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Home My WebLink About025-340-035..��- `�r t3}�"�. �: K ��`��•kk _ � � t '� t ��`!;'rl ��x"��; z ,',' �,�1?? �,,; � { t ' ::� - � a .. t r ,'. ,�, i ' �s � � � � �`I J � � t f f .jy � � �. .. . - . �- ". 'r _ .. � � ri x:��; �. .�-. ��':�. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT . 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (630) 538-7541 PERMIT NO. BP060793 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS 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 Issued Date: 04/07/2006 APN: 025-340-035-000 the Business and Professions Code, and my license is in full force and effect. ' ,+� S C3 `l License Class: License Number: - Site Address: 5555 POWER HOUSE HILL RD PAL Date: 0`fi A-7/0 LP Contractor: 1� kSV VgQ_(J6&1n IC Q ( Map Index: Description: REPLACE EX GAS WATER HEATER OWNER -BUILDER DECLARATION 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 permit to construct, alter, improve, demolish, or repair any structure, prior Owner: MILLER ROGER D (CB DVA) to its issuance, also requires the applicant for such permit to file a 5555 POWERHOUSE HILL RD signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95965 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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' State License Law does not apply to an Applicant: RISSE & SONS INC. owner of property who builds or improves thereon, and who does PO BOX 67 such work himself or herself or through his or her own employees, RIO LINDA, CA provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 95673 year of completion, the owner -builder will have the burden of 916-991-3030 proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with 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, Contractor: RISSE & SONS INC. and who contracts for such projects with a contractor(s) licensed PO BOX 67 pursuant to the Contractors' State License Law.). RIO LINDA, CA ❑ I am Exempt under Article 3 of the Business and Professions Code 95673 916-991-3030 Date: Owner: License #: 264815 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 Architect: is issued. I have and will maintain workers' compensation insurance, as . Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier policy number are: ,and _ RJK.-i �t /r l� ��W�i(/h Carrier: /rW{"� ��'� otal Square Ft: 0 S. F. Policy#: Valuation: $0.00 ❑ I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to .fiecome subject to .the workers' compensation laws of California, _ ` "T Q(_0793 and agree that if I should become subject to the workers' rp25-340-035 6 compensation provisions of Section 3700 of the Labor Code, I shall I MILLER, ROGER forthwith comply with those provisions. 5555 POWER HOUSE HILL RD, Date: Lf 16 7 0 j PALERMO Cont: RISSE & SONS INC Applicant:Adp- REPLACE EX GAS WTR HTR WARNING: Failure to secure workers' compensation coverage is "^ w 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. ' I ✓ , CONSTRUCTION LENDING AGENCY This permit is her by issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolution work indicated above for which fees have been paid. f Name: BY Date: V Address: PERMIT EXPIRE O Date ❑ I 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. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ 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. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize repr¢sentatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name_Q �� L�l/ Signature: am&,tLW6 � 6" L6 7 l Q Date: l ❑ Owner ❑ Contractor Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTIONO: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE 9: (530) 538-7541 A FEE I-VILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last NamerlI � beff First Naz l Address L JQ ' � Kr I rb City � Ov t � State Zip 9rq (OS - Phone 30 _ S3�J _ 6SZI Fax E-mail CONTRACTOR Name VQCV6t n1 Address 72LS Z(p Sk City State CA Zip gY073 Phone _ 3 /S Fax E-mail Nc. #1 Cla APPLICANT INFORMATION (jE.AJ-T ARCHITECTIENGINEER Name City 1 Address Zip (0 City Fax State Zip Phone Book Fax E mail Date Approved: State License Number APPLICANT INFORMATION (jE.AJ-T Name Address S�-Z C� yw City 1 State Zip (0 Phone 5uN -(4ZOU Fax E-mail APPLICANT SIGNATURE X N For office use only: Zoning Property Address Ss' P6-jW i trl1se H d ( Flood Zone Cross Street SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page TLot # Planner Date Approved: nVFR ,F:0R SUBMITTAL REQUIREMENTS PERMIT NO. C4 - BP BIN It PROJECT LOCATION . AP# Property Address Ss' P6-jW i trl1se H d ( City Cross Street WORKER'S COMPENSATION Policy Number t}So S 70s_(10 Carrier lily- Of-In.ilc,( IrLGIU1r-1 If hiring a yone other than license 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: Sq FT- Living Garage Open Cov, ❑ 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 renewlaction 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,by: Amount Bldg .SRA • Receipt #: Sheriff SMIP Date: OtherI Total 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 gfaph 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 A1C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A). Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 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. Building Permit Application Without Required Clearances Form ❑ 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). 1 ❑ 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). 117. Workers 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. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 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 KAFORNISWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05