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HomeMy WebLinkAbout031-271-008i JOHN CLASESSENS 31-271-8 1152 NEVADA AVE. OROVILLE' PE RMIp_#5463-75(1 T BLDG. SEWER) /F 031-271-008 03-1300 THEUS, LAURA 44� ` "I1152 N OILE V RELOCA R HTR/DUCT 036-460-008 04-3003 [IENRY, ,LAMES 276;0 OAK KNOLL WAY, OROVILLE Cont: OWNER ELECT SERVICE REPAIR 91 '2� 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. BP043004 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: 10/13/2004 APN: 031-271-008-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number. Site Address: 1152 NEVADA AVE ORO Date: Contractor. Map Index: Description: NEW PANEL 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, after, improve, demolish, or repair any structure, prior Owner: GABLE CHARLOTTE to its issuance, also requires the applicant for such permit to file a PO BOX 75 signed statement that he or she is licensed pursuant to the provisions of BERRY CREEK, CA the Contractor's State License Law (Chapter 9 commencing with'Section 7000) of Division 3 of the Business and Professions Code) or that he or 95916-0075 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).): 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 Applicant: GABLE CHARLOTTE 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.). ❑ 1, 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:. and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 11 am Exempt under Article 3 of,me Bus'ne s ancL Profes ions Code Date!o Owne License #: 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 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. Total Square Ft: 0 S. F. Policy#: 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: Applicant: WARNING: Failure to secure workers' compensation 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 attomey's fees. I CONSTRUCTION LENDING AGENCY s it is h eby issue d under the applicable provisions of the Butte County Coda an I hereby arm that there is a construction lending agency for the affirm performance of the work for which this permit is issued (Sec 3097 Civ.) s o work indicated above for which fees have been paid. / �) Name: (��� Datel By. l r7 �yDate� Address: PERMIT PIR SON: I ❑ 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 thesubstance of a official form or document of Butte County. I hereby authorize representatives of Buttes County upon the above mentioned property for inspection pure ses. toto'enter �// Ile— Print Name: Q./�<O / V Q CJ — Signature: 161,1 Date: ,lowner 0 Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT ,SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CIRCO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REO UIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" OWNER Last Namz�, 41ame v Address City State C Zip ojs-- Phone & 6 C Fax E-mail For office use only: CONTRACTOR Name tn Address SRA City No State Zip Phone Map Book Fax E-mail Planner Llc. # Class For office use only: ARCHITECT/ENGINEER Name tn Address SRA City No State Zip Phone Map Book Fax E-mail Planner State License Number For office use only: APPLICANT NAME Name tn Address SRA City No State Zip Phone Map Book Fax E-mail Planner For office use only: Zoning Property Add re Z fl e� Flood Zone Cross Street J SRA Yes No Occ. I Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERNIIT V q�3UQ BP BIN # LOCATION Property Add re Z fl e� City f Cross Street J WORKER'S COMPENSATION Policy Number 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 # Work: Sq. Footage ❑ 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. KIFORMSMILDING FORMS\BIdgApplSubRgmts.doc Page 1 of 2 Ktv /-Y/-U4 R Amount: Bldg yF SRA Receipt t Sheriff 6(, SMIP LDate:j i j 2) Other Total KIFORMSMILDING FORMS\BIdgApplSubRgmts.doc Page 1 of 2 Ktv /-Y/-U4 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paperl ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxesl ❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). ❑ 13. Sanitation and site plan approval from the Environmental Health Department. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530)538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS metunas can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 7.27-04 Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing 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 'ssued until this verification is received. 1. personally plan to provide the major labor and materials for construction of the proposed property improvement: YES] NO[ ]. 2. I HAVE HAVE NOT[ ] sign d an application for a building permit for the proposed o . 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 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. 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 PROPERTY M�Iyxl -11, 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. May 1995 2.26 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 benefit 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 1020 N 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 C. Viei* C.B.O. , Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. May 1995 2.27 .1 j 031-271-008 J THEUS, LAURA 03-1300 1152 NEVADA, OROVILLE RELOCATE WTR HTR/DUCT HTR -5--f it T G��' WT 1 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530'538-7541 ._ — PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT �// ( � __5 — /,Vv) ASSESSOR PARCEL NUMBER 031-271 ZONING 2Q BUILDING PERMIT OWNER RIEUS 9 LAURA TELEPHONE 534-3547 SO. Fr, OCC. BUILDING VALUATION OWNERS MAILING ADDRESS RD., SHARP O � 95966 CONTRACTORS �i7JlVi3`L TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation S ARCHITECT OR ENGINEER LICENSE NO. —FilingFee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 9152 NAVADA AVE., OWAeLE, ' 95965 Energy Plan Checking Fee $ $ j'ti. PERMIT FEE $ LOT NO. SUBDIVISIONS NAME "� PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE i SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 (� TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: C/O to M MAM R&=TE& DUCT VEWr HEAM Gas piping stem 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $-rD,Oo ELECTRICAL PERMIT Fling Fee 20.00 Main Service z�oo� oRR mss 23.00 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 for the following reason: O I, as owner of the property, or my employees with wages as their sole compensation,' will do the work, and the structure is not intendedior 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 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. sG OR ADONS. ( a ACC. BLDS. 3.5QFT: NS MWWRalO• - - MULTI-OUTLETTS @7,50 APPARATUS i PSINGLOWER E OUTLET CIR. .00 �. EX. Occup. OUTLET OR FIXTURES 8620 ® I.0 Ex.., Occup. OETAP� .GEl 5.00 Tem orar „ Service`. 23.00 i s Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 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:1 Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating g 115.00 15000 Cooling Hood 6.50 ' Ventilation j i PERMIT 'F't $ "1. 