PMT18-02039 City of Menifee Permit No.: PMT18-02039
29714 HAUN RD.
�J-�CCEL/� MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 0 412 712 01 8
PERMIT
Site Address: 29001 WICKERD RD, MENIFEE,CA Parcel Number: 372-150-001
92584 Construction Cost: $20,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of REPLACE EXISTING WOOD FENCE WITH CITY STANDARD FREESTANDING BLOCK WALL 6FTX
Work: 280 L. FT AT PROPERTY LINE.
Owner Contractor
KATHLEEN VERSTEGEN ,
29001 WICKERD RD
MENIFEE, CA 92584
Applicant License Number:
KATHLEEN VERSTEGEN
29001 WICKERD RD
MENIFEE, CA 92584
Phone: 5625726443
Fee Description Oy Amount Isl
Building Permit Issuance 1 27.00
Wall/Fence,standard 1 83.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 3.00
General Plan Maintenance Fee-Building 1 4.15
$118.15
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 Permk 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 I with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and 'K,I am exempt from licensure under the Contractor's Slate License Law for
Professions Code and my license is in full force and effect. the following reason:&YK e. 6 to H P e
License Class License 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
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 lvww.le info. ov ca a tml.
this permit is issued.
Policy#
Date
o I have and will maintain worker's compensation Insurance,as required by PROPERTY OWNEROR AUTHED AGENT
section 3700 of the Labor Code,for the performance of the work for which o By my signature below 1 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: I application and the information 1 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 enterthe ove identified roperty for inspection purposes.
(This section need not to be completed is the permit is for one-hundred / Date
dollars($100)or less PROPERTY O NER OR AUTHORIZED AGENT
❑I certify that in the performance of the work for which this permit is issued,
I shall not emolav any persons in any manner so as to LcpRRp�44Qt to the CITY BUSINESS UCENSE#
worker's compensation laws of California,and f!� t R l ecome HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provision w"Q3110 bf the Labor
Code,I shall forthwith comply with those provisions. p Will the applicant or future building occupant handle hazardous material or a
Applicant pgge'� mixture containing a hazardous material equal to or greater that the
rr 11`` amounts specified an the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS� o Yes 0 No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIM,�IN�e1 �\�� Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOU O,O N I occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION, AAA PROVIDED FOR I Coast Air Quality Management District_(SCAQMD)?See permitting checklist
1N SECDON 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ❑Yes ifNo
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 k No
OWNER BUILDER DECLARATIONS I 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
California Health&Safety Code,Section 25505 and 25534 concerning
IContractor's License Law for the reasons)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes / p
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 AurHORI&f6AGENT
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(RRPI
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(SSOD). managers who do the paint-disturbing work themselves or through their
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 P all of or( )portion of the work,and the structure is www.epa.gov/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 Contractor's State License Law does not apply to an owner of a o 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. in No EPA Lead-Safe Certified Firm is required for this project because:
a I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 70",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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: -pR - ( g PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL A-RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: OADDITION t..*ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK �_ W
�-{- - ZESO l.• �T
PROJECTADDRESS (,Jf t—d ZIP
ASSESSOR'S PARCEL NUMBER ?j 79/5 D U 0 ✓COT TRACT
OWNER NAME �[ 3�t'6 D 0 v=` � Cfty Of @nl @e
RidIdno De A.
ADDRESS �L_ UO
i
PHONE Cj7,�-` '�(o yy EMAIL `,
APPLICANT NAME 7` ¢ y H C®i V e
ADDRESS E
PHONEa_.S'7�'-[.. t/i1 EMAIL
CONTRACTOR'S NAME OWNER BUILDER? ES O NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
O 0 SQ FT L SQ FT go
APPLICANT'SSIGNATURE DATE LI-26 -/V
UTYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL GREEN SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
\ City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777.
www.cityofinenifee.us "✓''s'
REBAR PLACEMENT
ILLUSTRATION FOO NG OPTION B
A
�ME
C1� S
6011,010 AN A
(TYPICAL) pL�'N APpR
ALL REBAR SPLICES
24" MIN. OVERLAP
p\aM sh ,e f
'APP10 \of Son of0,
-Pl�ovaA a any 01
UI At
uA
j
A 212018 .,
ReCe►ve�
(TYPIICwA�L)
ONLEMLLS AND BO D Mff".
GROUTED
``'•., (DO NOT SOLID GROUT ENTIRE WALL-USE
i e GROUT STOP MESH AS APPROPRIATE)
FO TING OPTION
(TYPICAL.)
