PMT17-03088 City of Menifee Permit No.: PMT17-03088
29714 HAUN RD.
'ACCELA_? MENIFEE,CA 92586 Type: Residential Re-Roof
MENIFEE Date Issued: 0 8131/2 01 7
PERMIT
Site Address: 27721 MENIFEE RD, MENIFEE, CA 92585 Parcel Number: 333-152-007
Construction Cost: $3,500.00
Existing Use: Proposed Use:
Description of TEAR OFF ALL EXISTING LAYERS, INSTALL NEW COOL ROOF SHINGLES
Work: CRRC#0890-0012
Owner - Contractor
GREENS HERITAGE LLC M C D SERVICE INC
27721 MENIFEE ROAD 638 CAMINO DE LOS MARES
MENIFEE, CA 92585 STE H130-411
Applicant Phone: 9492700564
SATISH GARIMELLA License Number:968986
M C D SERVICE INC
638 CAMINO DE LOS MARES
STE H130-411
SAN CLEMENTE, CA 92673
Fee Description 9y Amount ISI
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
Administrative Fee 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
$228.90
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 Menifse.Except as otherwise stated,a peril 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_Bidg_Penit Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contacts for the projects
with a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
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
my license is in full force and effect. ` the following reason:
License Class 7 Lice 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
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 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.leginfo.ca.gov/calaw.html.
this permit is issued.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
❑I have and will maintain worker's compensation insurance,as required by
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 owner's behalf.I have read this
number are: application and the information 1 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 enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
\71 certffy 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 fo Jfi4 th com ly 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:FAILU SEC RE WORKER'S COMPENSATION(6VE;lAGE 15 ❑Yes ❑No
UNLAWFUL,ANDSH�SUBJECTAN 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 forguidelines
CONSTRUCTION LENDING AGENCY o Yes ❑No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 5000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Cade) ❑Yes ❑No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that 1 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)I have placed next to the applicable item(s)(Section 7031.5 oYes o 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 OWN ER 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 IRRP)
License Law(Chapter9(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
a 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( )all of or( )portion of the work,and the structure is www.epa.goy/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:
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.
BUILDING • SAFETY PERMIT/PLAN CHECK APPLICATION
p "iVSenifee
DATE 08/15/2017 PERMIT/PLAN CHECK NUMBER Q
TYPE: ❑COMMERCIAL 0 RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA [:]SIGN
SUBTYPE: []ADDITION ❑ALTERATION [—]DEMOLITION []ELECTRICAL ❑MECHANICAL
[]NEW []PLUMBING ❑✓ RE-ROOF-NUMBEROFSCIUARES 33
DESCRIPTION OF WORK Re-Roof the property due to massive leak during the rainy season
PROJECT ADDRESS 27721 Menifee Rd;Romoland,CA 92585
ASSESSOR'S PARCEL NUMBER 333-152-007 LOT 271 TRACT 2 of Dunwoodie Park
PROPERTY OWNER'S NAME Greens Heritage,LLC 13U..City of Menifee
batety De
ADDRESS 910 South El Camino Real;Suite A;San Clemente,CA 92672
PHONE (949)546-0565 EMAIL Accounting@GreensGlobal.com AUG1 2011
APPLICANT NAME Oversite Management, Inc
ROCeived-
ADDRESS 638 Camino De Los Mares;Suite#H130-411;San Clemente,.CA 92673
PHONE (951)289-0156 EMAIL Sam@OversiteManagement.com
CONTRACTOR'S NAME Aarav Construction OWNER BUILDER? ❑YES ZNO
BUSINESS NAME MCD Service, Inc.DBAAarav Construction
ADDRESS 1 Calls Boveda;San Clemente,CA 92673
PHONE (949)400-2788 EMAIL info@aaravconstruction.com
CONTRACTOR'S STATE LIC NUMBER 968986 LICENSE CLASSIFICATION B
VALUATION$ $11,500.00 SQQFFT' 3300 L SO FT
APPLICANT'S SIGNATURE �' DATE 08/15/2017
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE .� PAIDAMOUNT r; r,:
Joe
AMOUNT
PLAN CHECK 'CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT {;CASH %CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER C YES NO
City of Menifee Building&Safety Department 29714 Hour?Rd. Menifee, CA 92586 951-672-6771
www.cityofl»enifee.us Inspection Request tine 951-246-6213
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MENIFEE BUILDING PERMIT— PROPERTY OWNER'S PACKAGE
Disclosu s and forms for Owner-Builders Applying for Construction Permits
IMPORT ANTI NONCE TO PROPERTY OWNER
Dear Property Owner:
An application for building permit has been submitted in your name listing yourself as the builder of
are providing youlwith an Owner-Builder Acknowledgement and Information Verification Form to
make you aware of your responsibilities and possible risk you may incur by having this permit issued
in your name as t a Owner-Builder. We will not issue a building permit until y ou have to ad,
initialed y our understanding of each pr ovision, si gned, and returned this form to us at our
official address i dicated. An agent of the owner cannot execute this notice unless you, the
property owner, obtain the prior approval of the permitting authority.
