HomeMy WebLinkAbout007-200-0357FLOYDLINVILLE 7-20-35, Chico, Ha rd e
(new siding/SF)�� 3
007-200-035 •06-1288 .
THOMAS, JAMES' ,
g MAYFAIR DR, CHICO' --r- -K
Cont: FOUR SEASONS ROOFING
RE ROOF
35
O cc=3 !
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.
BP061288
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
Issued Date: 05/31/2006 APN: 007-200-035-000
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: e .3z License Number:
Site Address: 8 MAYFAIR. DR CHI
Map Index:
Date: Contractor:
Description: RE -ROOF COMP (TEAR -OFF) 29 SQ.S
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
Business and Professions Code: Any city or county which requires a
Owner: THOMAS JAMES W & ROSE M
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
8 MAYFAIR DR
the Contractor's State License Law (Chapter 9 commencing with Section
CHICO, CA
7000) of Division 3 of the Business and Professions Code) or that he or
95973-0707
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).):
❑ 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
Applicant: FOUR SEASONS ROOFING
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
#11 COMMERCE COURT
sale. If however, the building or improvements are sold within one
SUITE #1 95928
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
530-895-0418
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,
Contractor: FOUR SEASONS ROOFING
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
#11 COMMERCE COURT
❑ 1 am Exempt under Article 3 of the Business and Professions Code
SUITE #1 95928 '
Date: Owner:
530-895-0418
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
License #: 659073
❑ 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.
Architect:
❑ I have and will maintain workers' compensation insurance, as
Engineer:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier T r v oyif 1q_1
Total Square Ft: 0 S. F.
,�i
Policy #: % 7'
�V �2
Valuation: $0.00
ui-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:
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.
Com{
71\/7 -
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the pli able provisions of the Butte County Code and/or
I'hereby affirm that there is a construction lending agency for the
Resolutions to d work indicated abo a for hich fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
�_ :3
Date:
Name:
BY
PERMIT EXPIRES ON:
Address:
Date
El 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 upontheabove mentioned property for inspection purposes.
Print Name:�i��5 /—/ ir'/ �/i/i�G s Signature:
Date:
❑ Owner ❑ Contractor ❑ Agent for Owner Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
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 REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last Name,�,
r4
irst N e
�D .� E
Address 6' ` r
City d
Slate,.:,,
Zip
Phone
Fax
E-mail
APPLICANT INFORMATION
CONTRACTOR
Name
/
Address
o
sic: -
J - d
City C,� Co
r
State
Zip S-" -2
Phone
Fax
E-mailc
y'0 t7
ass
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
Address
Address
I No
City
Type Const.
State
Zip
Phone
+,,F
Fax
E-mail
E-mail
State License Number
APPLICANT INFORMATION
Name
Pro e0 Addr s
//
Address
£
I No
City
�i
Type Const.
teQ
Map Book
Phone
-53o-
+,,F
Planner
Date Approved:
E-mail
APPLICANT SIGNATURE.
X
For office use only:
Zoning Flood Zone
Pro e0 Addr s
//
SRA
I Yes
I No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
KAFORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
0
BP
BIN #
PROJECT LOCATION
AP#
6 01 r . �5
O�CJ
Pro e0 Addr s
//
Cross Street.
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
Page 1 of 2
escription or Scope of Work:
Sq FT- Livng Garage Open Cov
❑ 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 by7p' Amount: /&L5, GU Bldg
SRA
Receipt #: wi % Sheriff
SMIP
Date:
Other
CIO Total
REV 8-12-05
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 AIC for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bidgs: (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. Building Permit Application Without Required Clearances Form
❑ 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.
❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO.
❑
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 8-12-05
May 31 06 09:58a Reception 530-895-9201 P.1
R
ROOFING
11 COMMERCE CT., #1 CHICO, CA 95928
(530) 895-0418 - (530) 895-9201 FAX
FAX TRANSMITTAL COVER SHEET
NUMBER OF PAGES INCLUDING COVER: 1
DATE: 05-31-06
TO: BUTTE COUNTY
ATTN: PLANNING DEPT.
FAX: (530) 538-2140
PHONE: (530) 538-7601
FROM: LISA TAYLOR
MESSAGE:
PER YOUR REQUEST I AM SENDING THIS LETTER AS AUTHORIZATION
FOR OUR EMPLOYEE: GABRIEL BALLEJOS
TO ACT ON OUR BEHALF FOR REROOF PERMIT APPLICATION.
