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HomeMy WebLinkAbout005-434-011BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAI. PAYMENTS: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 876 E 16TH ST Owner: Permit No: B08-1014 APN: 005-434-011 MORENO, MARIO & SOCORR Issued Date: 06/02/2008 By KCG Permit type: MISCELLANEOUS 2082 ROBAILEY DR Subtype: Electrical CHICO, CA 95928 Expiration Date: 06/02/2009 Description: UPGRADE ELECT SERVICE TO 12. (530) 774-6259 Occupancy: Zoning: AR Contractor Applicant: Square Footage: MORENO, MARIO & SOCOR: Building Garage Remdl/Addn 2082 ROBAILEY DR CHICO, CA 95928 Other Porch/Patio Total (530) 774-6259 FEE INFORMATION DBE Single Phase Service-Resid $59.00 Total Charged: $59.00 Fees Paid: $59.00 Balance Due: $0.00 Receipt No: 87527 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires 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 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 pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. 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 X 06/02/2008 the applicant to a civil penalty of not more than five hundred dollars [$500]; Plea check one of the following: Contractor's Signature Date AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE LLLLLL�����LLLLLLIIIIII COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR WORKERS' COMPENSATION DECLARATION 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 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED ❑I as required by CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are, thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier: Policy Number: Exp. Date: (This section need not be completed if the permit is for one hundred dollars ($100) or less.) ❑ I AM EXEMPT under Section B. & P.C. for this reason: I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers'X Compensation Laws of California, and agree that if I should become subject to the workers' 06/02/200$ compensation pro isions of Section 3700 of the Labor Code, I'shall forthwith comply with those Owner's Signature Date provisions. X 06/02/2008 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 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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 AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. 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 prope y'owner's behalf. S'Gi'l'd 0��506/02/2008 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] Print ` ' Date the performance of the work for which this permit is issued. (3097 civ. code) Owner ❑ Contractor OR Agent for Owner Agent for Contractor FILE COPY Lender's Address City State Zip k Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party 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 or county. They are also required by law to put their license number on all permits for which they apply. If you 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 for 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 $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. n If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal 0 income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact 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. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor 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 contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLS13 (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. 1. 1 PERSONALLY PLAN -TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. (YES R NO) 2. HAV /HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS I CITY PHONE CONTRACTORS LICENSE NO 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: UPGRADE ELECT SERVICE TO 125 AMP (REPLACES BP 05-1200) Reference Number: B08-1014 Applicant Name: MORENO, MARIO & SOCORRO Owner's Name: MORENO, MARIO & SOCORRROO AP # : 005-4434-011 Signature of Property Owner: _�_-L %'�) //lle��-, Date: (0 , - C%(� BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION* OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 Z -_ A FEE WILL BE REQUIRED AT TIME OF APPLICATION 00_10J__ Website: www.buttecounty.net/ddsOV I_OtC PLEASE PRINT CLEARLY **When filed, this application and all supporting material becomes subject to the California Public Records Act. All related to this application is subject to public inspection and will be posted on the County's website for electronic access. ,,APPLICANT SIGNATURE � I X i l4 PROJECT LOCATION API (� _ �_ 0 Property Address �(� E V til S City • i m 1 PERMIT NO. f ► '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 i DESCRIPTION OR SCOPE OF WORK. x4neiC riC `.e to lQZ Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: OWNER INFORMATION Last Namr .( r Fir Name 5ocop rp Mailin dress 24 JD Y' City. C 7 Stat Zi Pho Fax _ E-mail Lic. # ,,APPLICANT SIGNATURE � I X i l4 PROJECT LOCATION API (� _ �_ 0 Property Address �(� E V til S City • i m 1 PERMIT NO. f ► '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 i DESCRIPTION OR SCOPE OF WORK. x4neiC riC `.e to lQZ Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: CONTRACTOR Name ' 0 rI Address �� City Gb State Zip Phone 77 l S Fax E-mail Lic. # Class ,,APPLICANT SIGNATURE � I X i l4 PROJECT LOCATION API (� _ �_ 0 Property Address �(� E V til S City • i m 1 PERMIT NO. f ► '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 i DESCRIPTION OR SCOPE OF WORK. x4neiC riC `.e to lQZ Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: ARCHITECT/ENGINEER Name ' 0 rI Address City Gb State Zip Phone 77 l S Fax E-mail State License Number ,,APPLICANT SIGNATURE � I X i l4 PROJECT LOCATION API (� _ �_ 0 Property Address �(� E V til S City • i m 1 PERMIT NO. f ► '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 i DESCRIPTION OR SCOPE OF WORK. x4neiC riC `.e to lQZ Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: APPLICANT INFORMATION Name rRoyfllo. ' 0 rI Address City Gb Stat Phone (3_a2t 77 l S Fax _ E-mail ,,APPLICANT SIGNATURE � I X i l4 PROJECT LOCATION API (� _ �_ 0 Property Address �(� E V til S City • i m 1 PERMIT NO. f ► '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 i DESCRIPTION OR SCOPE OF WORK. x4neiC riC `.e to lQZ Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: SRA Yes No Zoning Flood ZTTy Occ. pe Const. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. 1200 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS 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 Issued Date: 05/05/2005 APN: 005-434-011-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 876 E 16TH ST CHI Date: Contractor: Map Index: Description: UP GRADE EXISTING ELECTRICAL OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 SERVICE TO 125 AMP Business and Professions Code: Any city or county which 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 Owner: MARIO MORENO signed statement that he or she is licensed pursuant to the provisions of 2082 ROBAILEY DRIVE the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or CHICO CA she is exempt therefrom and the basis for the alleged exemption. Any 95928 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).): 530 894-1653 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' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: MARIO MORENO pp such work himself or herself or through his or her own employees, 2082 ROBAILEY DRIVE provided that such improvements are not intended or offered for CHICO CA sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 95928 proving 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 Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: pursuant to the Contractors' State License Law.). ❑ I/am ExemptunderArticle3 of the Business and Professions Code Date: f_ "66 Owner: 1� si , ` ' � / - WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: ❑ I 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. LII have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of Engineer: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Valuation: $0.00 Policy#: ( 1 certify that in the performance of the work for which this permit is - Census Code: 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. Date: Applicant: , G - WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($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. A� (l//� J 1qp�� c) / CONSTRUCTION LENDING AGENCY This permit iskpreby issued under the appl' able provisions of the Butte County Code and/or 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolution,991do work indicated dove f which fees have been paid. �_ By: ' Name: < Date'.�J PERMIT EXPIRES ON:-�� Address: (Date) ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ , Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon three abovementioned property for inspection purposes. \ Print O C a ! z Name: '/!/ / r j�%(� Signature: Date: os- S.U,Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REO UIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER Last Name Or ��� First N me ayi eot Address a -r V e City D Stale Zip Phone53�01 J Fax E-mail APPLICANT NAME CONTRACTOR Name City Address Zip City Fax State Zip Phone Map Book Fax E mail Planner Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X 115;10 For office use only: Zoning Property Address.., - �� Flood Zone Cross Street SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. la BIN # LOCAAfTION U Property Address.., - �� X - ' f Cross Street W RKER'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. SMIP LENDING AGENCY Name Address Page 1 of 2 Description or Scope of Work: <% Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received byp Receipt #: 36JI(A Dater J CS G v Amount: Bldg SRA Sheriff SMIP Other Total REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings, ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor'Plan, (D) Tie -down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg,Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site 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 (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4, NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grarit Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. 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 and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 it RECORDING REQUESTED BY Bidwell Title & Escrow Company AND WHEN RECORDED MAIL TO Name MARIO MORENO Street Address 2082 Robailey Drive Address City, st:m Zip Chico, Ca. 95928 Order -No. 00219977-002 21011215—toQ1 I CEO, -7Z5E� Recorded Official Records County Of CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 02:05P14 25 -Mar -2005 REC FEE 10.00 TAX 200.20 Mark Page 1 of 2 SPACE ABOVE THIS LINE FOR RECORDER'S USE Parcel No. 005-434-011 GRANT DEED %- THIS FORM FURNISHED BY BIDWELL TITLE & ESCROW COMPANY �,j The Undersigned Grantor(s) Declares) Documentary Transfer Tax is $200.20 11 13City/Town of 0 computed on full value of interest or property conveyed, or r• D Unincorporated Area ❑ full value less value of liens or encumbrances remaining at the time of sale ❑ Monument Fee of $10.00 FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Donald