HomeMy WebLinkAbout2. Permit# 09067:.
city of e Are Luis OBI SPO
,g;,- Building & Safety Division • 99v Palm Street/Box 8100 • San Luis Obispo, CA 93403-olUO • (805) 781-7180
CONSTRUCTION PERMIT
Project Address 40 PRADO
Assessor's Parcel Number 053-041-0034
Project Description MOVE RESIDENCE TO 1953 CHORRO
Permit Type
_Building
_Mechanical _Electrical
Property Owner
DIAMOND D CORP AN
OR CORP
Mailing Address
PO BOX 10638
City/State/Zip
EUGENE OR, 97440-
Contractor
L W ENTERPRISE CO
Mailing Address
PO BOX 1613
City/State/Zip
FREMONT CA 94538
Project Manager
TODD MILLER
Lender Name
U.B.C. Group
R-3
U.B.C. Type VVN
Census number
645 Demolish Single
Family Residence
VALUATION
Comments:
Application Number 30650
Application Date 09/10/93 Payment #1
Permit Number
Issuance Date
09067
12/03/93 Total Payment
LEGAL DECLARATIONS
OWNER BUILDER DECLARATION:
I am exempt from the contractor's license Law for the following reason:
_ 1, as owner of the property, or my employees with wages as their sole compensation
will do the work and the structure is not intended or offered for sale.
_ I, as owner of the properly, am exclusively contracting with licensed contractors to
Zct the project.
applicable
WORKERS COMPENSATION DECLARATION:
I hereby affirm that I have a certificate of consent to self -insure, or 'a certificate of
Workers' Compensation insurance, or a certified copy hereof (Sec. 3800, Lab. C)
_ Certified copy is hereby furnished.
Certified copy is filed with the City.
of applicable
c TIFICATE OF EXUMPTION FROM WORKERS COMP. INSURANCE
_ I certify that in the perfarmunce of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Worker's Compensation
Em%�n of CnGrnn fia.
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Legal Description SLO SUB TR PTN LTS 4 & 5 & 20
_Plumbing _Sign X Demolition _Grading
Occupant/Business Name
Architect/Engineer
License #
Contractor's Phone No. (_5101 651-1717
Contractor's State Lic. No. 419528
Project Manager's Phone No. 543-7473 (w
Lender Address
Stories 1 1 Codes: UBC 91
Units demolished 0•
FEES
PAYMENTS
Amount Date Receipt
52.00 12/03/93 1339
52.00
NOTICE TO APPLICANT:
NEC 90
Building Permit
0.00
Plumbing Permit
0.00
Mechanical Permit
0.00
Electrical Permit
0.00
Grading Permit
0.00
S.M.I.P.
0.00
Energy Surcharge
0.00
Accessibility Surcharge
0.00
Demolition Permit
52.00
Sign Permit
0.00
Administrative
0.00
Miscellaneous Charge/Cred
0.00
Investigation Fees
0.00
Microfilm
0.00
Subtotal 52.00
Plan Review
0.00
Construction Unit Tax
0.00
Water Impact
0.00
Water Meter Installation
0.00
Wastewater Impact
0.00
Total Fee Calculated
52.00
Balance Due
0.00
If, after making any of the foregoing declarations, you become subject to any Labor
Code or License Law provision, you must comply with such provisions or this permit shall
be deemed revoked.
I certify that I have read this application and state that the above information is correct,
I agree to comply with all city ordinances and state laws relating to building construction, and
hereby authorize representatives of this city to enter upon the above -mentioned property for
inspection purposes.
Unless noted under "Special Conditions", this permit becomes null and void if work or
construction authorized is not started within 180 days, or if construction or work is
suspended or abandoned for a period of 180 days any time after work is commenced.
Special Condiliotrst
Signature of Contractor, Authorized Agent or Owner Date
Address File