ALL REBAR SHALL HAVE A
MINIMUM OF 3" CONCRETE
COVER AT FOOTINGS
DESIGN PARAMETERS: WESYERN RIVERSIDE COUNTY CODE UNIPORMRY PROGRAM
ACTIVE SOIL PRESSURE(PSF) =30 """ CITY OF MENIFEE
PASSIVE SOIL BEARING(PSF) =150 BUILDING DEPARTMENT
COEFFICIENT OF FRICTION =0.25 MENIFEE
ALLOWABLE SOIL BEARING(PSF) =1500
WIND=80 MPH,EXPOSURE C FREESTANDING BLOCK WALL
SEISMIC:
NA=1.3,NV=1.5,Z=0A SOIL PROFILE=So
(951)672-6777 29714 H.4un RoAD,MENIFEE,CA 92586
FAX(951)6793843 2 12014 ry WWPI.CITYOFMENIFEE.US PAGE2OF2
City of Menifee
Building Dept.
FOOTING ING OPTION 66 �l 99 APR 2 7 2018 FOOTING OPTION 66B99
N 1.J.�..........I:I_°.� li 6'1l Recaived FOOTING�b.9 �V'
�(OTS2'BOND BEAM BLOCK) e�
tf `
6"OR'8".BLOCK
LLLLLL
„H., ..H.,
HEIGHT FROM TOP f #4 HORIZONTAL AT 32.' MAX:O.C. HEIGHT FROMTOP
OF FOOTINGM / . (USE BOND BEAM BLOC) OF FOOTING
fI SdE'fETAB{ "A" - - - SEETABLE"B"
FOR REBAR SIZE FOR REBAR SIZE
AND SPACING AND SPACING
ILO.OF�RE3AP.III C'clJl<R OF,CELU (LOCATE REBAR IN CEMER OF CELLI
-FINISH GRADE ?
(1 #4 REBAR
CONTINUOUS- — _ — .—
(2)-#4REBAR Ill'-
F 12„ 10„ lilll _ 101 12„
CONTINUOUS I�IIIII _
7
REVERSE _ =_lll�ll'I
w .. DIRECTION OF �- 'W' "W"
HOOK ON EVERY II (FI OOTING WID� (I FOOTING WID
OTHER REBAR SEETABLE"A'• SEETABLE"B"
ALL FOOTINGS ADJACENT TO
j SLOPES BE LEAST 5'TO
TABLE "A" " B"
DAYLIGHTT TABLE AS SHOWN BELOW. ,
4.r a VERTICAL " VERTICAL
H W' REINFORCEMENT I'1 w" REINFORCEMENT
3' 17" #4 @ 48" O.C. 3' 19" #4 @ 48"O.C.
r — 4'—-20 #4 @ 48"O.C. — --a:— 4' 22"— #4 @ 48"O:C.-
s 29" #4 @ 48" O.C.
5' 23" # 48" O.C. <oo� 5'
#4 @ 24" O. BOTTOM F. 6' 34" #4 @ 24" O.C.
FOOTING 5'MIN.
,Y VyV,
' NOTES: CHECK WITH THE BUILDING DEPARTMENT TO
w.: 1)THIS DESIGN DOES NOT ALLOW GRADE DIFFERENTIALS OF VERIFY IF A BUILDING PERMIT IS REQUIRED.
MORE THAN 6"ON OPPOSING SIDES OF THE WALL. THIS IS WHEN A PERMIT IS REQUIRED,THE FOLLOWING
NOT A RETAINING WALL. INSPECTIONS ARE REQUIRED:
2)FENCE HEIGHTS ARE REGULATED—CONSULT ZONING 1)FOOTING;EXCAVATION TRENCH CLEAN WRH
REGULATIONS BEFORE BEGINNING CONSTRUCTION. STEEL IN PLACE AND SUPPORTED 3"ABOVE AND
f3)NO WATER COURSE OR NATURAL DRAINAGE SHALL BE AWAY FROM THE SURROUNDING EARTH/DIRT.
OBSTRUCTED. 2)REBAR/PRE-GROUT:BOND BEAM REBAR AND pr
4)GROUT ONLY THE CELLS CONTAINING REBAR. THIS WALL VERTICAL REBAR IN PLACE-INSPECTION PRIOR TO
IS NOT DESIGNED FOR ALL CELLS TO BE GROUTED. PLACING GROUT.
5)ALL REBAR TO BE ASTM SPEC.A615,GRADE 40 MINIMUM. 3)FINAL;AFTER GROUT IS PLACED-PRIOR TO ANY
6)ALL REBAR LAP SPLICES TO BE 24"MINIMUM. DECORATIVE CAP PLACEMENT.
