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Home My WebLink About030-360-014BUTTE 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: 1684 BIGGS AVE Owner: permit No: B06-2754 APN: 030-360-014 BATES, LINDA E REV I V TRU Issued Date: 12/04/2006 By KCG Permit type: MISCELLANEOUS P O BOX 8704 Subtype: Re -Roof CHICO, CA 95927 Expiration Date: 12/04/2007 Description: RE -ROOF (22 SQ) 530345053 Occupancy: Zoning: AR_'/: Contractor Applicant: Square Footage: AFFORDABLE J C ROOFING AFFORDABLE J C ROOFING Building Garage Remdl/Addn 288 PANAMA AVENUE 288 PANAMA AVENUE CHICO, CA 95973 CHICO, CA 95973 (530)680-9471 (530)680-9471 Other Porch/Patio Total FEE INFORMATION Re -Roofing $137.50 Total Charged: $137.50 Fees Paid: $137.50 Balance Due: $0.00 Receipt No: B1051 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 AFFORDABLE J C ROOFING 868569 / C39 / 12/31/2007 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 for9p and eff 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 12/04/2006 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractors 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 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.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: 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: 285,0002582 Exp. Date:01/06/2007 Contractor's License Law.). (This section need not be completed if the permit is or on. hundred dollars ($100) or less.) ❑ I AM EXEMPT under Section B. & 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 sub;ect to the Workers' Compensation laws of California, and agree that if I should become subject to the workers'X 12/04/2006 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owners Signature Date provisions. ' 12/04/2006 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 State laws relating to building kswra 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 officeagents 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, a injury, including death, and property damage caused arising out in any way connected with DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge thatt is issuance of thisis pea rmit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the pro a own r or am au hod d to act on the property owners behalf. CONSTRUCTION LENDING AGENCY lW 12/04/2006 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a const-uction lending agency for ame of PermittSIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner V Contractor OR. Agent for Owner Agent for Contractor jaiLenders FILE COPY Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND' SUBMITTAL REQUIREMENTS OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buffecounty.net/dds "PLEASE PRINT CLEARLY* OWNER INFORMATION Last NameS irst Name Name Mailing Address -CS. �v City 6) 'cvcfi LLC State A Zip Phone 5 So 5— lax E-mail CONTRACTOR NameCA Name Address N P� �A t�U CityState G t ` C,o c� Zip 9 73 Phone C S 3 0 Fax E-mail j7(:jQ L20an�D Lic, #�685�`1 Clasc_31 APPLICANT INFORMATION ARCHITECT/ENGINEER Name City i Address Tzip City 1 State Zip Phone 'II Fax E-mail Page State License Number APPLICANT INFORMATION Name Address l City i State Tzip Phone i Fax E-maR i • I APPLICANT SIGNATURE C For office use only:: Zoning Property Ad res ; y /,31 S Avg Flood Zone Cross Street 18 Ti�t s7 SRA I Yes I No Occ. i Type Const. Subdivision Name i Map Book Page Lot # Planner Date Approved: PERMIT NO. BIN # PROJECT LOCATION AP# O.} Property Ad res ; y /,31 S Avg City prz�vfl (t G- Cross Street 18 Ti�t s7 WORKER'S COMPENSATION Policy Number 00o,7,58�� CarrierS,��C� 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: C9'S� Sq FT- Living Garage Open Cov ❑ 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. Received byt& Amount J� Bldg SRA Receipt #: Sheriff ` I Wl SMIP 06 � Other Date: J �' i l` l� Total