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PMT19-00104 City of Menifee Permit No.: PMT19-00104 29714 HAUN RD. Type: Residential Demolition .r' MENIFEE, CA 92586 MENIFEE MENIFEE Date Issued: 01/09/2019 PERM IT Site Address: 26510 TRUMBLE RD, MENIFEE, CA Parcel Number: 331-340-024 92585 Construction Cost: $3,500.00 Existing Use: Proposed Use: Description of DEMO OF EXISTING MOBILE HOME ON PERMANENT FOUNDATION Work: 1440 SQ FT Owner Contractor EDUARDO RODRIGUEZ OPM MOBILE HOME SERVICE 26510 TRUMBLE RD 26094 OLSON AVE MENIFEE, CA 92585 HOMELAND, CA 92548 Applicant Phone: 9514919132 CALEB JASSO License Number: 1025561 OPM MOBILE HOME SERVICE 26094 OLSON AVE HOMELAND, CA 92548 Fee Description f3yt Amount 1$1 Building Permit Issuance 1 27 00 Demolition Permit 14000 GREEN FEE 1 1.00 $168.00 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 LICENSED DECLARATIION. CITY OF MENIFEE 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 Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensu eunder the C nt Contractor's State License Law for Professions Code and my license is in full force and effect. �1 t—� the following rea on; License Class "l License J p?f,Sb Expires Signature By my signature bel w I acknowledge that,except for my onal residence in which I must have'I sided for at least one ear port WORKER'S COMPENSATION DEGLI4RATI0 Y P mpletion of improvements covere by this permit.I cannot lega se)1 a structure that I ❑I hereby affirm under penalty of perjury one of the following declarations:I have built as an owner- ilder if it has not been nstructed in its entirety by have and will maintain a certificate of consent of Leif-insure for worker's licensed contractors.I un erstand that a cop f the applicable law,Section compensation,issued by the Director of Industrial Relations as provided for 7044 of the Business and P fessions Colds available upon request when by Section 3700 of the Labor Code,for the performance of work for which this application is submitted r at the f awing website: this permit is issued. p, f www.leainfooca Gov w.htr Policy# ( y ❑I have and will maintain worker's compensation insurance,as required by Date PROPERTY OWNER OR A TH II AGENT section 3700 of the Labor Code,for the performance of the work for which ii Bythis permit is issued.My worker's compensation insurance carrier and policy owner r o signature below! ertify to ach of the following:I am the property number are: P Y owner or authorized to t on the pr erty owners behalf.I have read this application and the in rmation 1 have ravided is correct I agree to comply Carrier i"�iy"G. r(�L with all applicable ci and county ordin nces and state laws relating to Policy# Ex Tres to�� (� building construct n.I authorize represe tatives of this city or county to P(This section need not to be completed is the permit is for one-hundred enter the above i entified property for ins Ction purposes. dollars($100)or less _ J r — PROPERTY OWNER OR AUTH RIZED AGENT e ❑I certify that in the performance of the work for which this permit is issued, I shall not _y 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 subject to the worker's compensation provisions of Section 3700 of the Labor HAZARDOUS MATERIAL DECLARATION Code,I shall Fort ply with those provisions. Applicant Will the applicant or future building occupant handle hazardous material or a Date mixture containing a hazardous material equal to or greater that the WARNING:FAILURE TO SE URE WORKER'S COMPENSATION COVERAGE IS 41(0— amounts specified on the Hazardous Materials Information Guide? ri UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Yes AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the intended use of the building by the applicant or future building ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist CONSTRUCTION LENDING AGENCY for guideline 0Yes D Mo 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) OWNER BUILDER DECLARATIONS ❑Yes oYa—" 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 Contractor's License Law for the reasons)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting. Business and Professions Code).Any city or county that requires a permit to oYes f l [ l llf construct,alter,improve,demolish or repair any structure,prior to its issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNER OR AUTHORIZED AGENT Date that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION REPAIR AND PAINTING RRP License Law(Chapter 9(Commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-1978 an Applicant fora permit subjects the applicant to a Civil penalty of not more residence or childcare facility to be RRP-certified firms and comply with than($500), required practices.This includes rental property owners and property ❑I,as owner of the property,or my employee with wages as their sole managers who do the paint-disturbing work themselves or through their employtrnation about EA's Renovation compensation,will do( )all of or( )portion of the work,and the structure is www.e ea.s ovolead ormorercontact the National Lead InformationProgram atrt not intended or offered for sale.(Section 7044,Business and Professions Code;The Contractor's State License Law does not apply to an owner of a 1-800-424-LEAD(5323). property who,through employees'or personal effort,builds or improves the Ei An EPA Lead-Safe Certified Renovator will be responsible for this project property provided that the improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of Certified Firm Name: Completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.: 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 comf GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: COMMERCIAL ':::4-ESIDENTIAL I) MULTI-FAMILY <:: MOBILE HOME PO.OL/5PA SIGN SUBTYPE: :=ADDITION ALTERATION DEMOLITION ELECTRICAL {:: MECHANICAL NEW PLUMBING RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK OCCUPANCY GROUP r /� CONSTRUCTION TYPE (��U SPRINKLERS )YES -✓NO PROJECT ADDRESS b�V CLV_4AgL� { ZIP ASSESSOR'S PARCEL NUMBER � 5L-P MA LOT TRACT OWNER NAME VIDkgNrlo . E'J(�Ci � ADDRESS Q' G 1 (2-U'\s- `.� f) PHONE '� U �G EMAIL �j�G CCt/Y) APPLICANT NAME & �5G r ADDRESS rr o, 0 PHONE I L EMAIL CONTRACTOR'S NAME b(l Q ROP101 SeuIn,NeR BUILDER? YES 0 NO BUSINESS NAME `L / ADDRESS CL.r '�.� �� ''E"�1�� y PHONE �(�J q I EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION Gt� VALUATION$ SQ FT O _ L SQ FT APPLICANT'S SIGNATURE ..r f DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICE TOTAL TGREEN Ie SMIP OWNER BUILDER VERIFIED ES 0 NO DRIVERS LICENSE# A 4�05& NOTARIZED LETTER ') YES 0 NO City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityofinenifee.us Ni \j o►il�`' � ��`�"`tip` � q(, , C) Z .� LAC-, c7 Li, tvi M � S �