HomeMy WebLinkAbout018-440-090BUTTE 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.netlidds
LICENSED CONTRACTORS DECLARATION
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 is in full force and
effect. �j /.340!12
License Class -Co � License Number: /�
' j 1�. 6llt s�L_
Date: Q 7 -D/ -OS Contractor.,lar, f►KsIL. a i �„a�
PERMIT NO.
BPO51727
Ul"v-L"D 06�L
Issued Date: 07/01/2005 APN:011-100-090
Site Address: 503 STILSON CANYON RD CHI
Map Index:
OWNER43UILDER DECLARATION Description: dry rot repair
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a Owner: RICHEY DONALD F & MARY,OLEAR.Y,,.REV,,.•..,:._
permit to construct, alter, improve, demolish, or repair any structure, prior, TRUST
-to its issuance; -,also requires the applicant for such permit to file' a
signed' stateinent•thaChe or she is licensed' pursuant to•the'.provisiolns of; RICHEY' DONALD F &MARY OLEARY
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Divis on4oflthe'Business and Professions Code) or that he or TRUSTEES
she'is'exempttherefrom'a'nd the basis,forthe.a4eged exemption.. Any. 251 COHASSET-RD SUITE 240
violation of Section _7031.5 by any applicant for a permit subjects the CHICO, CA 95926-2235
applicant to:a-civil-,penalty of not more than five hundred dollars ($500).):
❑ 1, 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. 70
,.. .....,.... ,......,.:" a,._. _ C ,,,,. 44.�6uslr?ess and Professions..
Code: The Contractors"State`License Law does not apply to an
owner of property who: builds or, improves thereon, and.,who does J B CONSTRUCTION COMPANY
such work -himself or herself or through, his or her own,employees, Applicant:
provided that such improvements are not intended or offered. for
sale. If however, the building or improvements are sold wiihin 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 P O BOX 1516
sale.). CHICO, CA 95927
❑•-.I, as- owner. ofAhe.property, am.,exclusiveiy.,-contracting .with,. (530) 895-1573
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.).
Contractor: J B CONSTRUCTION COMPANY�''�'
O ,Tam Exempt under Article 3 of the Business'and Professions Code
Dafe:• `owner.
P O BOX 1516
:- .WORKERS''COMPENSATION DECLARATIONCHICO, CA 95927 !
I hereby affirm under, penalty of perjury one of the following declarations: .•.,
❑ •t'ha4-Wand",will• maintain a certificate of consent to self -insure for (530) 895-1573
workers compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit License #: 430112
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 ca 'er a policy_num rare, Architect:
Carrier: _ y Engineer:
Policy #:
❑ 1 certify that in the performance of the work for which this permit is O S. F.
issued, I shall not employ any person in any manner so as to Total Square Ft:
become subject to the workers' compensation laws of California, Valuation: $O.00
and agree that if I' should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall Census Code:
forthwith comply with those provisions.
Date: -.n I ,C 5
QZ `/ V
D�
Applicant:r/V ' f
ARNING: °'';Failure 'to secure workers' compensation coverage' is /
WI
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 This permit is her y issued d6d he appli a prov' ons of the Butte County Coda anrl/or
I hereby affirm that there. is a construction lending agency for the Resolutions to work i dicate above for ich f have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.) /
Name: BY Date:
Address: PERMIT EXPIRES ON: 7—
❑ 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.
O Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
O 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-- Fagree to comply with
all county and state1aws relating to building construction. I acknowledge it is unlawful to alter the substance of any official forth or document of B Ile County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.'
Print Name:�► �L / i,F! ict it Signature
r�:
Date: 0 7" o l- O�
❑ Owner Contractor ❑ Agent for Owner 0 Agent for Contractor '
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 591-2834
OFFICE #: (530).538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
APPLICANT NAT RE
X
63
r office use only:
OWNER
Name
Last Name
G
Address 104!�O1516
FirrW�—AWlg�me
State
Address
/_
d �✓ Oni
/
Ad
City /+ /
Fax
StateG�
Zip 9s-,%zf
Phone
-Class
Fax
E-mail
APPLICANT NAT RE
X
63
r office use only:
CONTRACTOR
Name
r moi✓ n/
Address 104!�O1516
City
State
State.
Zip 95-9 21
Phoneg%5-_1>
73
Fax
E-mail
State License Number
Lic. #I
-Class
APPLICANT NAT RE
X
63
r office use only:
ARCHITECT/ENGINEER
Name
Address
Flood Zone
City
o
State
Zip
Phone
Zip S92 7
Fax
E-mail
Fax
State License Number
APPLICANT NAT RE
X
63
r office use only:
APPLICANT NAME
Name
Flood Zone
Address
o
City
i+ / tp
State
Zip S92 7
Phone
Fax
E-mail
Planner
APPLICANT NAT RE
X
63
r office use only:
Zoning
Property Address
Flood Zone
.
SRA
I Yes
No
Occ.
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
KAFORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
rI
BIN #
LOCATION
Property Address
City
Cross Street r
WORKER'S COMPENSATION
Policy Number QD-;7
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 /A Lo A I C
Address
Page 1 of 2
Description or Scope of Work:
D2Jz
%10T A
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 b Amount: (�� Bldg
l��
O SRA
Receipt #: 2� Sheriff
ti�
`� � SMIP
a Other
Date: �(� .=
Total
REV 2-24-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
Auplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D)Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
❑ 1. Agricultural Buffer clearance and'site plan approval from the Ag Commissioner's office (if required).
❑ 2. Impact Fees.
❑ 3. California Department of Forestry plan approval (if required).
❑ 4. NPDES Form.
❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 6. Contractor's license information. (Number, Name Style, Classification).
❑ 7. Worker's Compensation Carrier and Policy Number.
❑ 8. Owner -Builder Verification (if required).
❑ 9. Letter of Signature authorization (if required).
❑ 10. Recorded copy of Agricultural Acknowledgment Statement.
❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑ 12. Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530)538-7541.
EXPIRATION OF APPLICATION -
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05
October 6, 2003
1228 Pep Circle
Gardnerville, NV 89410
,fir ,,pP "��C Ph: (775) 782-8886 Fax: (775) 782-8833
Consulling (5nglneei ng uG DeV
slgn emices E-mail: BCINC@nanosecond.com
City of Chico Building Division
411 Main Street ( P.O. Box 3420
Chico, CA 95928
(530) 895-4891
Re: Using HSS Steel Header for Richey Residence
503 Stilson Canyon Road
Chico, CA
To whom it may concern:
The owner has requested to replace the existing door at front entry with a full height door.
Based upon the design criteria of the City of Chico, an HSS3.5x2.5x0.25" steel header may be
used to support the roof rafters. The steel header should be supported with double 2x trimmers
at each end. A Simpson SPH4 plate tie or similar product (or straps) may be used to connect
the steel header to each trimmer (two required at each end). Each SPH4 may be attached to
steel header with (2) *12X0.5" self drilling screws.
Please feel free to contact me if you have any further questions or comments.
Sincerely,
Patrick Clark, P.E.
BUTTE cOU NTY
BUILDING DIVISION
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