PMT17-02629 City of Menifee Permit No.: PMT17-02629
29714 HAUN RD. Type: Mobile Home
'LACCELY MENIFEE,CA 92586
MENIFEE Date Issued: 1 013 012 01 7
PERMIT
Site Address: 23560 CASSANDRA DR, MENIFEE,CA Parcel Number: 350-231-043
92587 Construction Cost: $3,000.00
Existing Use: Proposed Use:
Oescription of SITE PREP FOR NEW MOBILE HOME, 1248 SF
Work:
Owner Contractor
GILBERTO RIOS
23560 CASSANDRA DRIVE
MENIFEE, CA 92587
Applicant License Number
GILBERTO RIOS
23560 CASSANDRA DRIVE
MENIFEE, CA 92587
Phone:9513589173
Fee Description O_yt Amount($l
Manufactured Residential Site Prep 1 196.00
Permit Fee 1 27.00
Plan Check Fee 51 51.25
$274.26
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 building 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 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 prior to completion of
improvements covered by this 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
❑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
this permit is issued. www.Ieeinfo.ca.eov/ca1aw.htmL
Policy# 4 i1 �' Date/ 7
❑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 o 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 the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Gam, C. 4. Date la —YO/l 7
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 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 ❑Yes o 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
1 hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)Indicated below by the hazardous material reporting.
checkmark(s)1 have placed next to the applicable item(s)(Section 7031.5 oYes ❑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,REPAIR AND PAINTING(RRPI
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 palm 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 more 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 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.epa.gov/lead or contact the National Lead Information Center at
not Intended or offered for sale.(Section 70",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 he 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 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.
• • z .
Menifee
DATE PERMIT/PLAN CHECK NUMBER - o 67l9a°1
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY COPMOBILE HOME :; POOL/SP &13Y(3Af Menif e
QdmIY Oept.
SUBTYPE: O ADDITION 0 ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
4RNEW O1PlLU^MBING 0 RE-ROOF-NUMBER OF SQUARES JUL 2 7 2 17
DESCRIPTION OF WORK ` 'j
"tjuelvc d
PROJECT ADDRESS p44G
CA
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME�� I-,lb� ��(� l 9 l 1 �, /�
ADDRESS d �(rr� .� « LCyl 7k N4tL�tn.1 c✓V
PHONE EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? QIYES O NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE 7 11-7
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN ' SMIP
INVOICE /��/^�2 PAID AMOUNT
AMOUNT C/QL✓ 0CASH 0CHECK# 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 Suiiding& Safety Department 29714 HDun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
STATE OF CALIFORNIA-BUSINESS.CONSUMER SERVICES,AND HOUSING EDMUND G.BROWN JR.,GOVERNOR
DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT
DIVISION OF CODES AND STANDARDS '
Title Search
Date Printed: OGt 27,2017
Decal#: LAE9010 Use Code: SFD City of Menrfee
Building Dept.
Manufacturer: 90002 SKYLINE HOMES Original Price Code: AEP
Tradename: SUNWOOD Rating Year: OCT 3 0 ZOi/
Model: 1101 Tax Type: LPT pp PP++
Manufactured Date: 02/09/1984 Last ILT Amount: Received
Registration Exp: Date ILT Fees Paid:
First Sold On: 05/11/1984 ;� ILT:Exemption: NONE
Serial Number HUD Label/Insignia 'Ltngth Width
31720349AT CAL276128 52' 12'
31720349BT CAL2761291. 5T 12'
Record Conditions:
Park Purchase Fee Exemption granted
Registered Owner:
GILBERTO RIOS
28867 ESCALANTE RD
QUAIL VALLEY,CA§2587.:.1.
Last Title Date: 09/21/2017
Last Reg Card: 09/21/2.017 ,
Sale/Transfer Info: Price S5,000:00 Transferred on:07/19/2017
Situs Address:
23560 CASSANDRA DR
QUAIL VALLEY,CA 92587
Situs County: RIVERSIDE
***END OF TITLE:SEARCH*** Page Number:I
rI .
