PMT17-00370 City of Menifee Permit No.: PMT17-00370
29714 HAUN RD, Type: Mobile Home
'5A—CCELA7. MENIFEE,CA 92586
MENIFEE Date Issued: 0 2/2 712 01 7
PERMIT
Site Address: 31292 BRADLEY RD, MENIFEE, CA Parcel Number: 360-220-003
92584 Construction Cost: $150,000.00
Existing Use: Proposed Use:
Description of SITE PREP FOR INSTALLATION OF NEW MOBILE HOME 2,146 SO FT
Work: SERIAL#FLE220CA17-37218A, FLE220CA17-37218B, FLE220CA17-37218C
Owner Contractor
ROBERT PULIDO AGENT
33080 MGANOLIA ST 31548 ELECTRIC AVE
LAKE ELSINORE,CA 92530 NUEVO, CA 92567
Applicant Phone:9514423238
DON LETEY License Number: 17-PEOP-00005
31548 ELECTRIC AVE
NUEVO, CA 92567
Phone:9514423238
Fee Description OQt Amount l$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 Pennit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe projects
hereby affirm under penalty of perjury that 1 am under provisions of with a licensed contractor(s)pursuantto the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and AI.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: P114UMA P940%ITJ 4C;Oy✓A"-AVILPL%
License Class License No. kS M mW-A7 i 05vC45
By my signature below I acknowledge that,except formy personal residence
Expires Signature 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
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 application is submitted or at the following website:
by Section 3700 of the Labor Cade,far the performance of work for which
this permit is issued, www.Ie&'iAFo.ca/RdLcaIaw.htmI.
Policy N 66W Date 2 0 17
o I have and will maintain workers compensation insurance,as required by PROPS OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which A 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.1 agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
building co structJ' I authorize representatives of this city or county to
Policy# Expires enter the a, ove'9e '�ified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date B (7
dollars($100)or less PROPERTY DINKIER OR IITHORIZED AGENT
o I certify that in the performance of the work for which this permit is issued,
1 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 a 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 a Yes ANo
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) )KYes a No
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
Contractors License Law for the reason h
s)indicated below by the Californiaealth&Safety ode, ection 25505 and 25534 concerning
S
checkmark(s)I have placed next to the applicable Rem(s)(Section 7031.5 hazzardoardo a us mate ' r a
.d
Business and Professions Code).Any city or county that requires a permit to es o No ' ��
construct,alter,improve,demolish or repair any structure,prior to its Date
issuance,also requires the applicant for the permit to file a signed statement PROPERTYO ER AU ORIZED AGENT
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 mare required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
❑I,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.eua.aov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-B00-424-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. o No EPA Lead-Safe Certified Firm is required for 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.
3
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Y� �S
" 5 'wMenifee S .0 T�,
e
DATE I Z8 1 7 PERMIT/PLAN CHECK NUMBER �, W
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY �I`MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBI�BING O RE-ROOF-NUMBER OF SQUARES-}- Q
DESCRIPTION OF WORK /VSfAr1//A JI,Oy 0 - IIA� �{V (PWffiC10 d"e(J� 9'We 9
1rrHA I/Up
PROJECT ADDRESS
ASSESSOR'S PARCEL NUMBER 3[,D -2 20-O/0 b LOT TRACT
OWNER NAME y l p v U Jo (�
ADDRESS '5 0 S 0 1#&, 01911a � 1/Jl{l( g/C/IUD YG 0 91 3 t�
PHONE �sI- S^S /� �JZ{� EMAIL 1/ 6�AiOe'S GI /FyOv LdOlfil
APPLICANT NAME pAl LATE
ADDRESS 3/( S4$ ELEG7I2.IC /IL NUE!/O elf9Z597
PHONE (gC-1) QI-Z-3238 EMAIL iahlete . CPK
CONTRACTOR'S NAME OWNER BUILDER? RYES ONO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ I50 000 S FT 2 4L L SQ FT /2 / Sao
APPLICANT'S SIGNATURE DATE 7 I�
7OWNER
ENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
PLANNING ENGINEERING FIRE GREEN SE7 PAID AMOUNT 0 nT 07 CASH CHECKq CREDITCARD VISA/MC
AN CHECK FEE$ PAID AMOUNT0 CASH 0 CHECK# QCREDITCARD VISA/MC
BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O 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
990472
NOTICE:THIS FORM IS COPYRIGHTED AND REPRODUCTION OF ALL OR PART IS STRICTLY FORBIDDEN,
MANUFACTURER HOME PUR ASE ORDER AND FEDERAL DISCLOSURE STATEMENT
>PURCHASER: V '� -c DATE:
' ADDRE$5: 3 p 6Z W t Q- PHONE:
CITY: [, `L 0 -S NO/' STATE: Q9 ZIP: :2 '3 SALESPERSON: r ��
Subject to the terms and conditions stated on both sides of this agreement Seller agrees to sell-: d? mhaser agrees to,purchase the.follow MFD xilcHome:
MAKE MODEL e.ROOMS APPROX.(NOT INCL. NEW SITUS
row aAR1EAVES.)
