HomeMy WebLinkAbout021-070-047"021'07-0447DILLAFiD Wesley
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1446 LEW , , :GRID 'EY -67E A4,
`�CONTR DOWNER '`• �" _
RE ROOF; �, . L A� e/s Lewis Oak Rd . 500no. of -.Little Ave
Gridley �'
CONTR: Joe.•Wright, . PBox 674, Gridley :;?Y
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"021'07-0447DILLAFiD Wesley
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1446 LEW , , :GRID 'EY -67E A4,
`�CONTR DOWNER '`• �" _
RE ROOF; �, . L A� e/s Lewis Oak Rd . 500no. of -.Little Ave
Gridley �'
CONTR: Joe.•Wright, . PBox 674, Gridley :;?Y
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COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PE MI No.
(Rev. 12/96) APPLICATION AND PERMIT &__ -
ASSESSOR PARCEL NUMBER
021-070-04
ZONING
BUILDING PERMIT
OWNER
WESLEY DILLARD
TELEPHONE
&
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
7T t) s
CONTRACTOR'S NA — 1 CA /5 v TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS 1446 LFNIS W RD.s GRIDIFY
Energy Plan Checking Fee $
$
PERMIT FEE $ 74.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF Or Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 7.00
Solar or heat pump water heater 23.00
Water piping 15.00
Each as water heater or vent 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: REROOF 34 SO COMP
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home I S I G I W @20.00
PERMIT FEE S
ELECTRICAL PERMITFling Feel 20.00
Main Service 2o.A OR LESS 23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 com
(commencing with Section 7000 of Division 3 of the Business and Professions Code,
( g )
and my license is in full force and effect.POWER
License Class LIC. NO.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for.the following reason:
[i.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.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
E,. ❑ 1 am exempt under Sec. Business and Professions Code for this
reason
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
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
�of one hundred dollars ($100) or less.)
Irl 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 0 1 should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
•
1 n Date / f l j
-Signature of Applicant - ❑ Owner ❑Contractor ❑Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction&)
of structures over 3 stories in height.
Main Service 200A TO 1000A 46.00NEW
CONST. DWELLING occuP. so
OR ADONS. ( a ACC. BLDS. 3.5Q�;
NEW OST
' MULTI.OUTLET
NON-RESID. @7.50
APPARATUS
a SINGLE OUTLET CIR.
Ex. OCCU OUTLET OR FDRURES BAL O 1.500
Ex. Occup. ouxnEEDTSA(RREES,6.LNSoEw 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE S
MECHANICAL PERMIT Fling Fee 20.00
Heating
—Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 74.00
HAZ.
I D. FEES 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.
` J Date O
PERMIT EXPIRES ON
De
Receipt No.
WHITE-D.D.S.-B.D. CANAL -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
�h
- COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 P I, O.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCELNUMBER
021-070-047
ZONING
BUILDING PERMIT
OWNER
WESLEY DILLARD
TELEPHONE
846-4377
SO. FT. OCC. BUILDING VALUATION
2040
. OWNERS MAILING ADDRESS
1446 TMJ
CONTRACTOR'S NA . 7 6A 95948 TELEPHONE
OWNER
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS 1446 LEWIS OAK
Energy Plan Checking Fee $
$
PERMIT FEE $
74,00
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF )UC Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: REROOF 34 SQ COMP
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home ISI GI W
@20.00
PERMIT FEE $
ELECTRICAL PERMIT
Filing Fee 20.00
600VOR LES
Main Service zo.A OR LESS
23.00
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 force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law fgthe 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
Main Service TO
46. 00
CCU000A
WEE200A
NEW CONST. DWELLING occuP.
O AD
oNS. ( ACCO. BILDS.
so
3.5QFG;
M
NO RfSID. CU
@7.50
POWER APPARATUS
8 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FOCTURES
pIaBay
Ex. Occup. oFlx�eED�A PP ES,
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE S
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
Policy Number
heabove sections need not be completed if the permit is for work of a valuation
one hundred dollars ($100) or less.)
Zof
certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
d
X� Date do
Ignature of AppI' nt - ❑ Owner ❑ ontractor ❑ Age
An OSHA permit is squired for excavations over 5'0" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 74.00
HAZ.
D. FEES IMP
FLOOD
CDF
PARCEL
PO
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicateo above for which fees have been paid.