, i
,ATE OF CALIFORNIA-DEPARTM'NI CP HOUSING AND COMMUNITY DEVELOPMENT
CERTIFICATE OF TITLE MOBILEHOME DECAL No. LAE9010 ,
{�INEUHOiES/90002 SW)d NAMEAD 0GDENAME 1101 MODEL 02/09/84 02/09/84 05/11/84 SPC ExPIRATION
SERIAL NUMDER LABEL/INSIGNIA NUMBED WEIGHT LENGTH WIDTH ISSUED CC EXEMPT USE TYPE
i 11721149AT CAL276128 015350 000624 000144 06/28/84X 33 Lit of LPT
p 31720349BT CAL276129 011715 000624 000144 Building & Safety Dept.
3 TOTAL
FEES
5 PAID: JUL 2 7. 2017
5
B $32.00
ecelv(a
A GREENTREE ACPT INC 3.
D RELEASE OF DEALER
D kX NEW REGISTERED OWNER, FILL IN ITEMS 4 - 9 XW
R 1855 W KATELLA AVE SUITE 330 // '1^_
E 4.A) CI(YJP/ S
S AND
s ORANGE CA 92667 OR D)
E NAME - PLEASE PRINT
R YEaGLEY STEPHEN L/ 3.A�'4� 4gcA .anj7� ie d,
E SANDRA L TENCON CURRENT MAILING ADDRESS
G M
I A PO EX 1077 ✓.41-t-1• Lg aria
S I CITY CNTY ST ZIP
T L
E TEMECULA CA 92390
R (y� �,�n �^ {'p gjIVL�4fy/ F'LUTURE MAILING ADDRESS
s '
DE 1RELEA.�,� 5 '1UCL�/'Cn OWNER /ITNVl�'LOk O'L lA� 'IT�/�'i
ADDRESS
W = 37 GA.460NI LN a) CYO/ V,9-I1y- C •9 • `a. -g7
N T CITY CNTY ST� ZIP
E u TEMECULA CA 92390 _ 4E <0'- -- ( ;-cl `
R S 8. 1- 1-4-
PURCHAS PRICE DATE
L AGREE-ENTREE ACPCT INC
/� p��/� ` y+ - C 4
GGREEN THE ACCEPT1 NCE. INC. . 9f/ NEW REGISTERED OWNER SIGNATVRE
A 1855 W KATELLA AVE SUITE 330 + �JEW LEGAL OWNER. FILL IN ITEMS 10 - 12 XX*
L
10.A)
O `ANGE CA 92667:
W DA /11/84 16:46:,Q0 B)
N +i NAME - PLEASE PRINT
E 2. )
R v, LE E OF LEGAL OWNER 11.
ADDRESS
B)
RETENTION OF LEGAL OWNER 12.
CITY CNTY ST ZIP
C) XXX NEW 1ST JR. LIENHOLDER, FILL IN ITEMS 13 - 15 XXX
ASSIGNMENT OF LEGAL OWNER
13.
J NAME - PLEASE PRINT
U F
N I 14.
1 R ADDRESS
O S
R T IS.
CITY CNTY ST ZIP
L XXX NEW 2ND JR. LIENHOLDER. FILL IN ITEMS 16 - 18 XXX
I
E 16.
N S NAME - PLEASE PRINT
H E
O C 17.
L O ADDRESS
D N
E D 18.
P CITY CNTY ST ZIP
IMPORTANT 02-178-00484
THIS CERTIFICATE OF TITLE MAY NOT REFLECT ALL LIENS RECORDED WITH THE DEPARTMENT
OF HOUSING AND COMMUNITY DEVELOPMENT AGAINST THE DESCRIBED UNIT. THE CURRENT
TITLE STATUS OF THE UNIT MAY BE CONFIRMED THROUGH THE DEPARTMENT. 0200035
DOC # 2017-0232067
City of Menifee 06/09/2017 01:13 PM Fees: $24.00
Building & Safety Dept.Page 1 of 4
Recorded in Official Records
JUL 2 7:2017 County of Riverside
Aldana
RECORDING REQUESTED BY Peter sor-Co
Q Assessor-County Clerk-Recorder
Chicago Title Company
Received
MAIL TAX STATEMENT "This document was electronically submitted
AND WHEN RECORDED MAIL DOCUMENT TO: to the County of Riverside for recording—
Gilberto Rios Receipted by: LISA#580
28867 Escalante Road
Menife4,CA 92587
Sparc Above This Line for Re rdees Use Only
A.P.N.: 350-231-043 File No.: 203-044709 (CH)
Title Order No.: 7101708026 1�)T)
GRANT DEED
The Undersigned Grantor(s)Dedare(s):DOCUMENTARY TRANSFER TAX,q-.VRITY TRANSFER TAX$0.00;
X computed on the consideration or full value of property conveyed,OR
computed on the consideration or full value less value of liens and/or encumbrances remaining at time of sale, K
unincorporated area; [X] � � ��,nl Gam„",��`
FOR A VALUABLE CONSIDERATION, receipt of which iss he-r'e'byouaackn'o'wledged, Ignacio Sierra and Hilda
Sierra, husband and wife as joint tenants 9
and Mercedes N. Rios, Husband and wife as joint tenants
hereby GRANTS to Gilberto/Rios,
the following described property in the f County of Riverside,State of California:
See Exhibit "A" attached hereto and made a part hereof.
