HomeMy WebLinkAbout1150 and 1160 Laurel Address Change Formsotyo[sanluls ontspo Construction Permit
Certif ication
IElectronic Scales, Int (213) 579-?323
owner's Name Business-Hour Phone-.--
Department of Community Development. 990 Palm Street
Post Office Box 321, San Luis Obispo, CA 93406 (805) 541-1000
1150 Laurel LaneProject Address
P. O. Box 1087, San Gabriel, CA 91776
Owner's Mailinq Address
Owner License No.-contractor's Name ----Phone
contractor's Address
Richmond,Rossi, Montgomery C9819
I Architect or Engi-neer
Address 555 Chorro St., San Luis Obispo, CA 93401
LICENSED CONTnACTORS DECLARATION
I hereby affirm that I am licensetl under the provisions of Chaptcr I (commenc-
ing with Seetion 7000) of Division 3 of the Ilusiness and Professions Code, and my
license is in full foree nnd effect.
License Class Lie. Number
Date Contractor
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contraetor's License Larv for the fol-
lowing rctrson (Scc.70111.5, Business and Profcssions Cotle: Any city or county rvhich
requires a permit to construct, alter, improvc, tlemolish, or repair. any structure,prior to its issuance, also rcquires the a1;plicant for such permit to file a signed
statement that he is licensed pursuant to the provisions of tho Contraetor's Li-
cense Larv (Chapter 9 (corumencing rvith Section 7000) of Division 3 of the Business
and Professions Code) or that he is exempr therefrom and the basis for the alleged
esemption. Any violation of Section 7031.5 by-any applicant for a permit subjects
the ?pplicant to a civil penalty of not more than five lirrndred dollars (gtO0).):
[f, o" owner of the property, or my employees with wages as their sole com-
ftfnshtion, u'ill tlo the work, and the strrrcture is not intendcrl or offcred for sale
(See. 7044, Business and Professions Code: The Contractor's License Law does
not apply to an owner of property who builds or improves thereon, and who does
sttch rvork hinrself or thlough his orvn ernployees, l,rrovidetl that such improve-
ments are not intendcd or offered for sale. If, horvever, the building or improve-
ment is sold within one year of completion, the owner-builder will have the burden
of proving that he ditl not build or improle for the purpose of sale.).
WORKERS' CO}IPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self-insure, or a certificate
of Worker's Compensation Insurance, or a certified copy thereof.
Poliey No. Company
$ Certified copy is hereby
I Certified copy is filed
License No.
phnn6 s43-1794
Cuui\\ \'l^\a\\)
inspeetion department,
y] nate FZ I Applicanr
t
as owner of the property, am exclusively contracting rvith licensed contrac-
construct the ploject (Sec. 7044, Business and Professions Code: 'Ihe Con-
tractor's License Latv does not apply to an otvner of property rvho builds or im-
proves thereon, and who contracts for such projects with n contractor(s) licensed
pursuant to the Contraetor's License Law.).
D I am exempt under Sec.
reason
CERTIFICATE OF EXE}IPTION X'NO}T WORKERS'
COT{PENSATION INSURANCE
(This section necd not be courpletcd if the permit is for one hundred dollars
($10o) or less.)
I certify that in the performance of the Jvork for whieh this permit is lssued, I
shall not employ any person in any marurer so {rs to become sutrJect to the \Yorkers'
Conrpensation Laws of California.
Date
-
Applicnnt
NOTICE TO APPLICANT: If, after making this Certificate of Dxemption, you
should beeome subject to the \\'orkers' Compensation provisions of the Labor Code'
you must forthwith comply with such provisions or this permit shall be deemed re'
voked.
CONSTNUCTION LENDI\-G AGI'NCY
I hereby affinn that there is a construction lending lgency for the performance
of the work for which this irerrnil is issrrctl
Lender's Nanre None
Lender's Address
I certify that I have rcncl this application and state that the above information
is correct, I agrce
relating to building
to comltly rvith all city antl county ortlintnces and state laws
, and heleby authorize represetttatives of this county
property for inspectiou purposes.
M;
Xt")/'- z-tr'i:i
44-80
& P. C. for this
to enter upon
of Applicant or Agent Date
ctl,\=)[
san lrts P€FIMIT
Department of Community Development
99O Palm Street / Post Office Box 321
San Luis Obispo, CA 934()6 aO5/541-1q)O El guiloing D Electrical D Humbing flFleatinglCooling
Proi$t Addrs:
11,50 Laurel Lane
I Fire Hydrants for const.
l-lw"ter Press. Regulator
l-l Backflow Protection
DGrading Permit
DRetainingwall Psmit
fl"tt" Busins License
f]city cor.r.ctor's Lic.
