HomeMy WebLinkAbout5. FIRE-2104-2018 (679 Monterey)_ CTTY O
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Building & Safety Division • 919 Palm Street • San Luis Obispo, CA 93401-3218
Project Address: 679 Monterey St Assessor's Parcel Number: 002-421-021
Unit or Suite(s):
Project Description: Fire sprinkler monitoring alarm Legal Description:
Contractor: Great Western Alarm, Inc
WILL CLARK
Business: (805) 391-4745 Other: (805) 238-9018
Owner: WALTER WILLIAM S TRUST AGREEMENT
WiNt OBISPO
C A L I F 0 R N I A
BUILDING PERMIT
Alarm
FIRE-2104-2018
Issuance Date: 11 /2/2018
Fire Sprinklers: Stories 0.00 Code Year: 2016 Dwelling Units: Motel Rooms:
Census: 324 - Office Building Construction Type:
Occupancy:
Dimensions Valuation
Category: SQFT: Group Type; Sq. Ft Factor Valuation
Fees
Fee Name
Sprinkler Monitoring System
IT Surcharge
Total Fees:
Payments
Fee Amount
Date Receipt #
Amount
$362.79
11/2/18 18,810-11-02-2018
$216.00
$9.63
11/2/18 18,811-11-02-2018
$156.42
$372.42
Total Paid:
$372.42
Plan Check Account Payment by Contact
Contact Name Account Name Status Total Credits Total Debits Account Balance
WALTER WILLIAM S TRUST FIRE-2104-2018 in use $216.00 $216.00 $0.00
AGREEMENT
Total Account Balance: $216.00 $216.00 $0.00
Balance Due:
$0.00
Legal Declarations
#2 IDENTIFY WHO WILL PERFORM THE WORK
2a --CALIFORNIA LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Ohaptpr 9
commencing with Section 7000 of Division 3 of the Business and Professions Code, and my license is in full force and effect.
#3 IDENTIFY WORKERS' COMPENSTATION COVERAGE AND LENDING AGENCY
WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties -and civil fines up to
$100,000, in addition to the cost of compensation, damages as provided for in section 3706 of the labor code, interest, and attorney's fees.
3a -WORKERS' COMPENSATION DECLA TION I hereby affirm under penalty of perjury one of the following declarations:
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 this
permit is issued.
#4 DECLARATION BY CONSTRUCTION PERMIT APPLICANT
By my signature below, I certify each of the following:
I am a CA Licensed Contractor.
Signature of Contractor, Authorized Agent or Owner
November 02 2018
Date