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HomeMy WebLinkAbout026-250-031213 P -026-25-0-031. 93_2. M ,• MARTIN, ARBIE t• �i(0 .G� ~ ! , •'�: � • I ,,: O 7510 OCCIDENTAL', PALERMO n i CONTR:. COMM. ACTION AGENCY WATER HEATER/SF ENVIRONMENTAL 026-250-031 02-3505HEALTH LEAR/ RANCE RAGANS, DENNIS 7570 OCCIDENTAL AVE., PALERMO ATTACHED GUEST COTTAGE LATE , .:hy. '. t:,l"•. 'M,.' Y - .: x�-, '. .,a -vs.. i; �•'-� ,.� Yh'�#'4 Y. .-'Ziv� ilY p+N� e�'•1.� M.f. : -4-. �., .)'wTK` '7 :1"•.:.t. �, .,> '.v 'i .. ,.R' ,+'�;s_ ,,�`• >;•. -e.' . _..' '�zTGc,. � dY�,. •�:''�;-1„�ru,,.y ,! > +'� r+'�"<•�. •c.•- ,, Yt-b.,,'�, .-.;�{, �.. y.'°�,ribl� }"s.y �� � ..i.,�. i.�f_: � .a �t� � a .•Sal ��i'., 7f� , .._., • hE� - rR9 ;.� y.:. t� } o- s s'f ,a.• , � q 2 '�, R si . County of Butte Oroville, California GENERAL CLAIM CLAIMANT: Dennis Ragans ADDRESS: P.O. Box 5302 IMPORTANT: CITY a STATE: Oroville, CA 95966 SEE INSTRUCTIONS ON REVERSE SIDE DATE OF CLAIM: 1/14/2003 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE I DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Reason for the Unable to build guest cottage , Refund: t3lag ermt pp No.: 02-3505 AP No: 026-250-031 Receipt No.: 369482 Receipt Date: 12/27/02 Bldg Permit Fees: $313.30 Owner's Name: Dennis Ragans TOTAL FEES PAID: $313.30 TOTAL FEES RETAINED (Breakdown Below): $105.00 Building Permit Filing Fees: $20.00 Plan Checking Fee: Plumbing Permit Filing Fees: $20`.00_ Energy Plan Checking Fee: Electrical Permit Filing Fees: $20.00 Refund Processing Fee: $25.00 Mechanical Permit Filing Fees: $20.00 Inspection Fee: SRA Fee: $208.30 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated Dated this day of , 2003, at Calif. Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Check one) for the same. Dated this _24th day of January_, 2003, at _Oroville Calif. Department Head or Authorized Deputy Dept. Code 440-001 Exp. Code 4210500 PAYABLE FROM Construction Permits FUND Dept. Code Exp. Code PAYABLE FROM FUND Dept. Code Exp. Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT & SUB. PROJ. SUB. OBJ CLAIM NO. INV. NO. INV. DATE ENCUMB GROSS AMT. County of Butte Oroville, California GENERAL CLAIM CLAIMANT: Dennis Ragans ADDRESS: P.O. Box 5302 IMPORTANT: CITY &STATE: Oroville, CA 95966 SEE INSTRUCTIONS ON REVERSE SIDE DATE OF CLAIM: 1/14/2003 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY AMOUNT Reason for the I--Iag Una q.1WI, ld'gue'st Cottages , r Refund: ' .. Cr..,.. App h No.: 02=3'505:'. ` AP No 2:50 031 - .026 . ...... . .. _,.:,.. l� Receipt No.: 369482 :. Receipt Date h :12/27/02;: Bldg Permit Fees Owner's Name: D@I1flIS 'RaganS; TOTAL FEES PAID: $313.30 TOTAL FEES RETAINED (Breakdown Below): $105.00 Building Permit Filing Fees x_,$20.00 Plan Checking Fee T . , Plumbing Permit Filing Fees , ,2Q Q0, Energy Plan Checking Fee: Electrical Permit Filing Fees: moor. Refund Processing Fee: Mechanical Permit Filing Fees: .: $20 O0; Inspection Fee: ,,, .,..... SRA Fee: .:.:.;:.�...... ...... $208.30 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or def er d, and that this claim is true ect as stated T Dated this( v day of , 2003, at D Calif.ax Signature of Claiman I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have een performed or deli ed and t It there is a Budget Appropriation or Speci c Bo rova heck for the same. /ne) Dated this day of January_, 2003, at _Oroville Calif. DepaEdent Head or Authorized Deputy Dept. Code 440-001 Exp. Code 4210500 PAYABLE FR0f4 Const ion Permits FUND Dept. Code Exp. Code PAYABLE FR6M FUND Dept. Code Exp. Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT & SUB. PROJ. SUB. OBJ CLAIM NO. INV. NO. INV. DATE ENCUMB GROSS AMT. 0TrF° \� c �. o 0 0 o�a�4.o c0U NZy Butte County Department of Development Services Building Division REFUND CLAIM APPLICATION REQUEST FOR REFUND ' Refunds can only be made upon written request by the person who paid the fee(s). The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance" for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked are not refundable. Fees paid N other County Departments arg not covered by this claim. [Butte County&ode Section 3-41(t)] CLAIMANT'S NAME: MAILING ADDRESS: ASSESSOR'S PARCEL #: BUILDING PERMIT #: RECEIPT NUMBER(S): b 350 5��qT� Please refund any applicable fees in the following categories: (Check those fees which you wish to have refunded) (,,I' Building Permit Fees,.. ( ) Sheriff Fees ( ) SRA Fees (CDF Fire Planning) ( ) Other (specify): Disposition of Plans: ( ✓� Plans returned to me at counter 3'd— r ( ) Please mail plans to me at above address ( ) Please dispose of plans Signature A Date r A COUNTY OF BUTTE GENERAL CLAIM FORM WILL BE MAILED TO YOU FOR SIGNATURE AFTER REVIEW BY BUILDING OFFICIAL. J:\My Documents\REFUND CLAIM APPLICATION.doc 12/17/02 FOR BUILDING DIVISION USE ONLY: Receipt Information: Number: Date: Issued To:" y�s�rua Amount: Fees Retained: _ � , ✓Processing Fee: $ � /Bldg Filing, fee:' $' i�41bg Filing,F, ee: $ ✓ Elec'Film g 'Fee: $ t��r ✓Mech. Filing Fee:' $ Cr)- Energy P/C Fee: $ Plan Check Fee: $ Inspection Fee: $ SRA P/C Fee: $ Other: $ 11otal Amount Retained: $ w J TOTAL REFUND DUE:$ aus Amount from 440-001 $ Amount from $ Amount from Amount from J:\Iy. Documents\REFUND CLAIM APPLICATION.doc 12/17/02 BP# Processing Fee: $ Bldg Filing Fee: $ Plbg Filing Fee: $ - Elec Filing Fee: • $ l Mech Filing Fee: $ Energy P/C Fee: $ Plan Check Fee: $ Inspection Fee: $ SRA P/C Fee: $ Other: $ Amount from Amount from J:\Iy. Documents\REFUND CLAIM APPLICATION.doc 12/17/02 COUNTY OF BUTTE - DEPARTMENT .OF DEVELOPMENT SERVICES - BUILDING DIVISION • 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-15 -- PERMIT NO. (Rev.12/86) APPLICATION AND PERMIT � � ''3�y v, ASSESSORPARCe-NUMSER ZONING o BUILDINGP ?MIT OWNER P in .. _ n Y 1 ,, — , , „ CTO -.2 -E- '2 '% S0. • FT. OCC. BUILDING VALUATION CONrRACTOR9 C'GLL S3 M-^ 514`i7 'jF CONTRACTORS MAIM ADDRESS CONSTRUCTION LENDER TENDER'S MID.ING ADDRESS ARCHITECr OR ENGINEER ARCHITECT OR eMEERS MAUNS ADDRESS v RCT NO. I SUBDMSIONSNAME USEOFSTRUCTURE SF � Duplex ❑ Mobilehome ❑ Other sPas+r TYPE OF WORK .New p9 Addition ❑��Remodel C3UbMas ❑ Installation E3stallatioOther 13Describe Work: Cxq-t X-Fj DG)�f'S� *PERM FEE PAlb SRA♦ SHEMRIFF AMOVtSIT RECGMt> $ 313.3C " TO a W ZNITO COMM nre Ince PERMIT FEE S ELECTRICAL PERMIT Total Valuation Main Service n0°Vi► oa L 29.00 Filing Fee $ 46.00 , 20.00 Permit Fee $ ,,SV Plan Checking: Fee $ Energy Plan Checking Fee $ PERMIT FEE $5r 7 PLUMBING 'PERMIT Fling Fee 20.00 Each Trap 7.00 gC. 0,4 Solar or heat pump water heater 23.00 Water piping 15.00 is, — Each gas water heater or vent 15.00 Gas piping system 1 -5 outlets 15.00 f -S— Buildin sewer 15.00 A.::;– Mobile Hom® I S I G I W @20.00 II Ex. OCCUD. ( OWLET OR FKnME9 ) I I A2° � ''OD I Ex. O=u airriETs r"ia�ew 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S J MECHANICAL PERMIT I _Filing. Fee 1 20.00 /S ,8.50 U PERMIT PEI: S ' 4V - D01MMSU Mobile Home Installation Fee $ Energy Inspection Fee $ 6. p Occ �Nsr. TYPE TO E $ HAZ 0. FEB IM CDF PARcEi 0 M This permit Is hereby Issu and a applicable provisions of the Butte County Code and/or Resolutions to do work Indicated above for which fees have been paid. By Date ReceiptNo. PERMIT EXPIRES ON WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I I ,,,_._. PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service n0°Vi► oa L 29.00 Main Service OM TO 100QA j 46.00 , NEw CONS . OR ADDNS. l MAMARG oOdEP.. \ a nec_ sLos_ 1 3.50' /• 2 . II Ex. OCCUD. ( OWLET OR FKnME9 ) I I A2° � ''OD I Ex. O=u airriETs r"ia�ew 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S