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PMT17-03705 City of Menifee Permit No.: PMT17-03705 29714 HAUN RD. Type: Mobile Home 71CCELJ!? MENIFEE,CA92586 MENIFEE Date Issued: 10/13/2017 PERMIT Site Address: 30102 PUERTO VALLARTA WAY, Parcel Number: 360-014-007 MENIFEE,CA 92584 Construction Cost: $2,975.00 Existing Use: Proposed Use: Description of INSTALL PERMANENT FOUNDATION ON EXISTING MOBILE HOME,65'x 24'SERIAL#: Work: A20620/1320620 HUD INSIGNIA MH273281/2 Owner Contractor SUSAN SCHWER PERMA-BRACE CONSTRUCTION 30102 PUERTO VALLARTA WAY 21690 VINE ST MENIFEE, CA 92584 WILDOMAR, CA 92595 Applicant Phone:9512459373 MENIFEE, CA License Number:636757 Phone:9512459373 Fee Description Qyt Amount($1 Manufactured Permanent Foundation 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. 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 eff/gctt}. �� the following reason: License Class C 4 aII License No. V J 5-7 By my signature below I acknowledge that,exceptfor my personal residence Expires " - — g Signature in which 1 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 K 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 Cade,for the performance of work for which www.legirrfo.ca.gov/calaw.htmi, this permit is issued. Policy# Date ❑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 worker's compensation Insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number are: ( 1 application and the information I have provided Is correct.I agree to comply Carrier �0.F-�V. with all applicable city and county ordinances and state laws relating to t� building construction.I authorize representatives of this city or county to Policy tl 4911 -J 'e� / Expires `— U 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 ❑Icerlffy 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 4 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 foyyy��}tttJ1f�y�Yr'�th comply with a 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 ast Air Quality Management District(SCAQMD)7 See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES rguidelines 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 SD00 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 under the State of Contractor's License Law for the reason(s)indicated below by 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 Ayes o / 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 p�OpERTY 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 Contractor's 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.