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HomeMy WebLinkAbout033-025-010I m ON 33-025-10 FAYE NEVERS 120 Lakeland Blvd'Oroville .lPermit#1343-85B(n(�w private detached garage) 033-=02 9�02�-5 33-02 NEVER -12- Z/96E I -S�T` �/ ' :� �-;, 20 La aye. ' ,Lakeland re e 120 La Lan'dil' Blvd L OfoVille- ,:r�' :'rewi're & sery �Chg -9 �733-025-010 s F ,e, ':04-'1142".-, -t.mooRE:WILLIAM , 120 LAKELAND:BLVD; OROVILLE .r,QPNT:-OWNER" A. COUNTY/0 ME '39 693 " OFFICIAL R CEIP OFFICE O P DEPARTMEN ISSUING RECEIPT ReceivC4114 1i�e Sum ofZ�,,x -Q I f = 1 For 1 Received: uy'- Received By Title CHECK - - ` By DAVCO BUSINESS FORMS • (530) 74.9-8511 Forth 75702 BUTT E COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net%dds PERMIT NO. BP041142 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 04/23/2004 APN: 033-025-010-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 120 LAKELAND BLVD ORO Date: Contractor. Map Index: Description: reroof w/comp 12 sq OWNER -BUILDER DECLARATION 1 hereby affirm under penally of perjury that I em exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, -or repair any structure, prior Owner: MOORS WILLIAM V 8 MARCIA F 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 120 LAKELAND BLVD 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 OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95966 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 Code: The Contractors' State License Law does not apply to an owner of properly who builds or improves thereon, and who does Applicant: MOORS WILLIAM V 8r MARCIA F such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or Improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or Improve for the purpose of sale.). ❑ I, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: ❑ I am ExemptunderArticle 3 of the Business a d Professions Code : _ Date__:?= 14Own. , I r 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 License #: workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. ❑ I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit Is Issued. My workers' compensation Engineer: Insurance carrier and policy number are: Carrier. Policy #: Total Square Ft: 0 S. F. I certify that in the performance of the work for which this permit is Valuation: $0.00 Issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Census Code: 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 atlomey's fees. - J� / q issued CONSTRUCTION LENDING AGENCY Thishis pe it is a eby under the applicable provisions of the Butte Couny�l/Code and/or I hereby affirm that there Is a construction lending agency for the Resoluti o wo ndicated ova for which fees have been paid. / ,- (r/f performance of the work for which this permit Is issued (Sec 3097 Civ.) BY: DDate: Name: 65-� 1 Address: PERMIT EXPI E ON: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification In accordance with Section 19827.5 of California Health & Safety Code Is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above Information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substan any officla o r document f Butte County. I hereby authorize representatives of Butte County to enter uuppon the above mentioned property for Inspection purposes. C I L..L i N " I M Com(. e, CJ lr � -� Print Name: Signatur Date: Owner EI Contractor El Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BI 14, OATE:4s n., � APN: / l v ZONING: OWNER'S LAST NAME: OWNER'S FIRST NAME: ILLI PHONE: 531-7ZISO' STREETADORESS: (-A CITY, ZIP: -Do A c -A• ZIP --E-MAIL: - A�� ��,(rJ SITE ADDRESS: " CITY, ZIP: S 101T� Y A /� +" - NEAREST CROSS STREET: TRACT/LOT t. APPLICANT NAME: PHONE: STREET ADDRESS: �.. ��, /� ^ � v , FAX CITY, ZIP: E-MAIL: CONTRACTOR NAME: PHONE: STREET ADDRESS: FAX CRY, ZIP: E-MAIL: LICENSE NUMBER: LICENSE TYPE: ARCHITECT/ENGINEER NAME: I A PHONE: STREET ADDRESS: (7) 1,d FAX CITY, ZIP: LICENSE NUMBER: E-MAIL: DESCRIPTION OR SCOPE OF WORK: ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: Notes: Application Received by- Date: Receipt number: eq ) Amount Received: 1 Master application 3-4-04 D.B.-1 OW1WR-BUILDER VERIFIC.A'TION 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. 