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Home My WebLink About030-192-008U ButteCDoptmfcoment Services AUT M NELINGSDIRECTE C ASSI V� TF, O ; 7 County Center Drive O O Oroville, C:!:!1!!!'.. 201 EP 14 L 1� Q, o * o (530) 7601 TeCSI D VELOPAIENT CY ,° - O cst 538 mile C - y ✓. ERVI$; ids oU Nt MINI RATION * BU DING * PLANNIN D j C F ESTIMATE RKSHEET In order to give urate fee estimate we will need the follows information. Please complete mu ation as possible to allow us to provide the most accurate CONTACT NAME: 0"r Are you the owner of the property: Contractor: other: �G DAYTIME TELEPHONE NUMBER: _ 4 O9 — L1 ZCo--f -7 &P� 2 EMAIL: OrgCLc'1 t(�OPowe'y- cy_ q 100• e -a ey-, IJ OWNER NAME: n C, I U LO PROPERTY ADDRESS OR LOCATION: (O ( 0 1 Z"a- ASSESSORS PARCEL NUMBER (APN):330 ��2 • [� TODAY'S DATE: S e�p� 1 4 1 I -o I O **SIGNATURE: "DISCLAIMER �( By signing this document 1 am aware that it is only to be used as a guide in the calculation of Building Cl Permit type fees. The Department of Development Services, Building Division does not warrant any part of said document. Actual fees may vary at time of Permit issuance based on conditions, and/or scope of work, and/or any newly adopted ordinances/resolutions/lmv/statute (Federal/State/County/City) and/or the imposition of other fees by City, County, State or Federal. This document does not warrant any fees not falling within the purview of the Department of Development Services, Building Division. This is not an exact document, henceforth; you are encouraged to verb all fees and requirements with the appropriate ordinances/resolutions/codes/laws/statutes before any reliance upon such estimate. **When filed, this form and all supporting material becomes subject to the California Public Records Act. All public information related to this form is subject to public inspection and will be posted on the County's website for electronic access. Note: We provide the first fee estimate free of charge. However, any additional requests will be charged at our hourly rate ($127.00) with a minimum charge of $32.00 for 15 minutes. We will try to provide all fee --�� estimates within 72 hours of receiving this document. Thank you. PROPOSED STRUCTURE: r e e +-0 Geo. q ng -� V USE OF STRUCTURE: C3 -6c,'ce- 5>xLAre- v -00v+% ESTIMATED CONTRACT PRICE OR VALUE OF WORK (Includes labor [including owner builder's labor] and material): (COMPLETE BOTH SIDES) A''tl"1\Ti;It&,Irl.h;1R't\b.wois21111,9PPROiE1l I%,hk0nurteiturlah,,Mh:3.10,(nr Pa , I ,1 , SQUARE FOOTAGE (SQ FTG) OF PROPOSED STRUCTURE: (Provide square footage to all that apply as shown on the page for your project. Be sure to circle that which is more specific. Add additional sheets if necessary.) SFD (Single Family Dwelling) or Manufactured Home (SQ FTG): S F I Please answer the following questions Will this be a Permanent Second Dwelling: (Circle one) YES WO Temporary Second Dwelling (Aunt Minnie) (Circle one) YES 6—Fo For Manufactured Homes Only: Soft Set (Circle one): YES or Permanent Foundation: (Circle one) YES Is this a replacement home: (Circle one) YES IVO Attached Garage Shop/Storage (SQ FTG) : a11A Detached Garage/Shop/Storage (SQ FTG) : 11. j1 X 211 I X /0 s Stairs/Landing/Deck/Uncovered Porch Areas (SQ FTG) : Covered Porch/Patio/Deck Areas (SQ FTG) : N / c3- Carport/Awnings (SQ FTG) : AJ LA N/4- Barn/Storage/Limited Agricultural Building (SQ FTG Non -Commercial Use): Commercial Use (SQ FTG) (Pro a brief description ofproposed use): Remodel Residential/Commercial: (list the scope of work, what you will be remodeling, additional square footage, will there be electrical work, plumbing, mechanical, structural, etc, be specific. If this is a commercial structure list the current use and the proposed use) i?c