PMT18-01306 City of Menifee Permit No.: PMT18-01306
29714 HAUN RD. Type: Mobile Home
<A-CCEL/-> MENIFEE,CA 92586
MENIFEE Date Issued: 0 312 312 01 8
PERMIT
Site Address: 30755 OLD WINDMILL, MENIFEE, CA Parcel Number: 360-120-005
92584 Construction Cost: $4,600.00
Existing Use: Proposed Use:
Description of PERMANENT FOUNDATION TO EXISTING 24 X 48 MOBILE HOME
Work:
SN#: 54720101AD/BD
HUD"CAL364979/80
Owner Contractor
JAMES FARRELL ALL AROUND MOBILE HOME SERVICE
30755 OLD FARRELL 27425 SWEETSPIRE TERR PLACE
MURRIETA,CA 92562
Applicant Phone:8663014499
ALL AROUND MOBILE HOME SERVICE License Number.793717
27425 SWEETSPIRE TERR PLACE
MURRIETA, CA 92562
Phone:8663014499
Fee Description Qttv Amount f$)
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 contractors)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and in 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 — LLii.cWse No. By my signature below I acknowledge that,except for my personal residence
Expires 42A 511gnature� in which I must have resided for at least one year prior to completion of
( 7 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 atthe following website:
by Section 37DO of the Labor Code,for the performance of work for which
this permit is issued. www.Jeginfo.ca.gov/calaw.html.
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 ❑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 Sj L /�i with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy ft Expires Ji
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
❑I 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 fl
worker's 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 with comp ith those provisions. �7 Will the applicant or future building occupant handle hazardous material or a
Applican Date ) mixture containing a hazardous material equal to orgreaterthat the
amounts sfecified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes M Na
UNLAWFUL,AND SHALL SUB1ECf AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP 70 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 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES —for guidelines- - - - — — - -
CONSTRUCTION LENDING AGENCY ❑Yes too
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 `IONo
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
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
hazardous aterial reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Mes ❑N ^
Business and Professions Code).Any city or county that requires a permit to T' Date rf
construct,alter,improve,demolish or repair any structure,priorto its PRO ER WNER 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(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 icensure 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 complywith
an Applicant for a permit subjects the applicantto 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 orthrough their
❑I,as owner of the property,or my employee with wages as their sale 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:eov/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 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:
in 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.
MENIFEE
DATE: PERMIT/PLAN CHECK NUMBER FILM
PLANNING CASE NUMBER
:.v TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: OADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK / (/alVAV-R t- t1- nJpAT(C7t%j
1-0 t%(<v1da M
PROJECTADDRESS 'j07!5�� 6(_0 tAmiloMll_C ZIP a
ASSESSOR'S PARCEL NUMBER —3-6o r l�;l6-oo5 LOT TRACT
OWNERNAME U- M A �IU_
ADDRESS '3o-75V n1 _6 wiWAVLL 0 .
PHONE !SI_677a— g6:73 EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME W Gi OWNER BUILDER? O YES AD
BUSINESS NAME /Lf 6 -56"tC6
ADDRESS TS / L �
I( 64,
PHONE EMAIL �ll'0.r01av��IM6pl (NLE�i t • Ga
CONTRACTOR'S STATE LIC NUMBER 7R?? 7 LICENSE CLASSIFICATION G"
If 7
VALUATION$ q600 SQ FT I If 5� L SQ FT nn �
APPLICANT'S SIGNATURE DATE �J I
CITY STAFF LIS)r`
DEPARTMENT DISTRIBUTION �.�i, ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING
^7�FIRE U
INVOICE TOTAL dQ •/ . a GREEN SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE N NOTARIZED LETTER '0 YES ':' NO
City of Menifee Building & Safety Department 129714 Haun Rd., McdpyA:ffk{951)672-6777
www.cityofinenifee.us Building DePt.
MAR 2 3 2018 'J elvlFe
Received
IC) U -
City of Menifee
Building Dept. i
MAR 2 3 2018 --
Received _
CITY OF MENIFEE
BUILDING AJD SAFETY DEPAR MET
PLAN APPROVAL
. . r
REVIEWED i3Y DATE
pans shall not be construed b e POnn t for,or an �]
.Approval of these Provisions of the Oral,state or city
any �ole6on of any P ns must be kept on the
approval of, roved P
regulations and o dironces. This set of app
lobsite until completion.
Z
sO
3Ys-
s�-l���t+•11L----
O
b4
ion , s
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: Mar 20,2018
Decal #: LAR5895 Use Code: SFD
Manufacturer: 90002 SKYLINE Original Price Code: AHX
Tradename: MAYFIELD "' Rating Year:
Model: 6002C Tax Type: LPT
Manufactured Date: 06/11/1990 Last ILT Amount:
Registration Exp: .'Date ILT Fees Paid:
First Sold On: 06/19/1990 ILT Exemption: NONE
Serial Number HUD Label /Insignia Length Width
54720101AD CAL364979a..c; :: ,..,.,� ,,,,,,,,,,,,,,,A8 11, 101,
54720101BD CAL3649N::-;-. ; _•,.I +_ ;;. ;;=•;g8' 11' 10"
Registered Owner:
JAMES L FARRELL
30755 OLD WINDMILL RD- -
SUN CITY,CA 92594. A
Last Title Date: 07/23/1990 '` ``•/7
Last Reg Card: 07/23/1990 Q
Sale/Transfer Info: Price$30,170.00 Transferred on 06/19/1990
Situs Address:
30755 OLD WINDMILL RD
SUN CITY,CA 92381
***END OF TITLEISEARCH*** 1
f r C :. , •"r117
r.