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HomeMy WebLinkAbout94 Palomar Address File_redactedIIIIIIII II �� PERMIj u hilS oBI AP 7� partment of Community Development 990 Palm Street / Post Office Box 321 Sak_jis Obispo, CA 93406 805/541-1000 Building '� APPLICANT('j�e�s SMIAOM Wed areas where appropriate, as fully as you can. Please print. WW State License No. G o IC �o o� ,- 47�5 Archi ct or l5esignor Address Phone State License No. Engineer Address Phone State License No. QBank or o r ce of loan Address Z DO NOT Type of Project: XAII new ❑Add []ILL Alter❑ ❑Repair Demolish ❑Move ❑ Install ElAlter FTHISN SECTION No. of new No. of bed- Bldg. No. of New Cost per Proposed use of the new building, addition, living units rooms in height stories area W. h. or area to be altered, repaired, etc. created new units (Total) (Total) (in sq. ft.) W 2.� 3. aNew work includes: Garage Carport — Attached Detached Legal Description: l�sess �lumber � ire Z e Lot Lot Block Tract � L 9S)Zone Sq. Ft. WPROPOSED SETBACKS - actual dis- Front tances from property lines to nearest �,7h 1 structure, after work is completed. �/ Rear nn''1I /�' Side / Side 1 Distance nearest existing lot. (Write from this new work to building on same "ATT" if attached). Chi ADDRESS OF 97+ THE PROJECT: Type of Construction: Type No. Occupancy Group FRAME: FOUNDATION: EXTERIOR WALL: ROOF: HEATING: W(Wood Stud ❑Continuous X Wood Siding ❑Brick ❑ Comp. Built-up ❑ Electric ❑ Metal Concrete ❑ Timber Slab ❑ Wood Trim ❑Conc. Block ❑ Stucco ❑Conc. Tilt -up ❑ Metal ❑ Comp. Shingle KGas Furn. ❑ Gas Wall 9-- 9P,ers El Stone Veneer ❑Metal 9 Wood Shingle/Shake ❑Solar []Brick Veneer ❑ Tile VALUE OF WORK Z EM O [� Structural: i — "� W Electrical: to y Plumbing: son I- Hosting/Cooling: 2 Other: J J IL Total F, Permit Fees: $ O PI a check (0 ) 2 Op Previously Paid TOTAL FEES $ REQUIREMENTS: ❑ Fire Hydrants for Const. ❑Water Press. Regulator ❑ Backflow Protection ❑Grading Permit ❑ Retaining Wall Permit ❑ City Business License Special Conditions: ❑ City Contractor's Lic. ❑State Contractor's Lic. ❑Water Fees to be paid ❑Sewer Fees to be paid ❑Curb, Gutter and Sidewalk Permit ❑ Encroachment Permit le ec'd. No. Cop!c'd. Additional Review ❑Environmental Impact R ❑Ord. 604-A Deficiency ❑Discretionary Action ARC No. Use Per No. Other — u2d I have read thjrfbmpletjd�plicationoCarefully. The information is accurate. Owner N 1Pj! \� 0O O O V -! [—]Agent / f II S n g Ire Date Agent's name printed ELECTRICAL HEATING/COOLING PLUMBING ITEMS FEES ITEMS FEES ITEMS FEES New Residence (Apt's.) Furnace - 100 MBTU or Less $ Bathtubs $ Jr With square feet $ '� Furnace -Over 100 MBTU �� '- i Showers Circuits and Feeders Heater: Suspended Bidet Service (Amps 1 Heater: Floor • Lavatories Lighting Standards Heater: Wall Water Closets Range and Oven Boiler - 100 MBTU of Less Kitchen Sink - Residential Dryer Boiler - 101 to 500 MBTU Floor Drain/Sink ' Water Heater Boiler - 501 to 1,000 MBTU Laundry Tray �j ) Transformers Boiler - 1,001 to 1,750 MBTU Urinal Welders Boiler Over 1,750 MBTU Water Softener Space Heat Comp. - 3 H.P. or Less Clothes Washer - Residential Temporary Service Pole 00 Comp. - 4 H.P. to 16 H.P. Dish Washer - Residential X-Ray Unit Comp. - 16 H.P. to 31 H.P. Disposal - Commercial Range - Commercial