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HomeMy WebLinkAbout030-360-007030-360-007 4-121 SKAGGS 1220 1STH ST, OROVIL Cont-. SEARS VINYL SIDING PERMIT RENXW AL DATE: S BP# EXPIRES: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION At: (530) 538-7636 (+OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP041215 LICENSED CONTRACTORS DECLARATION 1 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- 04/28/2004 APN: 030-360-007-000 the Business and Professions Code, and my license is in full force and effect. c - License Class: � License Number: - Site Address: 1220 18TH ST ORO CC -.IL Sir-'sc Date: �,� 1 L.1 Contractor: Mapindex: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NEW VINYL SIDING Contractors' State License Law for the following reason (Sec. 7031.5 1 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior I Owner: SKAGGS JAMES A & ROXANNA M 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 1220 18TH ST 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95965 violation of Section 7031.5 by any applicant for a permit subjects the 1 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 Aj plicant: SKAGGS JAMES A & ROXANNA M 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, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: SEARS HOME IMPROVEMENT PRODUCTS ❑ 1 am Exempt under Article 3 of the Business and Professions Code I INC j Date: Owner: 1024 FL CENTRAL PARKWAY LONGWOOD, FL 32750 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 License #: 721379 hn 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 Architect: insurance carrier and policy number are: Engineer: Carrier: Policy #: `I L.Q, 7Go L- Z Q j - f✓� ❑ I certify that in the performance of the work for which this permit is Ft: Square Total Sa 0 S•F• /�/0/dissued, I shall not employ any person in any manner so as to i - I / become subject to the workers' compensation laws of California. Valuation- $0.00 and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall Census Code: ^ forthwith comply with those provisions. / Date: 1"?0(�0�/� ' /-� //%`/Y��r Applicant: 1y✓ (� �( pensation coverage is WARNING: Failure to secure workMd' unlawful, and shall subject an employal penalties and one /��'v 1I' `� F�°4'((��, ! .0 hundred thousand dollars ($100,000tion 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 parm itis hereby. issued under the applicable provisions of the Brrtte County Code anrt/or I hereby affirm that there is a construction lending agency for the V Resolutions to do rk indicated a ve or which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) _ By: Date: Name: V. PERMIT EXPIRES ON: Address: Date ❑ 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. 1 hereby authorize representatives of Butte Cou to enter upon the above mentioned property for inspection pu ses Print Name: v Signature: T r� n <� `�-� L Date: 0 Owner 13 Contractor Agent for Owner 0 Agent for Contractor BALANCE. OF FEES SHEET DATE: q - 2S - J PERMIT #: 0y -1215 ASSESSOR PARCEL #: 0 so-� OWNER'S NAME: —EKa�� FEES (Amount and Purpose): BALANCE OF FEES: $ ADDITIONAL FEES: $ REVISED PLAN CHECK: $ SHERIFF FEE (commercial only): $ SRA: $ COPY FEES ($1 or more) $ DRAINAGE $ BASIN BC RESIDENTIAL IMPACT County Wide Chico Urban El Medio North Chico Specific _ $ WATER TENDER FEES $ BATTALION # FEMA $ SMIP $ OTHER Rpni 11J Q C RECEIPT NUMBER(S) BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.net%dds PERMIT NO. BP041216 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: 04/28/2004 APN• 030-360-007-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 1220 18TH ST ORO Date: Contractor: Sc- r-NKZ. S Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NEW VINYL SIDING 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: SKAGGS JAMES A 8r ROXANNA M 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 1220 18TH ST 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA 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 95965 applicant to a civil penalty of not more than five hundred dollars ($500).): O 