wV ry Wci�, , ►Jr 1Ola ekeGA,ic-rA WD <--Ocke Addition Residential/Commercial: (list the scope of work, what you will be adding or remodeling, will there be electrical work, plumbing, mechanical, structural, etc, be specific. For Commercial please list use of new and existing areas) Existing Square Footage: Proposed Additional Square Footage: Type of Construction: (What kind of material will be used for the proposed structure) Wood Framed X Metal Framed Masonry/CMU (Concrete Masonry Units): _ Other: Additional Questions: Is this a replacement for a structure that was involved in the Humboldt/Ophir and/or Concow (June Lightning Fires)? (Circle one) YES 9W If yes, then do you have insurance? (Circle one) YES NO' If yes, does your insurance cover your building permit fees? (Circle one) YES NO Do you plan on building to Title 25 code (Limited Density Owner Built Rural Dwelling Only allowed in specified areas of the county Per Butte County Ordinance 4003)? (Circle one) YES NO K: 81.11 DAG AFBVIT FOR.IfS-Fonus Zi110 A1'PROI'ED'Ri r Lsrm2rte a a ksherch _i.l0.doc !hY I1 'no Page?ot 2 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 PERMIT NO. BP042153 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: 07/20/2004 APN: 030-192-008-000 the Business and Professions Code, and my license is in full force and effect. / License Class: C. _3q License Number: e�oZ�lO Site Address: 1090 12TH ST ORO c Date: -�i0 —d Contractor: Map Index: Description: RE -ROOF 24 SQ. COMP NJ 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: DELEON ARLENE* to its issuance, also requires the applicant for such permit to file a 25 CALLS AMIGO DR signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section FREMONT, CA 7000) of Division 3 of the Business and Professions Code) or that he or 94539 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).): ❑ 1, 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 Applicant: DELEON ARLENE* Code: The Contractors' State License Law does not apply to an pp 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.). ❑ 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: GEORGE ROOFING and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 6810 LINCOLN BLVD ❑ I am Exempt under Article 3 of the Business and Professions Code OROVILLE, CA 95966 (530) 533-6393 Date: owner: License #• 452266 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of pedury 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 and policy number are: Carrier: �LC/K2�G Total Square Ft: 0 S. F. Policy #: A la -� R!o —per- 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 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 with those provisions. Date: �? 77a 0 •'p � c Applicant: WARNING: Failure to secure workers' pensation coverage is 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. "Welce, � /•n CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Cade 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.) Resolutionj� to do worrk iiinn�di�cated' a /eve for which fees have been paid. %'7 G� ,n� dl� Name: .. j/J ! w Q,0 �O / By: � (LCL�(/� c� Date: / &L PERMIT EXPIRES ON: 9- a"to�" Date Address: ❑ 1 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 representatives of Butte County to enter upon the above mentioned property for inspection purposes i. , nn Print Name:�/CC`(� Signature: h�� Date: ❑ Owner 13 Contractor Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION #: (530) 538-7636 (OROVII.LE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION APPLICANT SIGNATURE X Shirley Trew - AgeWeor a Roo in For office use only: OWNER Name Rafael Alvarado Address 1090 12th St. City Oroville State CA Zip 95966 Phone 530-533-3969 Fax E-mail Lic.