HomeMy WebLinkAboutPM_Building_Permit2021BUILDING PERMIT
Alt/Addition - Commercial
BLDG-0042-2021
Issuance Date: NOT ISSUEDBuilding & Safety Division • 919 Palm Street • San Luis Obispo, CA 93401-3218
001-031-028Project Address:190 Santa Rosa St Assessor's Parcel Number:
Unit or Suite(s):
Legal Description:MODIFICATION TO EXISTING T-MOBILE WIRELESS
FACILITY
Project Description:
Other: FRANCISCO PADILLA
Mobile: (661) 208-7384
SureSite Consulting Group, LLC
Jennifer White
Business: (818) 314-6008
Owner: SLO CITY OF
2019Code Year:Stories
:
Not ProvidedFire Sprinklers:Motel Rooms:Dwelling Units: 1.00
Census:Construction Type:
Occupancy:
Valuation
Group Type Sq. Ft Factor Valuation
$35,000.00 Manual
Category:SQFT:
Dimensions
Fees
Fee AmountFee Name
IT Surcharge $72.56
Cell Tower/Antenna - BLDG $2,024.23
C&D Recycling - UTIL $68.64
Green Building Fee $2.00
Building Plan Rev - Commercial - Minor $286.20
SMIP (Commercial)$10.00
Total Fees:$2,463.63
Payments
Date Receipt #Amount
4/13/21 $500.00 30,975-04-13-2021
4/13/21 $1,963.63 30,976-04-13-2021
Total Paid:$2,463.63
Contact Name Account BalanceTotal DebitsAccount Name Status Total Credits
Plan Check Account Payment by Contact
SureSite Consulting Group,
LLC
BLDG-0042-2021 in use $500.00 $500.00 $0.00
$500.00 $500.00 $0.00 Total Account Balance:
Balance Due:$0.00
Legal Declarations
#2 IDENTIFY WHO WILL PERFORM THE WORK
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of
the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed in its entirety
by licensed contractors. I understand that a copy of the applicable law is available upon request or athttp://www.leginfo.ca.gov/calaw.html.
#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.
#4 DECLARATION BY CONSTRUCTION PERMIT APPLICANT
By my signature below, I certify each of the following:
I am NO ROLE SELECTED
Signature of Contractor, Authorized Agent or Owner Date
April 13, 2021