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PMT17-00371 City of Menifee Permit No.: PMT17-00371 29714 HAUN RD. SkCCEI./-> MENIFEE, CA 92586 Type: Mobile Home MENIFEE Date Issued: 02127/2017 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 PERMANENT FOUNDATION FOR INSTALLATION OF NEW MOBILE HOME 2,146 SQ 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 OQtt Amount l5l 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 carded 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 Pernit_Templatexpt 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 ands am exempt from licensure under the Contractor's State License Lawfor Professions Code and my license is in full farce and effect. the following reason: WILING A74A 17-T dc;dkgge-[W"25e '+S elftmeblw Aerl pwc—/ License Class License No. By my signature below I acknowledge that,except formy personal residence Expires Signature in which I must have resided for at least one year priortu completion of WORKER'S COMPENSATION DECLARATION Improvements covered bythis permit.I cannot legallysell a structure that I have built as an owner-builder if it has not been constructed in its entirety by o l 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 for workers 7044 of the Business and Professions Code,is available upon requestwhen 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 ofwork for which ,�,r�y�y.le i f .c calaw.html. this permit is issued. Policy If am Date Z 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 construct-on.I authorize representatives of this city or county to Policy It Expires enter the ave' a ified property for inspection purposes.(This section need not to he completed is the permit is for one-hundred "f Date 8 (-7 dollars($100)or less PROPERTY OWf ER OR UTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is issued, I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 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 Ora 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 o Yes prNo 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 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)7 See permitting checklist forguidelines CONSTRUCTION LENDING AGENCY ❑Yes qNo 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) gYes o No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjurythat I am exempt from the permitting checklist.I understand my requirements underthe State of Contractors License Law for the reason(s)indicated below by the California Health&Safety ode,Section 25505 and 25534 concerning checkmark(s)I have placed nextto the applicable item(s)(Section 7031.5 hazardous mate' r o Business and Professions Code).Any city or county that requires a permit to ,PAkes ONO 8 '-7 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 A 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 fora perm it 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 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.eoa.aov/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 o 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: ❑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 RAP rule please fill out the RRP Acknowledgement. BUILDING i SAFETY PERMIT/PLAN CHECK APPLICATION ";Menifee erm . Town or\ DATE PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY ?`MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBIING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK If S`fAJ l A �,.