HomeMy WebLinkAboutEPM-2748-2025 SIGNED PERMITSifi'ttrs onrs po
Building & Safety Division . 919 Palm Street. San Luis Obispo, CA 93401-3218
BUILDING PERMIT
Electric Service Upgrade
EPM-2748-2025
lssuance Date: 1 1 12412025
CAI, IFORNIA
Project Address: 619 Grove St
Unit or Suite(s):
Project Description: PANEL UPGMDE 100A-200A
Owner: John Rourke
Mobile: (
Assessor's Parcel Number: 001-056-052
Square Footage' 0.00
Legal Description:
Fire Spdnklers:
Census:
Occupancy:
Stories 0.00 Qs(s\s1r. 2022 Dwelling Units:Motel Rooms:
Construction Type:
Valuation
Grou Type sq.Ft Factor Valuation
Manual $4,000.00
Fees Payments
Receipt #Fee Name Fee Amount Date Amount
Electric Service Upgrade (up to $166.94 11t24t25 48,828-11-24-2025
Total Paid:
$166.94
$166.94Total Fees:$166.94
PIan Check Account Payment by Gontact
Contact Name Account Name Status Total Credits Total Debits Account Balance
Total Account Balance:
Balance Due $0.00
Legal Declarations
#2 IDENTIFY WHO WILL PERFORM THE WORK
2b - OWNER-BUILDER'S DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the
reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or
county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter g (commencing with
Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption.
Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
l, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects
with a licensed Contractor pursuant to the Contractors' State License Law).
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of
the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed in its entirety
by licensed contractors. I understand that a copy of the applicable law is available upon request or athttp://www.leginfo.ca.gov/calaw.html.
#3 IDENTIFY WORKERS' COMPENSTATION COVERAGE AND LENDING AGENCY
WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to
$100,000, in addition to the cost of compensation, damages as provided for in section 3706 of the labor code, interest, and attorney's fees.
I certi! that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the
workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
#4 DECLARATION BY CONSTRUCTION PERMIT APPLICANT
By my signature below, I certiff each of the following:
I am the Property Owner.
November 24,2025
Signature of , Authorized Agent or Owner Date