PMT18-04069 City of Menifee Permit No.: PMT18-04069
Ay AV 29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Re-Roof
MENIFEE MENIFEE Date Issued: 08/16/2018
PERMIT
Site Address: 26033 LANCASTER DR, MENIFEE, CA Parcel Number: 335-132-003
92586 Construction Cost: $6,985.00
Existing Use: Proposed Use:
Description of INSTALL NEW COOL ROOF SHINGLES OVER EXISTING SINGLE LAYER SHINGLES
Work: CRRC#0676-0041
Owner Contractor
COMMUNITY DEV FUND IV REO ,
2015 MANHATTAN BEACH,#200
REDONDO BEACH,CA 90278
Applicant License Number:
MENIFEE, CA
Fee Description ON Amount I$1
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
$130.90
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_Pennit_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 perjurythat 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 ❑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 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
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
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 www.le info.ca. ov calaw.html.
this permit is issued. O 5(
Policy#
Date b u
PRO OWN ER OR AUTHORIZED AG ENT
o I have and will maintain workers compensation insurance,as required by
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 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 enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred
dollars($100)or less Date
q.
PIOPffTY OWNER OR AUTHORIZED AG ENT
❑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#
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 forthwith 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 15 ❑Yes o 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 Coast Alt Quality Management the
ruction D)?Seeor mods permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ❑Yes ONO
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 SCAOMD
I hereby affirm under penalty of perjurythat I am exemptfrom the permitting checklist.I understand my requirements under the State of
California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law forthe o the pp icableed below by the hazardous material reporting.
checkmark(sJ I have placed next to the applicable item(s)(Section 7031.5
Business and Professions Code).Any city or county that requires a permit to oyes O No Date
construct,alter,improve,demolish or repair any structure,prior to 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(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($500). managers who do the paint-disturbing work themselves or through their
o I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.Rov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
AI,as owner of the property am exclusively contracting with licensed
co tractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
—I'mism LIA&_t. . . . ,—
DATE: S `tp g PERMIT/PLAN CHECK NUMBER q
PLANNING CASE NUMBER
TYPE: O COMMERCIAL '$RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION ;> ELECTRICAL O T5V9'Wnifee
O NEW O PLUMBING RE-ROOF NUMBER OF SQUARES YY
DESCRIPTION OF WORK `(ee O0 -
PROJECTADDRESS Q- 00"33 L,(.ACQSI�f 'PY• ZIP Received
ASSESSOR'S PARCEL NUMBER �350"09-1 777) LOT TRACT
OWNER NAME wxvnk FUr ] NI 'VVAS--
ADDRESS OIS YV\nm\.. sk\JA- ea�.do � GR `1021
PHONE - 30"IO EMAIL
APPLICANT NAME N%V\\CkA,
ADDRESS LA�cLr'. ,IwA"t c\ �ZS 7D
PHONE (gS12 03 - `ll03 EMAIL 0C ' AAVCMb\i �vJza WODcI—t C-��
CONTRACTOR'S NAME OWNER BUILDER? YES O NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ `0 I�VS • 6 D SSQ FT L SQ FT
APPLICANT'S SIGNATURE DATE,OTY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: ' , CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE F►"'A 6
INVOICE TOTAL C.�O GREEN SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES O NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
Gin
www.cityofinenifee.us
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Community Development Fund IV Trust
2015 Manhattan Beach Blvd,Suite 100
Redondo Beach,CA 90278
Telephone: (310)640-3070
Facsimile:(310)640-3090
City of Menifee
Building Dept.
August 7,2018 AUG 16 2018
RE: 26033 Lancaster Dr., Sun City,CA 92586 Received
This letter is to verify that Ashley Buttacavoli is authorized by Community Development Fund IV Trust to act as a
property supervisor and rehabilitation coordinator. In such capacity,she may view,access or sign for any permits, liens,
billing paperwork,lease agreements,ownership paperwork, lot dividing paperwork,HOA documents and/or any other
documents related to this property. This also includes obtaining gate codes for gated communities in order to oversee the
installation of utility meters(including electric and gas), as well as to coordinate any repairs and rehabilitation.
Thank you in advance for your assistance and prompt attention to this matter. If you should have any questions,please
feel free to contact Elizabeth Lopez at(310)640-3070 xI05.
Sincerely,
Community Development Fund IV Trust,
a Delaware statutory trust
By:'V o ,
a C
a
li
oration
Its:A ini mr
By:Grego�y-L., eiser,President
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 the doctmrent.
State of California )
County of Los Angeles )
On 1 u t 1? before me, . T t QaeZ a Notary Public,personally appeared
yr6A• I- • 66 j Si9k ,who proved to me on the basis of satisfactory
evid� bo a the person(s)whose name(s)is/are subscribed to the within instrument and acknowledged to me that he/she/they
executed the same in his/her/their authorized capacity(ics),and that by his/her/their signature(s)on the instrument the person(s),or the
entity upon behalf of which the person(s)acted,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.
WITNESS my h lid and oM ial seal.
Signature (L�/ (Seal) E.J.LOPEZ
Commission#2126800
i', o it, Notary Public-Calltomla $
Los Angeles County
My Comm.Expires Se .2019