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HomeMy WebLinkAboutBLDG-L19908-2004ctty o[.san luls oBlsrJo Building & Safety Divisiu,r - 990 Palm Street. San Luis Obispo, CA 93401-32+v' (805) 781-7180 Consf n I n Permit Project Address 1540 FROOM RANCH Assessor'sParcelNumber 053-510-009 Project DescriptionNEW COSTCO WHOLESALE FACILITY Legal Description CY SLO PM 55-82 PAR 2 Permit Type X Building X Mechanical Property Owner TWISSELMAN CATHERINE A ETAL Mailing Address PO BOX 3910 Electrical X Plumbing Sign _Demolition OccupanVBusiness Name COSTCO (pROpOSED) ArchitecUEngineer MITCHELL C SMITH License #c27800 Contractor's Phone No.775-829-8887 Contractois State Lic. No.817882 Project Manager's Phone No. 4ZS-+Og-tOOZ Lender Address Fire Sprinklers Stories 1 Codes: UBC 1 NEC 1 Dwelling Units 0 Motel Rooms 0 Valuation X X Grading City/State/Zip Contractor sLo cA, 93403-3910 LEDCOR CONST ll.lC Mailing Address 5905 S VIRGINIA ST STE 3OO City/State/Zip RENO NV 89502 Project Manager PATSY BONINCONTRI Lender Name U.B.C. Group U.B.C. TypeV-N Census number 327 Store/Restau ra nUTavern Store/Customer Service Grading Fees Building Permit Plumbing Permit Mechanical Permit Electrical Permit Grading Permit S.M.I.P. Energy Surcharge Accessibility Surcharge Demolition Permit Sign Permit Misc Charge/Credit lnvestigation Fees Microfilm Subtotal 7,196,000 140,000 Sq Ft @ 53,295 yds. with A/C Fire Sprinklers $7,196,000.00 M L Total Building al Declarati $7,196,000.00Value ons26,845.05 3,578.45 3,578.45 3,578.45 708.35 1,511.16 3,758.04 2,442.73 0.00 0.00 0.00 0.00 934.80 33,633.36 5,885.84 29,030.45 6,700.53 0.00 168,484.00 2,818.00 53,284.00 283,640.00 143,920.00 35,480.00 0.00 0.00 1 46,935.48 Building Plan Review Fee Fire Safety Plan Review Plan Review Subtotal 39,519.20 Development Review Fee Fire Safety Surcharge Construction Unit Tax/Plan Preparation Water lmpact 115'626.00 lrish Hills - Water Meter lnstallation Wastewater lmpact 48,020.00 lrish Hills 5264.00 Traffic lmpact Affordable Housing Public Art Code Enforcement Park lmprovement Total Fees Balance Due ntsPayme Amount Application Number040145 Permit Number 1 9908 Application Date 02109t04 lssuance Dale 02124105 Law for the following reason: n l, "" owner of the property, or my employees with wages as fhelr so/e compensation will do the work and the structure is not intended or offered for sale. f] /, as owner of the property, am exclusively contracting with licensed contlactors to construct the project. @ Not appticable. 2. WORKER'S COMPENSATION DEGLARATION: I hereby affirm that I have a certificate of consent to self-insure, or a 'ceftificate of Wo*ers' Compensation insurance, or a cedified copy hereof copy is hereby furnished. Certified copy is filed with the City. 3.EXEMPTION FROM WORKERS GOMP. INSURANCE a I certify that in the pertormance of the work for which this permit is issued, I shall 9ot employ any person in any manner so as to hecome subject to the Work6r's Compensation Laws of California @ Notappticabte NOTICE TO APPLICANT: lf, after making any of the foregoing declarations, you become subject to any Labor Code or License Law provision, you must comply with such provisions orthis permit shall be deemed revoked. I certify that I have read this application and state that the above information is conect, I agree to comply with all city ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. Unless noted under "Special Conditions", this permit becomes null and void if work or construction authorized is not stafted within 180 days, or if construction or work is suspended o r abandoned for a peiod of 1 B0 days any time after work is commenced. Soecial Conditions: Comments: 0.00 Administrative Permit Area - 809,811.66 -39,519.20 Payment #1 Payment #2 Payment #3 Total Paid 39,519.20 35,480.00 774,331.66 849,330.86 Date 02109104 07t28t04 02t24t05 Receiot 13312 1 5950 31852 l- of Address File or L, Ltf - D5-