J MECHANICAL PERMIT I _Filing. Fee 1 20.00 /S ,8.50 U PERMIT PEI: S ' 4V - D01MMSU Mobile Home Installation Fee $ Energy Inspection Fee $ 6. p Occ �Nsr. TYPE TO E $ HAZ 0. FEB IM CDF PARcEi 0 M This permit Is hereby Issu and a applicable provisions of the Butte County Code and/or Resolutions to do work Indicated above for which fees have been paid. By Date ReceiptNo. PERMIT EXPIRES ON WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I I ,,,_._. COUNTY OF BUTTE - DEPARTMENT OF' DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7 1 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT !? 50c? ASSESSOR PARCELNUMBER ZONING BUILDING PERMIT OWNER TELEPH6MNE SO. FT. OCC. BUILDING VALUATION .OWNERS MAILING ADDRESS P.0- 15M97 T CONTRACTOR'S NAME T• TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS AVE7570' OCCIDENML Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDNISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Ulilibes ❑ Installation ❑ Other ❑ Describe Work: DETACHED GUEST COTTAGE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G w @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 800OR LESS Main Service OVA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I reby affirm under penalty of perjury that I am licensed under provisions of Chapter commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Llc. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law foL the following reason: 11a' 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. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION reby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 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 workers' pensation laws of California, and agree that if I should become subject to the wo kers' compensationprovi ' s of section 3700 of the Labor Code, I shall fort with comply with those J rov' ions. )Dte P/ �� na 0 Applicant -a Owner Fhrrac0Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in heig t. Main Service TO 46.00 gCU000A WEE200A NEW CONST. DWEILNO OCCUP. SO OR ADDNS. ( a C. BLOS. 3.50 so NEW RESID. MULTI.OUTLET @7,50 POWER APPARATUS & SINGLE OUTLET CIR. EX. OCCU OUTLET OR FIXTURES) .00 BAL @ I. 0 0FIXSAa D°Ep 5.00 Ex. Occup. Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ fA D. FEES IMP FLOOD I COF PARCEL PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON I the applicable provisions Resolutions to do work been paid. Date Date Receipt No. WHITE-O.D.S.-B.D. CANARY- SSOR PINK -INSPECTOR GOLDENROD•APPLICANT Y"•`t�l:'I[1t �"rp'�Iggr'!W�i'It+'�"f �PI�Iw►"�,n'q*r�.;y�r�e�.�V'oMA.�"�`!��'M1�"+'•7TA'�"f�'�ijjgr.,"1fFr'IY•�M�M Y�Frr ----�.ir.� COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET 5'!" OWNER: /-120 ASSESSOR PARCEL NUMBER pC 6 `e� � 3 �• Proposed Building U,se: • 6"Counter Technici Date: Items requiredzin order to apply for a permit. Al coxes MUST be checked OR marked NA in order o apply. — p 1.. Plot plans, 3 or 4 sets, signed,ty the preparer of the plans. Complete plans, 3 or 4 sets, signed by the preparer of the plans. 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. f6. .Engineered truss details and layouts in duplicate. No faxes! . Energy compliance design and supporting documentation in duplicate. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. a .. +• Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be indexed and returned to the plan review line-up when required items are received. Date Received By 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ` ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................... ❑ 11. Detached Accessory Building Form filled out by the owner.......................I ............. ❑ 12. Hazardous Material Form............................................................................... ❑ 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 14. Fees as shown on the attached Schedule of Fees Due Sheet ........................