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017-050-018
Augie Velasquez �--f �S �� E/S Humbug Rd.,app.8 mi.S.ofHelltown Rd., Chico-dl`s, Permit #424,;-77B,P,E,M(new sig l' 17 -05 family) 011-360-018 PERMIT#96-2272 SKARLATOS, Emanual , F�Lf,-; 1117/00 13454 Centerville Rd, Chico Cont: Unique Bldg Gas Line,Wtr Htr,HVAC,Ele & Spa/SF B07-0458 017-050-018 A ER M IT#96,,7 2272 /00 -dd jh Chico C, El e & Spa/SF 01 7_05 0_018 MISCELLANEOUS Ag Exempt AG BUILDING 13454 CENTERVILLE RD ALLEN, ROBERTA C ETAL B07-0457 017-050-018 MISCELLANEOUS Remodel ADD SHOWER AND TOILET 13454 CENTERVILLE RD ALLEN, ROBERTA C ETAL C v� Soa r PLANNING DIVISION - BUILDING PLAN APPROVAL Use: ate: Parking: Landscaping: Other. Signature: No -E PM 60 eA 69• o 0 m BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES AGRICULTURAL BUILDING EXEMPTION PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 13454 CENTERVILLE RD Owner: permit NO: B07-0458 APN: 017-050-018 ALLEN, ROBERTA C ETAL Issued Date: 6/5/2008 By KCG Permit type: MISCELLANEOUS 13454 CENTERVILLE RD Subtype: Ag Exempt CHICO, CA 95928 Expiration Date: 6/5/2009 Description: AG BUILDING Occupancy: Zoning: FR -10 Contractor Applicant: Square Footage: KEITH LYDON Building Garage Remdl/Addn 13454 CENTERVILLE RD CHICO, CA 95928 Other Porch/Patio Total (530) 345-4125 FEE INFORMATION DBEH Building Review Fee $75.70 DBOMSCF Ag Exemption Permit $109.98 Total Charged: $185.68 Fees Paid: $185.68 Balance Due: $0.00 Receipt No: B2108 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractors License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 6/5/2008 the applicant to a civil penalty of not more than five hundred dollars [$5170); Please ch one of the following: one Contractors Signature Date AS OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. ff, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). 1 HAVE AND WILL MAINTAIN WORKER'S ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED COMPENSATION INSURANCE, as required by ❑ CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or`improves My Workers' Compensation insurance carrier and policy number are; thereon, and who centrads for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Cartier. Policy Number. Exp. Date: (This section need not be competed it the permit is or one hundred dollars ($100) or less. ❑ I AM EXEMPT under Section B. & P.C. for this reason: CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ot 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' X 6/5/2008 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those hose 6wners Signature Date X 6/5/2008 ZA6�� I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building SignatureDate WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. t agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE injury, including death, and properly damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the proerora�otoon the property owners behalf. CONSTRUCTION LENDING AGENCY 6/5/2008 Name of Permittee [SIGN] Print f u Date I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) J er ❑ Contractor OR. ClAgent for Owner ❑Agent for Contractor FILE COPY Lenders Address pity State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS OFFICE #: (530) 53&7541 FAX 4: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name L 1r1 n0 first N e r Mailing Address ?1 69h /- //, yle— City C State Zp gs-y Phon 5 3 4 !/ Fax E-m APPLICANT SIGNATURE X For office use only CONTRACTOR Name t /Z " , r\ V Address Map Book City Lot # State Zip Phone LENDING AGENCY Fax E-mail Lic. # Class APPLICANT SIGNATURE X For office use only ARCHITECT/ENG/NEER Name t /Z " , r\ V Address Map Book City Lot # State Zip Phone LENDING AGENCY Fax E-mail State License Number APPLICANT SIGNATURE X For office use only APPLICANT INFORMATION Name t /Z " , r\ V Address Map Book City Lot # State Zip Phone LENDING AGENCY Fax E-mail APPLICANT SIGNATURE X For office use only Zoning Flood Zone SRA I rtes I No Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. r.-1 .G 4 - BIN # PROJECT LOCATION AP# ,6 D•0/ Property Address S cer/c�rv' /le -Ad City Gti . G v Cross Street lS a WORKER'S COMPENSATION Policy Number Carrier M hiring anyone other than license contractors, a certificate of workers compensation must be shown at the time of permit Issuance. LENDING AGENCY Name Address Description or Scope of Work: 36 = Cha 0 s Sq FT- Living Garage Open Co Structure Built Wthout 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 required. 