[st"t" contractor's Lic.
l-lw.t", Fe€s to be paid
[s*", Fees to be paid
! Curu, Gutter and Sidflalk Permit
I E."roachment Permit
Psmit No.?453
Additional Review
flEnvironmental f mpact Report
Doto- oo+a Deficiency
I-lD iscretionary Action
ARc No.-
Use Psmit N
$4,440.
FEES
Slructural:
ElEtrical:
Plumbing:
Heatingy'C@lang:
Other:
ToEI
Permit Fee: $
Plan+hck (#2
l-'lPreviously Paid
CorEt Unit Tax
ToTAL FEES $ 53.00
VALIDATION
John L. Kellernan/ve
Date lsued:
L2lL4l78
VALUE OF WORK
$32.00
Special Conditions:
21.00
FegPaid
L2lt4l78 Receipt
signed (se back of this form)
DATE
Other
-
Authorized DepartrEnt Repr6entative
ltJo.
F
f-l Wood Sidins
D wooo .f.i-
fls.r""o
flstone vener
!eri"t
flconc Block
l-lConc- Tilt-up
Suetat
[lB.i"k v".r",
Sl co-p. Built-up
I urt"r
I co-p. Shinsle
fl wooo Shinsle/Shake
Irit"
HEATING:
l-l Et."tri"
I cas Furn.
I Gas wall
I sotut
[lcontinrors
EXTERIOR WALL:
v-N
Concrete
uOccupancy GroupType of Construction: Type No.
FOUNDATION:
Isr"u
I ei"rs
FRAME:
Ewood stud
I urt"r
fl ti-u"t
ADDRESSOF
THE PROJECT:1150 LaureL tane
FrontPROPOSED SETBACKS - actual dis-
tancs from property lin6 to n@r6t
structure, after work is completed.
Distance from this new work to
n€r6t existing building on same
lot. (Write "ATT" it attached).601
SideRear SideltJEa
Lesat Decription: ggg. 1, T3LS , RL2E, l{DU
4-962-L6 Sq. Ft
As6or's Number
BlockLot Tract M 2
UseZone Firezone LotAra
Eo.
sg.
Co6t per
ft-
10,20
flAttached
3.
Nil work includ6r [Garage ICarport
r. Purop llouse 9t
! at.", f-l R"pri,Add
No. of bed-
rooms in
new unitE
New
at@
(in sq- ft.)
400
No. of
stori6
Bldgr
height
(Total)(Total)
I
No. of nw
living uhits
cr€ted
[-lDemorish Ir.lor" Etnstatl tr-
Propced use of the nfl building, addition,
or area to be altered, repaired, etc.
Type of Proiect: lf, alt t"*
Bank or other source of-loan
none
Address
547 ltarsh St., San Luis oblspo 543'L794
State Liense No.
No.
Phone
Richnond, Rossi, MontgonerYPrLeet
AddressArchitect or Designer]U
=z
Rallroad Square, San Luie ObLspor CAJohn Klng
Contractor or Buildet State Licens No.PhoneAddr€ss
544-4444 B-1
Mail Address ZIP
1L50 l"aurel Lane, San Luis Obispo, CA 93401
Business-Hour Phone
541-2900Vetter Fairing Corp.
Owns
WHITE - File LIGHT YELLOW - Applient PINK - clerk GOLD - counter
Ne 4?09
CITY OF SAN LUIS OEISPO
ELEGTRTGAL PERMIT
This permit is issued with the undersigned applicant's agreement and acknowleag"-9?l'!-tl-work will be done in accordance
with citv ordinances, t;J;il;y ri."l"li"!"ii"*."i.""dother applicable lais. This permit becomes invalid if work is not
;il#rii;;d d")"
-il;;t";i;t;'"t
,,ot it".l"d" permission to rnaie any structural altirations or install plumbing, sewage or
sidewalk facilities.
Business License X
Permit Card n
Street File n
$sa'&-
Items
New single-family residence with --- square feet'
..Circuits & Feeders Heater
fr v emporary Sewice Pole
Service Size
-..,, --Recept.
,-, -Fixtures u
Motors
o nn r/:-./-A :- 7-E- - Ib /-:/-O-:22 - - -
owner'lhE* furaue--6'-----
Address /e- /AtaeL - - I L2 - --- - --- .., Switches
,- --Lighting
- -- -*-Range
- - - ,-.Dryer
-.. ---_Water FEEH.PNo
License No. --------
Contractor ---A--v/A/EE ----
Address
Twe Btde,E{--Sfik Fire
A7^^^ -
Special Requirements
COVERAGE-Check appropriate box (one must be checked, Sec'
. Labor Code).
thereof or certi{icate
Relations, has been
of the work
---- -------C ity Clerk.
