HomeMy WebLinkAboutBLDG-5054-2019BUILDING PERMIT
Foundation Only
BLDG-5054-2019
Issuance Date: 9 / 10 / 2019Building & Safety Division • 919 Palm Street • San Luis Obispo, CA 93401-3218
004 - 961 - 087Project Address: 1241 Laurel Ln Assessor's Parcel Number:
Unit or Suite(s):
Legal Description: GRADING & FOUNDATION ONLY FOR NEW MIXED
USE BUILDING
Project Description:
Contractor
(Manually Verified):
Montage Development, Inc
Chuck Francoeur
Business: (818) 652-6705
License Type: California State Contractor License License Number: 738938 Classification: B - General Building Contractor
Owner: Laurel Lane Investments LLC
Business: (805) -55-0-58
2016Code Year:Stories
:
Fire Sprinklers: Motel Rooms:Dwelling Units: 0 . 00
Census: 750 - Grading Construction Type:
Occupancy:
Valuation
Group Type Sq. Ft Factor Valuation
$239,355.00Manual
Category:SQFT:
Dimensions
Fees
Fee AmountFee Name
Stormwater - Moderate Project - BLDG $1,863.94
Foundation New/Replace - BLDG $2,711.98
IT Surcharge $139.57
SMIP (Commercial) $67.00
Green Building Fee $10.00
Total Fees:$4,792.49
Payments
Date Receipt #Amount
9/10/19 $4,792.4923,640-09-10-2019
Total Paid:$4,792.49
Contact Name Account BalanceTotal DebitsAccount Name Status Total Credits
Plan Check Account Payment by Contact
Total Account Balance :
Balance Due:$0.00
Legal Declarations
#2 IDENTIFY WHO WILL PERFORM THE WORK
2a – CALIFORNIA LICENSED CONTRACTOR’S DECLARATION I hereby affirm under penalty of perjury that I am licensed under 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.
#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.
3 a - WORKERS’ COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain workers’ compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
#4 DECLARATION BY CONSTRUCTION PERMIT APPLICANT
By my signature below, I certify each of the following:
I am a CA Licensed Contractor.
Signature of Contractor, Authorized Agent or Owner Date
October 23, 2019