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 Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: SKAGGS JAMES A 8r ROXANNA M 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, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: SEARS HOME IMPROVEMENT PRODUCTS ❑ I am Exempt under Article 3 of the Business and Professions Code INC Date: owner: 1024 FL CENTRAL PARKWAY LONGWOOD, FL 32750 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 License #: 721379 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 Architect: insurance carrier and policy number are: C � Engineer: Carrier: J TOta(S ware Ft: 0 S. F. �� t��^^ Policy #: l.QA -.)- Cs� flc)o L� Z "!�i — o Z4 ❑ 1 certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to 4 become subject to the workers' compensation laws of California, Valuation: $0.00 and agree that if I should become subject to the workers.' compensation provisions of Section 3700 of the Labor Code, I shall Census Code: forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure wo pensation coverage is IMS. r 12°C�(%t�(1; ! co unlawful, and shall subject an employer i 'nal penalties and one hundred thousand dollars ($100,000), in a tion to the cost of compensation, damages as provided for in Section 3706 of the Labor 'q (. ' code, interest, and attorney's fees. ! >� CONSTRUCTION_ LENDING AGENCY. This permit is hereby issued under the applicable provisions of the Butte County Code ?nrVor I hereby affirm that there is a construction lending agency for the Resolutions todo►r rk indicated a ve or which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By: �/�/;�mnc�bamd Date: PERMIT EXPIRES ON: 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 buildinconstruction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte Cou enter upon the above mentioned property for inspection pu ses ;-o 4 `� Print Name: M �i V ` Signature: pLC� '0 L Date: 0 Owner ❑ Contractor Agent for Owner ❑ Agent for Contractor BUTTE COUNTY . DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION x'24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP' �)j aq- l ::� Il ,s DATE: /� 0 ! J APN: 0too OO-� ZONING: OWNER'S LAST NAME`: OWNER'S FIRST NAME: PHONE: S u — V\tc\C-1, STREET ADDRESS:` — FAX CITY, ZIP: r© N\`\� ( �� EMAIL: SITE ADDRESS. _ S CITY, ZIP: NEAREST CROSS STREET: TRACT/LOT P. APPLICANT NAME: PHONE: 17/& 605 3 STREET ADDRESS: FAX CITY. ZIP:XA � `O` J �` E`i E-MAIL CONTRACTOR NAME: PHONE: STREET ADDRESS: 16zL4 EL Cf -y--4 FAX -,%Cf -P%,4 � crrr, ZIP: Lan w000C f --L_ 32 E-MAIL: 4 LICENSE NUMBER: LICENSE TYPE: ARCHITECT/ENGINEER NAME: 'P PHONE: STREET ADDRESS: FAX CITY, ZIP: LICENSE NUMBER: E-MAIL DESCRIPTION OR SCOPE OF WORK: n f S t (p(9 L� 3 — ❑ 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 fees will be required. 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. For office use only: Notes: Application Received by: Date: Receipt number: Amount Received: Master application 3-4-04 .N THERMALITO IRRIGATION DISTRICT 410 GRAND AVENUE (�� OROVILLE, CALIFORNIA 95965 TELEPHONE: (916) 533-0740 FAX: (916) 533-9243 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: 1220 --18th Street Owner's Name: Ja,•m , Slza�,s Date: Narw 21, 1990 Address: 1220 -•18th StrcQt Acct. No.: 02072500 Oruville, CA. 95965 A.P. No.: 33-360-U0 Phone: 538-8450r New Unit: 1 IQ Applicant/Agent:ynnV;ard Con:;truetion (Sam Gardiner) Adding Units: Address: Fees: Phone: Permit: $ 30 00 T.I.D.: 6Vj 00 Preliminary Review By: Date: Ext. Fees: Remarks:* Clean oat uu to grade rcuuirea at promrtY line. SC -OR: 900 00 Lateral: ' Other: Total Fees: 153U GU Amount Paid: ,1530.00 By: Su' Fu,-- Finaled By , e Date: a %� nCollected 7 6 Location: Size Line: "� 3.S� �' d D t.!se rz-5 M4/ Al a t/ 7" 1/746 G' %i4 E �r o E/P �" ,L �i✓ '9- 40 6/d Ate)? q Signature of Owner/Agent: MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON COMPLETION Date Billed: Computer: Paid SC -OR: A.P. File: ' (R.F.C.) Blue Book: E-4ireAmentai Health Paid SC -OR: Meter Book: (S/C HG's) APR 1 b 19,9b nroville, California Rev. 6/96