1. I personally plan to provide the major labor and materials for construction of the proposed (DI im rovement : YES NO ❑ �2J" I HAVE HAVE NOT signed an application for a building permit for the proposed work. 3. I have ntracted with the following person (firm) to provide the proposed consh on: AME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO. 4. \I plan to provide portions of this work, but I have hired the following person to coordinate, �;upervise, and provide the major work: ADDRESS: PRONE: CONTRACT'OR'S LICENSE NO. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME SIGNED: ADDRESS PHONE TYPE OF WORK PROPERTYYOWNER: DATE: NOTA: This Owner -Builder Verification is required by Section 19531 and 19532 of the California Health and Safety Code. This verification must be completed and returned to our offu:e before we are permitted to issue the permit OVER I OWNER BUILDER INFORMATION 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 partyof 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 word 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 contactors 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 hwzm= costs, and unemployment compensation contributions. There may be financial risks for yon ifyou 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 stricture 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. lnfmmation about licensed contractors may be obtained by contacting 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. IYI /.. Mi ICVi ira, C.B.O. er, Building Inspection NOTE: Y71 is Omer BuilderLWormadon is required by Section 19930 of the California Health and Safety Code OVER h,iy.mr, r• ll :•t,;gx,F• .:..��,�,.y *NGv'w/.�19.:.'�.4.;._•i.���h�}i�M•+''l'i{�°F'�1i]►F.rG4ii�'�;,f.,.�f'R.a%�_7,7�� • . S„ � �'°. 1+ '1 f i'"'M1^ •'mow"� •033-02=57-010 NEVERS 92 {2796E �. Faye , >� { 120 Lakeland Blvd , Oroville rewire' �:; • & sery chg/sf ' u . was T12 -e r OFFICE COPY - Address AS • �� pates, ,' t* eter BY ' E ECTRIC i Me er By. • },�� . ' .. tare-•� _ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville. California 95965 - Telephone: 916.'538-7541 APPLICATIMAND PERMIT PERMIT NO. ASSESSOR PA}goj-0 MB go 11 ZONA'" BUILDING PERMIT OWNER FAYE NEVERS TEL``EP�TH�-ONE 53%-1944 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 120 LAKELAND BLVD ORMUE CONTRACTOR'S NAME OWNER TELEPCONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing •$e. $ 15.00 LENDER'S MAILING ADDRESS Permit Fie $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 120 LAKELAND BLVD ORMLLE 95966 1. Permit fee $ PERMIT Filing Fee 15.00 Each Trap 5.00 i�_PLUMBING Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARC 6',MAP Water piping 7.00 Each qas water, heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JW I 1 @ 15.00 TYPE OF WORK New[ 1 Addition ❑ Remodel ❑ Utilities ❑ Install4IE:]r ❑ Describe work: G Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 00VOR LESS Main service 600A OR LESS 2 18.50 18.50 Main service 200A TO IOOOA) — 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of theIsiness and Professions Code and my license is in full force and effect. ` License No. Classification F'2! LlV I, as the owner,or my employees with wages as their. sole.(compen- J sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) r ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) i ❑ I am exempt under Sec. Business and Professions Co"de for this reason ` NEW CONST. ( DWELLING OCCUPM OR ACDNS, l ACC. BLDGS. // 3.64 sq.ft. 00 NEW CONSTR OUTLET NO N•R E51 BRANCH CIRC ITS @ 5•00 (POWER APPARATUS h) SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 76 FIXED APPLNS. OR Ex. Occup. OUTLETS (REST D.1 EA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. �Virin 9 15.00 Permit Fee $ 71.50 — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): + ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. (� I shall not employ any person in any manner so as to become subject to the W. C. laws of California. x Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Coolin g Hood 6.50 Ventilation Perrnit Fee $ Contractor 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 authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X –^yam r. j,��*�'� �/ Date k' �- � ^- - pr Signature of,Applicant — Owner ® Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ DCC CONST TYPE TOTAL FEES 71.50I HAz I DFEES I IMP I FLOOD CD= HD I ISS boor This permit is hereby issued under the sions of the.Butte County Code and/or work ' dled abWgw"hich fees DI EP BLI By PERMIT EXPIRE Date applicable provi- resolutions to do �i'Fave been paid. RKS ` � Date 4�1 /1 J Receipt No. 122457 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916,'538-7541 �j Z _z-7 9n APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 033-025-010 ZO,�iYNGARt�I H BUILDING PERMIT OWNER FAYE NEVERS TELEPHONE 534-1944 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 120 LAKELAND BLVD OROVILLE CONTRACTOR'S NAME TELEPHONE OWNER CONTRACTOR'S MAILING AODRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ 120 LAKELAND BLVD OROVILLE 95966 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 SF ❑ Duplex❑ Mobilehome❑ Other Building sewer 15.00 Mobile Home S I G I W @ 15.00 SPECIFY TYPE OF WORK New❑ Addition❑ Remodel❑ Utilities❑ Installation[] Other F] Permit Fee $ Describe work:_ gF.PVTC'$'NANC$ R (A i� 're_ 6rA CX fi-e Contractor ELECTRICAL PERMITFiling Fee 15.00 00V OR LESS Main service 200AORLESS 4_18-50 1$,50 Main service 2oGATO IOOOA) 1 37.50 CONTRACTORS LICENSE LAW NEW CONST. ( DWELLING OCCUP.81 3.64 q.11.1 I declare under penalty of perjury (check one): OR ADDNS. ACC. SLOGS. II NEW CONSTR. MULTI -OUTLET @ 5.00 ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business NON -REST BRANCH CIRCUITS APPARATUS e1 and Professions Code and my license is in full force and effect. (POWER SINGLE OUTLET c,R. / ` License No. Classification Ex. Occ Up(OUTLETS OR FIXTURES 20 @ 76 .. I, as the owner, Or my employees with wages as their sole compen- FIXED APPLNS. OR Ex. OCCUp. OUTLETS IRESID.1 EA.) I 3.00 sation, will do the work,and the structure is not intended or offered Temporary service 15.00 for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- Mobile Home Facilities 15.00 ors. (Sec. 7044) Misc. Wiring '15.00 ❑ I am exempt under Sec. Business and Professions Code for this reason Permit Fee $ 71.50 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 1 15.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. Cooling g I shall not employ any person in any manner so as to become subject Hood 6.50 AJ to the W. C. laws of California. Ventilation Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such Permit Fee $ provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee S is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Energy Inspection Fee $ Butte to enter upon the above-mentioned property for inspection purposes. occ CONST TYPE I also agree to save, indemnify and keep harmless the County of Butte against TOTAL FEE $ 71.50 all liabilities, judgments, costs, and expenses which may in any way accrue HA2 0FEES IMP FLOOD CDF PARCEL PD HD ISS against said County in consequence of the granting of this permit. I I I I O X Date 6 �— / This permit is hereby issued under the applicable provi- Signature Applicant — Owner` Contractor ❑ Agent ❑ sions of Butte County Code and/or so r solutions to do An O5H permit is required for excavations over 5'0" deep and demolition or construct- work dic ed ab , f which f s ave been aid. ion of s ctures over 3 stories in height. DI E R F P BL Receipt No. 122457 BY Date PERMIT EXPIRE Date WHITE-D.P.W.• YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works i 7 County Center Drive,-Orovil.le; CA 95965 Phone: 916-538-7541 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. 1. I personally plan.to.provide the major labor and materials for construction of the proposed property improvement .(.yes or no) .2. I (have signed an appl'cation 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 this work, but I have hired the -following person , to coordinate, supervise, and provide the major work: .Name Address City. :.Phone: Contractors 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: Propert er Socialy umber2, Date Y NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of.the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916.