HomeMy WebLinkAbout007-260-083COMPLAINT TO INSPECTOR
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`007-260-083 "PERMIT#96-2047,.`
VOWELL, Beverly "� VOWELL, D. 211-69B
3484 Hackamore Ln: � Chico , _ 206-69E;,k n
Cont:' RMS Builder S �9 (� -� _ �6 _g3 190-6 F. '
Reroof/SF 10I
a ;s/e corner Eaton Rd. & Hackamore Lane, Cha,
007-260-0.83 �� '- CONTR: Gene Camp, Rt. 1, Box 548, Durham i
SOUSA, LESLIE _ �L r (riew single family)
3484'HACKAMORE LN, CHI +:
Cont: N/A r
RMV INT WALL RPLC W/ BEAM
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Butte County Department ofDevelopment Services
www.buttecounty.neUdds
7 County Center Drive
Oroville, CA 95965
(530) 538.7601 Telephone
(530) 538-7785 Facsimile
ADMINISTRATION * BUILDING * GIS * PLANNING
September 22, 2005
Regarding: Building Permit # 04-1702
A.P. # 007-260-083
3484 Hackamore Lane
Chico, CA
To Whom It May Concern:
On 7/19/05 the under floor pier footings for the above mentioned building permit were
inspected and signed off by Butte County Building Inspector, Rick Trent. Several of
these piers were in a crawl space under the floor, and were difficult to see or inspect. The
piers that were accessible were inspected and found to be of proper size and depth, and
apparently all 4 piers were then signed off.
At the owner's request, another inspection was conducted in August, again by Rick Trent.
After crawling under the structure, the owners had discovered that 2 of the 4 piers had not
been poured in the proper locations. At the time of this second inspection, it was
determined that all piers appeared to be of the correct size. However, the pier which was
shown on the approved plans under the end of the dining room wall, and appeared to be
located approximately 20" to 24" beyond this wall, and not directly under the 4 x 4 post
which supports the end of the structural laminated beam in the attic.
Sincerely,
Scott Rutherford
Chief Building Inspector
Butte County Building Division
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.netldds
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
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Date: Contractor.
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
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 State 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).):
❑ 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
such 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 improvements are sold within one
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
sale.).
txI, 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
pursuant to the Contractors' State License Law.).
❑ I am Exempt under Article 3 of the Business and Professions Code
Date:i __ZOwner:
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 workers' compensation insurance, as
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:
Policy
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 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.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec 3097 Civ.)
Address:
PERMIT NO.
BP041702
Issued Date: 06/14/2004 APN: 007-260-083-000
Site Address: 3484 HACKAMORE LN CHI
Map Index:
Description: RMV INTERIOR BEARING WALL RPLC
W/BEAM
Owner: SOUSA LESLIE H
3484 HACKAMORE LN
- CHICO, CA
4 95973-8728
5
Applicant: SOUSA LESLIE H
3484 HACKAMORE LN
CHICO, CA
95973-8728
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1
Contractor:
License #:
Architect:
Engineer:
1
E
(
Total'Square Ft: 0 S. F.
Valuation: $0.00
Census Code:
l 1
_b
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37 5 $ I q . �t !o tl 14'164-
hereby
4'16 --hereby issued under the applicable provisions of the Butte Co
:o_do uorlyindicated pWve for which fees have been paid.
PERMIT EXPIRES ON:
❑ 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 the above mentioned property for inspection purpo". e --N
Print Name: H,*W[WGL V . UO&Ca_ Signature
Date
13 Owner
❑ Contractor
❑ Agent for Owner
❑ Agent for Contractor
r' 1
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)536-2140
WEBSITE: www.buttecounty.netWds
PERMIT NO.
BP041702
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: 06/14/2004 APN: 007-260-083-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Site Address: 3484 HACKAMORE LN CHI
Date: Contractor:
Map Index:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Description: RMV INTERIOR BEARING WALL RPLC
Contractors' State License Law for the following reason (Sec. 7031.5
W/BEAM
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: SOUSA LESLIE H
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
3484 HACKAMORE LN
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
95973-8728
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
owner of property who builds or improves thereon, and who does
Applicant: SOUSA LESLIE H
such work himself or herself or through his or her own employees,
3484 HACKAMORE LN
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
CHICO CA
year of completion, the owner -builder will have the burden of
95973-8728
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 Exempt under Article 3 of the Business and Professions Code
Date:Owner:
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
License #:
❑ 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
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.
