HomeMy WebLinkAbout94 Palomar Address File_redactedIIIIIIII II �� PERMIj
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hilS
oBI AP
7� partment of Community Development
990 Palm Street / Post Office Box 321
Sak_jis Obispo, CA 93406 805/541-1000 Building
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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.