Dated: M 2017
Hilda Sierra gown
sgf,a�to s�eT�,
Mail Tax Statements To: SAME AS ABOVE
-------------------------------------------------------------------------------------------------------------------------------------
RECORDING REQUESTED BY
Chicago Title Company
MAIL TAX STATEMENT
AND WHEN RECORDED MAIL DOCUMENT TO:
Gilberto Rios
28867 Escalante Road
Menifeg,CA 92587
Space Above This Line for Recorder's Use Only
A.P.N.: 350-231-043 File No.: 203-044709 (CH)
Title Order No.: 7101708026-1�)D
GRANT DEED
The Undersigned Grantors)Dedare(s):DOCUMENTARY TRANSFER TAXdr q.&c?HTY TRANSFER TAX$0.00;
X ) computed on the consideration or full value of property conveyed,OR
computed on the consideration or full value less value of liens and/or encumbrances remaining at time of sale,
unincorporated area; [X] V L
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Ignacio Sierra and Hilda
Sierra, husband and wife as joint tenants
hereby GRANTS to Gilberto/Rios, and Mercedes N. Rios, Husband and wife as j oint tenants
the following described property In the I , County of Riverside,State of California:
See Exhibit "A" attached hereto and made a part hereof.
Dated: M .7
"'Ign Ei65ielra_i Hilda Sierra
T jc noi�o S�efrat
Mail Tax Statements To: SAME AS ABOVE
OJI'W' -FICK PL4, k �q � yp
-Ml-gEF40 jejos
221-C q3
City of Menifee
Building & Safety Dept.
JUL 2 7 2011
A
Received
(4
cp
1115yzdc
GTY bF N'IENI EE Cn
MWING AND SAFETY DEPART NT
P LAN APPIR,0VAL
REM E W BY 10 .
(9 0 *Approval of th ians I all not be construed to be a pe t or,or an
0 oval of an of any pro,isoMw of the federal, or city
regi:!atiors and antes. This set
approval of,an f, roved plans mu kept on the
jobsite until co tion
stake r 6 C-4us/3,1\; 0 D,( QocTL
r /\ Cl -;?<-V'4
STATE OF CALIFORNIA-DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT
_ CERTIFICATE OF TITLE
Manufactured Home Decal: LAE9010
Manufacturer ID/Name Trade Name Model DOM DFS RY
90002 SKYLINE HOMES SUNWOOD 11101 02/09/1994 05/11/1984
Serial Number Label/Insignia Number Weight Length Width Issued
31720349BT CAL276129 I I,715 52' 12' Sep 21,2017
31720349AT CAL276128 15,350 52' 12'
Addressee -.
GILBERTO RIOS
28867 ESCALANTE RD
QUAIL VALLEY,CA 92587
'tt
r
Registered Owner(s) _
GILBERTO RIOS
28867 ESCALANTE RD
QUAIL VALLEY,CA 92587
Situs Address
23560 CASSANDRA DR
QUAIL VALLEY, CA 92587 �` �� '� � t
+�':+di
���� �> x i f' iI �rn� i a �l � �..s.�'•
try
IMPORTANT
THE OWNER INFORMATION SHOWN ABOVE MAY NOT REFLECT ALL LIENS RECORDED WITH THE
DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT AGAINST THE DESCRIBED UNIT. THE
CURRENT TITLE STATUS OF THE UNIT MAY BE CONFIRMED THROUGH THE DEPARTMENT.
DTN: 9788454 09212017.2