HomeMy WebLinkAbout485 Woodbridge - 2006 Permitn�
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city of san luis oBispo
Building & Safety Division • 919 Palm
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Project Address 485 WOODBRIDGE
Assessor's Parcel Number 004-823-004
Legal Description CY SLO TR 736 LT 4
Project Description MISC UPGRADES ELEC, PLBG, ADD ISLD @ KIT
Permit Type X Building X Mechanical
X
Electrical X Plumbing Sign Demolition Grading
Property Owner RUDSER RALPH J & ELAINE D
Occupant/Business Name
Mailing Address PO BOX 200 STATION M
Architect/Engineer
City/State/Zip CANADA FR, PT2TH-8
License #
Contractor GANNAGE CONSTRUCTION
Contractor's Phone No. 550-6331
Mailing Address 1560 SANTA RITA
Contractor's State Lic. No. 778043
City/State/Zip TEMPLETON CA 93465
Project Manager MIKHAIL GANNAGE
Project Manager's Phone No.
Lender Name
Lender Address
C.B.C. Group R-3 U.B.C. Type V-N
Stories 0 Codes: CBC01 CEC04
Census number 434 Residential Alteration or Addition
Dwelling Units 0 Motel Rooms 0 Enforcement
Valuation
Residential Alteration/Addition/Conversion
15,000 $15,000.00
Total Building Value $15,000.00
Fees
Legal Declarations
Building Permit
296.85
1. OWNER BUILDING DECLARATION:
Plumbing Permit
39.57
1 am exempt from the contractor's License Law for the following reason:
Mechanical Permit
39.57
❑ 1, as owner of the property, or my employees with wages as their sole
Electrical Permit
39.57
compensation will do the work and the structure is not intended or offered
Grading Permit
0.00
1.50
for sale.
❑ 1, as owner of the property, am exclusively contracting with licensed
S.M.I.P.
Energy Surcharge
41.56
contractors to construct the project.
Accessibility Surcharge
0.00
❑ Not applicable.
Demolition Permit
0.00
2. WORKER'S COMPENSATION DECLARATION:
1 hereby affirm that I have a certificate of consent to self -insure, or a 'certificate
Sign Permit
0.00
of Workers' Compensation insurance, or a certified copy hereof
Misc Charge/Credit 0.00 Administrative Permit
0.00
Certified copy is hereby furnished.
Archival Fee
458.62
0.00
Certified copy is filed with the City.
Subtotal
Investigation Fees
415.56
Not applicable
PP
0.00
3. CERTIFICATE OF EXEMPTION FROM WORKERS COMP. INSURANCE
Building Plan Review Fee
Fire Safety Plan Review
0.00
❑ I certify that in the performance of the work for which this permit is issued,
Plan Review Subtotal 0.00
1 shall not employ any person in any manner so as to become subject to the
Development Review Fee
0.00
Worker's Compensation Laws of California
Fire Safety Surcharge
0.00
❑ Not applicable
Construction Unit Tax/Plan Preparation
0.00
NOTICE TO APPLICANT.
Water Impact 0.00 Area -
000
.
If, after making any of the foregoing declarations, you become subject to any
Water Meter Installation
0.00
Labor Code or License Law provision, you must comply with such provisions
Wastewater Impact 0.00 Area -
0.00
or this permit shall be deemed revoked.
Traffic Impact 0.00 Area -
0.00
Affordable Housing
0.00
1 certify that I have read this application and state that the above information
Public Art
0.00
is correct, I agree to comply with all city ordinances and state laws relating to
Code Enforcement
0.00
building construction, and hereby authorize representatives of this city to
Park Improvement Area
0.00
enter upon the above -mentioned property for inspection purposes. Unless
Waterway Management Fee
29.09
noted under "Special Conditions", this permit becomes null and void if work
903.27
or construction authorized is not started within 180 days, or if construction
Total Fees
or work is suspended or abandoned for a period of 180 days any time after
Balance Due
Payments
0.00
work is commenced.
Amount Date Receipt
Special Conditions:
Payment #1 903.27 07/07/06
27564
Total Paid 903.27
Application Number060616
Application Date 07/07/06
Permit Number 21234
Issuance Date 07/07/06
Comments:
Construction File /s/ Signed Original on File
Signature of Contractor, Authorized Agent or Owner Date
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