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ON-LINE PERMIT
CITY OF VALLEJO BUILDING DIVISION
555 SANTA CLARA STREET
VALLEJO, CA 94590

PERMIT No:
BP18-1883
 
WEBSITE: http://www.ci.vallejo.ca.us/cms/one.aspx?pageId=21904
PERMIT TYPE:
BUILDING COMMERCIAL
SCHEDULE INSPECTION ONLINE:
http://web.ci.vallejo.ca.us/eTRAKiT3/default.aspx
PERMIT SUBTYPE:
TENANT IMPROVEMENT
24 HR INSPECTION HOTLINE:
(707)648-4384
ISSUANCE DATE:
3/19/2019
BUILDING DIVISION:
(707)648-4374
PROJ. VALUATION:
$200,000.00
PROPERTY INFORMATION
DESCRIPTION
JOB ADDRESS:
904 ADMIRAL CALLAGHAN LANE
VALLEJO, CA 94591
APN:
0081010110
TESLA-INSTALL EV CHARGING STATIONS/ 14 LEVEL 3 CHARGERS;
 
(4) LEVEL 2; (4) FUTURE

***PLANNING NOTES: PRIOR TO ISSUANCE: 1) SUBMIT LANDSCAPE PLAN FOR REVIEW AND APPROVAL PRIOR TO FINAL INSTAL LANDSCAPE. 2) SUBMIT PARKING COUNT TO PLANNING. PLANNING INSPECTION PRIOR TO FINAL
Occupancy Group:
 
Code Year:
2016
Construction Type:
 
Fire Sprinklers:
YES
Climate Zone:
0
Building Sqft:
 
Zoning:
 
Historic Dist:
 
CONTACT INFORMATION
PERMIT FEES
OWNER:
TARGET CORPORATION
 
C/O ALTUS GROUP US INC PO BOX 72028
 
PHOENIX , AZ 85050
  
  
  
 
Fee Name
Fee Amount
BLG-BUILDING PERMIT
$1,644.09
BLG-ELECTRICAL PERMIT
$328.82
BLG-INSPECTION HOURLY-ADDITIONAL
$155.00
BLG-PLAN REVIEW FEE
$1,150.86
C1 GEN FD WASTE MGMT PLAN-BLG
$361.93
C2 SW FEE CONSTR & DEMO RECYCLING
$75.31
C3 SW COST CONSTR & DEMO RECYCLING
$5.76
STATE-BUILDING STANDARDS FEE
$7.20
STATE-BUILDING STANDARDS FEE-ADMIN SURCHARGE
$0.80
STATE-SMIP COMMERCIAL
$56.00
SURCHARGE-GENERAL PLAN UPDATE
$156.19
SURCHARGE-PERMIT STREAMLINING
$93.71
SURCHARGE-TECHNOLOGY FEE
$65.76
TOTAL FEES COLLECTED
$4,101.43
 
APPLICANT:
ERICKA MANLER -TESLA
 
6900 DUMBARTON CIR
 
FREMONT, CA 94555
 
(510) 507-6717
 
[email protected]
CONTRACTOR TO COMPLETE ALL DECLARATIONS BELOW: LICENSED CONTRACTOR, WORKERS' COMPENSATION,
CONSTRUCTION LENDING AGENCY AND
SIGN THIS PERMIT IN ORDER FOR IT TO BE VALID.
  
CONTRACTOR:
 
 
 
,
  
  
  
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.).
  
NOT APPLICABLE Initial:___________ Date:____________
 
NOTICE: This building permit will expire if work is not started in 180 days or if an inspection is not approved for more than 180 days. All work performed under this permit MUST conform to the current and adopted California Building Codes and City of Vallejo Ordinances. Do not conceal or cover any construction until the work is inspected and the inspection recorded on the inspection sheet of this permit.
Additional fees will be charged and collected to renew expired permits. Expired permits constitute a violation of state law and will be reported to the Contractors State Licensing Board.
Please place all inspection requests 24 hours in advance.
KEEP THIS JOB CARD AND FIELD SET OF PLANS ON SITE FOR THE INSPECTOR.
A building permit does not constitute an approval or waiver of any violation of the above provisions, nor of any state laws or City of Vallejo ordinances, regulations or requirements.
I agree to comply with all City of Vallejo ordinances and state laws relating to building construction and name this statement under penalty of law. I hereby authorize City of Vallejo representatives to enter upon the above mentioned property for inspection purposes.
This is a building permit when properly filed out, signed and validated, and is not transferable.
I certify that I have read this permit and state that the information is true and correct.
Print Name: ___________________________________________
 
Signature: _____________________________ Date:__________
CSLB License:
897792
License Type(s):
C10 B
City Business License:
 
Expiration Date:
10/31/2022 12:00:00 AM
    
LICENSED CONTRACTOR: I hereby affirm that I am under the provisions of Chapter 9 (commencing with Sec. 7000) of Division 3 of the Business and Professions Code and my license is in full force and effect.
    
Initial:____________ Date:____________
WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations:
  
I have and will maintain a certificate of consent to self-insure for workers' compensation, issued
by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code for the performance of the work for which this permit is issued.
 
Policy No:
ELWC010798
OR:
   
  
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. My workers' compensation insurance carrier and policy number are:
Insurance Company:
BERKSHIRE HATHAWAY HOMESTATE INSURANCE COMPANY
      
 
Policy No:
ELWC010798
OR:
   
  
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 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.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
    
Initial:____________ Date:____________