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-BOG-424-LEAD(5323). Code;The Contractor's 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 provingthat 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 Contractor's 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. - enitee DATE: PERMIT/PLAN CHECK NUMBER '1-0310 TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY '3 MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION C ELECTRICAL O MECHANICAL O NEW C PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK n 4016/4 F (){/( A. 9 _ v/Pb 1 Imo_ PROJECTADDRESS 3o �� yec,- o VGA //(:qe,J, �J AL(I ZIP ('(/ ASSESSOR'S PARCEL NUMBER 3 � 7Q- 0/ - 0? O -7 TRACT 7 7 3 OWNER NAME ff11SL,)S ci S Eck w eei _ ADDRESS C/ D 2, L)e&/- J Q / PHONE Z136l EMAIL APPLICANT NAME Ol n M o ylkS ADDRESS :sr PHONE EMAIL CONTRACTOR'S NAME CZC'(-,, . 4 OWNER BUILDER? O YES4 NO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATFLICNUMBER �LP 7$7 / LICENSE CLASSIFICATION VALUATIONS �<' 2�! ?S - SQ FT f S Co d L SQ FT / APPLICANT'S SIGNATURE ' DATE O " F USE ONLY DEPARTMENT DISTRIBUTION CITY MENIFEE BUSINESS UCENSE NUMBER D BUILDING PLANNING ENGINEERING FIRE ACCEPTE BY: PERMIT FEE ��,. SMIP GREEN PLAN CHECK FEE INVOICE TOTAL OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE If NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 925B6951-W97i6nifee www.cityofinenifee.us Building &Safety Dept, OCT 13 2017 MAMEB sef, wp/e PHONE ) 93 JOB ADDRESS 3 0 j o ;2- TRACUPARCELM" LOT 3-7 ASSESSORS PARCEL NO- 3 6 o 'V lq—oa� REAR PROPERTY IMM 07 / 170 XT t-U#) goP z[a >4 0 PQ M PC CITY OF MENIFEE BUILDING AND SAFETY DE RTME!INT PLAN APPROVAL REVIEWED BY WE CgAS%;j,eA tn ho a permit fnr,Of 2n City offtenif G approval of,any violation of any Provisions regulations-and ordina.nces. This set of approved plans must he kept on the OCT 13 20LI jobsite until completion, STREET Received STATE OF CALIFORNIH-BUSINESS.CONSUMER SERVICES,AND HOUSING EDMUND G BROWN JP.,GOVEPNOR DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DIVISION OF CODES AND STANDARDS Title Search Date Printed: Jul 7,2017 Decal#: LAX3136 Use Code: SFD Manufacturer: SILVERCREST Original Price Code: AFJ Tradename: SELVERCREST Rating Year. Model: SIGNATURE MARK Tax Type: LPT Manufactured Date: 01/01/1976 Last ILT Amount: Registration Exp: Date ILT Fees Paid: First Sold On: 03/01/1977 ILT Exemption: NONE Serial Number HUD Label/Insignia Length Width A20620 MH273281 65' IT . B20620 M0273282 65' 12' Record Conditions: Voluntary Conversion to LPT Q� Park Purchase Fee Exemption granted Registered Owner: roll*- SUSAN s 30102 PUERTO ERTO VALLARTA MENIFEE,CA 92594 Last Title Date: OS/20/1996 Last Reg Card: OS/10l1996 Sale/Transfer Info: Price$56,750.00 Transferred on 09/11/1995 Sites Address: 30102 MENI PUERTO VALLARTA MENIFEE,CA 42584 Situs County. RIVERSIDE Inactive Decal/DMV: DECAL AAZ7682,DMV N11553,DMV NJ1554 Legal Owner: EMPIRE AMERICAN REALTY CREDIT CORP 2300 E YATELLA AVE SUITE 450 ANABEDAv CA 