Description QtV Amount 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 specifimtions or from preventing buillcling operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Exmpt 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_l3ldg_Permit-Temp1ate.rpt Page 1 of 1 CITY O� 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 contracturls)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ci 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 13-1 License No fts.5 ell� By my signature below I acknowledge that,except for my personal residence Expires 10/31.6.1--Signatur It A-11 in which I must have resided for at least one year prior to completion of _ /-7 improvements covered by this perm it.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARVANGI� have built as an owner-builder if it has not been constructed in its entirely by o I hereby affirm under Pena Ity of perju ry 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 avallable 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.legInfb.ca.Rov/calaw.htmL Policy# —Date o I have and will maintain worker's 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 worker's compensation insurance carrier and policy owner or authorized to act an the property owner's behalf.I have read this numberare: 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 a have 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 ,<ie'rlify that in the performance of the work for which this permit is issued, I shall not ern Play any persons in any ma nner so as to become subject to the CITY BUSINESS LICENSE# worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the warker's compensation provisions of Section 3700 of the Lab., Code,I shall forthwith co h those provisions. Will the applicant or future building occupant handle hazardous material or a =p Date mixture containing a hazardous material equalto or greater that the amounts speofied on the Hazardous Materials Information Guide? MIARNING'F� 0 SECURE WORKER'S COMPENSATION COVERAGE IS 0 Yes WKO 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 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 Coast Air Quality Management District(SCAQMD)?See permitting checklist forguldellnes CONSTRUCTION LENDING AGENCY a yes �1�0 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) o Yes ale— 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 Contractor's License Law for the reason(s)indicated below by the California Health&Sale 'Code,Section 25505 and 25534 concerning haz s mat lal p ing. checkmark(s)I have placed next to the applicable item(s)(Section 7031.� No Business and Professions Code).Any city or county that requires a permit to Date 1 -7 construct,alter,improve,demolish or repair any structure,prior to its >—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 Contractor's Sta =I ---.'-kND PAINTING IRRIP) 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 Ilcensure 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 perniftsubjects the applicant to a civil penalty of not more than($500). required practices.This includes rental property owners and property managers who do the paint-disturbing work themselves or through their ci 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 I I all of or I )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 Contractor's State License Law does not apply to an owner of a 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 a re 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 pmject because: 0 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor'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. _S� M e n i f n.e DATE PERMIT/PLAN CHECK NUMBER fjAMko -nLGUQ TYPE: OCOMMERCIAL ORESIDENTIAL OMULTI-FAMILY qo4DBILEHOME OPOOL/SPA OSIGN SUBTYPE: OADDITION OALTERATION ODEMOLITION OELECTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 5 0),Jj'r P#AA;UfAc_-rwrl1,) A4p6E, 9 CM. f0WA_7jC).lT_( f0/"� PROJECTADDRESS �2-52,5' ��?Aptj&j 12-CAD ASSESSOR'S PARCEL NUMBER LOT TRACT -:S7- Elulld�ing 08, =y OWNER NAME crmyn4a @Am*F__ Dept. J? DEC 2 0 2916 ADDRESS U52�& 72ADL-,_, Pl>- PHONE EMAIL APPLICANT NAME Received ADDRESS PHONE -2c,.3,e- EMAIL CONTRACTOR'S NAME r0eW CAk& OWNER BUILDER? 