Policy#:
Valuation: $0.00
1 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
Census Code:
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: O
Applicant:
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
�t 3 7 S t q l
40 C-=,
code, interest, and attorney's fees..
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County CodR and/or
I hereby affirm that there is a construction lending agency for the
Resolutio sMooindicated tr6ve for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
BY Date: r
PERMIT EXPIRES ON: ttwJ
Address:
Date
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purpos
Print Name: Q sZ. Qa$a.. Signature:
Date:4��" /
❑ Owner ❑ Contractor ❑ Agent for Crooner 0 Agent for Contractor
,.rte - '-4
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVMLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
APPLICANT NAME
OWNER
Name
City
Address
Zip
City
State
Zip
Phone
Phone
E-mail
Fax
APPLICANT NAME
CONTRACTOR
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Page
Fax
E-mail
Date Approved:
Lic. #
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Page
Fax
E-mail
Date Approved:
State License Number
APPLICANT NAME
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
X
6�1� I _%-C�
Ll
For office use nl :
Zoning
Flood Zone
SRA
I Yes No
Occ.
I Type oust.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
BPo4. i7oz.
BIN #
LOCATION
AP#
oa . � �o • 083
Property Address
4-
• r<�I0 j2c LN
11 Cf4-
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
Description or Scope of Work:
RMV INT S e-.Aca/ 4 G Wim_ R P t_,C- W
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 by: x614' Amount: a �R � � Bldg
SRA
Receipt #: A,0&3 75 Sheriff
SMIP
ok'
I
Date: 4,114104 -Other
'- JI
19.1 � TotalI
or
SUBMITTAL REQUIREMENTS ~
The following drawings and specifications must be submitted to the Building Division in order to apply
fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE
LEGIBLE AND WINK.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER!
❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets -of staiiped and,signed
calculations.
❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 5. Letter from Engineer or Architect for truss design review.
❑ 6. 2 Energy compliance design and supporting documentation' . (Noti: Not required for addition':s to
mobile or modular homes.)
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 8. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 9. Sanitation and site plan approval from the Environmental Health Department. ' ,�, %r: '-I%-
❑ 10. Metal Buildings: (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.
Mobile, Manufactured, or Modular Homes:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line information.
❑ 4. 2 Floor plans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.
❑ 6. Sanitation and site plan approval from the Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑
1.
4 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑
2..
4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑
3.
2 Engineered truss details and layouts (if required) (NO FAXES!).
❑
4.
Letter from Engineer or Architect for truss design review.
❑
5.
2 Energy compliance design and supporting documentation (if required).
❑
6.
2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑
7.
Statement of Intent for Non -heated and A/C (if required).
❑
8.
Metal Buildings: (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.
❑
9.
Letter of intent.
❑
10.
Hazardous Material Forma _ _ •, , 1 .; , ,
❑
11.
Sanitation and site plan approval from the Environmental Health Department. �
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSSUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04
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007=260-083PERMIT#96-2047
VOWELL, Beverly*
3484 Ha&amore Ln., Chico
Cont -',RMS Builders-
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COUNTY OF BUTTE -DEPARTMENT OF4DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT 9�� ' ���
ASSESSOR PARCEL NUMBER
007-260-083
ZONING
ASR
--BUILDING PERMIT
WEVERj,Y VOWELL
T343—E7613
SO. FT. OCC. BUILDING VALUATION
SQ COMP
( 00
OWNERS MAILING ADDRESS40
3484 HACRAMORE LN CHSCO
SHEM G VAL 1 J=
CONTRACTOR'S NAME
RMS BUMDERS
TELEPHONE
899-9312
CONTRACTORS MAILING ADDRESS
PO BOX 7846. CHICO 95927
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $ 3,400
Filing Fee
$ 20.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 63.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty
$
BUILDINGADDRESS 3484 HACKAMORE LN
PERMITFEE
$ 83.00
PLUMBINGPERMIT
Filing Fee 20.00
Each Trap
7.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Solar or heat pump water heater
23.00
Water piping
15.00
USEOFSTRUCTURE
SFpEI Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Ublities ❑ Installation ❑ Other ❑
Describe Work: FMOOF 40 SQ w/SHEMNG VAL 1,000
—
Mobile Home S G W
@20.00
PERMITFEE
t
Contractor
ELECTRICAL PERMIT
Filina Fee 20.00
Main Service 0000. v OR Ess
( 200OR ESS )
23.00
Main Service ( 20000A TO I0000A )
46.00
LICENSED CONTRACTOR'S DECLARATION
1 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 f II force and effect. C
License Class Lic. No. �i>'�VS
OWNER -BUILDER DECLARATION
1 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 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
NEW CONST. DWELLING OCCUP.
