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Home My WebLink About007-380-021�rseman Dup x I V. Lot #21, lindo Gardens #6, Chico Permit #2861-79B(new duplex) Contr : Gore &/W' ite, Chico F P rmit #4400-79P(plbg/2861-79)dup t i contr: Park Sheet Metal, Chico Permit Y4951-79M(mech.for #2861-79) Contr: Fox Electric Permit #5353-79E(ele/2861-79) 01 007-380-021 06-0222 SHEDD TRUST, MARY E 819 NETTERS CIRCLE, CHICO Cont: FOUR COUNTIES ROOFNG REROOF W/COMP (40) I f y �` F cn ` t 2861-79A= PERMIT NO. PERMIT EXPIRES Morseman Duplex Investors OWNER CONTR. owner LOCATION (A.P. 44-37-12 port_ ) ) Lot #21, Lindo Gardens #6, Chico. 4 s� t it ; tl Temp. Power Pole ' Called PG&E _ Temp. EleZServ. Cal bePG& E tTem/Gas Serv. Called PG&E t O FINALED (Date) (Sig lure t Stucco COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS ° BUILDING INSPECTION RECORD Subpanels BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms ' Parapets 1st Floor Main Bldg. f, Restroom Finish 2nd Floor Footings , Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing / Water Pi in Piers Roofing Sewer Garage Fdn. Vents Fixtures l� Footings' Stemwall Garage Vents l/ Insulation Water Htr. Z� Heaters Slab Carport ` Footings Prov. for ph sically handica ed Conformance of ex. structure Appliances Gas PI in & Test J) Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing _ E ECTR AL Masonry Walls Throat Y 7 Rou h Relnf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Stucco Final V \ Subpanels Mesh Z / 2 1 96W MECHANI Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Under round ------ Interior Lath Ventilation Permanent Door Closer 12 Final Final MOBILEHOME UTILITIES ----------=------- Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping OB16EHOME INSTALLATION ............... Support Elec. Continuity Water Piping Drainage Gas Piping DATE ` REMARKS OR CORRECTIONS ``,,� �� 4; 4S/V (NOTE: An entry must be made on this form each time you visit the job site.) ti►1 I RES IDliN'1 I'AL ENERGY CONSLRVATION STANDARDS CONSTRUCTION COM01JANCE CER'i'l.FICATL THIS IS TO CERTITY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IV CQNFORMANCE IJITH CU RRLN" ENERGY CONSERVATION REGULATIONS (location) BUILD INC PERMIT NO.,Z%� j 7�-/3 A.P. NO. L — 3 THE F,OLLOWINC HAVE BEEN INSTALLED AS PER APPROVED PLANS: Wleck each item or write N/A if not applicable) INSULATION: GLAZING: Slab Edge. Single Glazed Fdn. Walls� Special (Insulated Floors CEtft. & LAUELEU WDS. Walls - & SLIDING DRS, Ceiling/Ro 'f fz _ WEATHL•'RSTRIPPED DRS. Ducts ?. BACK DAPfPL•'RED FANS Circulating,Pipesp�_ 1NIERMI'1`l'1;NT IGNITION DL''V CES APPROVED HEATER �ER'1. ADPL. ANCES APPROVED W`fR.IITR. •r I DECLARE TfMT•ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN A,CCOLWANCE'WITIL THE EURGY. CONSERVATION REQUI1MUNTS AND AG4, -'E THE CORPL L"XENESS - OfI TIIIIS .CLWr1C ICATE AS SUUMITTED & Insulation Appl:tcator Name' ,.Signature (please print) of i Tilsulation Appl).cator -� = State Contraepors _ , i�J i License No,]n _31? , General Contractor/Owner • J'Ls '/'� ��'' -1" "2-c•T _ ' (pl as Yet) Signature of General Contra .Kor/Owner Date re Contractors nse No. 'THIS CERT ITICAT.E MUST BE ' ON FILE WITH THE BU 1LD ING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION. AND SNAIL. BE POSTCA IN• A CONSPICUOUS LO•CAxION WITHIN Ta WELLING. 3 3 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 _•• ; Telephone: 534-4541 APPLICATION AND PERMIT( c BUILDING Owner'Nw 14,4 � � SQ. FT. BUILDING VA ON i Mailing Address 1 - oC',Telephone k,2 No. -3 3 - Contractor Mai l i ng Address Fireplace O O v Total Valuation S Z Telephone No. Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee 7 PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each TraD 1.50 ii (-1'43 voG#CAICIC Repair drainage or vent piping 1.50 A. P. No. f Zoning Pg 1.50?a piping Eachgas water heater or vent 1.50 C. SaqMn Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Parcel Plans Declaration arceI Ma 60' /W 1 Improv ents Each additional outlet .30 sewer 5.00 5Building B'11 9A PIan�R c'd Parcel rovol Plans rApproval Lawn sprinkler system 2.00 NEW 10 ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ MA6TV-9- PL" ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 00V OR LE Main service 100 AMP ORSLESS 5.00 Single Family ❑ Duplex Mobil Home ❑ Others ❑ Main service EA. ADD•L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service/ EA. ADD•L 100 AMP 1.00 NEW CONS.OR ADDNST ( ACCLBLDGS.CUP. S) 22sgft CONTRACTORS LICENSE LAW 1 am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under'the name style of: NEW RES,.,CONSTULTC.0UTL T NON-RESID `BRANCH CIRCUITS) 12.50ea NEW CONSTR. (POWER APPARATUS 9 NON-RESID. ,SINGLE OUTLET CIR. Ex. Occup{OUTLETS OR FIXTURES B L@; FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Lic se No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of ;W kmen's Compensation Insurance. 