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. Receiv by: Amount:' Idg SRA Receipt Sheriff SMIP Other Date:' 9S� 6C -Total BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVU LE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net/dds AGRICULTURAL BUILDING EXEMPTION STATEMENT Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated or packaged, nor shall it be a place used by the public. Buildings used for purposes other than described above or that are located in a flood hazard zone are not eligible for an agricultural exemption. Authorization of an agricultural exemption permit by the Department of Development Services does not preclude any requirements and/or review by the Butte County Public Works Department, Butte County Fire Department, Butte County Environmental Health, or any state and federal agencies. Initials JUL AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. Initials A AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a manufactured home, and 23 feet from a commercial/industrial buildings Initials A AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum 23 feet from a residence and a man}dactured home, and 40 feet from a commercial/industrial buildings Site Address: 13454 CENTfRVILLE RD Permit No: B07-0458 APN: 017-050-018 ' Square Footage: 0 Permit Type: MISCELLANEOUS Occupancy: Permit Subtype: Ag Exempt Zoning: FR -10 Description: AG BUILDING Required Setbacks: Applicant: KEITH LYI)ON Front: 20' Side: 20' Rear: 20' 13454 CENTtRVILLE RD Type of Construction: CHICOCA95928 (530) 345-41?5 Type of Siding: T-111 Owner: ALLEN, RO$ERTA C ETAL Est. Const. Cost: $ 10,000.00 13454 CENTERVILLE RD Roof Covering: Metal CHICO, CA 95928 Floor Type: Concrete I declare under penalty of perjury that the building will be used as stated above, and the proposed use conforms with the AG Buildilg definition. If any change in use or occupancy of the building is made, I will A contact the Building Division qnd obtain the necessary permits, inspections and approvals to comply with the requirements in effect at that e and prior to occupancy. Signature of owner: Date: 3/9/2007 4 FELE COPY BUTTE COUNTY FEE SUMMARY 7 County Center Drive Oroville, CA 75965 Department of Development Services Phone (530) 538-7541 Fax (530) 538-2140 Permit Number: B07-0458 Job Address: 13454 CENTERVILLE RD Contractor: Printed: 03/09/2007 8:31 am Fee Description Account Number Fee Amount Paid Date Pmt Amt DBOMSCF Ag Exemption Permit 0010-440001-4210500-1010 $109.98 03/09/2007 $109.98 DBEH Building Review Fee 0021-540013-4614901-1010 $75.70 03/09/2007 $75.70 Printed By: Gwyn Benedict 185.68 $185.68 Balance Due: $0.00 At the time of permit application, I was advised the above fees are required prior to issuance of the permit. These fees may change during the plan checking process. Signature: Date: 03/09/2007 Pursuant to Government code Section 66020, you are hereby notified those items listed above may have been imposed on your project. You have 90 days from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a protest are specified in Government Code Section 66020(a). Butte County Department of Public Works J. MICHAEL CRUMP, DIRECTOR LAND DEVELOPMENT DIVISION Storm Water Managment Program 7 County Center Drive Oroville, CA 75965 (530) 538-7266 Telephone (530) 538-7171 Fax www.buttecounty.net/dds O O s O O t f� wo`g National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment (LESS THAN 1 ACRE 1 Reference Number: B07-0458 Date: 03/09/2007 Location: 13454 CENTERVILLE RD By: GLB Parcel Number: 017-050-018 Sub Type: Az Exempt Owner Name: ALLEN, ROBERTA C ETAL Phone: Description: AG BUILDING By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the state of California Regional Water Quality Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. Signed: Date: 03/09/2007 Title: FILE Butte County Department of Development Services T rict, 300 Street, Biggs CA 95917 - (530) 868-1281 Biggs Unified Sch/DB •� y' TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR • • 7 County Center Drive • • Oroville, CA 75965 • • • (530) 538-7601 Telephone CO (530) 538-7785 Fax UN www.buttecounty.net/dds PERMIT APPLICATION DATA SHE Oroville Elemental District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 Reference Number: B07-0458 Date: 03/09/2007 Location: 13454 CENTERVILLE