`538-7541 APPLICATION'AND PERMIT PERMIT NO. ASSESSOR PAR EL NUMBER —��O 2TEL/EP/HvO+NE -z'�'I,� ' BUILDING PERMIT OWNER /i VC (lam 53 K 4 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS f/ d-c CONTR CTOR'SppNAME TELEPHONE 0vi klr CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS f r2 -0L 19{/E�,1J /� QLv` �'1� Permlt'fee $ PLUMBING PERMIT Filing Fee 15.00 L oyeon LC C Each Trap 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets EL[] 5.00 SF ❑ Duplex❑ Mobilehome❑ Other Building sewer---T--F15.00 Mobile Home I S GW @ 15.00 SPECIFY TYPE OF WORK New 7, Addition El Remodel[]. Utilities❑ Installation❑ Other[] I Permit Fee $ Describe work: Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service ?OOA OR LESS 18.50 50 Main service 200ATOI000A) 37.50 CONTRACTORS LICENSE LAW NEW CONST. ( DWELLING OCC UP.t4\ 3.6t sq.ft. 8 I declare under penalty of perjury (check one): OR ADDNS. \ ACC. BLOGS. I NEW CONSTR ULTI-OUTLET 4 v� @ 5.00 ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business NN-RESID BRANCH CIRCUITS) OPOWER APPARATUS e and Professions Code and my license is in full force and effect. (SINGLE OUTLET CIR. License No. ClassificationP Ex. Occup(OUTLETS OR FIXTURES 20 764 464 ❑ I, as the owner, or my employees with wages as their sole compen- FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) I 3.00 sation, will do the work,and the structure is not intended or offered Temporary service 15.00 for sale. (Sec. 7044) I ❑ I, as the owner, am exclusively contracting with licensed contra Mobile Home Facilities 15.00ct- ors. (Sec. 7044) Misc. byirin g 15.00 ❑ I am exempt under Sec. , Business and Professions Code I for this reason Permit Fee — Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 15.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. Cooling g ❑ I shall not employ any person in any manner so as to become subject Hood 6.50 to the W. C. laws of California. Ventilation Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such Permit Fee $ provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above informationMobile Home Installation Fee S J; is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Energy Inspection Fee $ Butte to enter upon the above-mentioned property for inspection purposes. I also indemnify OCC CONST TY PE/ 5� TOTAL FEE $ agree to save, and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue HAz OFEES IMP FLOOD CDF PARCEL PD HO ISSUE against said County in consequence of the granting of this permit. I I I I X Date This permit is hereby issued under the applicable provi- j Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ sions of the Butte County Code and/or resolutions to do An OSHA permit is required for excavations over 5'0" deep and demolition or construct- Work indicated above for which fees have been paid. Ion of structures over 3 stories in height. DIRECTOR OF PUBLIC WORKS i Receipt No. I ZI–Lf S7 By Date PERMIT EXPIRES Date WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT NO. 1343-85B PERMIT EXPIRES 161169 /* OWNER FAYE NEVERS CONTR., owner ASSESSOR PARCEL 33-025-10 LOCATION 120 Lakeland -Blvd, Oroville Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E f. Temp. Gas Service ti CalledPG&E A - JOB FINALED (Date) rl7ld,4" Signature ilk COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS. , 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 5344541 Skyway and Elliott Road, Paradise — Phone: 872-2961. Ext. 57 CORRECTION NOTICE D�1 vers 3 3 - �s OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correctio of work is completed. If you have any question pertaining to this - ma�n Vrne/addition,all explanation, please contact this office immediately. / L oti r nl,4 s Inspector.Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 1; 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 5344541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 :y CORRECTION NOTICE Fy 2. \" C ', j / --i/ ---? -k3" OWNER PE IT O. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Inspectorn Date �_ r t Inspectorn Date �_ J•= OK 'Ib 0 = Not OK - = Not Applicable * = Noy Ready RESIDENTIAL (Sin'gle and Duplex) Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning reqp irements-Setbacks-Easements +48�egar--ty Line Firewall & Openings 2. Ftg., Ma' ; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 4 . Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Yr Soils -Steel- / /" Ftg. Depth airs; i th-Headroom-Rise-Run-Landing-Fire Protection 4. Ftg., orches & Decks; Soils -Steel- / /" Ftg. Depth.. 