PMT18-03653 City of Menifee Permit No.: PMT18-03653
29714 HAUN RD.
�'r MENIFEE,CA 9258E Type: Mobile Home
MENIFEE MENIFEE Date Issued: 07/24/2018
PERMIT
Site Address: 25630 ANTELOPE RD, MENIFEE, CA Parcel Number: 329-120-003
92585 Construction Cost: $3,600.00
Existing Use: Proposed Use:
Description of INSTALL PERMANENT FOUNDATION ON EXISTING MOBILE HOME, 1680 SF
Work: SERIAL#:A6SC1241CA HUD#:065635
SERIAL#: 66SC124CA HUD#:065636
SERIALMC6SC124CA HUD#: 065637
Owner Contractor
CIRILO GOMEZ PERMA-BRACE CONSTRUCTION
25630 ANTELOPE ROAD 21690 VINE ST
MENIFEE, CA 92585 WILDOMAR, CA 92595
Applicant Phone:9512459373
IVAN MONTES License Number:636757
PERMA-BRACE CONSTRUCTION
21690 VINE ST
VNLDOMAR, CA 92595
Fee Description 01t rr Amount fSl
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_Pennil 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 effect the following reason:
License Class r_-q I Ucen 9 No. By my signature below I acknowledge that,except for my personal residence
Expires i_r,i - 2 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 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 at the following website:
by Section 3700 of the Labor Code,for the performance of work for which
www.1eRinfo.ca.gciv/caIaw.htm1.
this permit is issued.
Policy# Date
D 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 D 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 C ' Ga. tic �/ with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
�t
Policy# ✓)N pires — G 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 forwhich this permit is issued,
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers 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 f ith comply with those 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 in 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($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 for guidelines
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 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 ❑No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes ❑No
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,Improve,demolish or repair any structure,priorto its PROPERTY 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 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 Cade)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
o 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.epa.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 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. ❑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 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.
I
BUILDING &
DATE: / 2 PERMIT/PLAN CHECK NUMBER
TYPE, O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY rXAOBILE HOME O POOVSPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK O / f'
PROJECTADDRESS CI - ZIP
ASSESSOR'S PARCEL NUMBER q- /2'6- 662> LOT Z41V TRACT CAYnf► @@life—,
OWNER NAME cQ/1Z-e z Building Dept.
ADDRESS a s �3-0 4r) PJ re I JUL 2 4 2018
PHONE _6gd5ll q�l— bo(pZ- EMAIL
APPLICANT NAME ' "VP e
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAMEU"& a OWNER BUILDER? PES O NO
BUSINESS NAME
ADDRESS ^^ P / 0 -? !!��
PHONE l/��i�Q4,5--X -71 EMAIL rt e eo d Df
CONTRACTOR'S STATE LIC NUMBER �n ��O 7S7 LICENSE CLASSIFICATION ' C'
VALUATION$ 3L.P 0 o SQ FT & L SQ FT C�
APPLICANT'S SIGNATURE DATEglo
. 'Z - L�
CITYSTAFFUSEONLY '+ - -
DEPARTMENT DISTRIBUTION ._`J CITYOF MENIFEE BUSINESS UCENSENUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY:
PERMIT FEE SMIP K GREEN X
PLAN CHECK FEE INVOICETOTAL
OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of i✓lenifee Building to Safety Department 29714 Hemp Rd. Menifee, CA 92596 951-672-6777
www.cityofmcnifee.us
P.O. Box 1248
Wildomar, CA. 92595
Phone (951) 245-9373
FOUNDATION SYSTEMS Fax (9511245-8.988.
FO
License 636757
City of Menifee
July 31,2017 Building Dept.
JUL 2 4 2018
Ci f u Received
D f ui ing & Safety
90 P enu
Ca i a, A 20
To Whom It May Concern
I,Wendy L. Brown, Owner(CA Contractor License 4636757) give permission behalf of our to Ivan
cMont
Imp es'
CA D be pull-BRACE CONSTRUCTION-
building permits
company P
Si cer y
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e-mail address: permabrace@live.com
NAME C, I R 42
^ PHONE l/ f �O /
JOB ADDRESS 2, .S (p!7 /7/V /1 �Cn/,Vto/JI��
TRACT/PARCEL MAP - LOT
ASSESSOR'S PARCEL NO.