In accordance with the requirements of Section 3800 of the California Labor Code,-I, the
il,i";.igr;d, trt""ty 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:
x:f *:':3ft tlY:ilI'T:ffi 'f"T#s'x'i:;ii'ii"i#ilti'''Y
filed with the City and is still in effect'
tr The permit sought is for one hundred dollars or less'
IN
3800 Calif
Classification
d) l-u exempt from these provisions by reason of the following:
u* tfi" owner of thb property described jn this permit application and I am(LZ [;l,ti;; o"-impro"i"g Jt",ritu"""r thereon for my own occupancy and not to be
offered for sale.b, ih" *;"k l""olved is of a casual, minor or inconsequential, n_ature and will not
;;;;;d O"tHundred Dollars (9100.00) for all labor, materials and other items'
c. E;;;ptifi i. ffi;a;; the ioiiowing iection of the' State Cbntractors' License
Law: Section ----------
Insp ectar of Buildings.
---l--Permit ---=---
------New Dwell. ---
------Circuits --*---
------Outlets ------
*-----Fixtures ------
------Service -.-----
------Appliances ---
.------Transformer --
-,,-- Motors
------Alteration ----
------Other
TOTAL--- $__-Sb,-@
_____,&@
Fees
$ -- ---:r€=f
CONDUCTORswrTcHCONDU IT
tr manner
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Community Development Department, 990 Palm Street, San Luis Obispo, CA 93401 -3249
(805) 781-7171 ADDRESS CHANGE NOTIFICATION Grid
! Change Address l\5O Loure\L-ane
From:To:
tr Greate New Address:
tr Delete/Retire Address:
X
tr
Establish $uite Numbering:
Correction/Clarif ication :
Assessor's Parcel Nu mber(s): OO
Other Address(es) on this Parcel:
Reason for Application
Applicant:a rnor-r{t Ar r\\ F\^Phone:
Applicant's Address:
Property Owner:
Owner's Address
Phone
and Aufiorization
Sketch Addrding Pl.o B€low or Atteh Copy
190160
125
1n
145
150
f+ffi
115
110
' q (-.i.d4i'
100
(=r-
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Comments/Special Notif ication :5--o
990 Palm Street, San Luis Obispo, CA 93401-3249
February 28,2003
Atoll Holdings, lnc.
Attn: Property Management Division
P.O. Box 3259
San Luis Obispo, CA 93403
SUBJECT: Suite numbering at 1 150 Laurel Lane
Atoll Business Center
To Whom lt May Concern:
This has been an issue we have been trying to rectify since October 2002, and
appreciate the assistance you have provided so far. This letter is to give you the final
outcome of the suite numbering issues:
Suite 150 has become an open warehouse. The City will retain this suite number in our
database and note that the "tenant" is a warehouse use. Should you have the need to
put another tenant in that location in the future, the suite number is already established
and approved, but for that location only.
Suite 250 has been eliminated and replaced by Suite 260 in that same location, with
Caltrans as the tenant.
Suite 180 is a single suite adjacent to Suite 190 (currently vacant). Suites 185 and 188
are not valid suites, and are not approved by the City. Therefore, emergency
response (police, fire and ambulance services) has no record of their existence or
location.
Should you wish to create three suites in this location, please contact me so that the
City can assign the suite numbers prior to occupancy. At that point, you should also
check with the Building Division (781-7180) to ensure that permits for tenant
improvements are not required.
Again, thank your for your assistance is resolving this matter. lf you have any
questions, do not hesitate to call me at (805) 781-7171-
Sincerely,
cc:Address File
Building Division
Diane R. Stuart
Eunervisinq Administrative Assistant
lrL'l fn" City-of San Luis Obispo is committed to include the disabled in all of its services, programs and activities.
K-rLl feteconimunications Deviie for the Deaf (805) 781-7410.