RD By: GLB Parcel Number: 017-050-018 Sub Type: Ag Exempt Owner Name: ALLEN, ROBERTA C ETAL Phone: Description: AG BUILDING The above permit application has the following Clearances required p or to permit issuance. Please contact each department indicated below regarding specific requirements pertaining to your pe it application. Yes No DRAINAGE DIST ICTS M E] Thermalito Irrigation District, 410 Grand Avenue, Or ille CA 95965 - (530) 533-0740 El E] LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (5 ) 533-2000 City of Chico, 545 Vallombrosa, Chico CA 95926 (530) 895-4711 PARKS & REC ATION DISTRICTS Chico Area Recreation District, 545 Vallomb osa, Chico CA 95926 - (530) 895-4711 Durham Park &Recreation District, 9447 idway, Durham CA 95938 - (530) 345-1921 Feather River Recreaction & Park Distr ct, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011 Paradise Parks &Recreation, 6626 S ay, Paradise CA 95969 - (530) 872-6393 F1 F-1 Other: Signature of Property Owner: Date: 03/09/2007 FILE E] rict, 300 Street, Biggs CA 95917 - (530) 868-1281 Biggs Unified Sch/DB El Chico Unified Schtrict, 11 3 East 7th Street, Chico CA 95926 - (530) 891-3006 Durham Unified Sistric , 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 Gridley School Di29 agnolia, Gridley CA 95948 - (530) 846-4723 � E3 Marysville Schoolt, 919 B Street, Marysville CA 95901 - (530) 741-6000 Oroville Elemental District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 Oroville Union Hi1 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext:105 E] M Paradise Unified Sistrict, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER Recorded copy ofltural Acknowledgment Statement- See Attached Instructions E] E] City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 E] Other: F-1 Other: F1 F-1 Other: Signature of Property Owner: Date: 03/09/2007 FILE Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: k O Make sure your application is complete. 0 Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and,deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at hgp:Hmunicipalcodes.lexisnexis.com/codes/butteco/ Reference Number: B07-0458 Location: 13454 CENTERVILLE RD Parcel Number: 017-050-018 Date: 03/09/2007 Owner Name: ALLEN, ROBERTA C ETAL Phone: Description: AG BUILDING Signature of.Property Owner: lvr Date: 03/09/2007 FILE Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. 1. I PERSONALLY PLAN TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. C5T* OR NO) 2. I (1 A�/HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: AG BUILDING Reference Number: B07-0458 Applicant Name: KEITH LYDON Owner's Name: ALLEN, ROB ERTAACETAL AP # : 017-050-018 Signature of Property Owner: ) 4&<� —;4-, -,-- , Date: ���,� 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: www.buttecounty.net\dds KEITH LYDON 13454 CENTERVILLE ROAD CHICO, CA 95928 (530)342-6516 , FEE INFORMATION DBMSC Remodel -Residential $357.44 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. ' X 03/09/2007 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I 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. ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; /.\ Cartier: Policy Number: Exp. Date: (This se n nee not be completed if the permit is oror 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 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. 03/09/2007 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip Building Garage RemdUAddn Other Porch/Patio Total $357.44 Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's 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]; Please one of the following: AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE E. COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the 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 improvement is sold within one year of completion, the owner -builder will have the burden of proof 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 Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this nature 03/09/2007 Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and Slate laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property o mer or am authorized to act on the property owners behalf. l/� . -� ��i> _— 03/09/2007 Owner ❑ Contractor OR. E]Agent for Owner DAgent for Contractor FILE COPY PROJECT INFORMATION Site Address: 13454 CENTERVILLE RD Owner: Permit NO: B07-0457 APN: 017-050-018 ALLEN, ROBERTA C ETAL Permit type: MISCELLANEOUS 13454 CENTERVILLE RD Issued Date: 03/09/2007 By GLB Subtype: Remodel CHICO, CA 95928 Expiration Date: 03/08/2008 Description: ADD SHOWER AND TOILET Occupancy: Zoning: FRIO I KEITH LYDON 13454 CENTERVILLE ROAD CHICO, CA 95928 (530)342-6516 , FEE INFORMATION DBMSC Remodel -Residential $357.44 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. ' X 03/09/2007 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I 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. ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; /.\ Cartier: Policy Number: Exp. Date: (This se n nee not be completed if the permit is oror 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 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. 03/09/2007 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip Building Garage RemdUAddn Other Porch/Patio Total $357.44 Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's 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]; Please one of the following: AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE E. COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the 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 improvement is sold within one year of completion, the owner -builder will have the burden of proof 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 Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this nature 03/09/2007 Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and Slate laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property o mer or am authorized to act on the property owners behalf. l/� . -� ��i> _— 03/09/2007 Owner ❑ Contractor OR. E]Agent for Owner DAgent for Contractor FILE COPY Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perforin their work personally or through thier own employees, without a license contractor or subcontractor, only under Iimited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. 1. I PERSONALLY PL TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. ( OR NO) 2. I (19/HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO_ 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: ADD SHOWER AND TOILET Reference Number: B07-0457 Applicant Name: KEITH LYDON Owner's Name: ALLEN, ROBERTA C ETALL AP # : 017-050-018 Signature of Property Owner: % C/ �-- Date: 3� �� Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Cgnter Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile www.buftecounty.net/dds www.buttegeneralplan.net REQUIRED SWIMMING POOL SAFETY UPGRADES (EFFECTIVE JANUARY 1, 2007) TO: All Single Family Residential Remodel and Modification Permit Applicants FROM: Scott Rutherford Manager, Building Division RE: Correction of Pool & Spa Hazards, Assembly Bill 2977 (Mullin) Chapter 478, Statutes of 2006 California Health and Safety Code Section 115928 DATE: February 28, 2007 To eliminate safety hazards on existing pools and spas, Assembly Bill 2977 (Chapter 478, Statutes of 2006), effective January 1, 2007, requires the installation of pool anti -entrapment covers whenever a building permit is issued for the remodel or modification of a single family home. The permit shall require that the suction outlet of the existing swimming pool, toddler pool, or spa be upgraded so as to be equipped with an anti -entrapment cover meeting current standards of the American Society for Testing and Materials (ASTM) or the American Society of Mechanical Engineers (ASME), ASME/ANSI Standard A 112.19.8. DECLARATION The property located at r 3 45' /'i .��! q,o / _ m%c11y� XGP_ 9&6eal has: (Check all that apply) ❑ a swimming pool ❑ a spa ❑ a wading /toddler pool ❑ does not have a swimming pool, spa, or wading/toddler pool If there is an existing swimming pool, spa, or wading/toddler pool, I understand that a pool anti -entrapment device is required at the above address in conjunction with my permit. I also understand that if a pool anti -entrapment device is required, the completed Installation Certification below must be received by the building inspector at final inspection. Please note that permits cannot receive final inspection approval without this certification. I acknowledge that I have read and understand the requirements of AB 2977 and that the above is true and correct. Signature Print Name Date Relationship to Project (please check one): ❑ Owner ❑ Agent for Owner ❑ Licensed Contractor ❑ Agent for Licensed