OUR CONTRACTOR LICENSE NUMBER IS: #659073, CLASS C-39
WORKERS' COMPENSATION COVERAGE: AMERICAN HOME ASSURANCE
POLICY NUMBER: 1242444 // EFFECTIVE:' 04-30-06 THROUGH 04-30-07
THANK YOU VERY MUCH. HAV 6R DAY 1 O
1
CLAIMANT:
AMRE
&U"d* Of J13uft
OROVILLE, CALIFORNIA
GENERAL CLAIM
ADDRESS: 1260 San Luis Obispo Ave.
CITY & STATE: Hayward, CA 94544 IMPORTANT:
Aug ust 19, 1987 SEE INSTRUCTIONS
DATE OF CLAIM: ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
4
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
SUB. OBJ.
AMOUNT
INV. NO.
Owner has decided not to do work. .(Bldg Permit Appin. #2652-87B,
Receipt #89736, dated 8/10/87, A.P. #7=20-35). Owner: Floyd Linville./
ENCUMB. GROSS AMT.
Total building permit fees paid ---------------=-$78.50
Retain filing fee------------------------------- 10.00
Refund due ----------------------------------------------- $68.50
$68.50
TOTAL
$68.50
I, the undersigned, declare under penalty of perjury that the services or articles claimed hav�ben performed or delle red, and that this
Xclaim le true and correct as stated./ecTT�/ptyT1 1Dated this ......`./............... day o[ �l.��d.I..19et(.!!!�J/..Y.�%�•'.1Cali(......................
Signature of Claimant
I, the undersigned, hereby certify that, to the beat of my knowledge, the services or articles specified above have be performed or de-
livered and that there Is a Budget Appropriation❑ or Specific Board
//��Approval
•t❑ (Check one) for th me.
Dated this ..............27th.......... day of .....August....... 19..87 at ...Omo.Ka.l.7..e..... . Calif. ......... . ..... ./........ ........
................... ...............
partment Head or Authorized Dep
Dept. Code 0. nn PAYABLE FROM CO St . Permits
Code ........44�-I��2............... 4.2� ^.S.^.^...................................................................... F UND
............................
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
DEPT. 8 SUB.
PROJ.
SUB. OBJ.
CLAIM NO.
INV. NO.
INV. DATE
ENCUMB. GROSS AMT.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
f7— o2o.—
ZONING
BUILDING PERMIT
0 E
`a
TELEPHONE
-,pig
SQ, FT. OCC, BUIL-DING VALUATI N
O�N1,E ILIN D SS
�[jJ( 1
CONTRACT R ME
TELEPHONE
,CONTRACTOR*S MAI ING ADD SS
O
Fireplace
CONSTRUCTION LENDER UN NOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ �Q
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 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF * Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home I S I G JW I
10-00ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ®
Describe work: /_
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declar 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)
❑ 1, 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.A!
OR ADDNS. \ ACC. SLOGS.
, /20sgft
NEW CONSTF ULTI.OUTLET 2.50 ea NON.RESID BRANCH CIRC ITS
POWER APPARATUS &)
SINGLE OUTLET CIR.
Ex. Occu 20®30e
Occup(OUTLETS OR FIXTURES aALO 30
Ex. Occup. OUTLETS FIXED PRESID )REA.1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I de ar under penalty of perjury (check one):
14 T e permit is for $100.00 (valuation) or less.
c 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
Filing Fee 10.00
Heating
Cooling
Hood
3.00
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 County of
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
agai id County in copse. u e of the granting of this permi .
X 4 Date
Signature Of Applicant — caner ❑ Contractor ❑ Agent ff
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
$
Energy Inspection Fee $
TOTAL PERMIT FEE $
occuP.
CONST.TYPE
I
IFLOODIPARCrL.1
P11
I ND
1330
This permit is hereby issued under
sions of the Butte County. Code and/or
work indicated above r which
v DIRECTO O UBLIC
/p
e
vAir
PERMIT EXPIR Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
/Data g l() 47
Receipt No.e
WHITE-D.P.W., YELLOW-ASSE330R. PINK -INSPECTOR. GOLDENROD -APPLICANT
M