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Home My WebLink About026-221-001t 3 4 't:. a^• i� .y''„y« :..t � � �,� �.� s w- S:' rx SQ.�7+71"r F f wxd' �ri,t 'Y`i'R 3•Y'\R"f '( ...5-; yY %t t� _y a rt.� 1 ��'.n?i •ij `,:R 4! 1.+ s # ,4J.• k,y ... �.,:•'t e - `3 � � kr .H f t a ?4 .s„ r t � A .a s �-r�. .4''' r � fir- 3- �a�'Xi>;. i•YS'�v j � y `F 1 * `C�Ai•� r/4 x 3 rsi�u..r sir .f...,e..,+V•:.}'.t._,.... »...,,}...:s..r.�.,.:::;:'aar,,.,.^"i .........,... xr.,i i.,._. �.._� ,r� �7;?i_t,..s..?. 3'i�h�IS COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 (Rev.12/96)APPLICATION AND PERMIT�3"&%5N ASSESSOR PARCEL ruMBER 026-221-001 ZONING 1 BUILDING PERMIT OWNER White Thomas 993-2258 TELEPHONE SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS CONTRACTOR'S NA:AE owner TELEPHONE CONTRACTORS MAUNG ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE No. Filing Fee $ 20.00 Permit Fee $15.00 ARCHITECT OR EN3INER'S MAIUNG ADDRESS Plan Checking Fee $ BUILDINGADDRESS Energy Plan Checking Fee $ PERMIT FEE $ 35.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 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: rlpmn S1• Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 920.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200A 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 pass LIC. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for th,e following reason: I, as owner of the property, or my employees with wages as their sole compensation, wil do the work, and the structure is not intended or offered for sale. ❑ I, es 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 200A TO 1000A 46.00NEW CONST. DWELLING Occup. OR ADONS. ( a ACC. BLD S. so 3.5QFT: T. NON-RESID. MuLTI.OUTLET 97.50 POWER APRATUS 8 BINDLE OUTLPAET CIR. Ex. Accu OUTLET OR FIXTURES 20 Q 1.00 BAL @ .50 Ex. Occup. ounFrs RESID.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1by affirm under penalty of perjury one of the following declarations: szI !lave 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 Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (1fhe above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 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 forth it omply with those pr ions _ Date Signalure of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of strLctures over 3 stories in ei t. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $35.00 HA2. FEES IMP I FLOOD CD F PARCEL PD HD IS E This permit is hereby issued under the of ;he Butte County Code and/or Indic dab o whic fees have ByW PERMIT EXPIRES ON applicable provisions Resolutions to do work been paid 1 Dat V ate Recei�tNo. WHITE-D.D.S.-B.CANARY-ASSESSOR P K -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Orovitls, California 95965 ► Telephone (530) 538-1541��^- - �:1zts6) APPLICATION AND PERMIT ss Paae�an�sz ,� / zowxo BUILDiNG PER.MIT sQ. Fr. c,= SUUwra VALUAnoN W)9,wWAR 17Mi0 *PEPAiT FEE PUD .SkA OTM.SKEIN« , • AAkOVN 1 R -V X b SQL a TO Le wr srrro COMM 20.00 20.00 20.DO Ems.. • O oust oR su a se Er.M ft:a• S.DD Temww S Gs MOD Lbbl a FacNes 2MDD Mia: vving 2S.DD PERMIT FEE S BECHANICAL PERMIT F&n g Fee 20.DO HeaSng " H=d 6.50 PERT S rt b@e n Fee = rgy k�spezon Fee s TOTAL. FEE $ nr z a. Fm W ( tiaoa =F I Path"] FT HD ssu: This perm4 b hereby issued under to apple prov!s = of be Butte County Cade and/or Re=hiti= b do work mdeefed above for vfi : fees ban been paid By Dsie R�eiptNo. • - PERMIT EXPIRES ON erFRSF.e-e-s .w -n e�-ud� QSs�Ssea P�►u•IrSPaGi'OR �aOLC=NROG,4PPLI"�ANf �,.� F�eplace �� euaa�c �� ' Total valuation i �nse►a -F&Q Fee S Pam* Fea S m enms mum mw= S Pier ChenFes Eneegy Pian Chug Fes S PENT FE S DrrRs saw Paters mwPMABING "PERIET Re Each Trap 7.00 115EOFS iAUCi1JRESolar or heat wrbr beer 2s.oD 3F 0 Duplmc D Mbbiishome O Other Weer piping 15.OD Eneb g= wat r hater or vent S.OD TYPE OF WORK Cis woba rfsbm i .-sodfva 15.00 Pm O Ad33cn O D LJ� 0 t�C� _Other 0 9um 15.0 D lfls Fbrns S G W 820.00 t��Cp�l ![—'� Describe Wow - PST i m S • M2CTRrAL PSMIT Feng Fee Main Service � oma � MOD Mich SWAM 45.OD ri�ff cam -L, 62 A"ma I *PEPAiT FEE PUD .SkA OTM.SKEIN« , • AAkOVN 1 R -V X b SQL a TO Le wr srrro COMM 20.00 20.00 20.DO Ems.. • O oust oR su a se Er.M ft:a• S.DD Temww S Gs MOD Lbbl a FacNes 2MDD Mia: vving 2S.DD PERMIT FEE S BECHANICAL PERMIT F&n g Fee 20.DO HeaSng " H=d 6.50 PERT S rt b@e n Fee = rgy k�spezon Fee s TOTAL. FEE $ nr z a. Fm W ( tiaoa =F I Path"] FT HD ssu: This perm4 b hereby issued under to apple prov!s = of be Butte County Cade and/or Re=hiti= b do work mdeefed above for vfi : fees ban been paid By Dsie R�eiptNo. • - PERMIT EXPIRES ON erFRSF.e-e-s .w -n e�-ud� QSs�Ssea P�►u•IrSPaGi'OR �aOLC=NROG,4PPLI"�ANf �,.� Demolition Permits Asbestos Notification Statement Date AP# Pursuant to section 19827.5 of the California Health and Safety Code, all demolition permit applicants are required to fill out this form. "19827.5. A demolition permit shall not be issued by any city, county, city and county, or state and local agency which is authorized to issue demolition permits as to any building or structure except upon the receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both, pursuant to Part 61.of Title 40 of the Code of Federal Regulations, or the successor to that part. The permit may be issued without the applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project. The permitting agency may require the applicant to make the declaration in writing, or it may incorporate the applicant's response on the demolition permit appli— cation." Attached is a copy of my written asbestos notification to the United -States Environmental Protection Agency for the demolition project located at Signature of Applicant OR I hereby declare that a written asbestos notification to the United States Environmental Protection Agency is not applicable this demolition project. Signature of Applicant 2/19/91 O.B.- OWNER-BUILDER VERIFICATION 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 will be issued until this verification is received. 1. 1 personally plan to provide the ajor labor and materials for construction of the proposed property imp vement : YES NO ❑ 2. I HAVE 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: 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. 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 - r � i �.OP ` �• i NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must he completed and returned to our office before we are permitted to issue the permit. OVER OWNER BUILDER INFORMATION Dear Property Owner: O.B.- I ` ' 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. 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: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is '$300 or more for the entire project, and such persons are not licensed as contractors or subcontractors; then you may be an employer. ♦ 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. ♦ 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. ♦ 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 unlicensed persons professing to be contractors is to secure an "owner builder" 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. +rely,Vi ira, C.B.O. ,uilding Inspection NOTE. This Owner -Builder Information is.required by Section 19830 of the California Health and Safety Code. OVER