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Home My WebLink About027-150-010io lARFt; Leslie 36-6 2930P.v� 027-150-010 P06-0803 3655E LICON,JESSE 7-15-10 3465 GRUBBS RD, PALERMO 3465 Grubbs Rd. (app, 1 mi, westo oncut- CONT:DEER CREEK HEATING Wyandotte Rd.), Oroville HVAC C/O 1CONTR: Richard Wood, 1067 Pomona Ave.,Oroville (new, single family) I 71 B08-1557 027-150-010 MISCELLANEOUS Electric Panel NEW ELECTRIC PANEL f 3465 GRUBBS RD iL DILLMAN, ROY &LAURA 816-00.57 &/,,, 4.75 kW 5 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: 3465 GRUBBS RD Owner: Permit NO: B08-1557 APN: 027-150-010 DILLMAN, ROY & LAURA Issued Date: 08/07/2008 By KCG Permit type: MISCELLANEOUS 3465 GRUBBS RD Subtype: Electric Panel OROVILLE, CA 95966 Expiration Date: 08/07/2009 Description: NEW ELECTRIC PANEL (530) 533-4637 Occupancy: Zoning: A5 Contractor Applicant: Square Footage: ABLE HOME SERVICES INC DILLMAN, ROY & LAURA Building Garage Remdl/Addn PO BOX 7907 3465 GRUBBS RD CHICO, CA 95927-7907 OROVILLE, CA 95966 (530)899-9009 (530)533-4637 Other Porch/Patio Total FEE INFORMATION DBE Single Phase Service-Resid $59.00 Total Charged: $59.00 Fees Paid: $59.00 Balance Due: $0.00 Receipt No: B8192 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 ABLE HOME SERVICES INC 627760 / C36 C10 / 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 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 08/07/2008 penalty ($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 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: 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.). AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ Section ISI I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED M 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 The Contractor's License Law dows not apply to an owner of the property who builds or improves policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the DELOS INSURANCEpolicy 05/01/2009 Carrier: Policy Number: �. Date: Contractor's License Law.). (This section nee not a completed if the permit is or one hundred ollars ($100) or Fe-ss-.7— ess.❑ I AM EXEMPT under Section B. 8 P.C. for this reason: M IC%I I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS �J 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 Q X,,08/07/2008 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. X - 08/07/2008 1 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 ure 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 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 ATTORNEY'S use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte FEES. County to enter the above mentioned properly for inspection purposes. I hereby certify that I am the property owner or a `thorized to act on the property owner's behalf. CONSTRUCTION LENDING AGENCY P; ( 0 /07/2008 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee G Print e the performance of the work for which this permit is issued. (3097 civ. code) Owner [] Contractor OR: Agent for Owner ❑Agent for Contractor FILE COPY Lenders Address City State Zip i 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 c�UN'�y PLEASE PRINT CLEARLY "When filed, this application and all supporting material becomes subject to the California Public Records Act. All related to this application is subject to public inspection and will be posted on the County's website for electronic access. APPLICANT INFORMATION OWNER INFORMATION Last Name i.dC ��d-- F- t Name Mailing Ad S K CA Citgo \ Phone St Zip a� P b 5 Fax Fax E- ail Class APPLICANT INFORMATION CONTRACTOR NameWe Address ��d-- City C ; C D Stare Zip Phone �� _ 3 (� S Fax E-mail Fax Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name Address L p s 1 Address State City _4/lv 3 -7 Phon s 3 -3 _46 State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name rQ ImLan Address L p s 1 City O r .. I C d State Zips _4/lv 3 -7 Phon s 3 -3 _46 Fax E-mail APPLICANT SIGNATURE XIPJ PERMIT NO. I BIN # PROJECT LOCATION AP# _ 10 - 010 Property Address 1 i j S "1 Type Const. City ,1 \ WORKER'S COMPENSATION Policy Number Carrier If hiring anyone 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: Zoning Flood Zone SRA I Yes I No e e tr I Type Const. Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) . OFFICE #: (530) 538-7541 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 the Business and Professions Code, and my license is in full force and effect. -1 License Class : Zn License Number: Date: Contractor 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 to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with. Section 7000) 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 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 owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). PERMIT NO. BP060803 Issued Date: 04/10/2006 APN: 027-150-010-000 Site Address: 3465 GRUBBS RD PAL Map Index: Description: HVAC CHANGE OUT Owner: LICON JESSE J SR & DEBBY 3465 GRUBBS RD OROVILLE, CA 95966 Applicant: DEER CREEK HEATING & AIR P O BOX 171 VINA, CA 96092 (530) 839-2545 ❑ I, 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: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: !� I 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. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier:y 1 1Z—�y t^�ow—P Policy #:� ;-? ❑ 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply withthoseprovisions. Date: / —1!/ e7 AppliZG:::Fa.,,re WARto secur orkers' compensation coverage is unla,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. CONSTRUCTION LENDING AGENCY 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.) Address: DEER CREEK HEATING & AIR P O BOX 171 VINA, CA 96092 (530) 839-2545 License #: 865703 Architect: Engineer-: otal Square Ft: 0 S. F. Valuation: $0.00 Census Code: � 55 c0- 1�I �mq, 4- lo- OG This permit is hereby issued under the applicable provisions of the Butte County Code and/or ResTtfiv, s to do wojk indicat d above for which fees have been paid. By:pp �= /'mom Date: A I 0- Q PBRMIT EXPIRES ON: i0_0 ❑ 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 me fa Butte County. I hereby authorize reprdsentatives of Butte County to enter upon the above mentioned property for inspection pu Print Name: Geo -T FL / G r N Signal Date: ❑ Owner IE' 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 INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION "PLEASE PRINT CLEARLY" OWNER Last Name o � I First N Address Z S J City 'V e� State ZiP? PhoneFax State E-mail APPLICANT NAME CONTRACTOR _AO. �••: i...mleffiewe�� Address Phone City � State Zip Book Fax E-mail Planner State License Number APPLICANT NAME ARCHITECTIENGINEER Name Address / Address Phone City Email State Zip Phone Book Fax E-mail Planner State License Number APPLICANT NAME Name CQi Address / City -V / 1114 State �b�yt 7� v Phone Fax Email For a only: Zoning Property Address I Jt Flood Zone Cross Street SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. ..0 BIN N' / LOCATION � AP# ®27 ! D'' D / V Property Address I Jt City Cross Street WORKER'S COMPENSATION Policy Number C20v (/� Carrier If hiring anyone 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: ZPV40'� f 1_Sq_FTRa'ge ❑ 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 renew action 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. I I Received by: �b • Amount: t55. 00 Bldg I I Receipt #: q 14 Chv k gfp - SRA Sheriff IF, 4 �. Dater t5o Other Total SUBMITTAL REQUIREMENTS. - The EQUIR EMENTS.. The following drawings and specifications must be submitted'to the Building Division in order -to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BEACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! OR . 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (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. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. . Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (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. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. ' OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04