�I'oK IA �JGW �P Kl/FA C�u V� ®�2tc01 PROJECT ADDRESS ASSESSOR'S PARCEL NUMBER-F / 36 a ^Z 20"©O S LOT TRACT OWNER NAME v 10 i?Wc+ o ADDRESS 35 © &'o l#& yo/ia a L tl Ic/NO r't 00- 9xZ 3 0 PHONE �rj I-5^S�/ %J 3 ZI I EMAIL 1100feS GI /f y00, 60W APPLICANT NAME bw E7L ADDRESS 315¢0 E C-TRIG .¢1/e, /✓y�✓U CCfI yZ$G7 PHONE (iSI) ¢4L d- 32M EMAIL o" (efe oo 44,ov.co. CONTRACTOR'S NAME OWNER BUILDER? OES ONO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ 1990 DOO FT Z[4 L SO FT /7-rI 530 APPLICANT'S SIGNATURE DATE Z 7 I� _,CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAIDAMOUNT AMOUNTJUIR OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT OCASH 0CHECK# OCREDITCARD VISA/Mc OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586951-672-6777 www.citycfinenifee.us Inspection Request Line 951-246-6213 February 1,2017 City of Menifee 29714 Haun Road Menifee,California 92586 Re: Autborization to Submit and Process Building Permit Applications APN 360-220-003 Parcel of PM 19/21 Bradley Road Menifee,California To City of Menifee Departments: I am writing to grant permission to Mr.Don Letey to act as my agent in submitting and processing building permit applications and associated documents with the City of Menifee,for the above-referenced property. I am the record owner of this property. Please feel free to contact Mr.Don Letey at(951)442-3238 with any questions regarding this request,and thank you for your kind assistance with this matter. Respectfully yours, Roberto Pulido Owner 33080 Magnolia Street Lake Elsinore,California 92530 ACKNOWLEDGMENT 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 County California unty of RIVERSIDE On FEBRUARY 2, 2017 before me, SALLY BENAVIDES, NOTARY PUBLIC (insert name and title of the officer) personally appeared ROBERTO PULIDO who proved to me on the basis of satisfactory evidence to be the p son whose name I s scribed to the within instrument and acknowledged to me tha06/t1}ey executed the same in his /their authorized capacity0K,, and that b hi heir signaturekeron the instrument the person(Kor the entity upon behalf of which the person(,s�'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 seal. COMM.L B#2o3586a z 0, Notary Public California• o z Riverside County Comm. Tres Ju 30,21117 Signature (Seal) eU r.-wear: MUNICINI WAIIER September 21, 2016 oierei:, Roberto Pulido 33080 Magnolia St. Lake Elsinore, CA. 92530 Subject: SAN53—Will Serve Assessor Parcel Number 360-220-003 Dear Mr. Pulido: Eastern Municipal Water District (EMWD) is willing to provide water and sewer service to the subject project. The provisions of service are contingent upon the developer completing the necessary arrangements in accordance with EMWD rules and regulations. EMWD expects the developer to provide proper notification when a water demand assessment is required pursuant to Senate Bill 221 and/or 610. EMWD expects the developer to coordinate with the approving agency for the proper notification. Further arrangements for the service from EMWD may also include plan check, facility construction, inspection, jurisdictional annexation, and payment of financial participation charges. The developer is advised to contact EMWD's New Business Development Department early in the entitlement process to determine the necessary arrangements for service, and to receive direction on the preparation of a facility Plan-of-Service, which is required prior to final engineering. EMWD's ability to serve is subject to limiting conditions, such as regulatory requirements, legal issues, or conditions beyond EMWD's control. Expiration -one year from date of issue Thank you for your cooperation in serving our