92906- Lien Perfected On: 12/29/95 12:00:00 ***END OF TITLE SEARCH*** Page Number:l G�rw RECORDING REOIESTM BY 299101 l'mr&Z Regimmend By WCERMFORRECORD AM Ne1Ba RECCROED MAD.TO ATUDOMM NAME r , STREET awn echmW IR AID SEP 116% ASS3MO2 Weata Vaileeta Shy Rati6ea, f1 92584 lk.egreWlthaerCITY TATEZIP -ReaotlYr araa�'aa� dew-om-o �c THIS SPACE FOR RECDROERs use rnFl•• Gll/'11\1 CEO The undersigned Graetarn 60CWWS, that "DOWMENTARY TRANSM TAX IS: i 62_7D Courny i C':V . .Y'SFSSOR'S PARC'L•l. li0:qs7-2µ-007-0 XW=p~on the fell vowof the mMrest of prcavtV J 1• Tam 054-M conveyed or TITLE ORDER NO: 544552-5 eomp:tea an"a full wake ass the va+ue of :e"s o• encumbra . r9eax" thereon at the 1L of Sate f3C•RO%V \O: 416" OR transfer 6 a mpt from ax for the folto"r HMM FOR A VAl LIAmE CONSDERATICU reCeryt Of which is hereby achmaxledgeO Grarr lseow V. NDM. a taidor hereby GRANTS,to t Grantea/auyar SEM 9COM, an uWartied efottaa 1 all that real Mooerty situated in tha mijioorporaT,ed ales of R®ifce hname of city or unrico.porated area• Co my of Rivermi& Sate of Ca/.fc,,w xscncea as �1 IOi 37 OF Ma NO. 4439, AS SH7lt m FIM Li WN 73, PAM 61, 62 AND 63 OF LAPS. J` -gym OF RIVWMM TUINTlY, COSR7 M- >b 1� n 7ated June 30, 1996 ✓�ii�.d V. fl]YHi STATE OF CAgWAl ass COUNTY O Onlwrefm e✓ .a�tl personally , personally known 10 rrhe Wr proved to me On the bass of satisfactory evdnncel to be the persoNsl whose mnalsl hs4are subscribed to the within wstnawx. and acknowledged to the tha; helshert ey e. to same N hwherrthatr authorized and diet by rlthehr sgnahyefsl an hmatarhent the per I or the rA entity upon F of which eh sr aced. Q c, olouw executed the in am tooetuae D WITNESS my ad ffict �al. u Mth,i4" ura Build nY Menifee 9 Safety Oept. Signature IThis area fcr official notary Beall OCT 13 MAL TAX STATEMENTS TOt IG®n gaimimr, 30102 Fuerta Vallerta My, misi£ee, CA 92584 NAME AODRE55 CITY. STATE a ZIP 'R e c lived e d ..:___ •:n TICS FORM p.FMS ED COURTESY OF ORANGE COAST TITLE COMPAMES _ Branch:S06,User:4001 Comment: Station Id:AYM7 DOC#2015-0282466 Page 2 of 2 EXHIBIT A Legal Description The land hereinafter referred to is situated in the City of Menifee,County of Riverside,State of California,and is described as follows: Parcel 1,of Parcel Map 6450,County of Riverside,State of California,as per Map recorded in Book 19,Page 21 of Maps,in the Office of the County recorder of said County. APN: 360-220-001-2 City of Menifee Building & Safety Dept. OCT 13 61i Received RIVERSIDE,CA Page 2 of 2 Printed on 9/2920171:12:49 PM - -- Document,DD2015 282466— --------- ------- -_ --_—----- • p JOB ADDRtss OwNEN - = - DEPARTMENT OF R 111LDWG AND SAFETY COUNTY OF RIVERSIDE �+ °'� USF OF lFRMIE Y NO. bAT [WAIT NO. _ '' MOBILEHOME MOSILEHOME INSTALLATION — 100! 