HomeMy WebLinkAboutBLDG-L24726-2009city o" Sa►n tuis a31s-)o
Building & Safety Division • 919 I
Project Address 190 SANTA ROSA
Assessor's Parcel Number 001-031-028 Legal Description 009.82 AC RECREATION (PARK)
Project Description ANTENNA ADDITION (3) TO EXISTING LIGHT POLE
Permit Type X Building _Mechanical X Electrical Plumbing Sign Demolition Grading
Property Owner CITY OF SAN LUIS OBISPO (940) Occupant/Business Name SANTA ROSA PARK
Mailing Address 990 PALM ST Architect/Engineer
City/State/Zip SLO CA, 93401-3249 License #
Contractor METRO R. F. SERVICES INC Contractor's Phone No. 909/230-4920
Mailing Address 2320 SOUTH ARCHIBALD AVE Contractor's State Lie. No. 895236
City/State/Zip ONTARIO CA 91761
Project Manager SHANE TAKAHASHI Project Manager's Phone No. (714)362-6227
Lender Name Lender Address
C.B.C. Group B C.B.C. Type V-B Stories 0 Codes: CBC07 CEC07
Census 437 Commercial Alteration or Addition Dwelling Units 0 Motel Rooms 0
Valuation
15,000 $15,000.00
Fees
Building Permit
Plumbing+Electrical+Mechanical Permit
Grading Permit
S.M.I.P.
Green Building Fee
Energy Surcharge
Accessibility Surcharge
Demolition Permit
Sign Permit
Misc Charge/Credit 0.00 Administrative Permit
Archival Fee
Subtotal
Investigation Fees
Building Plan Review Fee
Fire Safety Plan Review
Plan Review Subtotal
Development Review Fee
Fire Safety Surcharge
Construction Unit Tax
Water Impact 0.00 Area
Water Meter Installation
Wastewater Impact 0.00 Area -
Traffic Impact 0.00 Area
Affordable Housing
Public Art
Code Enforcement
Park Improvement Area -
Waterway Management Fee
Open Space In -lieu Fee
Engineering Development Review Fee
363.07
319.44
316.70
42.22
0.00
3.15
1.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
319.44
0.00
254.39
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
47.49
0.00
0.00
Total Fees
984.39
Balance Due
Payments
0.00
Amount Date
Receipt
319.44 05/27/09
42288
FPayment
664.95 06/17/10
47383
984.39
Application Number090318 Permit Number 24726
Application Date 04/27/09
Issuance Date 06/17/10
Total Building Value $15,000.00
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: METRO R. F. SERVICES Class: B C10 C-7 License #: 895236
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: STAR INSURANCE CO Policy #:WC0422241 Expires 08/14/10
Fee Exemptions:
Comments:
Address File
Signature of Contractor, Authorized Agent or Owner Date