mutual customers. If you have any questions, please call me at (951) 928-3777, extension 4472. Sincerely, 7 Rafa I Re endiz, M.S., P� Civil Engineer New Business Department Eastern Municipal Water District RR:mdp 227o Trumble Road + P.O.Box 8300 • Perris,CA 92572-8300 T 951.928.3777 • F 951.928.617. emwd.org Branch :S06 User;:4000 DOC#2016-0465518 Page 2 of 2 I Exhibit A Legal Description All that certain real property ia 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 shown by Parcel Map.on file in Book 19,Page 21 of Parcel Maps,Riverside County,California- i t lililll � . RIVERSIDE. CA DocumentDD 2016-465518 Page:2 of 2 Branch:S06 User:4000 Recordln 9 fegtiesled by DOC#2016-046551 s V.Dwarf Me of CalffbiT la,Inc. 10/21/2016 05:00 PM Fees: $28.00 - Page 1 of 2 0.- RECORDINGREQUESTED BY: Recorded in Official Records Stewart Title Of CalHomia,Inc. County of Riverside - ;Peter Aldana - i 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#420 Order No.: 01180-243649 Escrow No.: 4304383-AH - A.P.N.: 360-220-0034 - - �� SPACE ABOVE THIS LINE IS FOR RECORDER'S USE vpv—UI Lt 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: 360-220-003-4 Bradley Road,Menifee,CA 92584 Dated: October 12,2016 rpublic or other officer completing this certficate ontyttle"identity of the individual who signed the nt towhich this cerli8cate is attached,and not theess,accuracy,or validity of that document J tte L: ;Sanchez T N EE STATE OF ) COUNTY OF MRLLK-y ) On - �C tZ 1 DO V before me, n�� - rt a notary public personally appeared —3 Okh 6ilG who proved to me on the basis of sa0shctory evidence to be `�• �•`'i POTryk the person(s) whose name(s) istam subscribed to the within. �. J• t - •• y instrument and acknowledged to me that he/shefthey executed �i OF the same in his/herAheir authorized rapacityCies), and that by ¢� ��,�p • • his/her/their signature(s)on the instrument the person(s),or the — TE1'+`''�"'— • � - entity upon behalf of which the person(s) acted, executed the �.�,r[� •:�. instrument. y +•• 1^+�"'� � • . , I certify under PENALTY OF PERJURY under the laws of the '49 '4'>/ ••••• �' State of California that the foregoing paragraph is true and � Y 60uN�.•` correct. WITNESS my I hand and official s I. pwlp• r�1 Uhn^%t 6siOn .Exp rus : f(lah \ 9t z02v Signature ` (This area for official notary seal) MAIL TAX STATEMENTS AS DIRECTED ABOVE- i RIVERSIDE. CA Document:DD 2016.465518 Pagel of 2 THIS SPACE FOR RECORDER USE ONLY STATE OF CALIFORNIA BUSINESS,TRANSPORTATION AND HOUSING AGENCY ODEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DIVISION OF CODES AND STANDARDS MANUFACTURED HOUSING PROGRAM RECORDING REQUESTED BY: WHEN RECORDED MAIL TO: NAME Roberto Pulido ADDRESS 31292 Bradley Rd. CITY,STATE,ZIP CODE Menifee Riverside CA 92584 ONLY THE ENFORCEMENT AGENCY MAY RECORD THIS DOCUMENT NOTICE OF MANUFACTURED HOME, MOBILEHOME OR COMMERCIAL MODULAR- INSTALLATION ON A FOUNDATION SYSTEM Recording of this document by the enforcement agency indicates compliance with California Health and Safety Code Section 18551(a). This document is evidence that the enforcement agency has inspected the installation and issued a Certificate of Occupancy,form HCD 513C,for the unit described herein,upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. ALL INFORMATION BELOW MUST BE ENTERED BY THE ENFORCEMENT AGENCY PROPERTY INFORMATON ENFORCEMENT AGENCY INFORMATION Roberto Pulido City of Menifee REAL PROPERTY OWNER NAMES) ENFORCENENT AGENCY ISSUING PERRIT and CERTIFICATE OF OCCUPANCY 31292 Bradley Rd. 29714 Haunt Rd. NAILINGADDRESS