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PMT17-00315 City of Menifee Permit No.: PMT17-00315 29714 HAUN RD. Type: Residential Addition <ACCELA? MENIFEE,CA 92586 MENIFEE Date Issued: 02/27/2017 PERMIT Site Address: 31292 BRADLEY RD, MENIFEE, CA Parcel Number: 360-220-003 92584 Construction Cost: $0,00 Existing Use: 1 &2 Family Residence Proposed Use: Description of ADDRESSING FOR FUTURE INSTALLATION OF NEW MANUFACTURED HOME Work: Owner Contractor ROBERTO V PULIDO 33080 MAGNOLIA ST LAKE ELSINORE, CA 92530 Applicant License Number: CA Fee Description Out Amount IS1 Building Permit Issuance 1 27.00 Additional Plan Review Building 148 148.37 $175.37 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 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 Contractors 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 priorto completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I 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 webslte: by Section 3700 of the Labor Code,for the performance of work for which this permit Is Issued. www.leginfo.ca.gov/calaw.htmi. 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 enter tl bd4 i entified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred '' Date Z,//Z-7/1 7 dollars($100)or less PROP RN OWNEfOR AUTHORIZED AGENT o I certify that in the performance of the work for which this permit is issued, /J I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If 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 Will the intended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($300,000),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 for guidelines CONSTRUCTION LENDING AGENCY D 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 D No 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 al Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the 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,REPAIRAND PAINTING(RRP) License Law(Chapter9(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 apre-]978 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 I,as owner of the property,or my employee with wages as their sole 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 ❑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: ❑I,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 nut comply with EPA RRP rule please fill out the RRP Acknowledgement BUILDING & SAFETY PERMIT/PLAN CHECK A• • . l Menifee DATE l 0t 1 7 PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL O RESIDENTIAL 0 MULTI-FAMILY MOBILE HOME O POOL/SPA O SIGN SUBTYPE: 0 ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK y A U Yt �K2t 43"t .+�_. ram•-(Jv.p �r ��( �� Dprz� SSrAJ�i /r PROJECTADDRESS ASSESSOR'S PARCEL NUMBER_(34 0-2 2O O/D 5 LOT � TRACT OWNER NAME rr��t,10 C O ADDRESS -5 17 �O 7`ydd- H011a 41� C/t}'�i o��/1UC V1 Chi. go7J C� PHONE 7 �v {-SAS/ �J 3 cf I EMAIL ,y 62//S4t 11-w a 6)w APPLICANT NAME b4�:7"E ADDRESS -9 ,/ �,'0e1C R�✓� AltlWV -7 PHONE Cgs1) ¢¢z� 3238 EMAIL 61/-71e CONTRACTOR'S NAME OWNER BUILDER? 0 YES ONO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ 14 FT L SO FT APPLICANT'S SIGNATURE DATE / 1� DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT AMOUNT O CASH OCHECKH OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER 0 YES O NO City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.citycfinenifee.us Inspection Request Line 951-246-6213 Branch :S06 User:4000 i Recordirigmquasfed by. DOC#2016-0465518 _Z a TiHDof California,Inc. 10/21/2016 05:00 PM Fees: $28.00 - Page1•of2 RECORDING REQUESTED BY: Recorded iR Official Records Stewart Tide of California,'Inc. County of Riverside' .. :Peter Aidana AND WHEN RECORDED MAIL TO: -Assessor-County.Clerk-Recorder - Roberto Pulido 33080 Magnolia Street _ .—This document-was electronically submitted Lake Elsinore,CA 92530-1431 " . to the County of Riverside for recording^ Receipted by:MARY ff420 Order No.: 01180-243649 Escrow No.'.4304383-Alf - - A.P N: 360.220-003-4 - - SPACE ABOVE THIS LINE IS FOR RECORDER'S USE rA v —U]` GRANT DEED THE UNDERSIGNED GRANTOR(S)DECLARE(S) DOCUMENTARY TRANSFER TAX IS$107.25 - (X]. computed on full.value of property conveyed,or ( ] computed on full value less value of liens or encumbrances remaining at time of sale. [ ] unincorporated area [ X ] City of Menifee FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged; Janette L'. --Sanchez,A Married Woman as her Sole and Separate Property hereby GRANT(S)to Roberto Pulido,A Married Man as his Sole and Separate Property the following described real property in the County of Riverside,.State of California: Legally,described as: See Exhibit'•A•'attached hereto The property more commonly known as: Vacant land Apn:360-220-0.03-4 Bradley.Road,Menifee,CA 92584 Rated: October 12;2016 - [d�,,Klyb pulI"orother officer completing this certificate -n1identityofta.whichthis certiflcate'is attadted,:and not theess,accuracy,or validity of that document - J - He L� Sanchez TFF��NE��FFEB STATE OF.'PJk'FFBRNtA ) COUNTY OFOn - . 't)2tZ before me, M�_ Oit!% a notary public . personally appeared SFXh?.t'FG _ $Ot.fReh1-Z who proved to me on the basis of satisfactory evidence to be ,`. .....0�A 2J',, the person(s) we name(s) istam subscribed to the in. Q. in and admowladged to me that he/sheAhey exeeuled tsr Q�:� a the same in hiwberAheir authoraed capacity(es), and that by OF _ hislherAheir signature(s)on the instrument the person(s),or the . entity upon behalf of which the person(s) acted, executed the f.(QT,A,�Rrr'f� _.`�. . instrument. the Sws ta a ofrtify under CalifomEa thatY OF PERJURYthe foregoing paragraphs is truer and �Y COUN �``�`, correct L - WITNESS myh and official se I. - - , (:U—. a,. `C� t, r-n�( �hnti,rsslo� xprus: rnah �9rZozv ' Signature t i (This area for official notary seal) MAIL TAX STATEMENTS AS DIRECTED ABOVE i Paeea of 2 Branch :S06 User :4000 l i DOC k016-0465518 Page 2 of 2 i Exhibit A Legal Description All that certain real property in the County of Riverside,State of California,described as follows: Parcel 3 of Parcel Map No.6450,in the City of Menifee,.County of Riverside,.State of California,as shoav by Parcel Map_on file in Book 19,Page 21 of Parcel Maps,Riverside County,California. I. II i i i Paoe'2 of 2 G1TY 0p jtAENIFEE' %ft /, Neil R.Winter Re: Address Assignment Date: February 15, 2017 Mayor Matthew Liesemeyer Mayor Pro Tern Greg August Councilmember To Whom It may Concern, Lesa A.Sobek The following address has been assigned: Councilmember APN Address John V. Denver 360-220-003 31292 BRADLEY RD Councilmember Please contact Craig Carlson at the City of Menifee if you have any questions. 9<--- Craig Carlson Senior Inspector City of Menifee ccarlson(@cityofnienifee.us 951-672-6777 ext. 119 29714 Haun Road Menifee,CA 92586 Phone 951.672.6777 Fax 951.69.3843 ✓ww.cityofinenifee.us