Ja S 6 1 W, J? [I USED .S.yotd lel e(X—)* /1r pG G l y
SERIALNUMSER APPRDX I HUD OR NCO NO. - - OT,OF MFG DEL.OATE �4'r 60 o o 03
THECOST+OFTHEMFO./MSL.HOME EXCLUDESTHE US=PRICES FOR THESE'ITEM5i' '' SD:FT:UVINGAREAL '
��OW BAR, J WHEELS,I_WHEEL HUSS, / TIRES,jZAXI 5S I�.L $ 1 F MFD.HOME PRICE
OATS MFO.ORD: .l ESCROW,OP,EN p STKW/OTHER USEOHOMESALESTAX,IFANY,(I5 SO OPRIORTd9/IMO) '$ 'I
ITEMIZED ACC SSORIl AND THEIR COSTS: (SEE ADDENDUMS) "�.____
TOTAL ACCESSORIES (OUTSIDE HOME) $
_ TOTAL MFG. HOME&ACCESSORIES $ ♦�
SALES TAX(ITEMS NOT INTEGRAL TO:HOME) $ -
FOUNDATION SYSTEM r TIE DOWNS $
DELIVERY_
• • OF
AKE MODEL BEDROOMS SET UP $
HCD FEES $ TUC
TITLE NO. SERIALNO. . GLOR INSURANCE PREMIUM (ONLY IF SOLD BY DEALER) $ C V I1
AMOUNTOWNG ACCOUNT NO.
ESCROW FEES $ 700
SCHOOL FEES $
TO WHO W ' OTHER/PRE PAID TAXES $
ESS/PHONE DOC. FEE(NOT A GOVERNMENTAL CHARGE) $ e U t
THE MANUFACTURER STATES THAT INSULATION HAS BEEN - 1.TOTAL CASH PRICE
INSTALLED IN TH S HOME AS FOLLOWS:(NEW ONLY) ,
-- TYPE THICKNESS 'R' FACTOR ALLOWANCE ON TRADE-IN $
LESS BAL. DUE ABOVE $;//yam S tf L
ROOF O5� NET ALLOWANCE $
EXTERIOR WALLS Pi y y(7 55 Yy PAID HEREWITH $
FLOOR 1 3 X _ CASH BEFORE DEL. ' - $—F �t--V—
WARNING—Unless a charge is included in this Agreement for DESIGNATED DEPOSIT $
Public Liability or Property Damage Insurance, Payment for such (INC. INDN.PMT)
Coverage is not provided by this agreement., y.: 2;LESS BUYERS DOWN PAYMENT $ t7-
"if the dealer is also licensed,as a real estate broker,`'the sale 3. UNPAID SAL ON CASH SALES PRICE $ a
Jar
of a manufactured home or mobilehome being installed on a 4. FINANCE CHARGE $
foundation system pursuant td Section 18551 may be 5.ANNUAL PERCENTAGE RATE
included in the purchase document for the underlying real 6.TOTAL PAYMENT AMOUNT(3+4) $ fl
property, provided •that the requirements of HSC SEC. 7. UNPAID BALANCE DUE PRIOR TO DEL. $
18035.3 are met." j8:TOTAL•-DEFERRED�PAVAEN gRICE(2+6) $ (7
(PAYABLE AS FOLLOWS; _'` z+� Q .a X r Cr o Ui K
THE DEALER CERTIFIES THAT THE ro, (f/ v m crfl
INSTALLATION CONTRACTOR IS:
NAME - `ilC-N y. IV(r ln! teca1N pe fCrdw
BUSINESS ADDRESS 5` within
the eve the Manufactured home cannot be delivered'and/or"inspection completed
onesto
CITY `,p. b (� 2 S CA ZIP;, - within the agreed delivery time due t0 nonperformance by the buyer, buyer agrees to
_ one of the following at the option of seller, either (1) to pay $
charges per day until a manufactured home Installation acceptance ar cenilicate of
-A Contractor is required by law to be licensed: and .regulated by the occupancy is obtained in addition to all other consideration owing or(2) pay the sum
Contractors.State License Board, P.O. Box 26000:Sacramento, CA 95827.
of$ in lieu of total consideration.
: 4
������ ....:. :..-...-.� .wn m rr nAwr 'h we
IPalm
I�QT' Fleetwood Rarbar NATIONWIDE, (ter,
��,_NOMFSM. HOMES Ra'mes iui Fwo� n
January 17, 2017 MS17-02
Subject- California State Approved Manufactured Home Foundation Plans.
To Whom It May Concern:
After a thorough review of the foundation plans listed below we can confirm that they meet
the requirements of the 2016 CBC and CRC without any significant changes or alterations.
Document Expiration Wind
Company SPA# Description Name Date: Speed
referenced
Cavco 109.5F Multi-wide, Single Story, CAV—F6 5/8/18 V.ult=
Industries Inc. Foundation 115 mph
Fleetwood MHC401
Double-wide Two Story, *V.asd=
Homes 18-I IF Foundation .2 ]0/10/17 90 mph
Fleetwood 18-14F Single-wide,Two Story, MHC601.2 3/17/18 *V.asd=
Homes Foundation 90 mph
Fleetwood 18-17F Srngle/Multi-wide, MHC901 10/31/17 *V.asd=
Homes Single Story,Foundation 90 mph
*V.asd = 90 mph is equivalent to V.ult= 115 mph.
If there are any questions or comments on this matter,please feel free to call
sl
Sincerely, City of Menifee Building & Safety Dept. 4Z,X s AV 4e
FEB 0 8 2011 W FP m j C70376 s
* 01/18/17
Manuel Santana,P.E. Received s' ervn
Director of Engineering OF rik
Cavco Industries Inc.
1001 North Central Avenue, Suite 800,Phoenix,Arizona 85004