MMUNGADDRESS Menifee Riverside CA 92584 Menifee Riverside CA 92586 CITY COUNTY STATE ➢PCODE CITY COUNTY STATE ➢P CODE SAME PMT17-00371 5) 672-6777 INSTALLATION ADDRESS(it digereng BUILDINGPERMTNO. TELEPHONE NURSER ❑I EVIDENCE UNI L NHOLOER(S)RELEASE,OR CONSENT TO INSTALLATION Cm COUNTY STATE ➢P CODE PROYID /A A —SEE REVERSE SIGNATURE OF ENFOR NIENT AGENCY OFFICIAL DATE OWNER INFORMATION DEALER INFORMATION SAME Lake Perris Realty UNIT OWNER pt.4 Popedyaener,wit'SAAE'J DEALER NANE(It W a deatr a ,wit NONE1 DL1266703 MMUNGADDRESS DEALER UCENSE NUMBER 25025 Red Maple Lane, Suite 106 CRY COUNTY STATE ➢PCODE DEALER BUSINESS ADDRESS Moreno Valley Riverside CA 92551 CITY COUNTY STATE DP CODE MANUFACTURED HOMEIMOBILEHOME/COMMERCIAL MODULAR UNIT DESCRIPTION Fleetwood Homes, Inc. Vogue II /2202V40564K 02/28/2017 MANUFACTURER'S NAME MODELRAM INUR®ER MMUFACTUREDATE FLE220CA17-37218A/B/C SERIAL NURSER(s) 56'x 40' PFS1181742 /43/44 LENGTNx WIDTH CA INSIGNIA(S)MUD LABEL NUNBER(S) 360-220-003 8818490 ASSESSORS PARCEL NUNBER HCDREGSTRATIONDECALNUREER NCONUNBER(Nwe Mlonty) REAL PROPERTY LEGAL DESCRIPTION Parcel 3 of Pareel Map No. 6.450, in the Gity of Menifee. eintirity of Riverside, state of ealifo, i a, as Show i by Pareel Map on file in Ronk 19 Page 21 of Parcel Mans Riverside County, California DISTRIBUTION—Original to County Recorder,One Copy to HCD;One Copy to Applicant;One Copy to Enforcement Agency HCD 433A(Rev.10/2011) GENERAL GUIDE AND INSTRUCTIONS ON REVERSE STATE OF CALIFORNIA NUMBER:BUSINESS,CONSUMER SERVICES AND AGENCY �} [} DEPARTMENT OF HOUSING AND COMMUNITY NG DIEVELOPMENT H�1 O Q J DIVISION OF CODES AND STANDARDS MANUFACTURED HOUSING PROGRAM MANUFACTURER CERTIFICATE OF ORIGIN ❑ CHECK IF THIS IS A DUPLICATE MCO-ENTER ORIGINAL MCO NO. MANUFACTURED HOME OR MULTIFAMILY MANUFACTURED HOME NUMBER OF ,J )Q SFD(SINGLE FAMILY DWELLING) ❑ MFMH(MULTIFAMILY MANUFACTURED HOME) TRANSPORTABLE SECTIONS COMMERCIAL MODULAR: OCCUPANCY GROUP MANUFACTURER NAME: MANUFACTURER LICENSE NUMBER. Fleetwood Homes, Inc. MF 1200755 MANUFACTURER ADDRESS: SUGGESTED RETAIL PRICE: (pg Jurupa Ave. (,Ity)Riverside (state) CA (Z1p)92504 MANUFACTURER TRADE NAME: MODEL NAME ANDIOR NUMBER: DATE OF MANUFACTURE: Vogue II 2202V40564K 02/28/2017 NAME OF DEALER OR TRANSFEREE(OWNERSHIP TRANSFERRED TOY CALIFORNIA DEALER NUMBER OR DATE OF TRANSFER: TRANSFEREE DESIGNATION: 03/O4/2017 LAKE PERRIS REALTY DL1266703 DEALER OR TRANSFEREE ADDRESS: (?&935 RED MAPLE LANE,SUITE 106 ( ,MORENO VALLEY (state) CA (zip) 92651 INVENTORY CREDITOR NAME: COD INVENTORY CREDITOR ADDRESS: (Street) (City) (State) (zip) SECTIDN MANUFACTURER SERIAL NUMBER HCD INSIGNIA OR HUD LABEL NUMBER LENGTH WIDTH WEIGHT 1,8 (INCHES) NCHES IPOUNDSi 1 FLE220CA17-37218A PFS1181742 652 162 31,100 2 FLE220CA17-37218B PFS1181743 676 160 30,700 3 FLE220CA17-37218C PFS1181744 654 162 28,750 TRANSPORTER NAME'. Quality Home Transport TRANSP RTER ADOR�SS• 92545 2750 III. Acacia Hemet CA (Street) (city) (Slate) 1ZIp) DESTINATION FOR UNIT DESCRIBED ABOVE: NAME IStreet (Col Stale 2i I certify under penalty of perjury under the laws of the State of California that the above fads are true and correct. Executed on 03/04/2017 at Riverside Riverside CA (Date) (City) (County) (State) SIGNATURE OF AUTHORIZED AGENT' - - - DISTRIBUTION: ORIGINAL(PINK) FORWARD TO THE INVENTORY CREDITOR.UNLESS THERE IS NONE,THEN FORWARD TO THE PURCHASER(DEALER OR TRANSFEREE). COPY 1(WHITE) FORWARD TO THE DEPARTMENT AT P.O.BOX 1928.SACRAMENTO.CA 95812-1828,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 HCD 483.0-Side 1(Rev.07115)