_................ 15. Statement of Intent for Non -heated and A/C Buildings ......................:. 16. Sanitation and plot plan approval from the Environmental Health Department in 17. City of Chico Plumbing permit ::..........:. " + ...........:...... ❑ 18. California Department of Forestry lan:appr , a ❑ paid. Sent. by: ...................... 19. Planning approval for (A) Use: (B)Parking: _ (C) Parcel Check: 20. Contact Land Development abo-u' '" ' improvements, ❑Drainage ............................... ❑ 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 22. Pre -Inspection for ' required ................. ❑ 23. Contractor's license informationf, Number, Name Style,Classification)...................... - ❑ 24. Worker's Compensation Carrier and Policy Number..........:..,..... ...............�" 5. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ... 1+ . •• ... C,$.`t 26. Letter of Signature authorization ............................................ ..................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement......... r:........ - ................ ❑ 28. Manufactured home utility clearance ......................... ... " ^' ❑ 29. Existing violations and/or expired permits....".':`..:...i........ .....�........................ ❑ 30. ❑ Grant Deed, ❑ Mbl =Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone — o'i % and hold for pickup. I have been nfo med of the above ite ;srd quirements for obtaining a 'Iding permit. App 'cant: 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required f ' Contractor, designer, owner, was advised cf the above data by ❑ phone, ❑ mail, ❑ counter, by Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Plans reviewed by: —Date:— Plans approved by: Structural reviewed by: Date: Structural. approved by: Note transfer by: Date: Yellow: Buildine Division Date: Date: Date:_ Date: COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 SCHEDULE OF FEES DUE OWNER PROPOSED BUILDING 1. BUILDING PERMIT FEES C Balance Due ....................... $ Additional Fees Due ................. $ Additional Fees Due ................. $ A Revised Plan Checking Fee ......... $ 2. SCHOOL DISTRICT FEES ' (paid at District Office) (Available after lan Check) 3. SHERIFF FEES (paid at Building Division) 3 Residential x $360.00 = $ J• OO ...................... Units Commercial (sq. ft'.) ............... x $0.03 = $ Sq. ft. 4. URBAN AREA FEES (paid at Building Division) Residential ................... —x-=$ # Units Amt. Commercial (sq. ft.) ............ —x—=$ Sq. ft. Amt. 5. RECREATIONAL DISTRICT FEES (paid at District Office) (Available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER A.P.# "- 8'J DATE RECEIPT # DATE REC. At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking proc ss. AP ICANT CP -4 — _ Pursuant to Government Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original - Buiding Div. 2nd Copy - Applicant 3rd Copy - Owner (Rev. 6/00) OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. personally plan to provide the major labor and materials for construction of the proposed property improvement: YES e NO C3 I HAVE e HAVE NOT 0 signed an application for a building permit for the proposed WO& I have contracted with the following person (firm) to provide the proposed construction: NAME: _ /1 . ADIk.ESS: CITY: PHONE: � 4. I plan to provide supervise, and pr( NALti1E: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO. as of this work, but I have hired the fa wing person to coordinate, :Le major work: CONI1LACT,OR'S LICENSE NO. I will provide some of the work but I ha the work indicated: / NAME DWI (hired) the following persons to provide TYPE OF WORK SIGNE PROPER OWNER: �' SOCIAL