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HomeMy WebLinkAbout3190 S Higuera copiescity of sari WIS OBI SPO Certificate of Occupancy THIS IS TO CERTIFY that the building described below was constructed under Building Permit No, ____y976_______ , This structure, owned by _Don Walter --------------------------- and located at 3 )0 S, ;uera n Lui; meets all the requirements of the Uniform Building Code for Group r• --------- occupancy, This certification applies to ---------------------- -_______ (DMW OFF Ic;E) of this building and remains in effect until such occupancy changes. By------------------ -- -- ------------------------------ Chief Building Otflclal city of 0 Soft WI S OBI SPO �. CONSTRUCTION PERMIT Department of Community Development, 990 Palm Street/Post Office Box 321, San Luis Obispo, CA 93406 (805) hate.x#..79_ TYPE OF ❑ Combination ❑ Building ❑ Remodel ❑ Electrical ❑ Plumbing ❑ Mechanical ❑ Solar ❑ Grading PERMIT ❑ Retaining Wall ❑ Parking Lot f3 Demolition ❑ Moving ❑ Other Project Address '21%'0 South Higuera Street Sall Leis Qi�i3_0, C!, Use Zone J—S Lot Number 22 Block T.r?t. Assessor's Number �J- 01-1 Owner Zalter ;3ros. �-mistrue t -on Contractor OTsner or Builder Architect or Designer Tenant- pddraSS BOX Sy � , SLO � � �=F'y"J �=b { Day Phone " 'O Add Address ress OCCUPANCY & GROUP TYPE OF CONSTRUCTION; FOUNDATION: ❑ Wood ❑ Concrete ❑ Slab ❑ Piers/Caissons FRAME: ❑ Wood Stud ❑ Metal ❑ Timber ❑ Masonry EXTERIOR WALL: ❑ Wood Siding ❑ Stucco ❑ Masonry Veneer ❑ Masonry ❑ Brick ❑ Concrete Block ❑ Metal ROOF: ❑ Built-up ❑ Metal ❑ Composition Shingle ❑ Tile ❑ Wood Shingle/Shake HEATING: ❑ Electric ❑ Gas Furnace ❑ Gas Wall ❑ Solar STATE REQUIREMENTS: ❑ Energy ❑ Sound ❑ Handicapped LEGAL DECLARATIONS LICENSED CONTRACTORS DECLARATION: I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class B-1 License Number—"' �+ Contractor T1 a7 -ter Bros. vonst. OWNER BUILDER DECLARATION: I am exempt from the contractor's License Law for the following reason ❑ I, as owner of the property, or my employees with wages as their sole compensation will do the work and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ❑ 1 am exempt under Sec. B. & P.C, for this reason _ Date A—ii—t WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self£ -insure, or 'a certificate of miners Compensation Insurance, or a certified copy hereof;Sec, 3864, Lab. C). 0 Certified copy is hereby furnished. / •' Certified copy is filed with the fY Plangin 06Wrtment_-! f:. ^afs� Applicant CERTIFICATE OF EXEMPTION FROM WORKERS COMP. INSURANCE I certify 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 Worker's Compensation Laws of California. Date Aoolic8m NOTICE OF APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Worker's Compensation provisions of the Labor Code, you must comply with such provisions or this permit shall be deemed revoked CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097, Civ. C.) Lender's Name Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. NOTICE Unless noted under "Special Conditions,'' this permit becomes null and void if work or construction authorized is not started within 180 days, or it construction or work is suspended or abandoned for a period of 180 days any time after work is commenced. Signature of Conifdc/tw w.'An/Sl�drft6d Apra Signature or ©wneretff Owner Builder) WHITE Applicant YELLOW — File PINK — Assessor GOLD — Counter Phone 54 3-5S 54 Phone Lic. No Day Phone PROJECT INFORMATION Type of Project: 7Pmn i i f• i nn f C, Al f 11 d n Proposed Use: Setbacks: Front Rear Floor Area Garage Barn CarportCovered Porch Deck Storage No Bedrooms No. Bathrooms No. Stories Building Height Retaining Wall Information: Length Height Material Mobile/ Modular Home Information: Manufacturer Year Serial No. D.0 H, No. D -M -V- Lic- No. Stats No- Bedrooms Moving Building Information: Present Location Locality Present Use Proposed Use Tot. Lin. Ft- of Fdtn-__ Grading Information: Tot. Cut Cu. Yds.; Tot. Fill Cu. Yds.; Area of Disturbance 5c' TOTAL VALUATION ......$ 0 Plan Check No. $ Combination Permit .......$ Building Permit ........... $ 2tn-�.n Electrical Permit .........$ Plumbing Permit ..........$ Mechanical Permit. Other: _ $ Other: _ $. TOTAL PERMIT FEES $ ❑ Construction Unit Tax $ TOTAL FEES $ REQUIREMENTS❑ Water Fees to be Paid p Other vi ❑ Fire Hydrants for Const. ❑ Sewer Fees to be Paid "rs. (curs ii i_,) El City Business License ❑ C/G/S Permit Reg'd. ® State Contractor's Lic. ❑ Encroachment Permit SPECIAL CONDITIONS ' Qao It aA bcnc_! ia%dr�l� VALIDATION Authorized Department Representative Date SEQ' DATE TOTAL AMOUNT