0 YES OeO BUSINESS NAME ADDRESS W - _�o?c -31 CWfc., AN 2A, CA PHONE (9750 EMAIL !�fWi 0de&cojLTgVAWcw-Ct-� CONTRACTOR'S STATE LIC NUMBER E&5 3 V/� LICENSE CLASSIFICATION VALUATION$ 10,Odd IQ FT 1-51 e� L SQ FT APPLICANT'SSIGN Ul��_M__ MOM ==Z920k, a , IV DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE PAIDAMOUNT AMOUNT I I 1 0 CASH 0 CHECK# CREDIT CARD VISAIMC PLAN CHECK FEES I PAIDAMOUNT I 1 0 CASH 0 CHECK 4 �CREDITCARD VISA/ OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO City of tvlenifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.dtyofmenifee.us Inspection Request Line 951-246-6213 FIDELITY NATIONAL TITLE DOC t-- man 10/03/2003 MOOR Fe"0-00 RECORDING REQUESTED BY: page I of 2 Recorded in official Records Fidelity National Title County of Riverside EscrowNo. 1717IG48-Z5 Gary L. Orso Title Order No.33039297 Assessor, County Clark L Recorder When Recorded Mail Document and Tax Statement To: 111011111111111111111111111111111111111111 Mr. and Mrs. Raxter 32525 Bradley Road M S U MGE EA PWR ! N"OR GMF W. Menifee, CA 92584 03 qA 4)-7- 2Z-') —A +RHL L. M. bvAut ADVVC I Nib I-N�1"H ubil lc:>5q GRANT DEED P The undersigned grantor(s) declare(s) Documentary transfer tax is $ CV— City Transfer Tax is *cG— I computed on full value of property conveyed, or I I computed on full value less value of liens or encumbrances remaining at time of sale, 0Z [ ->el Unincorporated Area FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Jeremiah D. Raxter and Kristen N. Raxter, Husband and Wife who acquired title as Jeremiah D. Raxter, an unmarried man and Kristen N. Raxter, an unmarried woman hereby GRANT($) to Jeremiah D. Raxter and Kristen N. Raxter, Husband and Wife as Joint Tenants the following described real property in the County of Riverside, State of California: ' Parcel 2 of Parcel Map 5090, In the County of Riverside State of California, as per map recorded in Book 8, page(s) 87 of Parcel Maps, in the office of the County recorder of said cou cou DATED: September 29, 2003 STATE OF CALIFORNIA 1�2 COUNTY OF eremiah D."Raxter before me, --%kA&rsonally appeared 3e-'rEWi%o-V-. -b. �� r�eNsv-r y 0�&Ar-r — Vurgon-affy-I=VM-W me (or proved to me on the basis Kristen N. Raxter of satisfactory evidence) to be the person(s) whose name(s)is/are subscribed to the within instrument and acknowledged to me that he,46he/they executed the same in h4ie Itheir authorized capacity(ies), and that A, I j KA 14 by hieAwltheir signatureis) on the instrument i�h personts), or the entity upon behalf of which 1h: Corn )251132 Notary Public-California Riverside County person(s) acted, executed the instrument. DMYComm-Fy,,;es ion 23,2M4 Witness my hand and offli i seal. Siqnature I I IL TAX STATEMENTS AS DIRECTED ABOVE FD-213(Rev 71961 GRANT DrED P�21f2 STATE OF CALIFORNIA BUSINESS,CONSUMER SERVICES AND HOUSING AGENCY DEPARTMENT OF HOUSING AND COMMUNITY DEYELOPMENT El DIVISION OF CODES AND STANDARDS MANUFACTURED HOUSING PROGRAM MANUFACTURER CERTIFICATE OF ORIGIN [0 ��CK IF THIS IS A DUPLICATE MCO-ENTER ORIGINAL MCO NO. MANUFACTURED HOME OR MULTIFAMILY MANUFACTURED HOME SFD(SINGLE FAMILY DWELLING) MFMHI(MULTIFAMILY MANUFACTURED HOME) SECTIONS COMMERCIAL MODULAR: OCCUPANCY GROUP MANUFACTURER NAME: MANUFACTURER LICENSE NUMBER: MANUFACTURER ADDRESS SUGGESTED RETAIL PRICE: (street) : ! , . : : I I � , q (City) (State) (zip) MANUFACTURER