S C NUMBER: DATE: NOTE: This Owner -Builder Verifccation is required by Section 198.31 and 19832 of the California Health and Safety Code. This verification must be compkted ottd returned to our office before we are permitted to issue the permit OVER OWNER BUILDER INFORMATION � Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder". you are the responsible parry of record on such a permit. Building permits.are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible, liability if that person applies for the proper permit in his or her name. Contractors are-required'by law to be licensed.and bonded by the State of California and to have a business license from the city of county. They are also -required by law to put their license number on all permits for which they apply u . Ifyou plan to do your own work, with the exception of various trades that you plan to subcontract„ you should be aware of the following information; foi your benefit and protection: ♦ if you employ.or otherwise engage any. persons other than your immediate family, and the work (including materials and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractors or -subcontractors. then you may be an employer. ♦ If you are an employer, you, must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U:S. Small 'Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of industrial Accidents. J.. If the structure is intended, for sale, property owners who are not licensed contractors are allowed to perform their work personally or through I t hei r own employees, without a licensed contractor or subcontractor, only under limited conditions. - A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder".; building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1030 N Street, Sacramento, CA. 95814. , Please complete the "Owner Builder Verification" on the reverse side of this form so that we can conftrm`thatyou are aware of these matters. The tiuildirig permit will not be issued until the verification is returned. i rely, Mir el C: Vi ira, C.B.O. y bt ger, Building Inspection NOTE: Tit is Owner -Builder Information is, required by Section 198.10 of the Californla Health and Scfery Code OVER E.H. USE ONLY Piot Pian Anachod Floor Plan Attachad Sanz to ®.D1 !P--) TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance RaQCIO S Cnn� S 6A,x Owner Location AP# Plan Approved for: Sewage Dispo Clearance for dwelling. Other Hold final for: Final clearance O.K. for: NOTE: Water Supgly: Public ell Environmental Healt Specialist Date; 8/96 • ..ti �� . .r ._ .?uw,.Y—'�{µr+r�. e'�*'+v►n ��g�sv.;.s •w;����'�v YET;."""�ar�.r¢•��'�"'1`i;v';,�wl;; 'r v_� �'�.t w 026-25-0-031 93-2213 P,M MARTIN, ARBIE 7510 OCCIDENTAL,,PALERMO CONTR: COMM ACTION AGENCY COOLER, WATER HEATER/SF .. i,ii - r � ' p'rr. ry y T«� tom«,,.,,, � ���� r -M1, .r��r•��'�'f^.Cid, ,- .�.'r'Y`n.."*'.. �."F "y�.�„'`,,,� � r� . � ..: 7L�P$_y . .. , . . �Si^nl % COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS. PERMIT NO. 7 County Center Drive'- Oroville, California 95965 - Telephone: 916.'538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 026-250-031 ZONING A �- BUILDING PERMIT r OWNER Arbie Martin TELEPHONE 741-1648 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1604 2nd Ave., Olive Hurst CONTRACTOR'S NAME C.A.A. TELEPHONE i CONTRACTOR'S MAILING ADDRESS 2255 Del Oro Ave., Oraville, j Fireplace CONSTRUCTION LENDER- t UNKNOWN ')} Total Valuation $ Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS , I. Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMITFiling Fee 15.00 7510 Occidental, Palermo ' Each Trap 1 5.00 ' Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP 1 Water piping 7.00 Each qas water heater or vent 1 7.00 7.00 USE OF STRUCTURE { SF [� Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK ) Newl j Addition U Remodel ❑ Utilities ❑ Installation❑ Other � Describe work: Install Swam Cooler _ Change out Water Heater Permit Fee $ 22.00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 18.50 200A OR LESS Main service 200A TO IOOOA) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business( and Professions Code and my license IS In full force and effect. License ,do. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason NEw M CONST. / DWELLING OCCUP3.64sq.ft. OR ADDNS. 1 ACC. BLDGS. II NEW CONSTR. MULTI -OUTLET @ 5 00 NON•RESID BRANCH CIRC ITS POWER APPARATUS 61 i SINGLE OUTLET CR. Ex. Occup(OUTLETS OR FIXTURES 20 76d' Ex. Occup. OUTLETS P(RESID )FIXED APLNS.REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ =Contractor- — WORKMEN'S COMPENSATION INSURANCE,. I declare under penalty of perjury (check one): ❑ The permit is for $100.00. (valuation) or less. I have placed on file with the County of Butte Building Department ' a Certificate of Workmen's Compensation Insurance or a Certificate ` of Consent to Self -Insure. . ; ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked.'. MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling ' Evap 1 10.00 0. Hood 6.50 Ventilation Penult Fee $ Contractor I certify that I have read this application and state that' the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X / % 4 jh' ,, Date 7- �'- 5;3 Signature o4 Applicant – Owner ❑ Contractor ❑ Agent �( An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories,in height. g I Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 47.00 HAz I DFEES I IMP I FLOOD CDF PARCEL PD HD Iss E This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do �� .4. work indicated above for which fees?he been paid. 4k, DIRECTO��,O�. PUBLIC WO KS By �,0At +7 X t'! 7Date. �/9* PERMIT EXPIRES Date ' •`yr 143602'—. Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone. 916.538-7541 APPLICATION -AND PERMIT PERMIT NO. �e�;;' -, 2� ASSESSOR PARCEL NUMBER 026-250-031 Z, I N G + - BUILDING PERMIT OWNER Arbie Martin TLEPHONE 741-1648 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1604 2nd Ave., Olive Hurst CONTRACTOR'S NAME C.A.A. TELEPHONE CONTRACTOR'S MAILING ADDRESS 2255 Del Oro Ave., Oroville Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 15.00 7510 Occidental Palermo Each Trap 1 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 1 7.00 7.00 USE OF STRUCTURE SF [?jDuplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New Ll Addition IJ Remodel ❑ Utilities ❑ Installation❑ Other �, Describe work: Install Swamp Cooler _ ChnnRp out Water Heater Permit Fee $ 22,00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600VORLESS 200A OR LESS 18.50 Main service 20CATO 1000AI 1 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. —� License .JO. (v/7 r�C_T Classification Fl 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING oCCUP.81 OR ADDNS. ACC. BLDGS. // 3.60 sq.ft. NEW CONSTR. ULTI.OUTLET NON-RESID BRANCH CIRCU ITS I @ 5•00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup( OR FIXTURES 20 76 JAL aD 4 FIXED APP LHS. OR Ex. Occup. OUTLETS IRESID.I EA.) 1 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g '15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department la1 a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling Evap 1 10.00 10.00 Hood 6.50 Ventilation permit Fee $ 25.0 Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyof Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X���/J Date 7� 3 g pp ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ OCCCONST TYPE TOTAL FEE $ 47.00 I HAz 1 0FEES IMP I FLOOD I CDF I PARCEL I PD I HD ISS E This permit is hereby issued under the sions of the B tte County Co a and/ work Indic a above ich fee RECT U LIC BY PERMIT I • E Date applicable provi- re olutions to do h e been paid. KS