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 Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation " Hood 1 1 2.00 Permit Fee $ $ 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 Land Development Fee $ TOTAL PERMIT FEE $ dutnorlZreseniFiilVes OT ine GOUniy 01 tiU[ie i0 enter upon ine abov entio ed property for inspec io urposes. C a 2/Z/ . X Date B ^/6 /0 gnature of Pe. ee ent Receipt No. �-3 96 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code andl'or resolutions to do work indicated above for which fees have been paid. DIRECTOR PUBLIC WORKS By � Date 7 (/ng2But permit expires Date �. .a NOT? --All Materials & . Worlmyins6iip Shrill Bet. iin Accordance withRec oclni-ed_�.Grn^ prra^tices � Of a qualifgi prescribed -For �e Saecified use ha Uniform Building, Plumbing & Machanical Cods aW the National Electrical Code. i nis set of plans and specifications MUST be .<ept on the job at all times and it is unlawful Jo make any changes or alterations on same without written permisson from the Department of Public Works, County of Butte. 1 I ' Sep i system and location of ,ng l rain stub -out build_ . But' County Health De t. Per qui ents. pt. RL, TheBldg. Setback shall be 5 1.) from the side property line and SO fl. imm the centerline of the road, permiH i a maxi- mum of a 2 ft. eave overhangt entirely ovt of all easements. BUTTE. COUNTY ILDING DEPARTMENT AD PROVED See Master Plan on plans. file for building �J J } COUNTY OF BUTTE — DlEPARTMENT OF PUBLIC WORKS 1 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes.}(� X Dat " — Signature of Per�miteeee or Agent Receipt No.=G White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant 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. ^ DIRECTOR OF PUBLIC WORKS 1J By ` Date -7— tn Building per )expires Date =� BUILDING Owner l ✓i SQ. FT. OCC. BUILDING VALUATION Mailing Address , No. Contractor Mailing Address Sb-- v Fireplace Total Valuation Gf�O Telephone No. Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee PLUMBING No. @ FEE PERMIT FILING FEE $3.00 r dD Each Trap 1.50 Qj� t,OUOZ) amu$ 6p GpT o� Repair drainage or vent piping 1.50 A. P. No. 7�!r Z Zoning 8 Planning Water piping 1.50 ,O?i Each gas water heater or vent 1.50 , rV '3enrtetron FireDept. FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg. Plans Rec'd Parcel Approval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ff Permit Fee $ 6 — $361 _... (p /-7 ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5•00 Single Family ❑ Duplexx' Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main Service/ EA. ADD'L 100 AMP 1.00 OR A.D.S. ACCNEW CONST.LBLDGS.CCUP. B) 20sgft C CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business &Professions Code under the name Style Of: � ^�� o NEW CONSTR (MULTI.OUTL T ID (MULTI CIRCUITS) 2.50ea NEW NEW CONSTR. /POWER APPARATUS 8 CO NON-RESID. \SINGLE OUTLET CIR. Ex. Occuo(OUTLETS OR FIXTI RES g L 1� 0¢ FIXED APPLNS. OR EX. DCCUp.(OUT LETS (RESID.) EA) 2•00 Temporary service 10.00 Mobile Home Facilities 15.00 -7 /' License No. / 2 Classification ��W Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code w 'ch requires every employer to be insured against liability for W men's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑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 Workmen's Compensation Laws of California. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 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 Land Development Fee $ TOTAL PERMIT FEE $ 3 . authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes.}(� X Dat " — Signature of Per�miteeee or Agent Receipt No.