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Home My WebLink About027-250-014Aft _ 774-68B., / rl— 680-68P 441 709-68F, s/s Alw Ave. a mi. east of Citrus-2ve1 corners Almy & Highland Ave.) Palermo (new single family) j B07-0419 027-250-014 _ MISCELLANEOUS HVAC Change Out HVAC HEAT PUMP SYSTEM 2994 ALMY AVE SINGLETON, GEORGE J BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 2994 ALMY AVE Owner: Permit NO: B07-0419 APN: 027-250-014 SINGLETON, GEORGE J Issued Date: 03/05/2007 By GLB Permit type: MISCELLANEOUS 2994 ALMY AVE Subtype: HVAC Change Out OROVILLE, CA 95966 Expiration Date: 03/04/2008 Description: HVAC HEAT PUMP SYSTEM Occupancy: Zoning: A5 Contractor Applicant: Square Footage: ELITE CONSERVATION SERVICES ELITE CONSERVATION SER Building Garage Remdl/Addn PO BOX 418088 PO BOX 418088 SACRAMENTO, CA 95841 SACRAMENTO, CA 95841 (800)322-2093 (800)322-2093 Other Porch/Patio Total FEE INFORMATION DBM Heat Pump (Package Unit) $55.00 Total Charged: $55.00 Fees Paid: $55.00 Balance Due: $0.00 Receipt No: B2046 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 ELITE CONSERVATION SERW 750199 / B C20 / 06/30/2008 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 X03/05/2007 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 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: HAVE AND the work himself or herself or through his or her own employees, provided that such improvements ❑I 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.). ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED EJ I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions 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 policy number are; The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Carrier: State Fund Policy Number: 1677392 Exp. Date:02/07I2008 Contractor's License Law.). (This section need not be competed if the permit is for one hundred dollars ($100) or less. 0 1 AM EXEMPT under Section B. 8 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 become subject to the workers' X 03/05/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. X 03/05/2007 I 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 Stale 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 EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including death, and property damage caused arising out of, in any way connected with the issuance of this permit. I hereby acknowledge thatt is issuance of this pea rmit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am auth rized to act on the property owner's behalf. CONSTRUCTION LENDING AGENCY G 03/05/2007 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee ISIG 'Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner ❑ Contractor OR. DAgent for Owner 2rgent for Contractor - FILE COPY Lender's Address City State Zip . BUTTE -COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION 1 Website: www.buttecounty.net/dds 4 BIN N "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name 14 0 LC -70A I Fig Name I—Ole6<5- Mailing Address ;2-7.7'7/ Avg' City L9 S atec Zip, Pho S Fax E -mai CONTRACTOR Name _ Address 2% City State Zip4s$�s.. Phon 3 ZZ- Fax E-mail Lic. # 7S0 ClassG APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address ZipQ�� City Fax State Zip Phone Fax E-mail Open Cov State License Number APPLICANT INFORMATION Name Address.,,7o City State A ZipQ�� Pho X23 Fax E -mai APPLICANT SIGNATURE X PROJECT LOCATION AP# O?r• Property Address A City dg— WORKER'S COMPENSATION Policy Number .167 .2-o Carrier �kN 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: a ��iX c1�' /•may .. SRA Yes No Occ. Type Cons t�, Sq FT- Living Garage Open Cov ❑ • Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): v For office use only: Zoning FloodZone SRA Yes No Occ. Type Cons t�,