Contractor Company Name Contractors State License Number INSTALLATION CERTIFICATION For the property located at I hereby certify that an anti -entrapment cover meeting the current standards of the American Society for Testing and Materials, or the American Society of Mechanical Engineers is installed in the ❑ swimming pool ❑ spa ❑ wading /toddler pool Signature Print Name Relationship to Project (please check one): ❑ Owner ❑ Agent for Owner ❑ Licensed Contractor ❑ Other: Date ❑ Agent for Licensed Contractor If "Licensed Contractor' or "Agent for Licensed Contractor' is checked, please complete the following: Company Name Contractors State License Number K: Forms/Building Forms/Swimming Pool Affidavit Anti -Entrapment Updated: 3/9/2007 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last N�me� t Name Mailing Addfess I Cityk Cb State(-),Zip Sid Phone, 3 ot_651 Fax E-mail' APPLICANT SIGNATURE X /&At— /' i For office use only. CONTRACTOR Name Flood Zone SRA Yes No Address 0 le City Subdivision Name State Zip Phone Fax E-mail Date Approved: Lic. # Class APPLICANT SIGNATURE X /&At— /' i For office use only. ARCHITECTIENGINEER Name Flood Zone SRA Yes No Address 0 le City Subdivision Name State Zip Phone Fax E-mail Date Approved: State License Number APPLICANT SIGNATURE X /&At— /' i For office use only. APPLICANT INFORMATION Name Flood Zone SRA Yes No Address 0 le City Subdivision Name Stsjz Z P Faxes L E-mail Date Approved: APPLICANT SIGNATURE X /&At— /' i For office use only. AP# 0 (--1pS b O 18 Zoning Flood Zone SRA Yes No Occ. I Type Const Subdivision Name Policy Number Map Book I Page Lot # Planner LENDING AGENCY Date Approved: PERMIT NO. BIN # PROJECT LOCATION AP# 0 (--1pS b O 18 Property Addressl City t. � l Cross Stroet Htl r WORKER'S COMPENSATION Policy Number Carrier N hiring anyone other than license contractors, a cer0cate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: �O �'n Sq FT- Living Garage Open Cov Structure Buift withoutPermits ❑ 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 required. 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. Receied by: Amount VBldg SRA Receipt #. Sheriff SMIP Other Da �� ' c Total RECORDING REQUESTED BY Bidwell Title & Escrow Company AND WHEN RECORDED MAIL TO Nnme Roberta C. Allen Street Address 13454 Centerville Road City, state Zip Chico, CA 95928 Order No. 00213584-008 Recorded Official Records County Of BUTTE CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 02:00PM 20 -Feb -2004 REC FEE 10.00 TAX 412.50 Jason Page 1 of 2 SPACE ABOVE THIS LINE FOR RECORDER'S USE Parcel No. GRANT DEED THIS FORM FURNISHED BY BIDWELL TITLE & ESCROW COMPANY L The Undersigned Grantor(s) Declare(s) Documentary Transfer Tax is $412. 50 ❑ Cit}/Town of 0 computed on full value of interest or property conveyed, or 0 Unincorporated Area ❑ full value less value of liens or encumbrances remaining at the time of sale ❑ Monument Fee of $10.00 FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Emanuel Skarlatos, An Unmarried Man hereby GRANT(s) to Roberta C. Allen, An Unmarried woman, as to an undivided 50% interest and Keith Paul Lydon, An Unmarried Man, as to an undivided 50% interest as Tenants in Common the following real property in the Unincorporated Area, County of Butte, State of California: SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF E el arlatos Document Date: February 17, 2004 State of California County of } SS. On 0- , before me, the undersigned, a Notary Public in and for said County and State, personally appeared Emanuel Skarlatos Personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hknA.4nd official seal. FOR NOTARY SEAL OR STAMP iz L. AANESTAD H COMM. # 1443699 DDH NOTARN PUBUC-CALIFORNIA w COUNTY OF BUTTE Comm. Expires Oct 21, 2007 MAIL TAX STATEMENTS TO: Same as Above BTEC/GRANTDEED Order No. 00213584-008 EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: BEING A PORTION OF THE SOUTHWEST QUARTER OF SECTION 4, AND THE SOUTHEAST QUARTER OF SECTION 5, ALL IN TOWNSHIP 22 NORTH, RANGE 3 EAST, M. D. B. & M., COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: PARCEL 2, AS SHOWN ON THAT CERTAIN PARCEL MAP FILED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON DECEMBER 16, 1983, IN BOOK 94 OF MAPS, AT PAGE 3. TOGETHER WITH AN EASEMENT 60.00 FEET IN WIDTH FOR ROADWAY AND PUBLIC UTILITY PURPOSES ALONG WITH A RIGHT OF USE AND MAINTENANCE FOR SAID PURPOSES OVER A