TRADE NAME MODEL NAME AND/OR NUMBER, DATE OF MANUFACTURE: NAME OF DEALER OR TRANSFEREE(OWNERSHIP TRANSFERRED TO): CALIFORNIA DEALER OF TRANSFER: I TRANSFEREE DESIGI DEALER OR TRANSFEREE ADDRESS: (81r,get), - — -1 -_, -7�� (City) (State) (zip) INVENTORY CREDITOR NAME: INVENTORY CREDITOR ADDRESS (Stne.q� (City) (State) (zip) SECTION MANUFACTURER SERIAL NUMBER HCD INSIGNIA OR HUD LABEL NUMBER , LENGTH WIDTH WEIGHT (INCHES) (INCHES) (POUNDS) TRANSPORTER NAME TRANSPORTER ADDRESS (Strol-li. ip � . I (G,ty) (State) (zip) DESTINATION FOR UNIT DESCRIBED ABOVE GO) (State) (zip) �"Smn if do,p a n,Aty ot po='6M Laws of the Sta�e oTcw�fe ,�ia that tfie above zf�a6ts--lebwe �d co,rect. Executed on at (City) (County) (Some) SIGNATURE OF AUTHORIZE 16TRIBUTION: ORIGINAL(PINK) FORWAW TO THE INVENTORY CREDITOR,UNLESS THERE IS NONE,THEN FORWARD TO THE PURCHASER(DEALER OR TRANSFEREE). COPY i(WHITE) FORWADTO THEDEPARTMENT AT P.O.BOX 1828,SACRAMENTO.CASS812-lUB.WITHIN FIVE(5)DAYS OF RELEASE. COPY 2(YELLOW) DELIVER TO THE TRANSPORTER To ACCOMPANY THE UNIT TO ITS DESTINATION. COPY 3(GOLDENROD) TO BE RETAINED BY THE MANUFACTURER. 456 CD 4a3.0-Side 1(Rev.07115) AS EVIDENCED BY THIS Ujd Xng THE MANUFACTURER CERTIFIES F E MANUFACTURER'S KNOWLEDGE AND ELI F THAT IS MANUFACTURED HOME HAS BEEN INSp CTED IN ACCORD. ANCE WITH THE REQUIREMENTS OF THE DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT AND IS CONSTRUCTED IN CONFORMANCE WITH THE FEDERAL MANUFACTURED HOME CONSTRUCTION AND SAFETy STANDARDS IN EFFE ON THE DATE OF MANUFACTURE. SEE DATA PLATE, AS EVIDENCED BY THIS LABEL NO THE MANUFACTURER CERTIFIES TO THE BEST OF THE MANUFACTURER'S KNOWLEDGE AND BELIEF THAT THIS MANUFACTURED HOME HAS BE INSPEC401NACCORD- I . -EN - - ANCE WITH THE REQUIREMENTS OF THE BE Eff OF HOUSING AND URBAN DEYELOPWRT AND it -ORUCTED . - VO IN CONFORMANCE WITH THE FIEOFRAL 14ANUFACTURED HOME CONSTRUCTION AND SAFETY STANDARDS IN EFFECT ON THE DATE OF MANUFACTURE. SEE DATA PLATE. E jN�l E '0'/ Neil R.Winter Mayor Re: Address Assignment Date: May 18, 2017 Matthew Lieserneyer Second Unit Mayor Pro Tem Greg August Councilmember Lesa A.Sobek To Whom It may Concern, Councilmember The following address has been assigned: John V. Denver APIN Address Councilmember 360-340-002 32527 Bradley Rd. Please contact Craig Carlson at the City of Menifee if you have any questions. Craig Carlson Building and Safety Manager City of Menifee ccar1sonO,citvof1menifee.us 951-672-6777 ext. 119 29714 Haun Road Menifee,CA 92586 Phone 951.672.6777 Fax 951.69.3843 vww.cityofmenifee.us Riverside County Fire Department Fire Protection Planning Section Rnmide Offm:�Meaket St.Ste.151).Rivemide,CA 92501 Ph.(01)95S,1777 Fmc(951)s5l�1886 Palm Desed Offiw:77-933 Us Mamallas Rd.,#201 Palm Des�ff,CA 922114131 Ph.(760)863 8886 F..(760)963-7072 Fire Department Clearance/Release Date: 03/01/17 To: ccarlsonlo)cityofmenifee.us: brivera@cityofmenifee.usm mbinnallOcitycli'menifee.us;tbi]oCa)citvofmenifee.us TractlParcel Map Permit/Lot#: 16-MEN 1-04262 (PMT1 6-04262) Job Site Address: 32525 BRADLEY ROAD 0 Final For Recordation 2 - Release For Building Permit(s) El - Shell Final Only(No Tenant) El - Final For Occupancy El - Release For Residential Sprinkler Installation ***NEEDS FIRE SPRINKLR FINAL PRIOR TO OCCUPANCY - Building Plan Check Fees Paid,Water Requirement Met-if water applicable El - Building Plan Check Fees Not Paid n Residential Sprinkler Plan Check Fees Paid F1 Residential Sprinkler Plan Check Fees Not Paid El Other Fees 7 - Fees Not Required If you should have any questions, please contact the appropriate Riverside County Fire Protection Planning office for further assistance. Frank Martinez Print Name of Plan Reviewer/inspector Approved Release Frank Martinez Sent By:Print Name F..C—Ramad 3ffil M012