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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.