=G White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant 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. ^ DIRECTOR OF PUBLIC WORKS 1J By ` Date -7— tn Building per )expires Date =� COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS ., 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X at*-,h�4.±:h Date 1 Signature of Permmitee or A ent Receipt No. Zgzo White-D.P.W. - Yellow -Assessor -!Pink-Inspector - Goldenrod -Applicant 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. DIRECTOR OF PUBLIC WORKS By WDate Ell ' 7 Building permit expires Date BUILDING 411 Owner 4102S&M,ft) bi) PLC -X /N V• SQ. FT. OCC. BUILDING VALUAT Mailing Address Telephone No. Contractor��e� s �1 % (, Mailing Address )P-d.�0X 3/�% Fireplace Total Valuation Gll/Gp � 19W2_7,02-416- Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 / 21 L4 �CO G 6 4 Repair drainage or vent piping 1.50 A. P. No. 441-37 — / Z(Pval) Zoning &Planning Water piping 1.50 Each gas water heater or vent 1.50 F s Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 Parking EQA Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg.14mffT'R -ec-c'- Parcel AEproyal Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ / 2 BP:' ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 00V OR L Main service 100 AMP ORSLESS 5.00 Single Family 0 Duplex 2 --,Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD•L 100 AMP 1.00 NEW CONST OR ADONS. ACCLLING BLOGS.CCUP. 1)2¢sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: p� G 1 PARK SUFE? Hl-(,. L T NEW CO ID ` BRANCH CIRCUITS) 12.50ea NEW RESID, I BRANIMULTCH NEW CONSTR. POWER APPARATUS 6 RESID. (POWER NON- ( OUTLET CIR. Ex. Occup(OUTLETS OR FIXTIIRES 5 L� Ex. Occup ( FIXED APP LNS. OR OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 G0 License No. 1331 AClassification N7 5L30 Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability Wfor orkmen's Compensation. LJ have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 3.00 Heating /t' &40 /Vf 9_J Cooling 7T_ 7111,- T Ventilation Hood 2.00 Permit Fee $ _Z -344V $ °Z3 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 Land Development Fee $ TOTAL PERMIT FEE $ Z3 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X at*-,h�4.±:h Date 1 Signature of Permmitee or A ent Receipt No. Zgzo White-D.P.W. - Yellow -Assessor -!Pink-Inspector - Goldenrod -Applicant 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. DIRECTOR OF PUBLIC WORKS By WDate Ell ' 7 Building permit expires Date Owner MO2-5GMA-0 Mailing Address Contractor COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT BUILDING LI P L -E4 I 0 v E5-V0(ZS SQ. FT. OCC. BUILDING VALUATIO 0C I Mailing Address 3,715- ou ve I+wY• OZOV 1 L LI Building Address -f- 2i C-6 l� E--, rI-2 S A. P. moo. 44-3-7 - I2 (eve -F 6S 1 *C. I &wAe4efl-J FireDept.1 Fire Zone P k'n P 1 elephone No. Fireplace Total Valuation FeFe o. %3� Permit Fee �� Plan Checking Fee&/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap if JA I L0 Repair drainage or vent piping Water piping Zoning & Planning Each gas water heater or vent Use Permit Gas piping system 1 - 5 outlets EQA I ar I g I arce parcel Ma 60' R/W I improvementsEach additional outlet Plans Declaration P NEW ❑ ADDITION Parcel UTILITIES ❑ u( Ing sewer Plans Approval Lawn sprinkler system OTHER Single Family ❑ Duplex Mobil Home ❑ Others ❑ CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: � License No. 3 ®S3l �- Classification r—t O ❑ I am exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. [3rI have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. r -1I 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 Workmen's Compensation Laws of California. 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- ed property for inspection purposes. X Date Signature of erml ee gent Receipt No.�� White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant Permit Fee ELECTRICAL PERMIT FILING FEE 600V OR LESS Main service 100 AMP OR Less Main service EA. ADD'L 100 AMP Main service OVER 600V 100 AMP OR LESS Main service EA. ADD'L 100 AMP NEW CONST. ( DWELLING 56 j; Pr¢9 $3.