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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 Sl 7 PLOT/SITE PLAN {J lUc�/r�7�—r 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 LU � LU w w o � H H 1 /3C,i t-f E/N'0/� e LT Lj n I FRONT PROPERTY LINE Property Owners Name I Property Address N 3FSy •cal �'a 33 City of Menifee Building&Safety Department 29714 Haun Rd.Menifee,CA 92586 951-677-672-677 wwwcityofinenifee.us