106634 _ INSTALLATION PERMIT cOMm DSF OFFICE E,o ' . IF a pESCtl PiION FEE FILING S 10 Sa } SETBACK "- NE JiF I•µ ` 6[I , -- ' PERMIT FEE S � R a _ .. Y REW$PECtxm FEE S `. ESCHSW CO ANS NCN Ofi1CF �[ TOTAL FEES » T eQ CASH D CxECR MO.E3 N.C.❑ ^ wts CITY zip CODE RFCNVfO RT o"MAMFS MlluL1 [AG7D6 t S MN MANDF w AOpxEES Asli JI ; sin < It Q/V f ❑IILOCATED I OTT' M WOE OFF ZIP CODf E l JPIL TIL.N0. ".'TOO. UCEIFSF (iRAgITED TownIII79733 '30 ',q aso l {TITS FEYr.V[SHIM l YECOME Y D If WCII 11 I:Ot CO:••AII.CF.1 J.YIHRI IA FAIL 3 �73� usAucvY OE.',Fox MIA DAs D C.;n1 Irv:m Ib Ncomt ran - i ElFlll llf$IERNJf Y 1 X!F@I AGff 1 Htl All a:OTA IN COKr.IGID•. .aSr• ill's PIWAO Will at 110'It AYE- u: ACCOIDAICi .y.:H bQ'A..S 9:n Iv.pt Ccu:'s+nuO I'llS!.tl ni CAI.IOk-r ., .�a. r _ ..E 10 Cue:f CO`:•i' .11 r••SJFF•F.'t .IF Yf1LOW-4V0{I "PL.Nf1 Cb.�hw•::1'a1D. .HI Ia R..CI L•I s'elE Or ufpi•.la L0![elpti t LiEDF-()wNE- Lt`1lli Oli 15 FI SOGweuI:LF D. PWY-9110 OFFICE i t.(ItL L T C(%l" :r inE V.IA'.Wlli.{ :.r.L: Gr.AP[U hIt ItAl.•. Al.b EEIO[-HIM Ficl• -e-:,% IIA,•� SIc o A`CC':"'.CI F 'I1:r01. 'k.1 .. •..l I'.S > O:a q Ill :.f D• 'a•nva., .. .ecm._war..�.y.`.._ •__ .na• .:�1...n. _.._...-..v._. W t .. .-. . .,.�. ... .n.`ard:.�.. :Cti riY. City of Menifee Building &Safety Dept. OCT 13 Z0t1 Received DEPARTMENT OF BUILDING AND 5AFEfY SOR ADDRESS `OV7NER- 000N:f OF RNER.SEOE __-.. - J ... •~~, _ ► USE OF fromir V, Np DAT1jF PIPAIITNO. M0$ILEHOME \` MOBILEHOME INSTALLATION f wsTALLdi_lOK PEl2AttT cOMMo TT �� rj�- � asT -Fa DESCD - ' nLlwDFIE PFTLNFT SEE S #MO F - FIN ^D T �( 'N OR �f7EINSrCTgN SEE f -: E W Aw IWANCH OFFICE TOTAL•FEE S _ CASH CHt.Cx .qmo-O - N.C. XDDUVSCw na• COof CONVACTOR - - -_- 1 -.— 0 IMEE NiMEDF�,., n o+ - tj{,_. 4 s +3'..�'-. f0_r V ._. J- ' `r llkl000 - 1 l..t 7' •.tom Cih" AF CT -ZIP COPE SYr7DiEEE STRULT mFAX IF LICENSE 310 C(;ro�f3 �DRAOW6 rmw R . 71115 FERMI SHAI .ffCOfAE VOID If WORK IS NOT C04wENCED WHHIN 'a DAYS. CESSASIDN Of WM FOR VA OATS SHAL L ALSO CAUSE 1tg"l TO ktcomt VOID. YTILFTIEk PERMIT R v ! HLUIY ACRE(T"AT ALL WORK IN GOt•HECDON VAIN 11115 FERMIf WILL Y E DONE ## WMIFE-i!O. IN ACC:MDAHCE WY:H THE LAW:CFRNER COUNTY 51Df COY AND THE STATE Of 7[[LOW^AU011 CA11fOW1A I ALSO ACEEE 70 CAUT COMPfNSATICH INSLIUNCE UPON MY :C 7 EMPLOT(•S. COMFIIANCE VAIK 114E SAWS Of THE STATE OF CAUfO1HU COVOWC 01EDII-GINNIC CavTRACTOES O ALTO ISUARANTEEa - ftlJK-gELD OFFICE 11[RERY C[SIIEY 11+A1 illL IN UAL VWO FAIPASED THE PLANE AND f"CiFICATIONS HAS DDI.E SD vi ACCORDANCE WITH SIECI�D+I SSAS Of 114E RPE-d FO-75 000F^HELD fUSVESS AND PMfLSS:ONS CODE Of Till STATE Of CAUSORNIA. City of Menifee Building & Safety Dept, OCT 13 2012 Received . .