HomeMy WebLinkAbout024-010-092• rte.
024-01-0-.092. 95 1708 B s
ERICKSON,: Dale'. : r �' / ERCCKSON, .-Dale---- - 1225-67B '
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219 Archer,.Gridle' % r
• (reroof/SF•}
2 -01-92 2
nYs Archer 3rd house west of.Gilstrap Gridley,_
(add 2 wi dows, siding & brick veneer] ;.
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024-01-0-092 95-1708 B
ERICKSON, Dale
219 Archer, Gridley
(reroof/SF)
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COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754 PERMIT NO.
APPLICATVON AND PERMIT 95
ASSESSOR PARCEL NUMBER OVA= 024-010 92
ZONING
AS
G
BUILD PERMIT
OWNER
DALE ERICKSON
TELEPHONE
RAA -4325
01
SO, Fr. OCC. 00 BUILDING VALUATION
OWNERS MAILING ADDRESS
219 ARCUR
13 60
CONTRACTOR'S NAME OWNER
TELEPHONE
CONTRACTORS MAIUNG ADDR S -
Fireplace
CONSTRUCTION LENDER
UNXNOWN
Total Valuation $
1/1
LENDER'S MAILING ADDRESS
Kling Fee
$ 20.00
Permit Fee
$ 21.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS 219 ARCHER
PERMITFEE
$ 41.00
GRID,EY
PLUMBINGPERMIT
Filing Fee 20.00
Each Trap
7.00
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
,Solar or heat pump water heater
23.00
USEOFSTRUCTURE
SF NX Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: _ REROOF
Mobile Home IS I G W
@20.00
PERMITFEE
g
Contractor
ELECTRICAL PERMIT
Filing Fee 20:00
Main Service 000V 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 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 for the following reason:
14 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 OCCUP. \
OR ADDNS. ( -.& _ACC. BLDS. /
SO.
3.50 FT.
NEW CONST. MULTI -OUTLET
NON•RESID. ( BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
8 SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES)
20 Q 1.00
BAL Q .SO
Ex. Occup. (oFIXEt-Drs PLNS. OR
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
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
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.)
�{ 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
forthwith comply with those_provisions.
• ,Date / -� � =
X ,>�( ��P % Z 22f
Signature of Applicant - *' Owner ❑Contractor ❑Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT
Filing Fee 20.00
9
Heating
Cooling
Hood 6.50
Ventilation
PERMITFEE S
Contractor
Mobile Home Installation Fee Is
Energy Inspection Fee Is
occ
CONST. TYPE
.1 •/V\00
41.00
TOTAL FEE $ 4
HAZ.
I D. FEES
I IMP
I FLOODCDF
PARCEL PD HD
ISSUE
This permit is hereby'issued under
of the Butte County Code and/or
indicated above for which fees have
"
YL
the applicable provisions
Resolutions to do work
been paid.
Date
(Date
Receipt No.PERMITEXPIRESON
WHITE-D.D.S.-A.D.- CANARY --ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
mow
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISI
7 .County Center Drive - Oroville, California 95965 - Telephone (916) 538-754PERMIT NO.
APPLICATION AND PERMIT S-1709
ASSESSOR PARCEL NUMBER
0ZAZ;�ZON 024-010-092
ZONING
A5
BUILD G PERMIT
OWNER
DALE ERICKSON
TELEPHONE
846-4325
SO. Fr, OCC. 11.0 BUILDING VALUATION
13 @ 60
OWNERS MAILING ADDRESS
219 ARCHER
CONTRACTOR'S NAME
RX OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDR
Fireplace
CONSTRUCTION LENDER
UNIOJOWN
Total Valuation Is
Fling Fee
$ 20.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 21.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
21 ARCHER
PERMITFEE
$ 41.00
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
SF NX Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work:PERMITFEE
-- RER,O(1F
Mobile Home I S I GI W 1
@20.00
S
Contractor
ELECTRICAL PERMIT
Filing Fee 20:00
Main Service 1700v OR LESS
( 200A OR LESS )
23.00
Main Service ( 200A To IooeA )
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 force and effect.
License Class Lic. No.
-BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
"K 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 OCCUP.SO.
OR ( R ACC. BLDS. )
3.5¢ F7.
CNS.
NEW CONST.// MULTI.OUTLET
NON-RESID. J. BRANCH CIRCUITS )
@7.50
8POWER APPARATUS
( SINGLE OUTLET CIR. )
Ex. Occup. (OUTLET OR FIXTURES)
2e @ 1.00
BAl w
Ex. Occup. ( OUFIXED TLETS(RES D.) EA)
OWNER
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
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
g Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
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.)
(� I certify that in the performance of the work for which this permit is issued, I shallTOTAL
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 ,ith comply with those rovisions. /f
X ate J
=�`� /_�
'Signature of Applicant - 'IW Owner ❑ 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 Is
occ
CONST. TYPE
FEE $ 41.00
HA2.
D. FEES
IMP FLOOD
COF PARCEL PD HD
ISSUE
This permit is hereby issued under the
the Butte County Code and/or
in
indicated a ove for which fees have
c
PERMITEX IRESON
applicable provisions
Resolutions to do work
been paid.
Date
o)
(Date
Receipt No. -
1WHITE-D.D.S.• .D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
� ` J
I
-2 .3 t-) -e 1
` -Attention Property Owner—
An "owner-builder"
wnerAn"owner-budder" 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 *ill
be issued until this verification is received.
1. I personally plan to provide the major lab r and materials for construction of the
proposed Property improvement : YES[ L f NO[ I
2. I HAVE[v] 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: QTY:
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.
NATNM:
ADDRESS: CTTY:
PHONE: CONTRACTOR'S 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
SIGNED:
PROPERTY OWNER:
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.
O.B.-1
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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 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. t
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:
0 If you employ or otherwise engage any persons other than your immediate family, and the work (including
materials and- bther 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 Gove.rr=ents 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, and these risks are especially
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
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 unlic--nsed 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 arc not required to be signed by property owners unless they are performing their own
work pem :nalIy.
Information about licensed contractors may be obtained by contracting the Contractors State License
Board in your community or at 1020 N Street, Sacramento, CA. 95811.
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.
Sincerjelly, /
Michael C. Vicira, C.B.O.
Manager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.