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 $3.00 5.00 2.50 25.00 1.00 ?2 so ft FEE FEE ,00 Ex. OCCUD(OUTLETS OR FIXTIIRES) B L @ALI EX. OCCU FIXED APPLNS. OR P• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee MECHANICAL PERMIT FILING FEE Heating Cooling $ $3.00 Ventilation Hood 1 1 2.00 Permit Fee $ $ Land Development Fee $ TOTAL PERMIT FEE $ 68130 This permit is hereby issued under the applicable provisions of the (7County Code and/or resolutions to do work indicated a e f whic fee have been paid. 00, TOR OF PUBLIC WORKS ^7 fj By Date d "ZC�_ / / Ba4d4g permit expires Date :4 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. BP060222 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: 01/31/2006 APN: 007-380-021-000 the Business and Professions Code, and my license is in full force and effect. L_ 3 22 5(SS� License Class: License Number: Site Address: 819 NETTERS CIR CHI 1-31--0(0 Contractor: fouA C'ouAj7"t✓5 Vooft- Map Index: Date: Description: REROOF W/COMP(40) 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 Owner: SHEDD MARY E TRUST to its issuance, also requires the applicant for 'such permit to file a C/O HIGNELL & HIGNELL INC signed statement that he or she is licensed pursuant to the provisions of 1500 HUMBOLDT RD STE 1 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 95928-9195 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 Applicant: FOUR COUNTIES ROOFING pP 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, 3 CRUSADER COURT provided that such improvements are not intended or offered for CHICO, sale. If however, the building or improvements are sold within one CA 95973 year of completion, the owner -builder will have the burden of (530) 343-1416 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, Contractor: FOUR COUNTIES ROOFING and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 3 CRUSADER COURT ❑ I am Exempt under Article 3 of the Business and Professions Code CHICO, CA 95973 (530) 343-1416 Date: Owner: License #: 774554 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 Architect: is issued. JUL 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: S f p ��a Co 'n �2 0 S. F. Total Square Ft: Policy #: Valuation: $0.00 ❑ I 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. / _ �— 0 Date: Applicant t 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 Thisl permit is hpre4yfssued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the of the work for which this is issued (Sec 3097 Civ.) Resolutions rk indicate above for which fees have been paid. 1 51 . G performance permit _ By Date: Name: PERMIT EXPIRESN: U 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 offi 'al form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. /� CO !)-A,0 Signature: Print Name: Date: ❑ Owner I( Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 .M N BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION ° AND SUBMITTAL REQUIREMENTS c . 24 HOUR INSPECTIONM OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WIL BE BEQUIRED AT TIME OF APPLICATION LOCATION �� AP# CO / . Property Address 91 9 � S 2 - Cross Cross Street WORKER'S COMPENSATION Policy NumbeL5 73-2003 Carrier State Comp. Ins. Fund 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 PERMIT UOQ BP BIN # • CONTRACTOR �■ ��iMW i_ii:: MM M �.� iffrfil Mad i Address 3 Crusader Court City Chico NONE= Zjp95973 Phone 343-1416 Fax 343-5274 • CONTRACTOR Name Four Counties Roofing Address 3 Crusader Court City Chico State CA Zjp95973 Phone 343-1416 Fax 343-5274 E-mail Uc.# 774554 1 Clasg'C3 APPLICANT SIGNATURE r X ! For office use onI ARCHITECT/ENGINEER Name Leo �noX Address City City State _....CA. State Zip Phone 343=5274 Fax E-mail Map Book State Ucense Number APPLICANT SIGNATURE r X ! For office use onI APPLICANT NAME Name Leo �noX Address :3 Crusader Court City : Chico State _....CA. Zip _..... -_._9.597_3...._ Phone 343=1416343—"5274 343=5274 E-mail. APPLICANT SIGNATURE r X ! For office use onI Zoning Flood Zone 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 Description or Scope of Work: 5k i e. Sq. Footage y p b O Structure Built without Permits 0 . 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 -- -ICL' 11 U1�.J.l...ri V K-iCl:rW'1 LJ ---- •----. _.. _ . .... 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. Page 1 of 2 by: Amount: '�C;Icj� Bldg SRA Receipt M Sheriff SUP Other Date: -3 66 --� Total REV 4-30-04