PMT18-05472 City of Menifee Permit No.: PMT18-05472
A& 29714 HAUN RD. Type: Residential Demolition
MENIFEE, CA 92586
MENIFEE MENIFEE Date Issued: 11/16/2018
PERMIT
Site Address: 33441 DAILY RD, MENIFEE, CA 92584 Parcel Number: 384-010-033
Construction Cost: $100.00
Existing Use: Proposed Use:
Description of DEMO SINGLE WIDE MOBILE HOME W/STICK BUILT ATTACHMENT
Work:
Owner Contractor
NUCAL INVESTMENT PROPERTIES
76194 HONEYSUCKLE RD
Applicant License Number:
NUCAL INVESTMENT PROPERTIES
76194 HONEYSUCKLE RD
PALM DESERT, CA
Phone: (760) 831-6108
Fee Description Otv Amount($)
Building Permit Issuance 1 27.00
Demolition Permit 1 140.00
GREEN FEE 1 0.00
$167.00
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 contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and KI 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: r f�M/? e W A/,�'/r
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 s ed or t the following website:
by Section 3700 of the Labor Code,for the performance of work for which
this permit is issued. www.leginf a.�ov calaw
Policy# Date — —1 4
DOPER NER❑I have and will maintain worker's compensation insurance,as required by OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which y signature below I 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: application and the information I have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier building construction. nze r presentatives of this city or county to
Policy# Expires enter the abo entified prop y for inspection purposes.
(This section need not to be completed is the permit is for one-hundred
Date
dollars($100)or less PR&ERTY OR AUTHORIZED AGENT
❑I certify that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's 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
mixture containing a hazardous material equal to or greater that the
Applicant Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes KNo
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 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 J(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 X No
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
California Health&Safe e, ection 25505 and 2S534 concerning
Contractors License Law for the reason(s)indicated below by the hazardous matey' eportin
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ,byes ❑N
Business and Professions Code).Any city or county that requires a permit to Date �,_ / 1
construct,alter,improve,demolish or repair any structure,prior to its PROP�R'TY ER 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 Contractor's State EPA OVATION,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
0,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.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 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 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: PERMIT/PLAN CHECK NUMBER
GRADING PLANNING CASE NUMBER OTHER RELATED CASES
TYPE: COMMERCIAL C'1* RESIDENTIAL MULTI-FAMILY MOBILE HOME PCOL/SPA C) SIGN
SUBTYPE: C)ADDITION C) ALTERATION DEMOLITION C) ELECTRICAL MECHANICAL
NEW PLUMBING RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK YV4 �e_
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS YES C N 0
PROJECTADDRESS zip
ASSESSOR'S PARCEL NUMBER '3 LOT TRACT
OWNER NAME 1V,..1e,,9 L /,,V v,�F_5 74�1/--", -7- NOP6�10_711;F=
ADDRESS 7�_Iq4f fpl::) t/V7
PHONE 71�00 — EMAIL
APPLICANT NAME Ajj
ADDRESS 4s
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? YES NO
City of Menifee
BUSINESS NAME Ruilding Dept
ADDRESS NOV 16 2018
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASS I
VALUATION$ 16,-� SQ F LSQFT
APPLICANT'S SIGNATURE DATE
OTY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING F RE rLNk
INVOICE TOTAL GREEN_T SMIP
0 NO
YES
OWNER BUILDER VERIFIED No DRIVERS LICENSE# NOTARIZED LETTER
City of Menifee Building & Safety Department 29714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofmenifee.us
ENIFE
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PLOT/SITE PLAN {J
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REAR PROPERTY LINE
CITY OF MENIFEE
BUIL IlNIG AND SAFETY DEPARTMENT .,
PLAN r.-+'ROYAL City of Menifee
Building Dept,
REV':' 'A" D BYOwe __�j NOV 16 2018
'Approval of tr ese plans shall not be construed to be a pem,.it. ;;r: ce I v e
approval It.a,ly violation of any provisions of the federai s, to c•c t.
regulation s ano ordinances. This set of approved plans mus:
jobsite ut til completion. I
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Property Owners Name
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Property Address
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City of Menifee Building&Safety Department 29714 Haun Rd.Menifee,CA 92586 951-677-672-677
wwwcityofinenifee.us