PORTION OF THE SOUTHEAST QUARTER OF SECTION 5, TOWNSHIP 22 NORTH, RANGE 3 EAST, M. D. B. & M., AND MORE PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCING AT THE SOUTHEAST CORNER OF SAID SECTION 5, SAID POINT ALSO BEING THE NORTHEASTERLY CORNER OF LOT 2 AS SAID IS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MARCH 8, 1977, IN BOOK 60 OF PARCEL MAPS, AT PAGES 68 AND 69; THENCE FROM SAID POINT NORTH 490 30'15" WEST ALONG THE NORTHERLY LINE OF SAID LOT 403.55 FEET TO A POINT IN THE CENTERLINE OF SAID EASEMENT AND THE TRUE POINT OF BEGINNING FOR THE EASEMENT HEREIN DESCRIBED THENCE FROM SAID POINT OF BEGINNING AND ALONG THE CENTERLINE OF SAID EASEMENT THE FOLLOWING COURSES AND DISTANCES: SOUTH 430 02'54" WEST 116.44 FEET AND NORTH 490 31'39" WEST 265.15 FEET TO A POINT ON THE SOUTHEASTERLY LINE OF HUMBUG ROAD AND THE TERMINUS OF THE HEREIN DESCRIBED EASEMENT. EXCEPTING FROM THAT PORTION PARTIALLY RECONVEYED BY INSTRUMENT RECORDED MARCH 3,1993 UNDER BUTTE COUNTY OFFICIAL RECORDS SERIAL NO. 93- 8620. AP NO. 011-360-018 Hors 1-0 NJ OL 4s of 0 O 6D .. ,_ .- yti J„-rc' ...-r •r '..: w,. r•3 `.�� r ` �,`�... r•.}-. moi; rt ��. ,,K!.'�¢ .r n F-•..•: ,ar.,►+•�+�-. .. �'i.�„'.-n.*-. �Y> a ! � •MPERMIT#96-2272 ! s SKARLATOS, Emanu'al ` 13454 Centerville Rd, Chico i Corit: Unique Bldg Gas Line,Wtr Htr,HVAC,Ele & Spa/SF r„ 0 t 5 1 I f a 1 t s 3 t r r OFFICE COPY Address GAS ,,//�� Meter By / Date`s ELECTRIC Meter By Date /A COUNTY OF BUTTE- DEPARTMENT OF'DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PE . MjrT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 011_360--018 ZONING t BUILDING PERMIT OWNER EMANUAL SKARLATOS TELEPHONE 828—CA70 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 1395, F RI). CHICO CONTRACTOR'S NAME UNIQ TELEPHONE 141-8680 CONTRACTORS MAILING ADDRESS W 22 ST. CHICO 95998 Fireplace CONSTRUCTION LENDER UNMOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDINGADDRESS 13454 CENTERVULE RD PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP - Solar or heat pump water heater 23.00 USEOFSTRUCTURE a SFY1 Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 15.00 Gas piping system 1 - 5 outlets 15.00. ISM Building sewer 15.00 TYPE OF WORK ' New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: ADD GASLINE FOR COOKTON, H2O HEATED, HVAC, - SPA-, & RELOCATE EXISTING ELECTRIC SERVICE Mobile Home IS I GI W @20.00 PERMITFEE $ 50:00 Contractor ELECTRICAL PERMIT Filing Fee 20.00 :, ... Main Service ECIOV OR LESS ( zooA oR LEss ) 23.00 Main Service ( 200A TO IoobA ) 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 full ce.and effect. `r / y/�y License Class Lic. No 3 4YGlJ OWNER -BUILDER DECLARATION 1 hereby,affirm under penalty of eru that I am exempt from the Contractors License p tY P 1 rY P Law for tf°e 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 W, NEW CONST. DWELLING OCCUP. so. OR ADDNS. ( a ACC. Blass. ) 3.50 FT. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) d SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR F[%TURES) SAL Ex. Occup. ( OUTLETS(RESID.°ea) r20. Temporary Service Mobile Home Facilities Misc. Wiring 3 (� 23.00 PERMITFEE $ 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 Heating 1 20.00 Cooling •00 Hood 6.50 Ventilation PERMITFEE $ 60.00 Contractor Policy Number (rhe above sections need not be completed if the permit is for workTof a valuation f one hundred dollars ($100) or less.) 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 1 should become subject to the ' workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with th se provisions. / - X p Signature of App cant - ❑Owner [tractor ❑ 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 is OCC CONST. TYPE I TOTAL FEE $ 153.00 HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL PD HD 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. BYL& Date %%'2 7 PERMITEXPIRESON /U'Z -C/ITE-D.D.S.-B.D. (Date) FReceiptNo. 