R. Gerfen, Successor Trustee of the Alta F. Gerfen Family Revocable Trust No. 1 established on October 23, 2003 hereby GRANT(s) to Mario Moreno and Socorro Moreno, husband and wife as Joint Tenants the following real property in the ❑ City of 2 Unincorporated Area County of Butte, State of California: SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF The Alta F. Gerfen Family Revocable Trust No. 1 esta lished on October 23, 2003 ona d r n, Successor Trustee Document Date: March 15, 2005 State of California �y County of fJ% SS. On 'j - (� - Z(� 0 5 , before me, the undersigned, a Notary Public in and for said County and State, personally appeared Donald R. Gerfen Personally known to me (or proved to me on the basis of satisfactory FOR NOTARY SEAL OR STAMP evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/shelthey executed the same in hisAer/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity Y. MhNMCK upon behalf of which the person(s) acted, executed the instrument. Gomrriis�cln.S J30256� -s Notary Ptt1c: WITNESS my hand official seal. au ftFl County My comm. E><pkes Jan 3.2007 Signature —T—: YYl i r) n t CAL, MAIL TAX STATEMENTS TO: Same as Above STEC/GRANTDEED Order No. 00219977-002 EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: COMMENCING AT A POINT ON THE SOUTHERLY LINE OF LOT SIX (6) IN BLOCK NINE (9), AS SHOWN ON THAT CERTAIN MAP ENTITLED, "OFFICIAL MAP SHUSTER-RODLEY ADDITION TO CHICO", WHICH MAP WAS FILED IN THE OFFICE OF THE COUNTY RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JANUARY 28,1890 IN VOLUME 1 OF MAPS, AT PAGE 63, WHICH SAID POINT IS DISTANCE EIGHTY-ONE (81) FEET IN A WESTERLY DIRECTION FROM THE SOUTHEASTERLY CORNER OF LOT SEVEN O, IN SAID BLOCK NINE (9), AND RUNNING THENCE IN A WESTERLY DIRECTION ALONG THE NORTHERLY LINE OF IRWIN STREET AND THE SOUTHERLY LINE OF LOTS SIX (6) AND FIVE (5), IN SAID BLOCK NINE (9), A DISTANCE OF SIXTY-EIGHT (68) FEET TO A POINT IN THE SOUTHERLY LINE OF SAID LOT FIVE (5); THENCE AT RIGHT ANGLES IN A NORTHERLY DIRECTION ON A LINE PARALLEL TO THE WESTERLY LINE OF LOTS SIX (6) RERM(i NO. 2271-80B PERMIT EXPIRES 5/7/81 OWNER RAY GERFEN CONTR. owner LOCATION (A.P. 46-154-11 876 E 16th St, Chico Temp. Power Pole Called PG&E _ Temp. Elec. S�d Called P�G&E _ Temp. Gas Serv. _ Called PG&E _ JOBS ALED Setback Forms Main Bldg. Footings StemwaI I Slab Piers Garage Footings Stemwa I I Slab Carport Footings Slab Patio Footings Masonry Walls Reinf. Steel COUNTY, OF BUTTE — DEPARTMENT OF PUBLIC WORKS .BUILDING INSPE6TION- RECORD BUILDfNG BUILDING (Cont'd) PLUMBING Firewall Soil Pipin Parapets 1st Floor Restroom Finish 2nd Floor Windows 3rd Floor Siding To out Roof Sheathing Water Piping Roofing Sewer Fdn. Vents Fixtures Garage Vents Insulation Water Htr. Heaters Prov. for physical handicapped Conformance of x. structure Appliances Gas Piping &Test Temp. Gas Final r Sanitation FIREPLACE Final Final ELErrRICAL Bond Beam _ I FIRE`GPRINKLERS I Motors \ Stucco inal 7 Brown Cooling Finish Ducts Interior Lath Ventilation Door Closer Final MOBILEHOME UTI (TIES .. .......... . . . . Elec. Service Water Piping Sewer f4QB16ELJOMEINS LLATION--------------Support Water Piping Drainage DATE REMARKS OR CORRECTIONS t e, l �%/� t1� %�G �L�l � /✓G� PFJ € �ct r E L-�iiir/�✓' St�/��J� /£,f 4 fa k ' G9 �uvf la�fv Grd. Fault Prot. Service Temp. Pole Underground Permanent Final Elec. Pedestal Gas Piping Elec. Continuity Gas Piping (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville,'California 95965 - Telephone 916/534-4541 APPLICATION'Mb PERMIT PERMIT A-NO +/1 11 (j�n ASSESSOR CEL NUMBtR -- (Su— l,� z0ING 2 BUILDING PERMITIV OWNERV49 �G4 FE/0 TELEPHONE uZ s�� ( SO. FT. OCC. BUILDING VALUATION OWNER'S MAILINM ADDRESS IS -7 G L 1,(D_k T CONTRACTOR'S NAME s IV vIZ TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKN WN Fireplace Total Valuation $ Q LENDER'S MAILING ADDRESS Permit Fee $ 5-00 ARCHITPC�T OR E�GINEER I�vl rl'/1N LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS , Permit fee $ S -QV BUILDING ADDRESS (Z-7GS , PLUMBING PERMIT FiIingFee 3.00 Each Trap 2.00 Repair drainage or vent piping 2.00 041 C10 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other ►[� Describe work: ' 2OoF — Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 800V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. OR ADONS. ( DWEACCLBLDGLING OCCUP,&� 20sgft 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 No. 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 CONSTR MULTI -OUTLET NON-RESID, BRANCH CIRC ITS 2.50 ea NEW CONSTR ( POWER APPARATUS &) NON.RESID, SINGLE OUTLET CIR, Ex. Occup(OUTLETS OR FIXTURES 50@251 BAL@l0¢ Ex. Occup. FIXED APP ESi' .) \ p•(ouTLETS (RESID,) EA./ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 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. rt�I shall not employ any person in any manner so as to become subject U 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 Filing Fee 3.00 Heating Cooling Hood 2.00 Ventilation permit 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 onsequence of the granting of this permit. 6- f- U X Date h Sign rur of 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. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ Occup. GROUP I TYPE OF CONST. PARCEL PD HD 55 This permit is hereby issued under sions of the Butte County Code and/or wor dica ed above for which WRACAOR OF P BLIC PERMIT EXPIR S Date the applicable provi- resolutions to do fees have been paid. WORKS (X�%� Date) ���U v Receipt No. _7 � WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT