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HomeMy WebLinkAbout031-245-00631-245-6 Bill Pearsall 81 CJ,Ave., lot 6, Therma]o ' ermit #402-77B,P,Er1(new single family) ' _. MISCELLANEOUS Re -Roof RE -ROOF, PRO 30 COMP(20 Q) 881 COLUSA AV . GRIGGS SONJA L%07; i ' B07-1460 031-245-006 MISCELLANEOUS Siding/Stucco INSTALLATION OF SECURITY BARS 881 COLUSA AVE LOU XIONG, AND LOR VANG B07=2134 - :031-245 006 MISCELLANEOUS ... Water Heater C/O C14ANGE-OUT WATER HEATER & M j 881 COLUSA AVE LOU XIONG; AND COR VANG LM 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: 881 COLUSA AVE Owner: Pennit NO: B07-1460 APN: 031-245-006 LOU XIONG, AND LOR VANG Issued Date: 07/06/2007 By TMP Permit type: MISCELLANEOUS 881 COLUSA AVE Subtype: Siding/Stucco OROVILLE, CA 95965 Expiration Date: 07/05/2008 Description: INSTALLATION OF SECURITY BA (530) 534-5927 Occupancy: Zoning: AR Contractor Applicant: Square Footage: LOU XIONG, AND LOR VAN( Building Garage Remdl/Addn 881 COLUSA AVE - OROVILLE, CA 95965 ' Other Porch/Patio Total (530)534-5927 FEE INFORMATION DBMSC Stucco/Siding-Stone/Bric $58.00 Total Charged: $58.00 Fees Paid: $58.00 Balance Due: $0.00 Receipt No: B3779 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 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 basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 07/06/2007 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does 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.). ❑ I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by n1,AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED 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. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractofs License Law.). Carrier. Policy Number: Exp. Date: (This section nee not a completed if the permit is or one 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 subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers'X 07/06/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. X 07/06/2007 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 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 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 DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge that issuance of this permit 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 property owne or am authorized to act on the operly owner's behalf. .rte. J 07/06/2007 CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of ern tee [SIGN] Print Date 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 Lender's Address City State Zip �VTrF BUTTE COUNTY 0 0 DEPARTMENT OF DEVELOPMENT SERVICES 0 o BUILDING PERMIT APPLICATION 0 0 OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 o--�- o A FEE WILL BE REQUIRED AT TIiVIE OF APPLICATION Website: w, +w.buttecounty.net/dds DUNS **.PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name; o n First P706 Mailing Address P9/ >91W1re_ City,119ROtr1%iC1 Stat e�A Zip s Pho Sap j3 rf Fax E-mail CONTRACTOR Name Address City State Zip Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X a PERMIT ,pANO. J VU�� BIN It PROJECT LOCATION API Property Address City WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a.certiftcate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY . . Name Address DESCRIPTION OR SCOPE OF WORK: 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 Yes No Occ. Type Const. IN�� Qro�-w oc�r' sh�jo bFPra�&ed prail"' g Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530)53 - 8-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations understate law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE . AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY PLAN TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION.OF THE PROPOSED PROPERTY IMPROVEMENT. (YES OR D I6IQV4'HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME. - ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS PHONE CONTRACTORS LICENSE NO I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: INSTALLATION OF SECURITY BARS FOR WINDOWS Reference Number: B07-1460 Applicant Name: LOU XIONG, AND LOR VANG Owner's Name: LOU XIONG�, AND LO/R�VANG AP # : 031-245-006 Signature of Property Owner: Date: - -o T- .. � ' . � .. � . • � . • Illiiillllilllllili0iill�lilliil6il •. } e' RECORDING REQUESTED By 2>I-7 00aS�3ag• Bidwell Title & Escrow Company, Recorded 1 REC' FEE 1®.88 Official Records I TRX 247.58 AND WItEN RECORDED MAIL TO t Cogunu�ye0f Lou Xiong OANM J. GRIM Coltnty Clerk-Recorder.l 881 Colusa l Addy KL Orovllle, CA 95965 I _ ?J, y 19:111M 15 -Jun -+2887 i Page 1 of 2 Order nm 