REAR PROPERTY LINE
>€9 4.71 City of Menifee _
Building Dept.
JUL 2 4 2018
Received lz"'.
.11JJ�
i �oir2�
z
0 0
Ad 94
a a
I ..
ENIFEE
BUIL NG AND SAFETY DEPARTMENT
PLAN APPROVAL '
REVI WED BY
DAI E
FRONT PROP approv—Tot,any violation of any provisions of the federal,state or city
regulations and ordinances. This set of approved plans must he kept on the
ST E�EWuntil completion.
STATE OF CALIFORNIA-BUSINESS.CONSUMER SERVICES,AND HOUSING EDMUND G.BROWN JR.,GOVERNOR
DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT
® DIVISION OF CODES AND STANDARDS
® eel „
Title Search
Date Printed: Jul 14,2018 City of Menifee
Decal#: AAW2553 Use Code: SFD Building Dept.
Manufacturer: SILVERCREST Original Price Code: AHT JUL 2 4 2018
Tradename: SIGNATURE Rating Year: 1978
Model: MARK I Tax Type: ILT Received
Manufactured Date: 01/01/1978 Last ILT Amount: $29.00
Registration Exp: 11/30/2018 Date ILT Fees Paid: 12/10/2017
First Sold On: 11/30/1978 ILT Exemption: NONE
Serial Number HUD Label/Insignia Length Width
A6SC1241CA 065635 60' 12'
136SC124CA 065636 60' 12'
C6SC124CA 065637 24' 10,
Record Conditions:
Park Purchase Fee Exemption granted
Registered Owner:
CIRILO GOMEZ
MARIA M GOMEZ
Joint Tenants with Right of Survivorship
25630 ANTELOPE RD
ROMOLAND,CA 92585
Last Title Date: 02/24/1992
Last Reg Card: 1 113 0/2 0 1 7
Sale/Transfer Info: Price$25,000.00 Transferred on 06/11/1987
Sims Address:
25630 ANTELOPE RD
ROMOLAND,CA 92585
Situs County: RIVERSIDE
Inactive Decal/DMV:
DMV SJ9885
***END OF TITLE SEARCH***
Branch:S06,User:S WEN Comment: Station Id:AFAN
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xuA Mr.and MRs. Cirilo Goren , O AVVV yys 000t F. ;,
25630 Antelope rsr i t F.
Romol and ca 9a 3 80 DR s
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WALL AROVL TMIi YNL IbR w[COwmwRy ULL
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1 1 Dmr U y M..rnr to ._�_�__...........
xm Competed on full Ydue of property,vnny d.or
A.mn same as above LJ Compuld on frail v*I=6.Item A ennm Mm
ren W.,thereon at 11w of ale
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Grant Deed '""en x,32R.f4o•ov3 yr
Thu Imw ftwtdrhed by Or=W CoadMUe CamvwW City of Menifee
FOR A VALUABLE CONSIDERATION,rmeipt of whi.h i.he..by odmWedyed. Building Dept,
Leo R. Gallegos JUL 2 4 2018
hereby GRANT(S) to
lY Cirilo Gomez and Maria M. Gomez, husband and wife as joint tenants Re
ceived
fthe following daeribed red property in the V+ inC-orpo'4CA
CL monty of Rlverside •sute of CJRorni.:
That portion of Lot 49 of Romola Farms. as shown by map on file in 80ok 12 Page
71 of Maps. records of Riverside County. California described as follows:
Beginning at the northwest corner of said Lot 49, Thence Easterly on the Northerly
line of said Lot. 6S2.27 fLet to the Northeast corner thereof. Thence Southerly
on the Easterly line of said Lot. 67.01 feet, thence Westerly line of said Lot
66.97 feet southerly from the Northwest corner thereof. Thence Northerly on
the Westerly line of said lot 66.97 feet to the point of beginning.
Dw.d February 24, 1987
STATE of CALIFORNIA
cnv. T or Riverside 55.
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RIVERSIDE,CA Page 1 of 1 Printed on 7/19/2018 11:02:46 AM
Document:DID 1987.130893