Comp. - 31 H.P. to 51 H.P. Water Heater Oven Commercial Comp. - 51 H.P. and Over Gas Piping Alteration (Residential) Air Handling Unit:-10,000 CFM Water Piping Alteration (Commercial) Air Handling Unit: +10,000 CFM Drainage Pipe Lighting Outlets Evaporative Cooler Fire Sprinkler (Heads) Recept. Outlets Vent System: Single Duct V Grease Trap Switchboards - Main Vent System; Multi Ducts Drink Ftn. Panelboards - Branch Circuit Grease Hood Slop Sink Elevator Air Conditioner - Package Sewer Conn. Motors Paint Spray Booth & Exhaust Sink - Bar Miscellaneous Sink - Commercial Kit TOTAL MOTOR FEES Sink - Other TOTAL FEE S Dishwasher - Commercial Clothes Washer - Commercial Gas Dryer - Commercial Backflow Preventer - Res. Backflow Preventer - Comm. SERVICE SIZE Well -Shallow - 25 ft. or less • Conduit Switch Conductor Well - Deep - Over 25 ft. Kettle - Commercial - Steam Vent - Comb. Prod. MOTORS Pvt. Sewage Disposal System No. H.P. Fee Sewage Ejector -Residential Sewage Ejector - Commercial TOTAL FEE $ /rr U TOTAL FEE $ THIS IS TO CERTIFY TIiAT INSULATION ILkS BEEN INSTALLED,IN CONFORMANCE WITH THE CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: Stree Numcer Tract No. EXTERIOR WALLS Manufacturer Thickness/Type R Value CEILINGS Batts: Manufacturer Thickness [c��i R Value 119 Blown: Manufacturer Thickness No.Bags Wt/Bag Sq. Ft. Covered R Value FLOORS Manufacturer Thickness/Type_Value `1 SLAB ON GRADE Manufacturer Thickness/Type R Value Width of Insulation Inches FOUNDATION WALLS Manufacturer Thickness/Type R Value GENERAL CONTRACTOR (/� • �5ti} LICENSE NUMBER 353855 BY_%.V. it;�z:., TITLE CL),h t- DATE 4-1 to h INSULAT RACTOR GEARHART INSULATION, INC. LICENSE NUMBER ;;5675 BY I TITLEDATE Return this fora to Building DeQartment when completed. QCCCi'•' ►►i►►n►►III Ilnlllhfll I �IIIII ►� II ( c�ty�� IIIIII j san Luis OBISPO DeWtment of Community Development 990 WorPalm Street / Post Office Box 321 ms San Luis Obispo, CA 93406 805/541 1000 Project Address: 94 Palomar Dr. PtRMFT ® Building ®Electrical ® Plumbing ® Heating/Cooling Date Issued: 6/29/78 Permit No. 7231 Owner Mail Address ZIP Business -Hour Phone Mike Pineau Contractor or Builder Address Phone W Architect or Designer Address Phone State License No. Gary McKibben P. 0. Box 6186 Los Osos, CA 528-0197 C-9305 Engineer Address Phone State License No. Bank or other source of loan Address None Type of Project: ®AII new ❑Add ❑Alter El Repair El Demolish El Move El install ❑ Proposed use of the new building, addition, No. of new No. of bed living units rooms in Bldg. No. of height stories New area Cost per ft. or area to be altered, repaired, etc. created now units (Total) (Total) (in sq. Tt.) sq, Ctt) 1. Residence 1 3 22' 2 1829 20.90 W 2. Garage 500 7.40 O 3. 0. New work includes: ®Garage Carport - ®Attached ODetachecl B-E-P-H/C Legal Description: Assessor's Number Use Zone Fire Zone Lot Area Lot Block Tract 545 52-161-83 Ot ISR1-PD 3 6000 Sq. Ft. WPROPOSED SETBACKS actual dis Front tan cesfrorn property lines to nearest 20' structure, after work is completed. I Rear 20' I Side 10' I Side 10 nearest existing building on same I Distance from this new work to lot. (Write "ATT" if attached). 