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HomeMy WebLinkAbout021-200-012rB08-1635 021-200-012 MISCELLANEOUS Remodel BATHROOM REMODEL & REROOF Z 280 W EVANS REIMER RD KILBY STANLEY CHARLE, KILBY, Stan1e 13-67B �.. 1083P n/s Evans Reimer Rd. approx. 1 mile we i of; 99ES, Gridley KILBY, Edward 142-70B* 24-70B 136-70E* 19-70E , 0 n/s Evans Reimer Rd. w. of 99E, Gridley CONTR: Meltun & Melton, 2433 Melton Circle., (add bedroom) Live 0 (*convert garage to - ving area,, construct garage & breezeway)Q, M ---- -- 1 O ��, � BUTTE COUNTY DEPARTMENTLOF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 280 W EVANS REIMER RD Owner: permit No: B08-1635 APN: 021-200-012 KILBY STANLEY CHARLE, Issued Date: 08/12/2008 By TMP Permit type: MISCELLANEOUS 280 W EVANS REIMER RD Subtype: Remodel GRIDLEY, CA 95948 Expiration Date: 08/12/2009 Description: BATHROOM REMODEL & REROC (530) 846-0397 Occupancy: Zoning: A40 Contractor Applicant: Square Footage: DOWNING T INC DOWNING T INC Building Garage RemdUAddn 1351 E 9TH STREET 1351 E 9TH STREET CHICO, CA 95928 CHICO, CA 95928 (530) 894-3473 (530) 894-3473 Other Porch/Patio Total FEE INFORMATION DBMSC Remodel -Residential $392.43 Total Charged: $392.43 Fees Paid: $392.43 Balance Due: $0.00 Receipt No: B8261 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 Contractor's License DOWNING T INC 803263 / B / 05131/2009 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 I 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 X basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil of not more than five hundred dollars 08/12/2008 penalty ($500]; Ignature Date Please check one of the following: I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE AND WILL the work himself or herself or through his or her own employees, provided that such improvements ❑1 MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, 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.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ©❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: 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; The Contractors 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 Cartier: 1838102 Policy Number: Exp. D,109/01/2008 Contractors License Law.). (This section need not be completed if the permit is for one hundred dollars ($100) or less. ❑ 1 AM EXEMPT under Section B. & P.C. for this reason: ❑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'X 08/12/2008 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. X 08/12/2008 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 Signa Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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 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, injury, including death, and property damage caused arising out of, in any way connected with DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge thatt is issuance of this pea rmit does not authorize the 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 props owner or horized to act on the property owners behalf. CONSTRUCTION LENDING AGENCY G rAAi o, ,,1 08/12/2008 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Print Date the performance of the work for which this permit is issued. (3097 civ. code) ❑ Owner Contractor OR. Agent for Owner L/yAgent for Contractor FILE COPY Lenders Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION* OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY PERMIT NO. 4 BIN N "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last Name �.lL/1? y First Name I Go&•4AlE Mailing Address 290 G✓ I_9V,4NS e—orIMifr2 26 City C72e7LE l State C4 Zip Phone 8126 - 03 97 Fax E-mail APPLICANT SIGNATURE X PROJECT LOCATION CONTRACTOR Name /)0wA11A.1 IN Address i7 s ,/f V F oll &_6 City IHIC 0 State G4 Zip ST52cS Phone 9¢_ 3473 Fax -3 5-206 E-mail _fC,4A-Jg 0^1 P i 4101-1/1NO/NC, Coiy Lic. # 903 2 6 3 Class 8 1 APPLICANT SIGNATURE X PROJECT LOCATION ARCHITECT/ENGINEER Name 1V/,4 Address i 77s Al 126 City C Fii �o State Zip Phone �'9�- 3f-73 Fax E-mail JC4A,tE/Lo,,VC' 7—downy/Ns/.-C, eoly State License Number APPLICANT SIGNATURE X PROJECT LOCATION APPLICANT INFORMATION Name , f6FF C 4�-z 2vr Address i 77s Al 126 City C Fii �o State c� Zip 9.F92 sr' Phone �'9�- 3f-73 Fax 35-`Z - J 206 E-mail JC4A,tE/Lo,,VC' 7—downy/Ns/.-C, eoly APPLICANT SIGNATURE X PROJECT LOCATION AP# O Property Address Z 8 v W Ev�f•c%i /iiu�� R City WORKER'S COMPENSATION Policy Number 16?3g/v2—o7 Carrier If hiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name A114 Address DESCR R SCOPE OF WORK: 2fz /LooF� /� Doty 4v4 7,F.4 6QYw��c Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning F FloodZoEType SRA Yes No Occ. st.