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HomeMy WebLinkAbout007-150-011W. Z7 J��s��bXk'`Y9tTj� 007-150-011 00-2128 STIL.WELL, JOE 3024 BURNAP AVE. CMCO CONTR: OWNER FiNIx '71ZZI"o RELOCATE COOK TOP IE GAS LINE Num oil '�.^�w^.:va �+x�7'•rfaccr^p'.��r'&ws, _r r.�=;i`.'9ve�.9�#323`-t,ra',a�:�a�0.9tM8?�'.^fii�i;�:,5•�%h;� .^'r.�nr'-rarl ".+Ky.rs�. ws; �,, � � a!a�ox> �c.'�,sns��y:�v,.ry.�L��i,^w�°}Nt'i�7�:�i�'��`i�'.+ �1i'fr.+e.�''e, b7 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISI¢N 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 / E O. (Rev. 12/96) APPLICATI'ONAND PERMIT - IT T ASSESSORPARC � - C...�,{�j �� ZoG� BUILD{ G PERMIT OWNER °NE SQ. FT. OCC. BUILDING VALUATION OWNER'S MA ADDRE / CONTRACTOR'S NAME TELEPHONE _ CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total V luatlon $ ARCHITECT OR ENGINEER UCENSE NO. ' Filing Fee $ 20.00 Permi4—ee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS � ti Energy Plan Checking Fee $ $ I PERMIT FEE $ LOT NO. SUBDN510N5 NAME PARCEL MAP 1 t PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF Y` Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Udlities ❑ Installation ❑ Other 13 � Describe Work: / 6-Q C_6C�� �Ii+!Z�,QJYL.L Gas piping system 1 - 5 outlets i 15.00 I .ai Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ " J5 - �Q ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2o0A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: 1 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 1 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. ❑ 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 Main Service To 46. CCUOOOA NEW CONST. DWELLNJO occuP. OR W: ( so 3.5QsFTo. cDNS. NON REsON ST. MUALrcou lo. @7.50 PowER APPARATUS 8 SINGLE OUTLET CIR. EX. Occup. OUTLET OR FIXTURES 20 akL 4D I 0 FIXED APPLINS OR Ex. Occup. ounETs RESID. EA 5,00 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 $ Policy Number (The above sections need not be completed 0 the permit is for work of a valuation of one hundred 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 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. X _� ' _ Date Signet cant - 1 Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee I $ Energy Inspection Fee I $ `CcPE J M TOTAL FEE $ 3 r3 . G� HA2. D. E IMP FLOOD CDF �.. PARCEL ..� PD HD UE This permit is hereby issued under of the Butte County Code and/or indiyate' above for which fees have By f PERMIT EXPIRES ON I the applicable provisions Resolutions to do work been paid. Date Is 3/ el/ Date ReceiptNo.gn-4 44/3 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT W COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISI 7 County Center Drive Oroville, California 95965 •Telephone (530) 538-754 (Rev.12/96) + APPLICATION AND PERMIT ASSESSOR PARC �,CJ - �.O^©1 zGN G� BUILDI. GPERMIT OWNER � T ONE a - SO. FT. OCC. BUILDING VALUATION .OWNER'S MAI ADDRE Au CONTRACTORS NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER UCEPSE NO. —Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS "UNG ADDRESS Plan Checking Fee $ BUIL.DINGADDRESS (�% _ -,eV/t�/L.lp. Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SFX Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 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 ❑ Remod I ❑ Utilities ❑ lInstallation ❑ Other ❑ Describe Work: /� ,, ,, C-Q� nn �� 1 C A YL.L I Gas piping system 1 - 5 outlets I 15.00 / SrOD Building sewer 15.00 Mobile Home S G W 920.00 PERMIT FEE $ '3'5,00 ELECTRICAL PERMIT'S. Fling Fee 20.00 Main Service z�D.AORLLE 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages astheir 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 Main Service 46.00so NEW CONST. DWELLING OCCUP. WEE200A NG OCCUR OR ADONS. ( 6 ACC. BLDS. SO 3.5¢FT. NON RES DT • MULTI.OUTLETITS 97,50 PowER APPARATus a SINGLE ourLFT CIR. Ex. Occup. ouTLETOR FD(TURES BAL @':So FIAPPLNS. OR Ex. Occup. ouTLETs RESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirino 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 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, 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.) A 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 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. X_ Date Sign dUe of Applicant - Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating .. Cooling Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ occ�ir� PE v-Ci� TOTAL FEE $ 3:5, 00 HAz. D EEs P FLOOD cDF PARCEL ..� ro HD UE This permit is hereby issued under of the Butte County Code and/or indicate above for which fees have h A4 11 By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. p a� Date O J Date Receipt No. / WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I • —i .s h. .r I.: a 4'''ti2.:r r. O.B.- 1 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. I personally pl provide the major and materials for construction of the proposed ro �t : YES. WNO 13 . .. property '2. 1HAVE6 HAVE NOT 13 signed an application fora building permit for the proposed work. 3. I have contracted with the following person. (firm) to.pmyi0, .tbe proposed construction: NAME: ADDRESS: CITY:- . PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired.the following person to coordinate, supervise, and provide the major work: NAME:. ADDRESS: CITY:- , PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the workbut I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIG D: PROPERTYOWNE SOCIAL SECURITY )��JDATE: NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and • returned to our office before we are permitted to issue the permit. OWNER BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of propeity 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 aro 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 yod Olid to dd�4+ r own'work, with the exception of various trades that you plan to subconulA 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 tridteriaIs 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. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their 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 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. rely, Mic el C. Vi ira, C.B.O. Ma ger, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code OVER