00231058-001 1 SPACE ABOVE THIS LINE FOR RECORDER'S USE l'amel No. 031-245-OD6 GRANT -DEED THIS FORM FURNISHED BY ©IDWELL TITLE & ESCROW COMPANY The Undcrsigned Grantor(s) Declare(s) Documentary Transfer Tax is $247.50 ❑ City/Town of 0 computed on full value of interest or property conveyed, or 0 Unincorporated Arca [Ifull value less value of liens or encumbrances remaining at K the time of sale ❑ Monument Fee of S 10.00 FORA VALUABLE CONSIDERATION, receipt of which is Hereby acknowledged, 881 Colusa Trust •, Delf i. Inc., Trustee : hereby GRANT(s) to Lou Xiong, an unmarried woman and Lor.Vang, •an unmarried man, as foint.Tenants the following real property in the ❑ City of 0 Unincorporated Area t County of Butte, State of California: • . K(� SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF ' 881 Colusa Trust By: Delfi Inc, Trustee (F.A. Randall, VP). Documentatc: June 12, 2007 State of California County of p ss (o �/'' �/niLc,✓ :tea ' On before •me, ' Notary Public, personally appeared F. A. Randall- Personally andall Personally known to me (or proved to me on the basis of satisfactory -.' FOR NOTARY SEAL OR STAMP evidence) to be the persons) whosc.name(s) istare subscribed to the within instrument and acknowledged to me that helshe/they executed ' t. the same in his/her/their authorized capacity(ics), and that by his/her/their signature(s) on the instrument the person(s), or the entity i upon behalf of which the pe n(s) acted, executed the instrument'. JODIE FlNATO. COMM. # 1559159 WITNESS hand `and ficial s I. W II(ITARYPUBLICC'FORMA COUNTY OF BUI•i t Comm. Explrea Feb -17.2009 Signature MAIL TAX STATEMENTS TO: Same as Above BTEC/GRANMEED as I . 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 Contractor Applicant: Square Footage: ABLE PLUMBING & ELECTRICAL ABLE PLUMBING & ELECTP Building Garage RemdUAddn PO BOX 7907 - PO BOX 7907 CHICO, CA 95927-7907 CHICO, CA 95927-7907 Other Porch/Patio Total (530)899-9009 (530)899-9009 FEE INFORMATION DBP Water Heater (qty) $58.00 ' •F LICENSED CONTRACTOR'S- DECLARATION, Contractor (Name) IState Contractors License No. / Class / Expires ABLE PLUMBING & ELECTRIC 627760 / C36 C10 / 02/28/2008. I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencm ith Sectio 00) of Division 3 of the Business and Professions Code, and my license is in full fond eff�.. Signature 10/15/2007 Date I 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. ` HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by 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; Cartier: DELOS INSURANCEpolicy Number: 01DKRM1200010(�xp Date:05/01/2008 (This section need not be completed if the permit isfor one hundre dollars ($100) or ess. ❑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 joS ion 3700 of the Labor Code, I shall forthwith comply with those WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. ,CONSTRUCTION LENDING AGENCY, , I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) IL Balance Due: $0.00 Receipt No: B OWNER / BUILDER DECLARATION ' I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License. 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 pursuant to the provisions of the Contractor's 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); Please check one of the following: , ❑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 the 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 improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: 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 Contractor's License Law.). ❑ I AM EXEMPT under Section B. 8 P.C. for this X 10/15/2007 Owner's Signature Date r. 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 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 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 use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte �enterentioned property for inspection purposes. I hereby certify that I am the rents to act on thepr c ars bah I 10/15/2007 Nl Print nate Owner Contractor OR. ElAgent for Owner Agent for Contractor Lenders Address City State • Zip FILE COPY - PROJECT_INFO_RMATION Site Address: 881 COLUSA AVE. Owner: Permit No: B07-2134 APN: 031-245-006 LOU XIONG, AND LOR VANG Permit type: MISCELLANEOUS 881 COLUSA AVE Issued Date: 10/15/2007 By KEJ Subtype: Water Heater C/O OROVILLE, CA 95965 Expiration Date: 10/14/2008 Description: CHANGE OUT WATER HEATER & (530) 534-5927. Occupancy: Zoning: AR Contractor Applicant: Square Footage: ABLE PLUMBING & ELECTRICAL ABLE PLUMBING & ELECTP Building Garage RemdUAddn PO BOX 7907 - PO BOX 7907 CHICO, CA 95927-7907 CHICO, CA 95927-7907 Other Porch/Patio Total (530)899-9009 (530)899-9009 FEE INFORMATION DBP Water Heater (qty) $58.00 ' •F LICENSED CONTRACTOR'S- DECLARATION, Contractor (Name) IState Contractors License No. / Class / Expires ABLE PLUMBING & ELECTRIC 627760 / C36 C10 / 02/28/2008. I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencm ith Sectio 00) of Division 3 of the Business and Professions Code, and my license is in full fond eff�.. Signature 10/15/2007 Date I 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. ` HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by 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; Cartier: DELOS INSURANCEpolicy Number: 01DKRM1200010(�xp Date:05/01/2008 (This section need not be completed if the permit isfor one hundre dollars ($100) or ess. ❑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 joS ion 3700 of the Labor Code, I shall forthwith comply with those WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. ,CONSTRUCTION LENDING AGENCY, , I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) IL Balance Due: $0.00 Receipt No: B OWNER / BUILDER DECLARATION ' I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License. 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 pursuant to the provisions of the Contractor's 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); Please check one of the following: , ❑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 the 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 improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: 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 Contractor's License Law.). ❑ I AM EXEMPT under Section B. 8 P.C. for this X 10/15/2007 Owner's Signature Date r. 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 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 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 use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte �enterentioned property for inspection purposes. I hereby certify that I am the rents to act on thepr c ars bah I 10/15/2007 Nl Print nate Owner Contractor OR. ElAgent for Owner Agent for Contractor Lenders Address City State • Zip FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name • W/V ,a> First Name Mailing Address / [' City �� Stat Zip Phone -57 Z 7 Fax E-mail APPLICANT INFORMATION CONTRACTOR Name a ,% /_ Address � •�� ` �./ City •�o State/l ��-- J.Z Phone �p� 7 Fax E-mail Lic.# 2.7 ® Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip . City Fax . State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip . Phone Fax . E-mail ALWR 0 P N-91 P, PLISANT SIGNATURE PROJECTLOCATION Property Address g 777 j/ Policy Number. Carrier NO. BIN # WORKER'S COMPENSATION If hiring anyone other than license contractors, a certificate of worker's compensation must tie shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: 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. a.a�atz�;G'�.h'�.�,rv"ai'.�N�'`'�:� - .. ,. /� .»,�,�. Y�.r�rp.:.•,�•�;-i9��'�r,��• Win'fro`ri°w#-""�'f5�3tit''`<�_°`,:�r�s:�.—�•,_. // 1 -. � i4 j, _ ' � ji f r �. 4 .. ,. .. I � r 1 �i _ .. � � .. . r t. .. � � ' � � _ • ._ • � '' t . � � �_, ` ��-�� fir. A �. . �. /�. :''_ ',r _ COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 031-245-006 ZONING AR BUILDING PERMIT OWNER SONJA GRIGGS TELEPHONE 533-8756 SO' FT' OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 881 COLUSA AVE OROVILLE, 9 965 CONTRACTOR'S NAME OtJPtFJt TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN I Total Valuation $ LENDER'S MAILING ADDRESS 4I Filing Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEERS HARI Energy Plan Checking Fee $ n Penalty $ BUILDINGADDRESS 881 COLllSA AVE PERMITFEE $ OROVILLE 95965 PLUMBING PERMIT Filing Fee 20.00 Each Trap •" •. 7.00 LOT NO. SUBDIVISION'S NAME PARC'L MAP Solar Or lieat,pump water heater 23.00 i USEOFSTRUCTURE t SF ❑L Duplex ❑ Mobilehome ❑ Other 1 SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: RECOTT"M F.LFCTRIC Mobile HomeS G W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT FilinQ Fee 20.00 Main Service a OR LESS ( 200A OR LESS ) 23.00 + Main Service ( 200A TO 1000A ) 46.00 t LICENSED CONTRACTOR'S 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. License Class Lic. No. OWNER -BUILDER DECLARATION 1 herebyaffirm under penalty of perjury that I am exempt from the Contractors License P tY P 1 rY P Law or the following reason: 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. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to, construct the project. 1 ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP. OR ADONS. ( & ACC. BLDS. ) SO. 3.50 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( d SINGLE OUTLET POWER APPARATUS ) CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL .50 Ex. Occup. FIXED E SO.) A P R 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 3.00 Contractor 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 is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: , Carrier ► MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the�permit is for work of a valuation f one hundred dollars ($100) or -Jess:) \ 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 workers' 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 omply with those provisions' ' ' X / � Date Sinature�of Appl� ntt-her ontractor ❑ Agent An OSHA permit is requirerforxcavations over 60" deep and demolition or construction of structures over 3 stories in height.., - Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE I TOTAL FEE $ 43.00 HAZ I D. FEES IMP I FLOOD I CDF PARCEL I PDJISSUEcompensation This permit is hereby issued under the applicable prof the Butte County Code and/or Resolutions to d indicated above for which fees have been paid. / �[[ (.ter- Date PERMITEXPIRESON (Date) JLJ Receipt No. I WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7`��c PERMIT NO. APPLICATION AND PERMIT -�- ASSESSOR PARCEL NUMBER 031-245-006 AR ZONING BUILDING PERMIT �u OWNER SOTdJA GRIGGS 53PHONE SO. Fr. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 881 COLUSA AVE OROVILLE, 95965 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNMOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 881 COLUSA AVE PERMITFEE S 0TROVILLE 95965 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF EX Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: RECONNECT ELECTRIC Mobile Home I S I GI W (_a20.00 PERMITFEE g Contractor ELECTRICAL PERMIT Filina Fee 20.'00 Main Service / 800V OR LESS OR LESS ) 23-00200A 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S 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. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law or the following reason: 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to, construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ADDNS. ( a ACC. BLDS. ) SO. 3.50 FT. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( 8 POWER APPARATUS ) SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 SAL .50 Ex. Occup. oFIXEEDis (RES o.j ea ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 43.00 Contractor WORKERS' COMPENSATION DECLARATION I 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 is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation loW one hundred dollars ($100) or less.) 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 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 omply with those provisions. P X __ Date �� —�� �� Si of Appli rf =A -O ner Contractor ❑ Agent An OSHA permit is requir for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 43.00 HA2. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have PERMITEXPIRESON_ applicable provisions Resolutions to do work been paid. Date o -- (Date) Receipt No. 185238 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ::..... O.B. 1 :}:':><:::::::>:::::>::E?<::>::::>i:::?::'::Y:;:?':?::::':_:::::..::..::::<.::.:z:.>:z::.:::i:;:>:zz:::::>.<.::vv>:i::.:;:.:::.i:.,:.,::.»:::i::::::::>:<z«:::>::>:;<z::.::.::.:::.:::;::•.:::..:..:::::::::';: �: ir:,.. ':� BU :iv}ii. �•�. '� . nv• Kti xg .EM v: r{.: N :v. Attention Property Owner: An "owner-builder" building permit has been applied".for in your name- and be your _ — - signature. Please complete and return _this information at your earliest. opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. . 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement YES 6m/4 r, NO[ ]. 2. I HA HAVE NOT[ ]signed an application for a building permit for the proposed work. 3. I have contracted with the following ' person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: , ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide *the work indicated: , NAME ADDRESS PHONE TYPE OF WORK SIGNED: i PROPERTY OWNER: SOCIAL SECURITY NUMBER: DATE • NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Dear Property Owner: - An application for a building.permit has been submitted in your name listing yourself as the builder of property improvements specified. - - - - For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit: Building permits are not required to be signed by property owners unless they are personally. - performing their own work. If your work is being performed by someone other than yourself you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your b�nefit and protection: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. 0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract- the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions: A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1026N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. r Sincbrelv. •. Michail C. Vlelra, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER 45 h -I'D -`I BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico), Office: (530) 538-7541 Fax: (530) 538-2140 Website:www.buttecounty.net/dds Permit No: B07-1153 Issued: 05/25/2007 Address: 881 COLUSA AVE Area: OROVILLE Owner: GRIGGS SONJA L APN: 031-245-006 Applicant: ALLADIN ROOFING Map Page: Permit Type: Re -Roof Description: RE -ROOF, PRO 30 COMP(20 SQ) r AREA 1 Flood Zone: None SRA Area: No Front Setback: Side Setback: Rear Setback: Other Setback: Minimum Setback From Centerline of Street: ALL PLAN REVISIONS MUST BE APPROVE BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test House 404 Gas Test Yard 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Holdowns/Straps 122 ShearwalUB.W.P.-Interior 135 Shearwall/B.W.P.-Exterior 135 Roof Nail/Drag Trusses gy 129 Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Shower Pan/Tub Test 408 Fire Sprinkler Test 702 Fire Sprinkler Final 702 Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Pool Final 802 Mobile Home Final 802 Inspection Type I IVR I INSP DATE Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Swimming Pools Setbacks 132 Pool Plumbing Test 504 Gas Test 404 Pre-Gunute 506 Pool ElecBonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 507 Manufactured Homes Setbacks 132 Blocking/Underpining 612 Tiedown/Foundation System 611 Site Utilities/Trench Insp. 137 Gas Test Yard 404 Manometer Test 605 Continuity Test 602 Skirting/Steps/Landings 610 Coach Info Manufactures Name: Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: Insignia: Public Works Fina 538-7681 Fire Department/CDF 538-6837 cxt 169 Env. Health Final 538-7281 Sewer District Final "PROJECT FINAL 801 , -rrolect rmai is a uernucate of Occupancy for (Residential Only) PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A I YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy 37 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 X 05/25/2007 Site Address: 881 COLUSA AVE Owner: - Signature Dateto Permit NO: B07-1153 APN: 031-245-006 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 GRIGGS SONJA L injury, including death, and property damage caused arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS $100,000, IN ADDITION TO THE COST OF COMPENSATION, ( ) Issued Date: 05/25/2007 By KCG Permit type: MISCELLANEOUS 1805 ELGIN ST ATTORNEY'S FEES. Subtype: ' Re -Roof CONSTRUCTION LENDING AGENCY OROVILLE, CA 95965 " Expiration Date: 05/24/2008 Description: RE -ROOF, PRO 30 COMP(20 SQ) , , the performance of the work for which this permit is issued. (3097 civ. code) , Occupancy: Zoning: AR Contractor Applicant: Square Footage: ALLADIN ROOFING ALLADIN ROOFING Building . Garage RemdUAddn P O BOX 4262 P O BOX 4262 OROVILLE, CA 95965 OROVILLE, CA 95965 Other Porch/Patio Total (530)533-2934 (530)533-2934 FEE INFORMATION DBMSC Re -Roofing* $110.00 Total Charged:. $110.00 Fees Paid: $110.00 Balance Due: $0.00 Receipt No: B3245 -LICENSED CONTRACTOR'S DECLARATION OWNER/ BUILDER DECLARATION `•' a Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License ALLADIN ROOFING 532834 / C39 / 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, I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 also requires the applicant for such permit to file a signed statement that he or she is licensed (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 e eIX. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the �CiC basis for the alleged exemption. Any violation of Section ed dol by any applicant for a permit subjects X /J �„ � �)' / 05/25/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; Signature Date Please check one of the following: I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE ,WORKERS' COMPENSATION DECLARATION 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 I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: Law does not apply to an owner of the property, who builds or improves thereon, and who does 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.). ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED - I'v I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: action 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves. My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License taw.). r Carrier: State Fund Policy Number: 7130001977 Exp. Date:10/01/2007 (This section need not be completed if the permit is torone Mundred dollars ($100) or less.) ❑1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ' ISSUED, Ishall 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 ❑ I AM EXEMPT under Section B. & P.C. for this 05/25/2007 provisions. Owner's Signature Date X 05/25/2007 - - - - :: . . I hereby certify that I have read this application and state that the above information is correct. I agree - Signature Dateto comply with all City and County ordinances, rules, regulations, and State laws relating to building 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 injury, including death, and property damage caused arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS $100,000, IN ADDITION TO THE COST OF COMPENSATION, ( ) the issuance of this permit. I hereby acknowledge thatt is issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to ant a above mentioned property for inspection purposes. I hereby certify that I am the CONSTRUCTION LENDING AGENCY Pro er off^ au d to act on the property own r s behalf. " ! 05/25/2007 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name O Permittee [SIGN] PrintDate the performance of the work for which this permit is issued. (3097 civ. code) , ❑ Owner . Contractor OR. Agent for Owner Agent for Contractor Lender's Address City State Zip FILE COPY rs BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530)'538-2140 A FEE WILL BE. REQUIRED AT 711WE OF APPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Lastme 11 Fi me Maili g Address City State Zip Phone 73- Fax E-mail CONTRACTOR Name Address City State Zip Phone Y- -,�3 Fax 56�� E-mail Lic. #s. y Class APPLICANT INFORMATION A RCHI TECTIENGI NEER Name City Addtess Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE PROJECT LOCATION AP# Property Address V City� �`' G c c / o PENT NO. 10� v1)5�) BIN # . WORKER'S COMPENSATION Policy Number `713-197? -ds 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: / C, Sq FT- Living C;)OA Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA Yes No Occ. Type Const. I i PERMIT NO. 4027-77B,P;h,M PERMIT EXPIRES OWNER Bill Pearsall CONTR. owner LOCATION (A.P. 31-245-6 $jifXl�IdiFXib� 88.1.Colusa Ave., lot 6, Thermalito R T6 'A Temp. Power Pole ¢ Called PG&E -± Temp. Elec. Serv. ` Vii, Called PG&E Temp. Gas Serv. _ 9� Called PG&E • JOB FINALED `4 (Date) (Signal re) ,,/� 41-e 7. 7 THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT REGULA- TIONS, CALIFORNIA, ADMINISTRATIVE CODE, TITLE 25, STATE OF CALIFORNIA, IWTHE BUILDING LOCATED AT: Street Lot Number Tract No. EXTERIOR WALLS Manufacturer �a'�� ✓ ' - 'Thickness/Type �C R Value CEILINGS Batts: Manufacturer Thickness R Value Blown: Manufacturer �x's2��'�/ Thickness S No. Bags Wt./Bag Sq. Ft. Covered / _z R -Value FLOORS Manufacturer Thickness/Type R Value SLAB. ON GRADE Manufacturer Thickness/Type R Value Width of Insulation ;nches FOUNDATION WALLS Manufacturer, Thickness/Type R Value GENERAL CONTRACTOR LICENSE No. BY TITLE — DATE INSULA ION CONTRACT = R: HAWKIN'S INSULATION CO. LICENSE No. 215-925 BY TITLE ' ate- DArF COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING _ I BUILDING (Cont'd) I PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 1 5� %7 3rd Floor Stemwall Siding — To out Slab ' .% Roof SheathingWater Pi in Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwall Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for ph s cally: handicapped Conformance of ex. structure A Iiances Gas Piping 8 Test Temp. Gas Slab Final Sanitation Patio FIREPLACE. Final Footings Footinq ELE-CTRICA.L , Reinf. Steel / Final Temp. Pole Fixtures Bond Beam Underground FIRE SPRINKLERS Motors Framing Test Final o-7 Water His. Stucco Final Elec. Pedestal Subpanels Mesh 3 % Gas Piping MEC NIC% Grd. Fault Prot. Scratch Heatin �41__, Service Brown Cooling - Temp. Pole Finish Ducts Al la Underground Interior Lath 047Ventilation Permanent .'f,3 Door Closer Final o-7 Final MOBILEHOME UTILITIES ------------------ Elec- Service Elec. Pedestal Water Piping Sewer Gas Piping M01316EMOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS 01 04-1 (NOTE: An entry must be made on this form each time you visit the job site.) f/ COUNTY OF BUTTE^ — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Uroville, California 95965f< —7 7 Telephone: 534-4541 / APPLICATION AND PERMIT A ham/ au a w„cc representau ves UI the L,Uunty Of Butte to enter upon the above-mentioned property for inspection purposes. X .1 X a ,e G Signature of Perm a or Agent Receipt No. —� �-7 FS White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. le DIRECTOR OF PUWLIC WORKS By Date Building permit expires Date _�-- BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address 130 �eleplione No ' Fireplace Contractor Total Valuation 19 E-01 no Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. a O Permit Fee P IT 9zuix Building Address f 8 A lulaPERMIT PLUMBING No. @ FEE FILING FEE $3.00 I S Each Trap 1.50 Repair drainage or vent piping 1,50 Water piping 1,50 Zoning Verification O il1 Each gas water heater or vent 1,50 3 , o� A. P. No., ..0 /� �?a n� Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F s 4,6/ S—rl FireDept. FireZone Use Permit Building sewer 5.00 EQA Parking Parcel Declaration Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 ``Plans �Ta ec Parce Approval PIa pproval Permit Fee $ 1 $ NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 3 Main service 100 AMP ORLESS5.00 Main service EA. ADD•L 100 AMP 2.50 Single Family R2'�o' Duplex ❑ Mobil Home ❑ Others ❑ OVER 600V___ Main service 1100 AMP OR LESS 25.00 Main service EA. ADD•L 100 AMP 1.00 • ' NEW CONST. DW OR ADDNS. ( ACE I G CUP. &) 20 sq ft NEW CONSTR. MULTI -OUTLET N0N.RESID, ( BRANCH CIRCUITS) 2.50ea ' NEW CONSTR. (POWER APPARATUS & NON.RESID, SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES50 )@2!S¢ 109 Ex. Occu FIXED APPLNS, OR Occup. 2.00 OUTLET S.(RESID•) EA) Temporary service 10.00 _ Mobile Home.Facilities 15.00 License No. Classification Misc..Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. J t have placed on file with the County of Butte a certificate of. Workmen's Compensation Insurance. ❑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 Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 p Heating pp *Do Cooling. Ventilation Hood 2.00 Permit Fee $ $ 00 I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL 'PERMIT FE $ au a w„cc representau ves UI the L,Uunty Of Butte to enter upon the above-mentioned property for inspection purposes. X .1 X a ,e G Signature of Perm a or Agent Receipt No. —� �-7 FS White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. le DIRECTOR OF PUWLIC WORKS By Date Building permit expires Date _�-- z V !'�his set of" Plans and'specifications MUST 6t, ker-� on flie i6b at all fines and if is unlawful fc rKDkc. e,-Iy chanr—s or a!t torafions,oii same wifhoui wriflen PGrrnissiclia fr6m"the-Deparfmenf of Pub Inc Works,,Coynfy 064putfq.-r kOTE:—All Mcierip.1 S & Workmanship qk,.Il Be.ACCO VIn Practices, and ed Good af a V 1, for the Specified use in the Wr;foirm D L' ildiqgl PILW.Is; 9 & Mechanical Codes and' the National Electrical 'r' Code. The Bid Setback shall be 5 ff. frdrn 9 the 4,01Z 0 4w 47 c. side prcperty line and 50 ff. from the centerline of the road, permiff ing q rnaxi- A-5-nurn of a 2.ff. eave overhang but eftfirely. Lor out of all easements. 4C po t�, Av buildi'nL, o,, 0 w 2!A This set Of. 0dris ands flans UST be , pecifiry kep on the iob.at all Mmes assd.: it is s wful to mak any changes or a7terati6nson sa me ithout written.permission from Elie Department o Pu6rc Works; County of Buttel . See Master Plan on'file for building J` The Bid g: Setback shall be ft: from the plans. ` :'ide .property line and So t. from t /centerline of the road the mum of a 2 ft, eave ove h ni nentire y out.of -all easements. but r v5&AA A BUTTE CC UNT1t BUILDING DE ARTM:. �a$�y AP.PRC VEC P414 ff Is c t� ' - --° THERMAL.ITO IRRIGATION DISTRICT 410,Q -RA -,D AVENUE V7 OROVILLE, CALIFORNIA 95965 ' TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: Owner's Name: r Date: Address: Acct. No: 1 -- "�✓'i l A.P. No. Phone: No. Units: Applicant/Agent: Agents Proof: Address: Fees: Phone: Application $ �' Arrearage Preliminary Review By: r Date: %- CSA 26 ` Remarks: SC -0 R 1st mo. S.C. Other Total Fees Collected By: Date: >` Field Review By: Date:^ Remarks: _ r .. , 17 e y_ p♦ ' i MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON: ❑ Date of TID approval of completed building sewer (early connection). ❑ 30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("existing construction", prior to Mar. 5, 1974). 180 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("new construction", after Mar. 5, 1974). DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD -. DPW to TID , .