PMT17-02940 City of Menifee PermitNo.: PMT17-02940
29714 HAUN RD.
4fX=EL/-> MENIFEE, CA 92586 Type: Residential Electrical
"' MENIFEE Date Issued:
08I18/2017
PERMIT
Site Address: 33625 SWEETWATER CANYON RD, Parcel Number: 384-080-003
MENIFEE,CA 92584 Construction Cost: $150.00
Existing Use: Proposed Use:
Description of VERIFY ELECTRICAL METER REMOVED FROM FIRE DAMAGED MOBILE HOME
Work:
Owner Contractor
ROBERT GUY JACOBSON ,
33625 SWEETWATER CANYON RD
MENIFEE, CA 92584
Applicant License Number:
ROBERT GUY JACOBSON
33625 SWEETWATER CANYON RD
MENIFEE, CA 92584
Phone:9512160507
Fee Description ON Amount I$1
Receptacle, Switch,Outlet&Fixture 1 116.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Electrical 1 5.80
$149.80
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_Perrnit_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 perjurythat 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 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 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 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 Code,for the performance of work for which
www.leainfosa.eov/calaw.html.
this permit is issued.
Policy# Date
❑I have and will maintain worker's 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 worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy# Expires entertlbveidenGfi pertfor inspection purposes.JL
(This section need not to be completed is the permit is for one-hundred t Date
dollars($100)or less OW ZSE#
THORIZED 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 Li
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. WIII 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 ❑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 exempt from the permitting checklist.I understand my requirements underthe 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 nextto the applicable item(s)(Section 7031.5
°Yes ❑No
Business and Professions Code).Any city or county that requires a permit to
Date
construct,alter,improve,demolish or repair any structure,priorto 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(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 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( )all of or( )portion of the work,and the structure is mm epa.xov 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
completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.:
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Finn 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.
BUILDING • • • ;Ek
City of Menifee
Building & Safety Dept.
ATE AW-81 7 PERMIT/PLAN CHECK NUMBER
L O RESIDENTIAL O MULTI-FAMILY * MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION C}ALTERATION O DEMOLITION O ELECTRICAL , MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF/S�QUARES
DESCRIPTIONOFWORK N4) L{
TDI (,avAtFu
PROJECTADDRESS �CasS,u�crWA-ram cs�� ETC-F
ASSESSOR'S PARCEL NUMBER j&kV ) - Cr _LOT L+ TRACT
OWNER NAME �a�- /cjy� L' Q/
ADDRESS 3��CJ /// V66-z- VAT D v4,ll
PHONE ���QV(�j- D-50 7 EMAIL j.
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES '0 NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION C D� L SO FT
APPLICANT'S SIGNATURE DATE
y.
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING flRf GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT 0CASH GCHECK# %'CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT C;CASH 'CHECK# ^CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
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Riverside County Parcel Report Page 5 of 5
MISCELLANEOUS
SO. CALIF,IT
(19,30,33,36,37,56)
PERMITS/CASES/ADDITIONAL
Building Permits
Case # Description Status
151912 MH SITE PREP FINALED
154080 MH INSTALLATION FINALED
263535 GARAGE TO EXTNG M/H 36X24 FINALED
BMR011803 MOBILEHOME SITE PREP- GUEST DWLG - EXPIRED
TIEDO W NS
BMR020293 INSTALL GUEST DWELLING MOBILE HOME FINAL
Environmental Health Permits
Case # Description Status
No Environmental Not Applicable Not Applicable
Health Permits
Planning Cases
Case # Description Status
No Planning Cases Not Applicable Not Applicable
Code Cases
Case # Description Status
No Code Cases Not Applicable Not Applicable
http://tzvmagOl.rivcoit.org/Riverside Report/PublicAPN Report.aspx?APN=384080003&Lat=2174... 8/18/2017
CITY OF MENNIFEE
CODE ENFORCEMENT DIVISION
NIF 29714 Haun Ro ad,Menifee,CA 92586
Ph:(951)672-6777
Fax:(951)679-3843
NOTICE OF VIOLATION
August 14,2017
Occupant RE: 33625 SWEETWATER CANYON RD
33625 SWEETWATER CANYON RD APN: 384-080-003
MENIFEE,CA 92584 Case No: CE-17-1839
Officer: Donna Burks
To Whomlt May Concern:
An inspection of the above referenced property was conducted on August 13, 2017. In an effort to improve and restore the
community, the City of Menifee is actively enforcing the Menifee Municipal Codes.According to available records, you are
listed as an owner or other interested party regarding this property. This Notice of Violation is submitted to you, requesting
your cooperation in correcting the violations below.
The following violations were observed during the property inspection, it is necessary to perform the corrective
action(s) before the Compliance Date.Another inspection will be conducted on or immediately after the compliance
date to verify compliance.
Code Section Violation Detail&Corrective Action Needed Compliance Date
UCADB§202 Abatement of Allbuildings orportiom thereof whichare determined after August 27,2017
Dangerous Buildings inspectionby the building officialto be dangerous as defined inthis
code are hereby declared to be public nuisances and shallbe abated
by repair,rehabilitation,demolition o r remo val in accordance with the
procedure specified in Section 401 of this code.
PLEASE SECURE FIRE DAMAGED HOUSE IMMEDIATELY
FROM UNAUTHORIZED TRANSIENT ACTIVITY.
CONTACT BUILDING AND SAFETY FOR ALL NECESSARY
PERMITS,REGULATIONS,AND/ORREQUIREMENTS FOR
REHABILITATION ORDEMOLITION FROM FIRE.
..STRUCTURE IS UNSAFE AND UNINHABITABLE.
HSC§ 17920.3 (h) Any building orportion thereof,device,apparatus,equipment, August 27,2017
Substandard Building -Fire combustible waste,or vegetation that,in the opinion of the chief of
Hazard the fire department orhis deputy,is insucha conditionas to cause a.
fire or explosion orprovide a ready fuel to augment the spread and
intensity of fire or explo sio n arising from any cause.
CONTACT THE CITY OF MENIFEE DEPARTMENT OF
BUILDING& SAFETY TO OBTAIN INFORMATION AND
PERMITS-THE STRUCTURE IS UNSAFE,AND
UNINHABITABLE.
Failure to correct the violations above may result in fines up to $1,000.00 per violation/per day; criminal prosecution, the
issuance of a misdemeanor citation, administrative citations, and/or other legal action including abatement proceedings being
taken to ensure compliance with the applicable codes. If the city is forced to proceed with abatement proceedings, the
owner(s) of record may incur direct costs plus an administrative fee.Any unpaid fines and/or costs will be placed as a lien upon
the property orsent to an authorized collection agency.
The City would like to avoid taking any further actions and requests your cooperation in this matter.By acting immediately to
correct the violation(s) referenced, you will avoid further action by the city.If you have any questions, please contact Donna
Burks at (951) 723-3738. Please provide the case numberCE-17-1839 and the property address. We appreciate your
cooperationin this matter.
Photographs