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HomeMy WebLinkAbout028-110-023BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES ` BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#:.(530) 538-2140 WEBSITE: www.buttecounty.ne6dds FEE INFORMATION DBE Single Phase Service-Resid $55.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires PAUL'S ELECTRIC C376492 / C10 / 06/30/2007 I HEREBY 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. X 03/05/2007 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: aI 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. I HAVE AND WILL MAINTAIN WORKER'S 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; X Carrier: Policy Number: Exp. Date: _ (This section need not be completed if the permit is or one hundred dollars ($100) 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 03/05/2007 bIgnature - — Date WARNING: FAILURE TO SECUE 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 FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip Total Charged: $55.00 Fees Paid: Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION I'HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 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 such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom 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]; Please check one of the following: ❑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 (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner. of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this reason: I Q 03/05/2007 Owner's Signature Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County.to enter the above mentioned property for inspection purposes. I hereby certify that I am the roPowner or am authorized to a o the property owner's behalf. A l a,44.0_4A/ 03/05/2007 �� lv�Yy`l YCIC Contractor OR. DAgent for Owner MAgent for Contractor FILE COPY PROJECT INFORMATION Site Address:' 5050 LA PORTE RD Owner: Permit NO: B07-0421 APN: 028-110-023 ROMER, WILLIAM & NANCY Permit type: MISCELLANEOUS PO BOX 144 Issued Date: 03/05/2007 By AAM Subtype: Electric Panel BANGOR, CA 95914 Expiration Date: 03/04/2008 Description: ELECTRICAL PANEL UPGRADE Occupancy: Zoning: A5 Contractor Applicant: Square Footage: PAUL'S ELECTRIC ROMER, WILLIAM & NANC7 Building Garage RemdUAddn 625 MISSION OLIVE ROAD PO BOX 144 OROVILLE, CA 95966 BANGOR, CA 95914 Other Porch/Patio Total (530)589-4100 (530)538-6245 FEE INFORMATION DBE Single Phase Service-Resid $55.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires PAUL'S ELECTRIC C376492 / C10 / 06/30/2007 I HEREBY 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. X 03/05/2007 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: aI 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. I HAVE AND WILL MAINTAIN WORKER'S 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; X Carrier: Policy Number: Exp. Date: _ (This section need not be completed if the permit is or one hundred dollars ($100) 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 03/05/2007 bIgnature - — Date WARNING: FAILURE TO SECUE 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 FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip Total Charged: $55.00 Fees Paid: Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION I'HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 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 such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom 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]; Please check one of the following: ❑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 (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner. of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this reason: I Q 03/05/2007 Owner's Signature Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County.to enter the above mentioned property for inspection purposes. I hereby certify that I am the roPowner or am authorized to a o the property owner's behalf. A l a,44.0_4A/ 03/05/2007 �� lv�Yy`l YCIC Contractor OR. DAgent for Owner MAgent for Contractor FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" CONTRACTOR OWNER INFORMATION Last Name City LA -0— 0/10 Fi t Nam Mailing Address A �StateCA City E-mail Lic.# e,lo -1 q7 I Zipg Phone Fax Fax E-mail State License Number CONTRACTOR Name Address City LA -0— 0/10 State Cj- Zip 15-w Phone3 70 Fax E-mail Lic.# e,lo -1 q7 Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT S/ NATURE X PROJECT LOCATION AP# Property Address -6 City i� C PERMIT NO. 0' -d`p I BIN # WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning FloodZoneEType SRA Yes No Occ. onst. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) ;OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 ' WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 5050 LA PORTE RD Owner: Permit No: B07-0367 APN: 028-110-023 ROMER, WILLIAM & NANCY Issued Date: 02/26/2007 By GLB Permit type: MISCELLANEOUS PO BOX 144 Subtype: HVAC Change Out BANGOR, CA 95914 Expiration Date: 02/26/2008 Description: HVAC C/O WITH DUCTS Occupancy: Zoning: A5 Contractor Applicant: ISquare Footage: SECO HEATING. AND AIR SECO HEATING AND AIR Building Garage Remdl/Addn 4320 ANTHONY CT, SUITE 1 4320 ANTHONY CT, SUITE 1 ROCKLIN, CA 95677 ROCKLIN, CA 95677 Other Porch/Patio Total 652-6755 (916)652-6755 FEE INFORMATION DBM Heat Pump (Package Unit) $55.00 :LICENSED CONTRACTOR'S DECLARATION Contractor(Name) State Contractors License No. / Class / Expires SECO HEATING AND AIR 788807 / C20'C38 / 12/31/2008 I HEREBY 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 fulffl%Land effect. . + X \ -*,� 02/26/2007 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY 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. ❑I HAVE AND WILL MAINTAIN WORKER'S 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 caries and policy number are; Cartier. PREFERRED EMPL(policy Number. WKN1275722 Ezp. Date;05/01/2007 (This section need not be competed if the permit is for one is dollars ($100) or less. ❑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 X X" \ 02/26/2007 Signature 4, Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES: ` CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip $55.00 Fees Paid: $55.00 Balance Due: $0.00 Receipt No: B1967 . OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 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 such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom 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]; Please check one of the following: ❑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 (Sec: 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). k ❑ I AM EXEMPT under Section B. & P.C. for this �(� 02/26/2007 Owner's Si ature Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, riles, regulations, and State laws relating to building . construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County,.its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorized to act on the property owners behalf. 02/26/2007 Owner ❑ Contractor OR. DAgent for Owner ElAgent for Contractor FILE COPY BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 .6 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds BIN # "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Nam ` 0 n 6R—First 0 C' 0 Mailing Address Soso Lp o(di_ - City%AW rra StateC, s, Zip Phone s3 b - c -� 9 222E Fax E-mail CONTRACTOR Name �© Address X3 2-0 p N-; Now Y c r City a(C(—k a State Zip VG :�q Phone/( - 6S2 -GLV, Faxgl` 2. E-mail Lic. # `$ gG Class C _ APPLICANT INFORMATION ARCHITECT/ENGINEER Name cite& Address Zip �G City Fax State Zip Phone Fax E-mail Sq FT- Living Garage Open Cov ❑ . Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): 4454, State License Number APPLICANT INFORMATION Name l SVo t $11S $A Address 4% 7,o w,'6,,A ,,-r "F � cite& Stat Zip �G PhoneglG Fax E-mail APPLICANT SIGNATURE X PROJECT LOCATION Zoning `% AC, C kp,(v 6 9, PropertyAddress sO Sd LA art City °AWGo s\. QA QiS l IC' WORKER'S COMPENSATION Policy Number U Kv Carrier(� (c-�.'c�,�t If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Zoning `% AC, C kp,(v 6 9, Q (Al l+lQw ii kC SRA I Yes I No Occ. Type Const. Sq FT- Living Garage Open Cov ❑ . Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): 4454, For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. Ct (0 --� 2(2� (a