7)ALL MASONRY UNITS TO BE ASTM C-90 GRADE N.
8)REBAR TO BE CENTERED IN MASONRY CELLS.
WESTERN RIVERSIDE COUNTY CODE UNIFORMITY PROGRAM
'SEE PAGE 2 FOR ADDI110NAL INFORMATION' �,��a. CITY OF MENIFEE
DISCLAIMER: " BUILDING DEPARTMENT
ALTERNATE DESIGNS MAY BE POSSIBLE MENIFEE
WHEN PROVIDED WITH AN ENGINEERED FREESTANDING BLOCK WALL
ANALYSIS. USE OF THIS STANDARD DESIGN
IS AT THE USER'S RISK AND CARRIES NO
IMPLIED OR INFERRED GUARANTEE AGAINST (951)6726777 29714 HAUN ROAD,MENIFEE,CA 92566
FAILURE OR DEFECTS.
FAX(951)6798 WVJ
843 2/yy�pOi4 W .CITYOFMENIFE'c.US PAGEI OF2
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Property Owners Name 14ALI—1 P n I/e_,(/-'e fe gE h
Property Address `J-900 / UJi Lcrd i2,/
To Whom it may concern,
I Carlos Corona authorize Kathleen Verstegen to pull a residential building permit for
alteration wood to block in the middle of property line, between 29001 Wicked Rd. Menifee, CA
92584 and 29045 Afton Ln. Menifee, CA 92584.
sM 11tuw d2Id
City of Menifee
Building Dept.
APR 272018
Received
CALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKHOWLEDGMENT
A notary 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 `off Riverside �r ,}� '",�' i I p f , /, f7i f I,� ,
On (�°'! -9u �b before me, _(, u�(t(,�, 'VimetVLCWoY,UI,ut d �f�w c
//!!�� t ere nsen name a l e o Inc 0(lieer)
personally appeared bat
)� ��.5 W {�
who proved to me on the basis of satisfactory evidence to be the persoD,(aj'Gvhose
name*ishee subscribed to the within instrument and acknowledged to me that
he/sbe/t�ey executed the same in his/ber/fbeir authorized capacity(kiary, and that by
his/W/th it signature(s�on the instrument the persop(ST,, or the entity upon behalf of
which the persorpKacted, 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.
CANDICE NICOLE MCGOWAN i
COMM. 12202687 0
WITNESS my hand and official seal. ° NOTARY PUBLIC-CFLLIFORNA $
RNERSIDE COUNTY
�� n/� My Comm.EresJuly21,2021
Nota ublic Signature (Notary Public Seal)
ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONSFORCOMPLETINGTHISFORM
This form minplies with errent California statutes regarding notary wording and
DESCRIPTION OF THE ATTACHED DOCUMENT fneeded,should be completed and attached to the do u.Ackwipledgarenes
from other scores xrap be completed for data eing sent to dial slate so long
as the warding does not mquire die onda wormy to wolate Califmnda notary
lmv.
(Fide or description of attached document) State and Co u ormation must be the State and County where the document
sign onally appeared before the notary public for acknowledgmenL
(Title or dworiptlon of aftached document continued) of notarintion most be the date that the signer(s)personally appeared which
• most also be the same date the acknowledgment is completed.
• The notary public must print his or her name as it appears within his or her
Number of Pages Document Date commission followed by a comma and then your title(notary public).
• Print the names) of document signer(s) who personally appear at the time of
notarintion.
CAPACITY CLAIMED-BY THE SIGNER Indicate the correct singular or plural forms by crossing off incorrect forms(i.e.
El Indi ' (s) he/sbe2`m is/are)or circling the correct forms.Failure to correctly indicate this
information may lead to rejection of document recording.
❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible.
Impression must not cover teat or lines. Irseal impression smudges,re-seal ira
(Title) sufficient area permits,otherwise complete a different acknowledgment form.
❑ Partner(s) • Signmrc of the notary public must match th(Cobj M(j(q�gehe oDice of
die county clerk. r� r••�� }}
❑ Attorney-in-Fact Additional information is not rcquirBLI9dll�QRPld ensure this
❑ Trustee(s) acknowledgment is not misused or attached to a different document.
Other Indicate title or type of attached documept,nvIr pf pygri4Qnd date:
❑ Indicate the capacity claimed by the si r. F e cla upactr IS a
corporate officer,indicate the title(i.e.CEO,CFO,Secretary).
?ti;-'•-\,,1,1,I,I lII �4N ^-.? ^_ , ..':i:- • Securely attach thisdocumcnl to the sinned document wititastaple.