05 ''�^ ADDRESS OF THE PROJECT: 94 Palomar Dr. Type of Construction: Type No. V Occupancy Group I FRAME: FOUNDATION. EXTERIOR WALL: ROOF: HEATING. Wood Stud ❑Continuous ® Wood Siding ❑Brick ❑ Comp. Built up ❑ Electric W® ❑ Metal Concrete ❑ Wood Trim ❑Conc. Block ❑ Metal ® Gas Furn. 0. 0 ❑ Timber Q Slab ❑ Stucco ❑Conc. TiltupEl Comp. Shingle ❑ Gas Wall ❑X Piers ❑ Stone Veneer ❑Metal ® Wood Shingle/Shake ❑ Solar ❑Brick Veneer ❑ Tile 41,900. $ VALUE OF WORK FEES Structural: $ 163.00 Electrical: 34.30 Plumbing: 28.00 Heating/Cooling: 11.00 Other: Eng. 115.00 Total Permit Fees: $ Plan -check (N ) Previously Paid 150.00 Const. Unit Tax TOTAL FEES $ 501.30 REQUIREMENTS: ❑ Fire Hydrants for Const ❑Water Press. Regulator ❑ Backftow Protection ®Grading Permit ❑Retaining Wall Permit ®City Business License Special Conditions: John L. Kellerman/ve 6/29/78 Authorized Department Representative DATE ®City Contractor's Lic. ❑State Contractor's Lic. ®Water Fees to be paid ❑Sewer Fees to be paid ❑Curb, Gutter and Sidewalk Permit ❑ Encroachment Permit Additional Review ❑Environmental Impact Report ❑Ord. 604 A Deficiency ❑Discretionary Action ARC No. 78-05 Use Permit No. Other LJ Fees Paid Date Receipt No. n Certification signed (see back of this form) [� L - C. C. . J WHITE - File LIGHT YELLOW -Applicant PINK Clerk GOLD - Counter a W CERTIFICATION BEFORE THE CITY CAN ISSUE THIS PERMIT, THE APPLICANT MUST COMPLETE THIS CERTIFICATION ON ALL COPIES. INSTRUCTIONS — In section A, on contractor's licenses, you must either give your State contractor's license number or certify that you don't need a license. Check the appropriate box and fill in any informa- tion that applies to you. In section B, you must certify either that you have worker's compensation insurance or that you don't need it. Check one of the boxes. Then read section C and sign at the bottom. A. CONTRACTOR'S LICENSE In accordance with the requirements of Section 3800 of the California Labor Code, I, the undersigned, hereby state with regard to Chapter 9, Division 3 of the Business and Professions Code: W z 0 V U w x U ❑ 1 have a valid California State Contractor's classification and license number: Classification License in full force and effect with the following License No. am exempt from these provisions by reason of the following: ❑ a. I am the 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. 61c'. Exemption is based n the follbwing section of the State Contractors' License Law: Section B. INSURANCE COVERAGE (Sec. 3800 Calif. Labor Code) ❑ Certificate of worker's compensation insurance, copy thereof or certificate of consent to self -insure from Director of Industrial Relations, has been filed with the City and is still in effect. W o ❑ The permit sought is for one hundred dollars or less. w;21""l certify that in the performance of the work for which this permit is issued, I shall not employ u any person in any manner so as to become subject to the worker's compensation laws of California. I understand that failure to comply with applicable worker's compensation laws shall cause revocation of the permit. C. COMPLIANCE WITH THE LAW All work allowed by this permit shall comply with City and State laws. I understand a separate permit is required for work within a public right-of-way. I also understand this permit becomes invalid if work. is not started within 60 days of the date the permit is issued.