HomeMy WebLinkAbout424 Higuera Building Permits#ru CONSTRU. TION PERMIT \
Clly of San Luis Oblspo o Building Dlvlslon . 990 Palm Streot/Box 8100 . San Luis Obispo, CA 93403-8100 o (8O5) 549.7180
Address
Assessor's Parcel Number t-5 i l-t)6pt-
ProJect Descrlption nFFIi.t rJulLilitifi tti PriRlillrii iitt rlil
Permlt Glass tiEll ti]|isTtiUtTlitti
Permlt Type ;. Bulldlng i Mechanlcal
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Demolitlon
Property Owner F[5[il-*[Flj HARi. {
Malllng Address 1354 lifift;r*ii t-ji
Phone Number
Occupant/Business Name
Buslness Owner's Name
Contractor's Name ni ruin
Mailing Address
Contractor's Phone No.
ProjectManager/Architect tiF:[t: i'laiUflti.ftt-L
Lender Name
u.B.c.U.B.C. Type irfi"!Fl{ififii.El
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Zip Code
,{ Eleclrlcal
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Grading
Bullding
Legal Descriptlon
Suite/Unlt
Plumbing
Olher
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P]11 iil ri
Sign
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Phone Number
City/State/Zip
Cbntractor's State Lic. No.
Project Manager's Phone No. c"rt'' 'i^)"t.1
Lender Address
Subject to Flood Zone Requirements ..
Census
Number
2'itt
Census
Sub-Code
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Census Number Description
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A = Area
D = Dollars
Y = Yards
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Bldg. Value
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per Bldg.
No. of
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Total Bldg. Area 7 il?()
Total Bldg. Value
or Yards ol Gradlng lll-il:j Height (ft.) -t! stories ?Plan No.S lti
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ELTITftIIAL PERITIT
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Speclal Condlllons:
Permlt Number
a1'r i
. ^)r/. )2lssuance Dale
Authoalzed Doparlmont Repres€ntativg Oate
APPlication Num5sl I jr"i
APPlicatlon P31s l:'ii rii"r
Activity Code
Date iji'i-iill
t
Thls permlt ls only valld when endorsed by an authorlzed represeniatlve ol the Communlly Development Departmenl.
LEGAL DECLARATIONS
OWNEB BUILDER DECLARATION:
I am exempi trom the contraclor's Ucense Law lor the lollowing reason:
LJ l, as owner ol lhe pr0perly, 0r myrmployees with wages as their sole compensation will d0
lhe work and lhe struclure is not intended 0r otlered lor sale.
El, as owner ol the properly, am exclusively contracting wilh licensed conlraclors l0
tonstrucl the proiect.
n Not applicable
WORKERS COMPE}ISATION DECLARATION:
I hereby atlirm that I have a cerlilicate ol consenl lo sell-insure, or 'a certiticate of V.brkers'
Compensalion insurance, or a cerlilied
! CertitieO copy is hereby lurnished.
! Cerlitied copy is tiled with lhe City.
copy hereol (Sec. 3800, Lab. C)
ffruot appticalte
CERTIFICATE OF EXEMPTION FROM WORKERS COMP. INSURANCE
n I certily thal in the perlormance 0l lhe work lor which lhis permit is issued, I shall not
employ any person in any manner so asto become subiect t0 the li/brker's Compensalion Laws
ol Calilornia.
F.Not applicable
NOTICE TO APPLICAI{T:
ll, atter making any 0l the toregoing declarations, you become subiect to any Labor Code or
License Law provision, you must comply with such provisions or this permit shall be deemed
revoked.
I certily that I have read this application and state thal the ab0ve inl0rmation is correct, I agree
t0 comply wilh all city ordinances and slale laws relating t0 building construclion, and hereby
aulh0ri?e represenlatives 0l lhis city to enler upon the above-menlioned pr0perty tor inspection
purposes.
Unless 0oled under "Special Condilions," lhis permit becomes null and void il work 0r
construclion aulhorized is not starled within 180 days, 0r il construclion 0r work is suspended
or abondoned lor a period 0f 180 days any lime aner work is commenced.
Aosnt or ownor DatBol
original-Applicanl White-Fils Pink-Assess0r Gold-Counter 59-87
N9 ts25
,2 l uGCITY OF SAN LUIS OBISPO
BUTLDING PERMIT
Business License tr
Permit Card n
Street File n Permit Fee
PIan Check Fee
Other Fees
$-----_----__
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 install electrical, plumbing, sewage or sidewalk faciliries.
$___
TOTAL $____________
DESCRIPTION OF STRUCTURE OR WORK
Ise No.-
[.nr H*k -h- / - subdivision - -
Estimated value ------u"it-d--
NewE AdditionE AlterationE RepairsE MoveE Demolish Use zone---- Fire zone---- Lot Y
Width-------- Length-- Height------- Stories------
L t ^[^,]1\d--,Owner
Address \t
Arch. or Eng.
