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PMT17-03643 City of Menifee Permit No.: PMT17-03643 29714 HAUN RD. T Mobile Home �l-�CCELA—. MENIFEE,CA 92586 yam' MENIFEE Date Issued: 1110 812 01 7 PERMIT Site Address: 29563 ALICANTE DR,MENIFEE, CA Parcel Number: 327-410-002 92585 Construction Cost: $103,500.00 Existing Use: Proposed Use: Description of INSTALL FOR REPLACEMENT WITH NEW MOBILEHOME 1680 SQ FT Work: Owner Contractor ELAINE NAGORE DIAMOND HOMES INC 29563 ALICANTE DRIVE 29875 PATTERSON AVE MENIFEE,CA 92585 WINCHESTER, CA 92596 Applicant Phone:5625777580 JAVIER DELATORRE License Number:761185 DIAMOND HOMES INC 29875 PATTERSON AVE WINCHESTER, CA 92596 Fee Description City Amount Ibl Manufactured Install 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 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. CONDITIONS Condition Comment 1 DO NOT FINAL 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 cantractor(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 Contractor's State License Law for Professions Code and my license is in full farce and e—ff7ect. the following reason: License Class Cq't— Lic s�N . '--['�P L �f� By my signature below I acknowledge that,except for my personal residence Expires 5 M Signature I in which l must have resided for at least one year priorto completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I '� have built as an owner-builder if it has not been constructed in its entirety by ryrnereby 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 webshe: by Section 3700 of the Labor Code,for the performance of work for which www,leeinfo.ca.aov/calaw html. this permit is Issued. Policy# a IS?s u S Date cp.l fiiiave 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 o 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: 'f�+�'�-U, 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 —2S' iS- 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 o l 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 It POO- 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 forth /v/rq/h��(6/}�nwith those provisions. ` Will the applicant or future building occupant handle hazardous material or a Applicant /J�/// Date '� 6 �� mixture containing a hazardous material equal to or greater that the �Qy amounts spe ified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes 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 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 forguidelin CONSTRUCTION LENDING AGENCY oyes 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 bo,u�nd}^ryof aschool? (Section 3097 Civil Code) ❑Yes � 1 OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of Contractors License Law for the reason(s)indicated below by the California Health&Safety Cod ,Section 25505 and 25534 concerning haz ous material p in checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 / Business and Professions Code).Any city or county that requires a permit to es D No / Date construct,alter,Improve,demolish or repair any istructure,priortota PROPERTY OWN 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 www.eoa.aov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-SOD-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 forthis 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: D 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 & SAFETY PERMIT/PLAN CHECK APPLICATION I .,lenifee 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 NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK t'.w !'1016112 PROJECT ADDRESS ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME Cja•Ir.P_ �J& DyL ADDRESS CX,IN CA PHONE EMAIL APPLICANT NAME V\\ ,It ADDRESS J�� �I V-0'�'tC. W \+nC Pt 9-"2- PHONE 9s - 2 /O-yr(Q EMAIL c�e'la�u�rea•3 F•vlt1� •Wv✓� CONTRACTOR'S NAME OWNERBUILDER? OYES d0 BUSINESS NAME c16) A vx� ADDRESS PHONE -]� EMAIL n CONTRACTOR'S STATE �LIIC�NUMBER -1 \P 1�FSS LICENSE CLASSIFICATION 1. VALUATION$ .JvV ' FT I( �Q L SQ FyT l APPLICANT'S SIGNATURE DATE low l DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE ''I PAIDAMOUNT AMOUNT I-a OCASH OCHECK# OCREDIT CARD 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 ChTottkerlfec I gg Safety Dcpt. City of AAenifee Building&Safety Depa,iment 29714 Haun Rd. Menifee, CA9253695pgN!,977 www.cityofinenifee.us Inspection Request Line 951-246-6213 ^OCT j 2017 R0Croivc."G RECORDING REQUESTED BY: DOC# 2017-0371341 CHICAGO TITLE 09/07/2017 09:26 AM Fees: $28.00 Page 1 of 2 Recorded in Official Records WHEN RECORDED MAIL DOCUMENT AND County of Riverside Peter Aldana TAX STATEMENT TO: Assessor-County Clerk-Recorder Elaine Leah Nagore 29563 Alicante Drive "This document was electronically submitted Menifee,CA 92585 to the County of Riverside for recording" Receipted by:MARY#880 APN: 327410-002-7 TITLE ORDER NO.:7101706043-TH ESCROW NO.: 18947-L THIS SPACE FOR RECORDER'S USE ONLY GRANT DEED The undersigned Grantor(s)declare(s)that the DOCUMENTARY TRANSFER TAX IS."ounty _computed on the full value of the interest of property conveyed,or _computed on the full value less the value of liens or encumbrances remaining thereon at the time of sale. _OR transfer is EXEMPT from tax for the following reason: FOR A VALUABLE CONSIDERATION,receipt of which is hereby acknowledged,Elaine L. Nagore,an Unmarried Woman HEREBY GRANT(S)to Elaine Leah / an Unmarried Woman and Dionne Rea Elmer, an Unmarried Woman as Joint Tenants Nagore All that real property situated in the City of Menifee,County of Riverside, State of California,described as: Parcel 2 of Parcel Map No.9250, In the City of Menifee, County of Riverside, State of California as Recorded in Book 37 of Parcel Maps,at Page 57 , Riverside County Records.APN: 3 2.1 4 10 d U L-'7 Commonly Known As:29563 Alicante Drive, Menifee,CA 92585 Dated:August 11,2017 A notary public officer or other officer completing this oedificste verifies only the identity of the individual who signed the document to which this certificate is attached and not the truthfulness accuracy or validlN of that document STATE OF CALIFORNIA } COUNTYOF RAIPYSIjP ) On AI IQl ISM 11 I �h1�1 before me, By. -�-'-- Elaine L.Nagore, t1(X lP Af)N1_1fi ,a Notary Public personally appeared Elaine L.Nagore, l , who proved to me on the basis of satisfactory evidence to be the person( whose name(%)Is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capaclty(urs), DMitt ROBERTS and that by his/IV/their signature(g) on the Instrument the person(s), or the 404w1kCommis,lon N 2139253 entity upon behalf of which the person(p)acted,executed the instrument. Notary Public-California Riverside County I certify under PENALTY OF PERJURY under the laws of the State of My Comm.Expires Jan 31,2020+ California that the foregoing paragraph is true and correct. - - WITNESS my hand and official seal. Signature nkcd (SEAL) MAIL TAX STATEMENTS AS DIRECTED ABOVE DOC#2017-0371341 Page 2 of 2 EXHIBIT A Order No.: 7101706043 For APN/Parcel ID(s): 327-410-002-7 Parcel 2 Of Parcel Map No.9250, In The City of Menifee, County Of Riverside,State Of California,As Recorded In Book 37 Of Parcel Maps,At Page 57,Riverside County Records.