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HomeMy WebLinkAbout169 Prado (9)CITY OF SAN LUIS OBISPO Business License ❑ Permit Card ❑ PLUMBING PERMIT Street File ❑ This permit is issued with the undersigned applicant's agreement and acknowledgement that all work will be done in accordance with City Ordinances, including any special requirements and other applicable laws. This permit becomes invalid if work is not started within 60 days. This permit does not include permission to make any structural alterations or install electrical, sewage or sidewalk facilities. J :lit- ` Fili 5 b 1 9 7 5 N2 3364 C-, FEE $-_ - -5, - `� Fixtures Gas Appliances Items Fees , % 9 �f DATE - ------ti --------L-- i_-! _--- Owner _-___-Bathtubs ------ Grease Trap ------ Water Heater ___1__Permit $_____ 2.00 ------ Showers ______Drink Ftn. ____ __Lavatories ------ Slop Sink Space Heater ---f__Fixtures ZV— WL _Sewer --/--------_ f . _5 Q - -- _. _ _ __— ________ -------- Location ------ Water Closets ------ Other ------ ------Furnace ------Gas Heating ______Kitchen Sink ------ Other-- ____ ------ Water Heater ----------- Occupancy ______Floor Drain ______Other--____ Wall Heater ------Gas Outlet ----------- �__f_ ------ Laundry Tray ------ Other ------ ______ Gas Dryer ______WaterPiping ----------- Contractor ________/ _______ ------Urinal ----------------- ------Drainage Pipe --------- y� Address --��- -61) '-�---- ------ Water Softener ----------------- ------Register ------ Lawn Sprinkler ----------- ------ Clothes Washer ------------------ ___---Flues ______Fire Sprinkler ----------- P.._...... _..._... _.. __ Special Requirements ------ Dish Washer _________________ ------Disposal -- -- TOTAL - - - - $- --'- --------- ------------ - - -----------------------City Clerk. In accordance with the requirements of Section 3800 of the California Labor Code, I, the IN undersigned, hereby state with regard to Chapter 9, Division 3 of the Business and Pro- fessions Code: ❑ 1. I have a valid California State Contractor's License in full force and effect with the following classification and license number: Classification _____ __ _ _ ..-----__-_____ License No. ______________ ❑ 2./� m exempt from these provisions by reason of the following: l . I am the owner of the property described in this permit application and I am /CR` building or improving structures thereon for my own occupancy and not to be offered for sale. b. The work involved is of a casual, minor or inconsequential nature and will not exceed One Hundred Dollars ($100.00) for all labor, materials and other items. c. Exemption is based on the following section of the State Contractors' License Law: Section ---------------------------------------------------- Inspector of Buildings. IiRANCE COVERAGE —Check appropriate box (one must be checked, Sec. 3800 Calif. Labor Code). Certificate of workmen's compensation insurance, copy thereof or certificate of consent to self -insure from Director of Industrial Relations, has been filed with the City and is still in effect. The permit sought is for one hundred dollars or less. I certify that in the performance 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 workmen's compensation laws of California. I understand that failure to comply with applicably workmen's compensatio laws shall cause revocation of the permit. + 1 r , --------------- j'