350{ . Policy Number __ (The above sections need not be compleved'ifthe permit Is for work of a valuation of 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 comply with those provisions. R V / X Date / JET Q ' "Signature of Applicant - ;131 Owner ❑ Contractor `O -Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee s Energy Inspection Fee s OCC CONST. TYPE TOTAL FEE $ �5oQ0 o ';'s' f/ D CDF � " pgRCEI � pD �� HD ISSUE - 1.11, This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fee6'have been paid. By i�� �ll j/j,��� I Date _ , . PERMIT EXPIRES ON pate) Receipt Noo/bj n WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 1' COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 E MIT NO. (4v.12/96) APPLICATION AND PERMIT Jr ASSESSOR PARCEL NUMBER 031-271-008 ZONING AR BUILDING PERMIT OWNER rf4SCiTC' LAURA LHIJ L�t'i TELEPHONE SO.SO' FT' OCC. BUILDING VALUATION . OWNERS MAILINGADDRESSA•D"IIDJJREEESS 16 SHARP RD. OROVILLE 95966 CONTRACTOR'S NAME OtiNER TELEPHONE CONTRACTORS MAUNG ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS AWUNG ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1152 NAVADA AVE.. OROVILLE 95965 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: C/O 14ATER HEATER RELOCATE & DUCT VENT HEATER Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI w 020.00 PERMIT FEE $50.00 ELECTRICAL PERMIT Filing Fee 20.00 Main Service eoOV OR LESS 2ooA OR LESS 23.00 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 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for 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 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 Main Service To 46.00 WEL200A OCU000A NEW CONST. OWEAM ACS. ADDNS. ( 8 ACC. BLDS. 3.5QFT.. NEWOR NON.RESID. MULTI.OUTLET @7,50 POWER APPARATUS & SINGLE OLm.ET CIPL EX. OCCU 011TLErOR PDRUREs BAL ®'.w Ex. Occup. o Ds''ID.oE, 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating 1 15.00 15.00 Cooling Hood 6.50 Ventilation PERMIT FEt $ 35.00 Policy Number (The above sections need not be completed if the permit Is for work of a valuation of 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 comply with those provisions. X ature of Applicant - Owner ❑ Contractor �en 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 $ 85.00 HAz _ D I P oo CDP ARc PD U This permit is hereby issued under of the Butte County Cod d/or indicated Ove for wh' fees ve B PERMIT EXPIRES ON ^�_0 the applicable provisions Resolutions to do work been paid. Date J Je Receipt No.37637 1 $ 85.00 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing 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. personally plan to provide the major labor and materials for construction of the proposed roperty improvement: YESA NO ❑ HAVE ❑ HAVE NOT,(signed an application for a building permit for the proposed work. . 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: ork:NAME: ADDRESS: 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 SIG MPRO:PERTYOWNER-: — m% 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. OVER s I OWNER BUILDER INFORMATION I 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 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 '$300 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 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. ♦ 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. ♦ 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 "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 contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Budder 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. rely, MJer, 1 C. Vi ira, C.B.O. M Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER 11 P7 S��L 0 1 PERMIT NO. 546C —75P P E M MH UTIL. PERMIT NO. PERMIT EXPIRES OWNER JOHN CLASESSENS CON TR. LOCATION (A.P. � 1 -271 —8 ) 1152 NEVADA AVE., OROVILLE Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. IIed PG&E JOB FINALED DATE REMARKS OR CORRECTIONS COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Pielng Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. StemwaII Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heatinq Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS THERMALITO IRRIGATION DISTRICT 410 GRAND AVENUEC% OROVILLE, CALIFORNIA 95965 TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: h 5�'� v Owner's Name: `i- ;�P Dates�� Address: a 1\ P171 -1 o u 11 Acct. No: �_om� 1A I&0 A.P. NoFI ` � Phone: No. Units: - Applicant/Agent: Na h' Agents Proof: � V Address: Phone: Preliminary Review B`y`e r ; n���� ,� e�:'� 777. Dat Remarks:� Field Review By: Date: Remarks: Fees: Application $ Arrearage CSA 26 SC -0R 1st mo. S.C. 1� r Other Total Fees Now-; Collected By: Date: IN 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 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS �/� 2 —7S' 7 County Center Drive — Oroville, California 95965 / •./ Telephone: 534c4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Vate ignature of Permitee or Agent Receipt No. White-D.P.W. — Yellow-Assessat/— 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. dDWECTOR OF PUBLIC WORKS By ll. Date l07'In2 g permit expires Date 2 BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mailing Awress.� y Telephone No. 3 - Fireplace Contractor Total Valuation Mai I i ng Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address �/� �, PLUMBING No. @ FEE PERMIT FILING FEE $3.00 3. CSU Each Trap 1.50 Repair drainage or vent piping. 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. 1— a f — Q Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F V6e- SaR� I Fire Dept. Fire Zone Use Permit Building sewer 5.00 .5-,00 EOA Parking Plaris Parcel Declaration Parcel Ma p 60' R/W, Improvements p Lawn sprinklers stem 2.00 ans Rec d Parcel Approval Plans Approval Permit Fee $ — d( NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE . $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) — Single Family Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixturesb Receps„ switches & fix outlets 20 P25 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: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar, disp. or D.W. 1.00 Air conditioner, or heat pump Water pump Mobil Home Facilities 5,00 Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ 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. ❑I 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. PERMIT FILING FEE o $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 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 FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Vate ignature of Permitee or Agent Receipt No. White-D.P.W. — Yellow-Assessat/— 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. dDWECTOR OF PUBLIC WORKS By ll. Date l07'In2 g permit expires Date 2 t... .. .. - � � �- ,— � ... � s � r � r, � .. .. � ' .. .. � 4 �� �`, _ _ - ..