OR ( a ACC. BLDS. )
SO.
T.
NEW CCNS.
ONST. MULTI.OUTLET
NON-RESID. ( BRANCH CIRCUITS )
@7. 0
@7.50
WER
( a STING E OUTLETT CSR. )
Ex. Occup. ( OUTLET OR FIXTURES)
B20 @ 1.000
Ex. Occup. ( OUFIXED APPLNS. TLETS (RESD.)EA)
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
_
Contractor
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.
❑ 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
MECHANICAL PERMIT
Filing Fee 20.00
g
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) .or IeSS.)
VIN 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'comly with those provisions.
I C lj 7 ( q
X r \\ F— � V� r > Date �S " J
Signature of A p ant - ❑ OwnerContractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ 83. OC
HA2:
D. FEES
IMP FLOOD
CDF PARCEL PD HD
ISSUE
This permit is hereby issued under the
of the Butte County Code and/or
indicated above for which fees have
By 7�-�.� .y1
i �
PERMITEXPIRESON 7 "
I
applicable provisions
Resolutions to do work
been paid.
Date 5 ft0
z
(Date)
Receipt No. zubU1
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE- DEPARTMENT OF DEVEI OPMENT SERVICES - BUILDINGDI ION
7 .County Center Drive - Oroville, California 95965 - Telephone (916) 538- 41 PERMIT NO.
APPLICATION AND PERMIT !2("" --
ASSESSOR PARCEL NUMBER
007-260-083
ZONING
ASR
UILDING PERMIT
OWNER
BEVERLY VOWELL
TELEPHONE
343-7613
SO. FT. OCC. BUILDING VALUATION
40 SQ COME 2,400
OWNERS MAILING ADDRESS
3484 HACKAMORE LN CHICO
T
CONTRACTOR'S NAME
RMS BUILDERS
TELEPHONE
899-9312
CONTRACTORS MAILING ADDRESS
PO BOX 7846, CHICO 95927
Fireplace
CONSTRUCTION LENDER
UNIwOWN
Total Valuation $ 3,400
Fling Fee $ 20.00
LENDER'S MAIUNG ADDRESS
Permit Fee $ 63.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT Off ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS 3484 HACKAMORE LN
PERMITFEE $ 83.00
PLUMBING PERMIT Filing Fee 20.00
Each Trap 7.00
LOT NO.
SUBDNISIONS NAME
PARCEL MAP
Solar or heat pump water heater 23.00
Water piping 15.00
USEOFSTRUCTURE
SFxD Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each gas water heater or vent 15.00
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe work: REROOF 40 SQ W/SHEETING VAL 1,000
Mobile Home I S I G W 1 @20.00
PERMITFEE s
Contractor
ELECTRICAL PERMIT Filino Fee 20:00
Main Service e00V OR LESS
( 20oA OR LESS ) 23.00
Main Service ( 200A TO l000A ) 46.00
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 II force and effect.
j ��
License Class Lic. No. URS 60S
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 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
NEW CONST. DWELLING OCCUP. SO.
OR ACDNS. ( 8 ACC. BUDS. ) 3.5¢ FT.
NEW CONST. MULTI.OUTLET
NON-RESID. ( BRANCH CIRCUITS ) @7.50
POWER APPARATUS
( & SINGLE OUTLET CIR. )
Ex. Occup. (OUTLET OR FIXTURES) 2e ®I•�
BAL SO
Ex. Occup. ( APPLNS. OR (RESID.) EA) 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMITFEE s
Contractor
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
MECHANICAL PERMIT Filing Fee 20.00
9
Heating
Cooling
Hood 6.50
Ventilation
PERMITFEE $
Contractor
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.)
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
worke ompensation provisions of section 3700 of the Labor Code, I shall
fort it com ly with those provisions.
X &A��JJ��S q�r_
- Date _q -`S " 1 `�'
Sign a of A ant - ❑ Owner j Contractor ❑ Agent
An OSHA permit is required for excavaPo(ns over 5'0" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee Is
Energy Inspection Fee Is
OCC
CONST. TYPE
TOTAL FEE $ 83.0
HA2.