# APPLICANT SIGNATURE X Shirley Trew - AgeWeor a Roo in For office use only: CONTRACTOR Name GEORGE ROOFING Address 6810 Lincoln Blvd City Oroville State CA Zip Phone (530) 533-6393 Fax (530) 533-0287 E-mail dan@abcgc.com Lic.# Class dan@abcgc.com 452266 1 C39 APPLICANT SIGNATURE X Shirley Trew - AgeWeor a Roo in For office use only: ARCHITECT/ENGINEER Name N/A Address 6810 Linocln Blvd City Oroville State CA Zip Phone (530) 533-6393 Fax E-mail dan@abcgc.com State License Number APPLICANT SIGNATURE X Shirley Trew - AgeWeor a Roo in For office use only: APPLICANT NAME Name GEORGE ROOFING Address 6810 Linocln Blvd City Oroville State CA Zip 95966 Phone (530) 533-6393 Fax (530) 533-0287 E-mail dan@abcgc.com APPLICANT SIGNATURE X Shirley Trew - AgeWeor a Roo in For office use only: Zoning Flood Zone SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: LOCATION AP# Property Address 1090 12th St. Cross Street PERMIT NO. 6Q'q - 2153 BP BIN # WORKER'S COMPENSATION Policy Number 272-596-02 Carrier STATE FUND If hiring anyone other than license contractors, a certificate of workers compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work Reroof House Sq. Footage 24 Squares ❑ 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 required. FOR REFUNDS rods can only be made upon written request by the person who paid the The request must be made prior to the expiration of the permit and no truction work has been done. Filing fees, plan check fees for work plan ked and other department costs are not refundable. Received by:r159 . Amount: —Bldg SRA Receipt #: / Sheriff A Gl i16 SMIP Other Date: r_;�L ��,�/ 73 7 Sd Total REV: George Roofing RESIDENTIAL BUILDING RECORD DESCRIPTION OF BUILDING single ROOF LIGHTING AIR CONDITION Ctl `iS9 SHAPE CONSTRUCTION STRUCTUR L EXTERIC ' Light Sub - Stondard _%-k Frame - _ Stucco on ARCHITECTURE S/ondord_ _ Above -standard S_heothiny Sidi" Conere& Block �Slories Jpecio/ ad$. USE TYPE Coble Brick Shingles RESIDENTIAL BUILDING RECORD DESCRIPTION OF BUILDING single ROOF LIGHTING AIR CONDITION i/ot ' 41 Pitch Wirin y HAW17411 Cootie ROOMS Gob/e Ir T. Az Conduit Forced gni f Hip / B X. Coble Grovity Humid. Al/ Shed Fixtures Not/ Unit PLUMBING Cut Up Few I Che -p /LS7 Ent. Noll Dormers X Avq. I jWedivm1_V1,r1oo,,,1-i-, 2"�: "X - '1141, Liv./nq PARCEL J Q SHEE7 OF SHEETS i ROOM AND FINISH DETAIL FLOORS IFLOOR FINISH TRIM INTERIOR FINISH i I 2 Moterio/ I Grode W01/3 Ceilings - i Ire;" 1 11;nh/1 IHpovw I I/nsu/ated No//s I (Screens - FNIComOo.Shinale I\IGos I IE1ect. I I -Veo I uroin bd. I molertol: ILOI1r. rt. Isb/osh: CONSTRUCTION RECORD single FOUNDATION Adobe Shakes (E, G, A,F P) BATH DETAIL Moray Special ZoneUnil Dining i Remoin9 Toble ^/o Aqe Life . _ DoubleConcrete Az F/oor.Joist: B.8 B. T. BG. Gullers a Centrol" y5-- q - Duplex Reinforced Nt ► z •,- / PLUMBING Bed 1 12. - /LS7 Apartment Brick 2"�: "X - Brick SAin /e r ood Bed I Flot Wood Sub Floor Stone Shake Oi/Burner - Court Piers WINDOWS rile Fixtures Shutters ' /vfole/ D.H. osemenJ Tile Trim IYolerHeoler M.-BT.U.. Insulated Ceilin s Slee/ Sosh Composition v • Autamolic Fiiep/oce� j=9 Kitchen Ire;" 1 11;nh/1 IHpovw I I/nsu/ated No//s I (Screens - FNIComOo.Shinale I\IGos I IE1ect. I I -Veo I uroin bd. I molertol: ILOI1r. rt. Isb/osh: CONSTRUCTION RECORD EFFEC. APPR. NORMAL % GOOD RATING. (E, G, A,F P) BATH DETAIL Permit No. For Amount Dote YEAR YEAR Remoin9 Toble ^/o Aqe Life . Cond. Arch. Func. Attr. Plan Con- Stora eSpace Worn- Fl. No. FINISH FIXTURES SHOWER form. upbd /osef 'reship Floors Wo/ls a Lo. ub Type Grode t. Q Finish a y5-- q - S /LS7 �. SPECIAL FEATURES Book Coses Built-in Beds YeneNan Blinds Shutters ' COMPUTATION MISCELLANEOUS STRUCTURES Structure Found Cons. Ext. Roof Floor Int. Sire etc. c, COMPUTATIONS X2,1- I�XU• �' � ar6"' �'L3.9 � T1 r-3 Remarks: (0(�) r "7 0o M I