styo[san luls oBtspo
PrS""rX
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Community Development Department, 990 Palm Street, San Luis Obispo, CA 93401-3249
(80s) 7s1-7171 ADDRESS CHANGE NOTIFICATION Grid:N\^13
I\5O LaureL Lor,etr Change Address
From:To:
X Create New Address:c,r ri{e. }'rr lrrrnhe\^
tr Delete/RetireAddress
Xn
Establish Suite Numbering:
Correction/Clarif ication :
Assessor's Parcel Number(s):
Other Address(es) on this Parce!:
Reason for Application:
Applicant
Applicant's Address:
Property Owner:
Phone:
Phone
Owner's Address:
Owner/Agent and Authorization
Sketch Addr6in0 Plln BGlow d Att ch Copy
d)
(g
J
6
=oJ
oro
100
(=,-
110
115
' ,r criqo Y'
lqolEo
125
1n
Comments/Special Notification:
'hA*i',?- e -o 2*
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Community Development Department, 990 Palm Street, San Luis Obispo, CA 93401'3249
(8os) 7s1-7171 ADDRESS CHANGE NOTIFICATION Grid:N\-13
X Change Address
From
! Create New Address
I l5O )^o.ureL )*one
To:,9t r it e, \-1 5
Del ete/Retire r$dress :Sr.rte.l-1 C\
X Establish Suite Numbering
EI Correction/Clarification:
Assessor's Parcel Number(s):C;OL! ^ q A C\I Q
Other Address(es) on this Parcel
Reason for Application:
Applicant:
Applicant's Address:
Property Owner:
Owner's Address:
Owner/Agent
Phone -113 - 51 h*
Phone
and Auttorization
Sketch Addrerinq Plln Below ot Attach copy
L_,1
250 2BO
SECOND FLOOR
1OO - Central Coast Surfboards
1 1O - Central Coast Surfboards
1 15 - DK (Warehousing)
120 - Historical Society
1 25 - Vacant
130 - Atoll Holdings (Office)
1 32 - SLOCO Access
CC Assistive Tech Center
lndependent Living Resource Ctr
1 34 - Vacant
135 - Fidelity Title (Record Storage)
140 - Atoll (Storage)
145 - tLC
150 - No Slack
1 60 - Vacant
175 - Caltrans
1 B0 - Vacant
250 - Caltrans
2BO - Caltrans
-.5e AC
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Gomments/Special Notif ication
21-96
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Community Development Department, 990 Palm Street, San Luis Obispo, CA 93401-3249
(8os) 781-7171 ADDRESS CHANGE NOTIFICATION Grid:lvl -t3
n Change Address
From:
Create New Address:
Delete/Retire Address :
To:
A/n[x Establish Suite Numbering:
tr Correction/Glarification:
Assessor's Parcel Number(s):()c\ r-+ - q h) - O\ R
Other Address(esl on this Parcel:
Reason for Application:
Applicant:Otr.\v\€v^Phone
Phone:,a44 ^ gr"o3
5-\_1 -na)
Applicant's Address:
Property Owner:
Owner's Address:
Owner/Agent Signature and Authorization Date
Sketch Addrodne Plln Below or Attlch Copy
100
110
115
t20
125
130
t32
Cent r ol Coost Surf boqrds
Central Coost Surf boqrds
DK (Worehousing)
Historicol Society
Vocont
Atoll Holdings (Business Office)
SLOCO Access
CC Assistive Technical Center
f ndependent Living Resource Cent er
Vocont
Fidelity Title (Record Storoge)
Atoll (Storoge)
TLC
No Slock
Vocont
Vocont
t34
135
t40
145
150
t60
t70
i
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Gomments/Special Notification
21-96
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Community Development Department, 990 Palm Street, San Luis Obispo, CA 93401-3249
(8os) 7s1-7171 ADDRESS CHANGE NOTIFICATION Grid: X 15
tr Change Address
From:
d createNewAddress: Aoo 5.^*E. @ ltSO "Leuu.t LRn,=,
tr Delete/Retire Address:
To:
fr ettuulish suite Numbering IOC *ina,, l-7O ,)E ?. Ar-rA c.FLq.A OLnil
tr Correction/Clarification:
Assessor's Parcel Number(s):o
Other Address(es) on this Parcel:
_ol
Reason for Application:T -ft
<
Applicant l-lms t fi-l^ra w,e-Phone:
Applicant's Address:l\<O Iarr?2L Lnup--
Property Owner:E*co??Phone:
Owner's Address:
Owner/Agent Signature and
3
Sketch Add.esing Pl.n Below or Attrch Copy
1--q8
Date
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CommentslSpecial Notification:
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Community Development, 990 Polm Street (P.O. Box 8100), Son Luis Obispo, CA 93403-8100
ADDRESS CHANGE APPLICATION
n Change Address
From:To:
n, Create New Address:
n Delete Address:
Assessor's Parcel Number(s):
Other Address(es) on this Parcel:
L.
(-
Reason for Application:/a>
1-1p- f"-phone: 1 9.,/ B'Zc-rZ
c2-a- {)
Phone:
(>
Siignature and Authorization Date
Skttch PLn B.low or Att efi CoFV
L+r>u tV Mltl/' fu,tt
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Received By:
Application Numbers:
Dates Entered: DataBase:
Project Planner:
l-Date:
Comments/Special
A.P. Maps:Gounterbook:lo