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Home My WebLink About022-240-084NIT.- ! z TOMAGITI Tom 4680B 1 1 45578 3681P 1 1 s/s Justeson Ave 1651 E Grace Aver ey i (new.: Joe Wright t Rt,. 2� Bac 54_6 Gridley i (new, single family) l/�'.,,v.1L .5-G - 6 G J �.....�-.-_-.__j �•�.__ J J 808-1125 022-240-084 MISCELLANEOUS Re-Roof - REROOF W/COMP (43) HOUSE AND I 729 JUSTESON RD TAMAGNI, LUELLA ADEN SS (scannm) &�•2I52 zHa • cMl -Jokwn Rd. 6ri 1ky Tqm pi�, LueWcAnr, Redac. wmtrn th+tr Con If: Q;sst 4�. ins Znc. BUTTE COUNTY DEPARTMENT OF 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: 729 JUSTESON RD Owner: Permit No: B08-1125 APN: 022-240-084 TAMAGNI, LUELLA ANN SS Issued Date: 06/16/2008 By KEJ Permit type: MISCELLANEOUS P O BOX 841 Subtype: Re -Roof GRIDLEY, CA 95948 Expiration Date: 06/16/2009 Description: REROOF W/COMP (43) HOUSE AN (530) 846-5780 Occupancy: Zoning: A5 Contractor Applicant: Square Footage: PRYDE ROOFING COMPANY PRYDE ROOFING COMPANI Building Garage Remdl/Addn 6255 WALL LANE 6255 WALL LANE PARADISE, CA 95969 PARADISE, CA 95969 (530) 846-0502 (530) 846-0502 Other Porch/Patio Total FEE INFORMATION DBMSC Re -Roofing $261.50 Total Charged: $261.50 Fees Paid: $261.50 Balance Due: $0.00 Receipt No: B7670 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 PRYDE ROOFING COMPANY 612809 / C 39 / 02/28/2009 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 AFFIRM UNDER PENALTY OF PERJURY that I tensed under provisions of Chapter 9 mis Section 700 ) of Division 3 of the Busin and Professions Code, and my licensepursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) k1HEIREBY orce and a et. 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 6/16/2008 the applicant to a civil penalty of not more than five hundred dollars [$500); Please check one of the following: Contractor's Signature Date ❑ 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 Contractors 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: 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. 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.). 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. The Contractor's License Law dows not apply to an owner of the property who builds or improves y Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Cartier: State Fund Policy Number: 713-00218494 Exp. Dale:01/31/2009 Contractor's License Law.). (This section nee not a competed if the permit is or on'e h ed dollars ($100) or less. ❑ I 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 come subject to the workers' X 06/16/2008 compensation provisions of coon 3700 of the Labor C I shall forthwith comply with those Owner's Signature Date Bions. - X06/16/2008 � I hereby certify that I have read this application and slate that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature 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 EMPLOYERTO 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 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 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 prop owner or am authorized to act on he property owner's behalf. CONSTRUCTION LENDING AGENCY �� . 1d„/ 06/16/2008 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for err.HUN Date the performance of the work for which this permit is issued. (3097 civ. code) ❑ OwnerContractor OR. El Agent for Owner Agent for Contractor FILE COPY Lender's Address City State zip 4 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" 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 PERMIT NO. BIN # "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 k� Cpunty's�y"fo eleectrronic ac esus, C// i OWNER INFORMATION Last Namee ��1f 6AJ I Address FirsName 4— ct £G G Mailing Address Zip5rF6 CiC��i Fax E-mail Z So ? Phone , V(' - 51) 8'0 Fax E-mail CONTRACTOR Nam z ,, ,,, Address City'�.4 r>1 S Stat Zip5rF6 Phone ,g,;?_ ,c�Z 7 ,o_ Fax E-mail Z So ? Class APPL/C T INFORMATION ARCHITECT/ENGINEER Name City D(SE_ Address Zip5rF6 City Fax State Zip Phone Fax E-mail State License Number APPL/C T INFORMATION Nam Address City D(SE_ Sta4 Zip5rF6 Phone' 7, . Z 70 Fax E-mail PROJECT LOCATION API eC)CI _3(10 - Property Addr C City WORKER'S COMPENSATION Policy Number O / - y� // 0t" 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 Address DESCRIPTION OR SCOPE OF WORK. Zoning Flood Zone �p D S62 I No Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ' ❑ Proposed Change of Occupancy Du (Note previous use): For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const.