206213 CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 P T APPLICATION AND PERMIT G ASSESSOR PARCEL NUMBER 11— — 011-360-018 ZONING FRIO BUIL NG PERMIT OWNER OWNER TELEPHONE SO, Fr, OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 11994 CENTERVILLE RD, CHICO CONTRACTOR'S NAME UNIQUE BUILDING TELEPHONE 141-8680 CONTRACTORS MAILING ADDRESS 149 W 99 RTI CHICO 95928 Fireplace CONSTRUCTION LENDER UNMOWN Total Valuation $ LENDER'S MAILING ADDRESS Fling Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDINGADDRESS 13454 CENTERVILLE RD PERMITFEE $ PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USE OF STRUCTURE SFX3 Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 15.00 Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: ADD GASLINE FOR COOKTOP, H2O HEATER, HVAC, SPA, & RELOCATE EXISTING ELECTRIC SERVICE Mobile Home ISI GI W @20.00 PERMITTEE $ 50.00 Contractor ELECTRICAL PERMIT Filinq Fee 20:00 Main Service a00V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 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 full ce and effect. A /. �� �� License Class LIC. No. Gam..// ��{{ (L!/ 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 OCCURSO OR ( 8 ACC. BLDS. ) . 3.50 FT. CNS. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POSINGLEWER APPARATOUTLET US ) 8 CIR. Ex. Occup. (ourLET OR FIXTURES) 20 Q 1.00 BAL .50 Ex. Occup. OUTLETS �R (PESID ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc . Wiring 23.00 23.00 PERMITFEE _ - 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 Heating 20.00 Cooling 20.00 Hood 6.50 Ventilation PERMITFEE $ 60.00 Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation 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 forth comply with se provisions. - X Date _ Signature of Ap Icant - ❑ Owner M -Contractor ❑ 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 Isf OCC CONST. TYPE TOTAL FEE $ 153.00 HAZ. I D. FEES I IMP I FLOOD CDF PARCEL PD HD 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. f BY Date �"Z -9(, PERMITEXPIRESON 10-71 -9?- (Date) Receipt No. 206213 I WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT } PQRMIT NO. ';4 242-77B,P,E,M I 'PERMIT EXPIRES O' OWNER Augie Velasquez ICONTR. owner I51-01-102 LOCATION (A.P. ) E/S Humbug Rd., app. .8 mi.S.of Helltown Rd. Chico 1. Temp. Power Pole Called PG&E, Temp Elec. Serv. Called PG&E — % 4� - Temp. Gas Serv. Called PG&E JOB=(Date FINALED i COUNTY OF DEPARTMENT OF PUBLIC WORKS Il BUILDING INSPECTION, RE0ORD Interior Lath .- BUILDING BUILDING (Cont'd) Door Closer -- Z r PLUMBING Setback /�r�%fr--7 Firewall .� ��--� Soil Pipin Elec. Pedestal Forms - 7 Parapets M96I EHOME INSTALLATION - - - - - - - - - - - - - - KO - :5-,- 7? Main Bldg. Water Piping Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out'^ - 3- 72. Slab Z Roof Sheathing Water Pi p In Pier Roofing Sewer Garage Fdn. Vents Fixtures Footings - jr- i7 Garage Vents Water Htr. Stemwall Insulation — 2- Heaters Slab / Carport Footings 7 % Prov. for physically handica ed Conformance of ex. structure Appliances Gas Piping & Temp. Gas Slab Final Sanitation ::—,Z — Patio FIREPLACE Final — j Footings Footing.�-^ s- ELECTRICAL Masonry Wallsr Walls/ a V— a-3 -� Rough Relnf. Steel Final .-- 2 Fixtures Bond Beam FIRE SPRIbWLERS Motors Framing Test Water Htr. Stucco Final Subpa Mesh //t 3 MECHA ICAL Grd. Fault Prot. Scratch Heating Service Brown Finish r- Cooling \ D Temp. Pole Underground Interior Lath .- Ventilation Permanent Door Closer -- Z r Final i:7 Final MOBILEHOME UTILITIES ------------------ Elec_ Service Elec. Pedestal Water Piping Sewer Gas Piping M96I EHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS Q,,^ Z�& oo (NOTE: An entry ust be made on this form each time you visit the job site.) CERTIFICATIONS Ass -required by the State regulations, -both the builder and the insulation applicator must sign a card certifying that the proper "R" values for all insulation locations have been installed. 'An example of a.certification. card, which is furnished by the builder or -insulation applicator is shown in Fig. 13. THIS IS TO CERTIFY THAT IRSUI,ATIO3 NAS BEE" PMTALLED IA CONFOR.VM WITH THE CURRENT- ENERGY RESULATICM. CALIFORNIA AOMINISTRATIVE CGDE. TITLE 25. STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: QA ueet o um er Traces.' ExTERIOR WALLS �'`01797,41GW- Manufacturer TS,*t ness/Type 4 -Value__ CEILINGS Batts: Manufacturer Th`ckness_ f o R Value ' B anufacturer��_ Thickn*ss No. Bags Wt./Bag_�� Sq. Ft. Covered R Value FLOORS Manufacturer Thlckness/Type R Value SLAB ON GRACE Manufacturer Thlekness/Typo.;._., R Value Width of Insula Ston Inches FOUNOATION WALLS Manufacturer ThlcknassjType R Value :Fig. 13 8-14 CA OKNEIt- LOCAtRUN AP# p ns are approved for:.. Sewage Disposal. Water�Suppl YX_ Hold.up final for: Clearance ok for: Elearance is for a bedroom (home or mobile home). -The adaition(s) will be Water Supply Water Supply Other Or C -T DaLe COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive – Oroville, California 95965��- 7 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date -Vd ILIIS' n ure of Per itee VA9eV Receipt No.