PMT17-00393 City of Menifee Permit No.: PMT17-00393
29714 HAUN RD.
<A_CCELA_ MENIFEE, CA 92586 Type: Residential Re-Roof
MENIFEE Date Issued:
02/10/2017
PERMIT
Site Address: 27545 CAMDEN WAY, MENIFEE, CA Parcel Number: 335-231-008
92585 Construction Cost: $8,000.00
Existing Use: Proposed Use:
Description of TEAR OFF F)USTING 1 LAYER, REROOF WITH OWENS CORNING COOL ROOF IN SHASTA WHITE
Work:
Owner Contractor
PAUL J SEMINARA
27545 CAMDEN WAY
MENIFEE, CA 92586
Applicant License Number
PAUL J SEMINARA
27545 CAMDEN WAY
MENIFEE, CA 92586
Phone:7606284419
Fee Description ON Amount
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
$130.90
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 ❑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 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 prior to completion of
Improvements covered bythis permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
in 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 website:
by Section 3700 of the Labor Code,for the performance of work for which ww le info.ca. ov ca aw.html.
this permit is issued.
Policy# Date 1 'j
❑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 1 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 enpter the above identi led property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred l o�n d . Date 1— I % _ r
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
❑I certify that in the performance of the work for which this permit is issued,
I shall not employ 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 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($100,000),IN occupant require a permitfor 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 forguidelines
CONSTRUCTION LENDING AGENCY ❑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 ❑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 exemptfrom the permitting checklist.I understand my requirements under the State of
Contractors License Law for the reason(s)indicated below 6y the California Health&Safety Code,Section 25505 and 25534 concerning
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 permitto file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION.REPAIR AND PAINTING IRRPI
License Law(Chapter 9(commencingwith 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 Applicantfor a permitsubjects 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
❑1,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( I all of or( )portion of the work,and the structure is www.eva.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 not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
APPLICATIONBUILDING SAFETY PERMIT/PLAN CHECK
Menifee
DATE 2 "/ 0 — / 7 PERMIT/PLAN CHECK NUMBER 1�
TYPE: O COMMERCIAL XRESIDENTIAL O MULTI-FAMILY t> MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING E-ROOF-NUMBER OF SQUARES 3 7
DESCRIPTION OF WORK p I P(<, v ca 1 E P_C L
PROJECTADDRESS Z75tI C/7 w E A/ E-f-I I. Pc E (',a y 25�
ASSESSOR'S PARCEL NUMBER LOT 1 TRACT I
OWNER NAME -Pp , I
ADDRESS 27�U(S CA MD� Lu CJA ff -) LT`C #,D t tY
PHONE 76o -. Co Lt If 12 EMAIL
APPLICANT NAME J iv 4, " r�, ✓.-
ADDRESS D. 7_� Ll {a �- J7 c b.J wA. `.y` �� t `- E E
PHONE ? I-Q!, P EMAIL
CONTRACTOR'S NAME OWNER BUILDER? KES O NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION -emO, 'Q SQ FT L.SQ FT
APPLICANT'S SIGNATURE .DATE �" _ I J 17
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ap CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE �''{� PAID AMOUNT
AMOUNT • 0CASH 0CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O 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
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DOC#2016-0561089
12/15/2016 04:11 PM Fees: $18.00
RECORDING REQUESTED BY Page 1 Of 2
Recorded in Official Records
T j(A( County of Riverside
AND WHEN RECORDED MAIL THIS DEED AND Peter Aldana rr�
TAX STATEMENTS TO: Assessor-County Clerk-Recorde!P ty Of Menitee
Name Building & Safety Dept.
Street Paul J. Seminars&Veronica Seminars
Address 27545 Camden Way "This document was electronically s+E#d 10 2017
City Sun City, CA 92586 to the County of Riverside for recording"
State Receipted by:CAROL#914
Zip
Received
RECORDERS USE ONLY
ORDER NO. 00432674 GRANT DEED
ESCROW NO. 9578-LC
TAX PARCEL NO. 335-231-008-9 TRA 026-033
The undersigned grantor declares that the documentary transfer tax is $242.00 and is
X computed on the full value of the interest of the property conveyed,or is
computed on the full value less the value of liens or encumbrances remaining thereon at the time of sale.
The land,tenements or realty is located in
unincorporated area X city Sun City and
FOR A VALUABLE CONSIDERATION,receipt of which is hereby acknowledged,
Bruce O.Watkins,Successor Trustee of The William O.Watkins Family Trust dated June 9,2007
hereby GRANT(S)to
Paul J. Seminara and Veronica Seminara, Husband and Wife as Joint Tenants
The following described real property in the City of Sun City,County of Riverside, State of California:
Lot 31 of Tract No.4567, in the City of Menifee,County of Riverside, State of California,as shown by map on file in
Book 73,Page(s)28,29 and 30 inclusive of maps,Records of Riverside County,California.
Dated 11/15/2016 --
A notary public or other officer completing this certificate verifies only the
identity of the individual who signed the document to which this certificate
is attached,and not the truthfulness,accuracy,or validity of that document.
STATE OF CALIFORNIA, ) The William O.Watkins Family Trust dated June
9
COUNTY OF 1�3 Ah�.e/x2/J ) 7 �rrc�ssov
On ti p Vim p Z n 1 r' before me,
,Notary Public �, a O.Wa tins,S stee
personally appeared Bruce O.Watkins .ry4j}ee..
i�clnc� 0- vJq}Y%inStSt4ccc5Snc'�
who proved to me on the basis of satisfactory evidence to be the person(fi whose
name(j) islaxe subscribed to the within instrument and acknowledged to me that
he/shs4thay executed the same in his/herAheir authorized capacity(iea), and that by
hislhco"r signature($)on the instrument the person(j),or the entity upon behalf of
which the person(p)acted,executed the instrument R.SADIGHIM
Own ,)
Commission A 2011867
I certify under PENALTY OF PERJURY under the laws of the State of CaliforniallotayPuhlic-Calllarnla zthat the fore oin ara rah is true and correct.g B P g P Los Angeles County
WITNESS my hand and official seal. My Comm.Expires Mar 14.2017
t
Signature t Notary Public (Notary Seal)
MAIL TAX STATEMENT TO: SAMEASABOVE