OWNER' AC WLEDGEMENT AND VERIFICATION OF INFORMATION
DIRECTIONS:S KN Read and initial each statement below to signify that you understand or verify this
information.
1. 1 unds ffind a frequent practice of unlicensed persons is to have the property owner obtain an 'Owner-
Builder" bu ding permit that erroneously implies that the property owner is providing his or her own labor and
material personally. I, as the Owner-Builder, may beheld liable and subject to serious financial risk for any
injuries sustained by an unlicensed person and his or her employees while working on my property. My
homeowne 's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder
and am aware of the limits of my insurance coverage for injuries to workers on my property.
2. 1 under tend building permits are not required to be signed by property owners unless they are responsible
for the construction and are not hiring a licensed Contractor to assume this responsibility.
3. 1 understand as an"Owner-Builder"I am the responsible party of record on the permit. I understand that I
may prate myself from potential financial risk by hiring a licensed Contractor and having the permit fled in his
or her nam)instead of my own.
4. 1 und0ttand Contractors are required by law to be licensed and bonded in California and to list their license
numbers on permits and contacts.
5. 1 under,itand if I employ or otherwise engage any persons, other than California licensed Contractors,and
the total v lue of my construction is at least five hundred dollars ($500), including labor and materials, I may
be conside an"employer°under State and Federal law.
6. 1 under tend if I am considered an "employer"under State and Federal law, I must register with the State
and Feder3l government, withhold payroll taxes, provide workers' compensation disability insurance, and
contribute o unemployment compensation for each 'employee.* I also understand my failure to abide by
these laws may subject me to serious financial risk.
7. 1 unde tend under California Contactors' State License Law, an Owner-Builder who builds single-family
residential structures cannot legally build them with the intent to offer them for sale, unless all work is
performed by licensed subcontractors and the number of structures does not exceed four within any calendar
year, or all of the work is performed under contact with a licensed general building Contractor.
8. 1 under 3tand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable
for any firiancial or personal injuries sustained by arty subsequent owner(s) that result from any latent
construction defects in the workmanship or materials.
I
i
i
9. 1 understand I may obtain more information regarding my obligations as an "employer' from the Internal
Revenue Service, the United States Small Business Administration, the California Department of Benefit
Payments, and the California Division of Industrial Accidents. I also understand I may contact the California
Contractors' State License Board (CSLB)at 1-800-321-CSLB(2752)or www.cslb.ca,aov for more information
about licensed contractors.