� 9 f 6 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. DIRECTOKIC r F PUBLIC WORKS By Date – 33� – 7-7 B ilding permit expires Date F— 30 - 7-? BUILDING Owner ie -SQ. FT. OCC. BUILDING VALUATION Mailing Addres O l6a' Bleph ne r– Fireplace 1 © 6 Contractor Total Valuation Mailing Address Permit Fee e Plan Checking Fee&/or Penalty Telephone No. Permit Fee $ , Building Address S V ink, PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 0 Repair drainage or vent piping 1.50 Water piping 1.50 Zoning Veritpcat' n Onl Each gas water heater or vent 1.50 A. P. No.. g Gas piping system 1 - 5 outlets 1.50 Each additional outlet 30 F ation FireDept. Fire one Use Permit Building sewer 5.00 EQA Plans Declaration PtWATP 60' R/W Improvements Lawn sprinkler system 2.00 Bldg. PI -recd Porcel Approval Plan pprovoI Permit Fee $ $ NEW P-- ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No.1 @ I FEE PERMIT FILING FEE $3.00 10D Main service 100 AMP OR1 OR LESS5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family Duplex Mobil Home ❑ Others ❑ Main service 100 AMP oR LESS 25.00 Main service EA. ADD'LQI�oGof AMP 1,00 NEW CONST. DW OR ADONS. ( AC fir UP &) 22sgft 11) NON.NEWCONSTRESID R. ( BRANCH CIRCUITS) *2.50ea NEW CONSTR. POWER APPARATUS & NON-RESID. (SINGLE OUTLET CIR. 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: f Ex. Occup(OUTLETS OR FIXTURES) BAL@251 Ex. Occu FIXED APP LNS. OR p•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 1 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 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 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.1 @ FEEPERMIT FILING FEE J$3.00 Heating 010Code Cooling Ventilation +� Hood 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 TOTAL PERMIT EE authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date -Vd ILIIS' n ure of Per itee VA9eV Receipt No.� 9 f 6 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. DIRECTOKIC r F PUBLIC WORKS By Date – 33� – 7-7 B ilding permit expires Date F— 30 - 7-? RESIDENTIAL PLAN CHECKING GUIDE (S.F., DUPLEX, & MISC. ONLY) Bldg. Permit # b Ji OWNER A. P. �# A. 'GENERAL V V (/ Zoning requirements (sideyards and parking). aluation. 3. Signature by R.C.E. or Architect (if required). B. PLOT PLAN Complete parcel size and dimensions. 4:.-�etbacks, sideyards, easements, etc. 3. Other buildings or 'structures. 4. Grading, fills, drainage. C. FLOOR PLAN Complete to scale plan with dimensions. 4 -Required windows for light and ventilation (Sec. 1405). C`i'.— Required windows for second exit (Sec. 1404). 422---A-1lowable glazing for energy requirements (20% max. per State law). ;5;--`--�,,Iuman impact glass (Sec. 5406). required room sizes, ceiling heights (Sec. 1407). '1:--&.F.C.I.'s in baths and exterior outlets (Sec. 210-8). 4-zi'ght fixtures, switches, receptacles, and exterior receptacles for maintenance of mechanical equipment. 4. � ations of water heater, heating & cooling equipment, other electrical or gas equipment, and plumbing fixtures. AGarage firewall, door size, and closer (Sec. 503(d)(4)). IT:_1 - 3'0" exterior exit door (Sec. 3303d). Fireplace location. 12 -r ----Smoke detectors (Sec. 1413). D. STRUCTURAL DETAILS Foundation plan complete enough to construct building. Falo9F construction details complete enough to construct building. —Elevations and wall construction details complete enough to construct building. _Roof construction details complete enough to construct building. 4—.Fireplace construction details and calcs if over one-story in height. qr — --icient data and details to satisfy energy insulation requirements (State law). E. MISCELLANEOUS ITEMS TO LOOK OUT FOR 4:i--CCX plywood on exposed locations and overhangs.' 2. Stairway details (Sec. 3305). 3. Guardrail details (Sec. 1716). -44---Zzick or stone veneer (Chapter 30) . --Exterior plaster — weep screeds (Sec. 4706 & 4708). 6L.q--1,,eper roof pitch for roof covering (Chapter 32). I Rafter ties or bearing ridge beam. (Zlc— arage door or porch header sizes. dequate bracing. 10. Living area over garage - complete 1 -hour separation required including supporting walls and posts, etc. 11. Two (2) exits on three-story dwellings (Sec. 3302).