Date 143602 Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT P ASSESSOR F ARCEL NUM /•9 -7 /e — 'tea e W WNER'S MAILING AD CONTRACTOR'S NAME 4 a a� CONTRACTOR'S MAILING AOI CONS RUCT ON LENDER L LENDER'S MAILING ADORES., s� ARCHITECT OR ENGINEER ARCHITECT OR ENGINEER'S MAILING A'Jf'LILA'l ION ANU PERMIT © �S ZONING T_CL i PHON5 � �� S0. FT, J 1�5Z G /} 7 EyyL O N Eg BUILDING ADORE LOT NO. SUBOI VI SION NAME RESS USE OF STRUCTURE SF9 Duplex[] Mobilehome[] Other I UNKNOWN ICENS PARCEL MAP SPFr'I Fv TYPE OF WORK New LrJ Addition L; Remodel C Utilities o Installation[ Other la Describe work: Zd is"A BUILDING PERMIT OCC. BUILDING VALUATION Fireplace Main service 20GATO1000AI 37.501 Total Valuation g NEW CONST. \ DWELLING OCCuP.s\ OR ADONS. ACC. BLOCS. sa.ft. Filing Fee g Permit Fee 15.00 s Plan Checking Fee s Energy Plan Checking Fee S Penalty S Permit fee = PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.001 Solar or heat pump water heater 20.00 Water piping 7.00 Each Qas water heater oEvent 7.00 �, miGas piping system 1 - 5s 5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200ESS AORLLESS 18.50 CONTRACTORS LICENSE LAW Main service 20GATO1000AI 37.501 declare under penalt of er'ur Y P perjury (check one): NEW CONST. \ DWELLING OCCuP.s\ OR ADONS. ACC. BLOCS. sa.ft. I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions NEW coNSTtL uL t.pUTLET NO N.RESIO BRAN O CTR ITS @ 5.00 Code and my license is In full f rce and effect. License No._-�%7��_ Classification POWER APPARATUS N) 4NGLE OUTLET IR. Ex. Occup (OUTLETS OR FIXTURES 20 764 `! I, as the owner, or my employees with wages as their sole compen- sation. will do the work,and the structure F'XED ALNS. DR Ts IREsIo,, EA.) I 3.00 Is not intended or offered for sale. (Sec. 7044) Temporary service 10 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) 15.00 Mobile Home Facilities 15.00 _ - U I am exempt under Sec. Business and Professions Code Misc. Wiring 15.00 for this reason Permit Fee s WORKMEN'S COMPENSATION INSURANCE Contractor leclare under penalty of perjury (check one): _� The permit is for 8100.00 MECHANICAL PERMIT Filing Fee 15.00 (valuation) or less. I'V I have placed on file with the County of Butte Building y� Heating Department a Certificate of Workmen's Compensation insurance or a Certificate of Consent to Self -Insure. J I shall not employ any person in any Cooling '�nn v manner so as to become subject to the W. C. laws of California. Hood 6.50 lice to Applicant: If after making tnis statement, should you become subject the W. C. provisions of the Labor Code. Ventilation you must forthwith comply with such Wisions or this permit shall be deemed revoked. Permit Fee $ _ Contractor ertTfy that I have read this application and state that the above Information to to lC -orrenne Ordinances Mobile Home Installation Fee iState Laws tlIwf ldg construction. ane d hereby authorize teesentatves of the County of to to enter upon the above-mentioned Ener p Energy Inspection Fee Droperty for In so agree t0 save. indemnifySCeCt u)n purposes. S. and >.eeP harmless g OCC i0ns7 rrPE liabilities, the County of Butte agalns; __ judgments, costs, and expenses TOTAL FEE $ .Ynlcn :na , Inst said County In consequence Uf ;he gr.lfl; lila is this permatny way accrue _ -I I1nA( OFEf$ IMP FL000 CDF PARCEL PO r,0 -SSUt _ Gate alure of Applicon, i This permit is hereby issued under the applicable provi. ' _ O..ne. — �onL,�,a. • A9en1 )SHA per,.,,,—• dons of the Butte County Code and/or r i resolutions t0 ti0 • i reaui,ed for ­ca�nl on, o,.. )'C" .«p and a,mlr�ar can,,,c,. II 9hl. , indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS r "'' •• +c�,n• .., ...L,r.�, - >o.. - c - PERMIT EXPIRES Date Date — --------- --- Al I A J, #I 40- 600 6kNA, 4:iV\ tk I i m m 00 xl® #I 40- 600 6kNA, 4:iV\ tk I i