10. 1 am Ewers of and consent to an Owner-Builder building permit applied for in my name, and understand
that I am the party legally and financially responsible for proposed construction activity at the following
address:
11. 1 agre that, as the party legally and financially responsible for this proposed construction activity, I will
abide b al applicable laws and requirements tagova _O - uleawell smh B eployes_______
12, 1 agree to notify the issuer of this form immediately of any additions, deletions, or changers to any of the
information I have provided on this form. Licensed contractors are regulated by laws designed to protect the
public. If you contract with someone who does not have a license, the Contractors'State License Board may
be unable jo assist you with any financial loss you may sustain as a result of a complaint. Your only remedy
against un icensed Contractors may be in civil court. It is also important or you to understand that if an
unlicensed Contractor or employee of that individual or firm is injured while working on your property,you may
be held liable or damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be
responsible for verifying whether or not those Contractors are properly licensed and the status of their
workers'cc mpensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the
property owner and returned to the agency responsible for issuing the permit. Note: A copy
of the property owners driver's license, for ' notarization, or other verification acceptable to
the agency is required to be p ted the permit is issued to verify the property
owner's signature. +�
Signature of Property Owner: U Date: v I
Note: The following Authori on Form is required to be completed by the property owner only when
designating an agent of the property owner to apply for a construction permit for the Owner-Builder.
AUTHoce RIZATION OF AGENT TO ACT ON PROPERTY OWNER' BEHALF
Excluding the N to Property Owner, the execution of which I understand is my personal
responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and
file the documents necessary to obtain an Owner-Buitder Permit for my project.
Scope of Construe ion Project (or Description of Work):
Project Location or Address:
Name of Authorize Agent: Tel No:
Address of Authorized Agent:
I declare under penalty of perjury t I am t e operty owner for the address listed above and I
personally filled out the above in tion a rtify its accuracy. Note: A copy of the owner's
driver's license, fo m notarization, or ther It at n acceptable to the agency is required to be
presented when thepermit is issu t verify a roe ne' signaikre.
Signature of Prope Owner: / Date: d�
MCD Services Inc. - DBA Aarav Construction
CSLB#968986
08/30/2017
City of Menifee,
Building & Safety Division:
29714 Haun Rd.
Menifee, CA 92586
Re: Authorization of agent to act on contractor's behalf
To whom it may concern,
I Sahil P. Desai of MCD Service Inc. DBA Aarav Construction holding a contractor's license 9 968986 in
the State of California. Hereby Declare that:
The undersigned individual(s) are employed by my company and are authorized by me to pull permit(s),
from the City of Menifee, on my behalf. If this list changes,we will contact your office in writing. There
is no expiration date for this letter.
THE BELOW LISTED PERSONNEL ARE AUTHORIZED TO PULL PERMITS UNDER MY
CONTRACTOR'S LICENSE NUMBER:
Print Name(s) Signa ;e(s)
SATISH GARIMELLA �
Signature of Licensed Contractor Date
A not 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
County of
On before me, Notary Public,personally
appeared who proved to me on
the basis of satisfactory evidence to be the person(s) whose name(s) is/ate subscribed to the within
instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized
capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or 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.
Signature of Notary Public (Notary Seal)
638 Camino De Los Mares; Suite#H130-411; San Clemente, CA 92673
D: (951) 289-0156 F: (949) 492-2923
Greens Heritage, LLC
910 S. El Camino Real, Suite A 100, San Clemente, CA 92672
P :(949)546-05601 F :(949) 546-05611 www.GreensGIobal.com
O8/30/2017
City of Menifee,
Building & Safety Division:
29714 Hann Rd.
Menifee, CA 92586
Re: Authorization of agent to act on property owner's behalf
To whom it may concern,
Excluding the Notice to the Property Owner, the execution of which I understand is my personal
responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign
and file the documents necessary to obtain a Permit for the project located in City of Menifee.
Project Location or Address: 27721 Menifee Rd and 27627 Menifee Rd
Scope of Construction Project (or description of work): Get the properties mentioned above to
code.
Authorized Agent's Name: MCD Service Inc. DBA Aarav Construction.
Address: 638 Camino De Los Mares; Suite H130-411; San Clemente, CA 92673
Phone Number: 949-400-2788
I declare under penalty of perjury that I am the property owner for the address listed above and I
personally filled out the above information and certify its accuracy.
Property Owner's Signature:
Property Owner's Name: Rajesh J. a, eveloper Member, Greens Heritage, LLC