Address
Builder --$+*f:rg-bJ
AddressFoundation-- Exterior wall---------- Roof---
How heated- Typ"------- Group--------
Garage Carport tr ------X------ Atached E Detached EI
Special requirements
In accordance with the requirements of Section 3800 of the California Labor Code, f, the
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:
City Clerk.
Classification License No.
I am exempt from these provisions by reason of the following:
a. I am tf,e owner of the property described in this permit application and I am
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 -------
Lt-t Insp ector of Buildi.ngs.
INSURANCE COVERAGE-Check appropriate box (one must be checked, Sec.
3800 Calif. Labor Code).
tr Certificate of workmen's compensation insurance, copyof consent to self-insure from Director of Industrial
filed with the City and is still in effect.
tr The permit sought is for one hundred dollars or less.
'f,*
thereof or certificate
Relations, has been
2.
Permit to Erect $ign
Datefu---1$J-2t**---
(7/z of t%) -F""' gf-(1--Valuation: $-
(Minimum fee .00)
.,;--')DEPARTMENT OF BUILDING
Crry or SeN Lurs Osrspo
Ne L027
INSTALLATION INFORMATIO
Flag length Wall -
Susp'd mount -14:---- Structure
Flush mount---------- Other
Use permit required---- Date granted
Base mount
Center mount
Variance ---- Date
Pole
Roof
RMATIONTI
Owner
or, Lot ----Blk-----Su
(-t
Contractor 4-/zzz= .,
No. {-z-{-
Address fz/--
Address l-4**-z--
DESCRIPTION OT SIGN
Neon ---: Metal --4'-- Single face --
Weight 2-a:-&------ Shop No.
TT
{""-t^-reads
2(€t
faceDoublePlasticFluorescent
Amperage
Wattage
Other Other
U. L. No.
Painted
Length --6-:-
Wood Other
Imspeetor of Building
\t''
if..:.'
/-
,/vDEPARTMENT OF BUILDING
Crrv or Ses Luls Ogrspo Application to Erect $ign 7
Valuation,SJA9 \ - Fee: $1
')
..---, I .'l I
].- : .-::'-:-.: ir'.. $l.il,r
BLocK No, -& 2 4
INSTATLATION INFORMATION
Flag length \\/all
Susp'd nrount -/-,---- Structure
Flush mount---------- Other
Use permit required---- Date granted
\/ariancc requcstccl - -- Date nted
Base mount
Center mount Pole
Roof
DESCRIPTION OT SIGN
Neon ---- \letal ---'/',- Single face --*
Fluorescent Plastic Double face X-
Lcngth - A /r.f
IJeight -- 3----
Thickncss J *
\\/eight ,J s1 ,14-,-
-/11-e'
copy &_a_^t2-.>,,b-
F F /--rf,e--_SERT}
Amperage
Other Other
Other
\\Iattage
U. L. No
Shop No
Painted ,X-,- \\Iood
LO L-.\T: ON INF ORMATION
\t,.4 2 9 S::.-ii 4r C- I/EKA-- df -_
Subdr
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,--Ut-Ge,ee-O sr
City of San Luis Obispo
Building Inspector
L
Ch
I hate carefulll' exnnrined the abote ,conpleted.app.li-
cation and kno'rv the saue is tnrc and correct. AII city
ordincmces and statc lau,s Eovcrrting sigrr constrttction
T
N
Auill be crtrttltlierl witlt.
ln
B1 -l r
Permit Issued , /-Z{
Inspection
DATEINSI'ECTON
Plans Rec'd
By
Date
E.rcavati,rn ,
Sisn'Slrr,u) ,
Pole
Othcr
(See retersc side for skctch)
e65
Y OF SAN LUIS OBISPO
PERMIT for CON,STRUCTION of
IVEWAY, SIDEWALK CURB AND GUTTER
Ne 1579
n arc - -. - -/ /: Z-f - - - - - -, to 6t- -}RK:
---42-Y---Owner
Phone
of-
d"-
I WORK:
Concrete Driveway .Width----
Concrete Sidewalk Width---- Length---
Concrete Curb and Gutter tength---
--M,"!lL
Final Survey by ---------
Cut Sheet by
Owner Notified by -------
Form fnspection by -----. -
Final Inspection by ---------:----
Date---------
Date---------
Date---------
Date---------
Date---------'
I work performed under this permi.t shall be i4 accordance with the Standard Plans and. Specifi'cati'ons for_Construction of
vay, Siiew'alk, Curb and. Gutter in the City of San Lui.s Obispo and the General Provisions on the reverse:side of this permit.
UNTIL FO RM INSPECTION IS N4ADE AND
-Lffi--
No coNCRErE owor,rff"ffi -v,::i"2,,/x-,,D---