• _ INSPEC TarE necaxo REINSrEQgN A"ROVAL A ED _ = BLDG PERMIT DATE 1 BISF'4CIlOR r: ;,{ AND:REQUIRED APPROVALS - PLUMBING •_ - _ _TITLE,25 SYSTEM WAtER EDSTHj um - .. - SOW w. 1._it'== -[RUUNAGE PIPING SYSTEM. tat E 6: ' FUEL GAS A1WG- 1'• ELECTRICAL !f _i CONDUtYD0.1NSUlwAON .5m1G ".1-4 C--_ :4_...'YONQ'COFIDUCT�f.ON1WUtlY - [`y� .. :..:_ SUPPORT SYSTEM? FOOTINGS W -I - - •, ;I to; "eGL-kJMN SUPPMTr" �•.: cal •<, ' lt�: CLEARANCE s, RIVERSIDE COUNTY DEPARTMENT OF BUILDING AND SAFET`-` CORRECTION NOTICE ADDRESS: ��0 Y DATE: r MOBILEHOME INSTALLATION INSPECTION � Plumbing 1. Water distribution system t`ki 2. Drainage Piping system Vie. Cr+%:ima Terns- v f 4. Fuel gas piping Electrical: 5. Conductor insulation i— 6. Bond conductor continuity 7. Fixtwes and appliance banding rr E Support system: — 8, Faosings � f = 9. Jacks or piers 10. Coluonupport .p E C (inspector) Correct the above circled items, then obtain a Mobilahtmtt Insto n .Rein E spection Permit (as per-Title 25), then call for your reinspection_ -- DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE MOBILEHOmE INSTALLATION APPLICATION DISTRICT TRAILER PARK. x z. INDIVIDUAL LOT I ,_ NAME OF PARK v _ ADDRESS IOC. P O /a��a/?�- TELEPHONE NO Kill /-�' OWNER/AGENT 1'�I� N tinr 5 .'. SPACE NO ADDRESS�30 P� r�fc) 1rr/a//l�0.fT� MOBILEHOME INSTALLER I Mbl7 M �lloil F? ?ELr^HONE un 77733�0 -- ADDRECC n gSD3c�:? LnSiHLLCriS wiiTtn�T^PIS LICENCE Nn c_ u` g � WIDTH �. LENGTH(LESS HITCH) dr`. DATE OF MANUFACTURE OF MOBILE 6 _z i3rC.fP NEW }C--kfWCAYE 11 mANUFHCTURER .S Y MODEL N u *tLgTATE INSIGNIA: U-unit s j��� X-unit �3�_� ` SERIAL NUMBER ROOF LIVE LOAD 2V WIND LOAD �� £ Jol - APPLICANT_ '^ >o 'a NPPL11 Hry 1 i PRINT N ) SI ATURE) PARK OWNER/MANAGER PARK OWNER/MANAGER -i (PRINT NAME) (SIGNATURE) ..� e � � +� � s ■ e +� s . eree +� seere er ♦ e +� ee +� • e • eereer +� * � * * � .;_ COMMUNITY AC ZONE CASE NO r j LEGAL DESCRIP ION �eY 3 7 ..emuy3 �� 7'a 6 SETBACKS: FRONT o;L a SIDE -� ( S� REAR fJ ". DATE - SIGNATURE OF LAND USE OFFICIAL H `_.�:j 284-77 12/74 s r e 0 :M. 0 M 0 C W a. J] - a 3 QT 01, m . ro W - . n C .. eµ ._ m CL Q M H rn ; gag f ++ v m h c� a' 0 M F Q v Ct U 0 Q w .-. N I� _- --m T W 9 O W U m C N. .:.: W F 0 US W C O 0 N N w - 1 F FvwW Ir J f� w O +` A +•� O a W U CI I O M ID v v m F W 4 O ...I a N - 31 7 C Q- U » m C O_ .yi CD U F C U1 4: _ S- V r-1 U 0 F W m £ 0 'a •rr• C IU.i m t 2 2 Q 0 U C 0 F a 9 U. .m •.Ci 1 F Un N 1 O TO C C a 2 Q ¢ ._ U .-i U C +-� C U ` U1 m Z U C C m U N W W 'U A La CC i+ F +� 7 F ++ .••1 f. F Q .. - 0 U U ^V m 0 0 ♦0.+ 3 I� a OJ a� 2 m Y. ;. Uf 3 0, F ^ 1I 1!1! Q y I I a c c o tr C-1 ? ^c F" V: 2 lr 4. t+1 Q LENGTH= Y - , c, \ 7 W W • J nl Locate all utility connections t � in this area (Rear 1/3 of road AA side of m/H, within 4 ft. of ry^ a a-_. •'�• 11. 1— tj m Y. J ` J W } Ilk