_
Q
Date V
PERMIT EXPIRES ON " thkl
e
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASS SOR PINK -INSPECTOR GOLDENROD -APPLICANT
c'' • `COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 No.
(Rev.IZV6) APPLICATION AND PERMIT
0-70-- Q 4 7 ZONIW BUILDING PERMIT
N°rk?-j-7 LSO. FT. f OCC. I BUILDING VALUATION
is Oak. i
6101V
EX. OCCU RXEO APPLNS O.R.
GIBLETS ESIO.
5.00
Temporary Service
MCTO77 INH
Mobile Home Facilities
1lLlPIgN!
Misc. Wiring
23.00
_777'm
00"rRACT0111 U06110q"J ADORUS
COMT14lCT10N LEMER
LENDER" MAIU10 ADORUS
Fireplace
Total Valuation b
ARCNrrECT OR ENGINEER
UCENse No.
Filing Fee
b
20.00
ARCHITECT OR ENONEER'S MAJUNO ADDRESS
Permit BeF
b
,T- ,
Plan Checking Fee b
OULMO ADDRESS
Energy Plan Checking Fee
b
�
b
PERMIT FEE b
IGT NO.
SUaDIValONSNAME
PARCqL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF Duplex ❑ Mobilehome ❑ Other
BPEcsY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑'rRemodel ❑ Utilities ❑ Instigation
Describe Work: Y e. �`� �LA
❑ Other,
�'l�
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home tS I G I W 1
(920.00
PERMIT FEE t
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service eoov OR LE S
za.OR LESS
23.00
Main Service TooA TO 1006A
48.00
NEW CONST. OWELLNO OCCUP.
OR ADONS. A ACC. BLDS.
3.5Q f{,
MULTFOUTLET `
NOKRESID. BRANCH CIRCILMM /
/�
l=, 7.50
EX.. OCCU . OUTLET OR FIXTURES
g w
aAL .SO
EX. OCCU RXEO APPLNS O.R.
GIBLETS ESIO.
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
I PERMIT FEE b P
I MECHANICAL PERMIT Fling Fee 1 20.00
1 Hood I 1 8.501 1
Mobile Home Installation Fee b
l Energy Inspection fee b
O" CONST. TYPE TOTAL FEE $
�Z• D. fEE4 IMP I FLOOD I COf I PARCEL ,PD I ND i ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
Indicated above for which fees have been paid.
By Date
V PERMIT EXPIRES ON
ro
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your
signature.
Please complete and . return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit *M .
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 : YES[Lj"' NO[ ].
2. I HAVE[v] HAVE NOT[ ] signed an application' for :a binding permit for the
proposed work....:
3. I have contracted with the following person (firm) to provide.: the -proposed
construction:
NAME:
ADDRESS. CITY:
PHONE: . . . CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired_ the following person to
coordinate, supervise, and provide the major work:
NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
5. I .will provide some of the work but I have contracted (hired) the followip&4wsons to
provide the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED: J
PROPERTY OWNER: 10J, 0_��
SOCL-kL SECURITY NUMBER:
DATE:
NOTE
This owner -Builder Verification is required by Section 19831 and
19832 of the California Health'and Safety Code.
This verification must be completed and returned to our office before
we are permitted to issue the. permit.
Mav 1995 2.26
r
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of .
property improvements specified
For your protection, you should be aware that as "owner -builder" you are the responsible party ok'r6ord
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 t you plan to subcontract, you
should be aware of the following information for your benefit and protection: -
0 If you employ or otherwise engage any'persons other than your immediate family, and the work-(mcluding
materials and other costs) is 5300 or more for the entire project, and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
0 If you are an employer, you must register with the State and Federal Governments 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. .
0 There may be financial risks for you if you do not carry out these obligations,4and these risks esp
are.ecially
serious with respect to worker's compensation insurance. . ..
0 For more specific information about your obligations under Federal Law, contract the Internal Revenue
Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your r
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 their own employees, without a licensed contractor or subcontractor, only
under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder"
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 contracting the Contractors State License
Board in your community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm
that you are aware of these matters. The building permit will not be issued until the verification is returned
Sincerely,
Michael C. Vieira, C.B.O.
Manager, Building Inspection
NOTE: This 0,.�%.-Builder Information is required by Section 19830 of the California Health and Safety Code.
May 1995 2.27