I D. FEES
I IMP
I FLOOD
I CDF
PARCEL
PO HD
I ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
p
B �� G '` Date '��
y
PERMITEXPIRESON 9——�? 3L—
(Date)
ReceiptNo. 206121
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
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BUTTE COUNTY
burr , DEPARTMENT OF DEVELOPMENT SERVICES
O O BUILDING PERMIT
° _ O 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
o -_ .Ir. `o OFFICE #: (530) 538-7531 FAX#: (530)538-2140
\ - J WEBSITE: www.buttecounty.netldds
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
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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
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 State 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).):
0
❑ 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
such 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 improvements are sold within one
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
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
pursuant to the Contractors' State License Law.).
❑ 1a_m_ E'xeemppt under Article 3 of/the
'Buusiness and Professions Code
/
Date: � Owner: a�1 I• Sa•-V,�
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.
❑ 1 have and will maintain workers' compensation insurance, as
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:
Policy
(� 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 provisions.
Date: —/,/— 0
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.
Issued Date: 06/14/2004
JPERMIT NO.
BP04'1702
APN: 007-260-083_1000
Site Address: 3484 HACKAMORE LN CHI
Map Index:
Prescription: RMV INTERIOR BEARING WALL RPLC -
•W/BEAM
Owner: SOUSA LESLIE H '
3484 HACKAMORE LN r
CHICO, CA
95973-8728
r
Applicant: SOUSA LESLIE H
3484 HACKAMORE LN
i CHICO, CA
95973-8728
Contractor:
t
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i
License #:
Architect:
Engineer:
Total Square Ft:
Valuation:
Census Code:
r
40� 37 5
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Jul 26 05 11:03a ANGELA J. SOUSA (530)893-4995 p.1
3884 HACKAMORE LH CHW. CA. 35973 a s a e b
(5W)89349% PrVW
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Fmc Page=
Phonec - y�, Date:
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1�t9�n� Cl Ear Review o Please Comment 014� Reply o Please Recycle
COMMENTS:
Jul 26 05 11:03a ANGELA J.; SOUSA
(530)893-4995 p.2
LESLIE &i. ANGELA SOUSA
.....................................................................................................................................................................................................................................
3484 Hackamore Ln.
Chico, Ca.
95973
phoneifax 530-893-4995
Aaasafetyandair@aol.cor ;
July 25, 2005
Butte County Department of Development Services:
To: Scott Rutherford,
Mr. Rutherford I came in to see you again on May 12,2005 and brought the plans as you
requested. At that time you told me you would write a tetter saying your inspector Rick who had signed
off on PERkli7• No .10041702 ON 7119/04 for our Piers %vhick contractor ' . had told
him all four piers had been poured. Ne had taken the contractors word because he could see the 2 in the
front doorway but the other two were in a crawl space of 3 ft and 25 ft under the house. When Rick came
over the secottd time be said" 1 Singed those off I can't believe I did". The cuntraclor had only done two of
the four piers. Please fax the letter to me so we can get his lean otTour house. I'm sorry this has been a
problem I promised my husband I would not do any more work on the house. Please call inhere is a
problem and 1 will come back and see you again. I really, appreciate what you are doing for us Thank you.
Sincerely,
-Angela J. Sousa
L -z .
i
Aug 22 05 01:25p ANGELA J. SOUSA
f
(530)893-4995 p.2
LESLIE & ANGELA SOUSA
............................................................................................................................................................................................................................................
3484 Hackamore Ln.
Chico, Ca
95973
phone/fax 530-893-4995
Aaasafetyandair@aol.con
July 25, 2005
Butte County Department of Development Services:
To: Scott Rutherford,
Mr. Rutherford I came in to see you again on May 12,2005 and brought the plans as you
requested. At that time you told me you would write a letter saying your inspector Rick who had signed
off on PERMIT NO. 13P041702 ON 7/19/04 for our Piers which contractor WiI Iiam B. Lo_,sdon. had told
him all four piers had been poured. He had taken the contractors wordbecause he could see the 2 in the
front doorway but the other two were in a crawl space of 3 ft and 25 ft under the house. When Rick came
over the second time he said " I singed those off 1 can't believe I did". The contractor had only done two of
the four piers. Please fax the letter to me so we can get his lean off our house. I'm sorry this has been a
problem I promised my husband I would not do any more work on the house. Please call if there is a
problem and I will comeback and see you again. I really appreciate what you are doing for us Thank you.
Sincerely,
nAngela J. Sousa
(� j
H
0
0
0
0
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: w1w/w.buttecounty.neAdds
PERMIT NO.
