HomeMy WebLinkAbout696 Permitcity of san Luis oBispo
spa'rd ct onpRarm �t401-3218 • (805) 781-7180
Project Address 692 MARSH
Assessor's Parcel Number 002-422-024
Project Description REPLACE FIXTURES WITHIN SUSPENDED CEILING
Permit Type X Building X Mechanical X Electrical X Plumbing Sign Demolition Grading
Property Owner GORDON SYLVIA THE Occupant/Business Name REDBOX AUTOMATED RETAIL;7-ELEVEN FOOD
Mailing Address 12 GEARY ST #303 Architect/Engineer
City/State/Zip SAN FRANCISCO CA, 94108- License #
Contractor SYLVANIA LIGHTING SERVICES Contractor's Phone No.
916/638-8403
Mailing Address 2455 MERCANTILE DRIVE STE 150 Contractor's State Lic. No. 317264
City/State/Zip RANCHO CORDOVA CA 95742
Project Manager Project Manager's Phone No.
Lender Name Lender Address
C.B.C. Group B C.B.C. TypeV-B Stories 0 Codes: CBC10 CEC10
Census 437 Commercial Alteration or Addition Dwelling Units 0 Motel Rooms 0
Valuation
Fees
Building Permit
0.00
Plum bing+E lectrical+Mechanical Permit
0.00
Grading Permit
0.00
S. M. I. P.
0.50
Green Building Fee
0.00
Demolition Permit
0.00
Sign Permit
0.00
Misc Charge/Credit 0.00 Administrative Permit
132.50
Archival Fee
0.00
Subtotal 133.00
Investigation Fees
0.00
Building Plan Review Fee
0.00
Fire Safety Plan Review
0.00
Plan Review Subtotal 0.00
Development Review Fee
0.00
Fire Safety Surcharge
0.00
Fire Systems
0.00
Fire Sur/Sys Subtotal 0.00
Construction Unit Tax
0.00
Water Impact 0.00 Area -
0.00
Water Meter Installation
0.00
Wastewater Impact 0.00 Area -
0.00
Traffic Impact 0.00 Area -
0.00
Affordable Housing
0.00
Public Art
0.00
Code Enforcement
0.00
Park Improvement Area -
0.00
Engineermg Development Review Fee
0.00
Open Space In -lieu Fee
0.00
Total Fees 133.00
Balance Due 0.00
%Ay 11 IVI 1L7
Amount Date Receipt
Payment #1 133.00 10/27/11 53581
Total Paid 133.00
Applicaticn Number110960
Application Date 10/27/11
Permit Number 25886
Issuance Date 10/27/11
Legal Description CY SLO MRY & CH ADD BL 7 OTN LTS 15 & 16
Total Building Value $0.00
Legal Declarations
2a - CALIFORNIA LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
commencing with Section 7000 of Division 3 of the Business and Professions Code, and
my license is in full force and effect
Contractor: SYLVANIA LIGHTING Class: C10 License #: 317264
3a(2) - WORKERS' COMPENSATION DECLARATION - 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. My workers' compensation insurance carrier and policy number are:
Carrier: LIBERTY INSURANCE Policy #:WA761 D26077 Expires 10/01/12
Fee Exemptions:
Comments:
Construction File /s/ Signed Original on File
Signature of Contractor, Authorized Agent or Owner Date