BP041702
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penally of perjury that I am '':3nst der
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 06/14/2004 APN- 007-260-083-000
the Business and Professions Code, and my license is in full force and
effect.
License Class : License Number:
Site Address: 3484 HACKAMORE LN CHI
Date: Contractor:
Map Index:
OWNER -BUILDER DECLARATION
Description: RMV INTERIOR BEARING WALL RPLC
I hereby affirm under penalty of perjury that I am exempt from the.
Contractors' State License Law for the following reason, (Sec. 7031.5
W/BEAM
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: SOUSA LESLIE H
signed statement that he or she is licensed pursuant to the provisions of
3484 HACKAMORE LN
the Contractor's State License Law (Chapter s 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
95973-8728
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
owner of property who builds or improves thereon, and who does
Applicant•• SOUSA LESLIE H
such work himself or herself or through his or. her own employees,
3484 HACKAMORE LN
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
95973-8728
t proving that he or she did not build or improve for the purpose of
sale.).
j 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
i
not apply to an owner of property who builds or improves thereon,
f
and who contracts for such projects with a contractor(s) licensed
Contractor:
{ pursuant to the Contractors' State License Law.).
❑ 1 am Exempt under Article 3 of the Business and Professions Code
Date:f.� Owner. c) dLsoata�
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.
Architect:
❑ 1 have and will maintain workers' compensation insurance, as
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.
Policy#:
Valuation: $0.00
' 1 certify that in the performance of the work for wNch this permit is
ffi
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'
f compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
i 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
4o�375 14 -104 -
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code a..nrUar
indicated ve for which fees have been paid.
I hereby affirm that there is a construction lending agency for the
Civ.)
Resolutio s to 0 o
performance of the work for which this permit is issued (Sec 3097
By: Date:
Name:
��
i
PERMIT EXPIRES ON:
Address:�(Date)
❑ 1 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 representativ-ess/ of Butte enter upon the above mentioned property for inspection pufpos .
-County (to
Print Name:. V IJ OD C u.
Signature:
Date: 9 -4
❑ Owner ❑ Contractor
❑ Agent for Owner ❑ Agent for Contractor
' PERMITS BECOME NULL AND VOID 11 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
F
I
{
Butte County Department of Development Services Inspection Card
o®VptF0 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
0 o OFFICE #: (530) 538-7541 FAX #: (530)538-2140
0 0
o e
°�,- a Visit our website at: www. buttecounty.neVdds
Inspection Type Insp. Date
Ground work
Setbacks
Foundation/Footings
Piers
Grade Beams '
Eufer Ground
Hold downs
Stemwalls
Do Not Pour Concrete Until Above Sioned
Slab -
Slab -Garage
Gas Test Yard Pipe
Blocks CMU/Logs
1 Lift
2" Lift
3m Lift
Final Lift
Under Floor/Slab
Framing
Shear Transfer
Plumbing
Mechanical
Gas Piping
Do Not Install Floor Sheathing or Slab
Until Above Sioned
ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING
Inspection Type Insp. Date
Framing
Rou h Framing
Rough Plumbing
Rough Mechanical
Rough Electrical
Rough Gas
Roof Sheathing
Straps
Shear Transfer
Shower Pan
Rough Sprinkler
Do Not Insulate Until Above Sinned
Insulation
Wall Insulation
Ceiling Insulation
Do Not Cover Until Above Si ned
Shear
Interior Shear
Exterior Shear
Braced Wall
Wall Covering
T -Bar Ceiling/RC
Sheet Rock -15 layer
Sheet Rock -2nd layer
Separation/Location °
Framing/Openings
Gas Test House Pipe
Stucco
Lath
Scratch + Brown
Finish
Inspection Type
Insp. Date
Final
Plumbing Final
Mechanical Final
Electrical Final
Insulation Certificate
Final Sprinkler
Swimming Pool
Setbacks
Pool Steel/Pre-Gunite
Electrical Bonding
Enclosures & Alarms
Plumbing .
Electrical
Gas Test
Light Nitch
Other Agencies
Insp. Date
Public Works
Sewer
S ec Ins ection
Fire Department
Underground
Final Sprinkler
Fire Final
Temp Elect Auth
Elect Authorization
/Ggs Authorization
Permit Finaled
ri ti. it eS
���► ' / �jh'v
1
MOTES Insp. Date
PERMITS BECOME NULL. AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OF STATE LAWS L
I
F
` B. C. Insp. Card 02-17-04 pg 2
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