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Ste IIs, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer mwalls, Garage; Steel-Blockouts-Wrapped- amu MMesh-Drip Screed-Fdn. Vents-Underflr. Access 7. Piers-Fi place Ftg.-Steel azing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: all -Fittings -Test -2 way C/O -Sewer Test 55 ar Walls; Nailing -Bolts 9. Gas Pi e; Size -Anchors 10. Water ipe; Test -Anchors -Regulator -Service Test 11. Ele ric; Underground 12. PI nums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date S Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date C -BI t!5-jjKjQ Card -BI Date Date FINAL (Plans) OK except H's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except p's 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector 14. Water Ht.; Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Date Card -BI Date ELECTRICAL Permit OK except q's 66. Elec. Outlets & Receptacles at Kit. Counter 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. &Mech. Equip. Listed for Location 23. Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic F] Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size Guard Rails & Deck Construction -Post Caps 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral ❑Yes F-1 No 75. Following instld.: Drive E) Yes E3 No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. 80. Water Well; Disconnect, Electrical, Plumbing Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. 82. Ventilation throughout House Glass Protection Card B -I Date Card -BI Date Date MECHANICAL (Permit) OK except q's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. 33. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 86, Energy Compliance Certificate -Other Certificates 34. 35. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet Attic Access & Platform if Furnace in Attic Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FR G Plans OK except q's Comments at Final: Si ; Proper Material & Anchors 37 IIs; Studs -Nailing, Spacing & Bracing -Plates -Sound IL -Bearing Walls over Girders & Floor Nailing raft Stop in Walls (rat proof) 40., Furred Ceilings -Stairs -Chases -Tub 4 . Header & Beam -Size & Bearing 4 F8ngers-Post Caps -Anchors -Connectors 43/Cing. Joist-Rftr. Ties -Purl in-Roof_Brac.-Truss-_Shthng.-Rfn_g_. or Fireplace Tor Type A Flue -Fireplace Throat T* 45. Attic ess; Size & Romex Protection -Draft Stop -Ins. Baffles 46. 50M6. Windows or Exiting Doors -Sill Hgt. & Dimensions 47 Garage Fire Protection Framing (NOTE: An entry must be made each time youvisit jobsite) J' = OK 0 = Not OK - = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except ft's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except Ws 1. Zoning Requirements -Setbacks -.Easements 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except ft's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4, Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghig. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date 1 Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date ✓ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville,'California 95965 - Telephone 916/534-4541 APPLICATION AND ,PERMIT . PERM4NO.� ASSESSOR=ARRCCEL NUMBER ZONI yt BUILDING PERMIT OWNER, a e TELEPHONE s SO. FT. 0CQ.J BUILDING VALUATIbA OWNER'S M ILING / © ADD SS met o ` CONT CTOR'S AM I An Vt _ TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ � .S ARC'VE CT OR ENGINEER O VX_ GL LICENSE No. Plan Checking Fee ,$• , Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS r� r PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRU SF ElDuplex❑ Mobilehome❑ OtherCTU Ag S F Building sewer 5.00 Mobile Home S G W 10.00ea TYPE OF WORK New [ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑ Describe work: — Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 800V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST DWELING OR ADDNS. ACCLBLDGS.CCUP.&) 21/20sq It CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ElI am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner,' am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW NON.RESID R. BRANCH CIRCUITS2.50 ea NEWCONSTR. (POWER APPARATUS 6 NON -RESID. SINGLE OUTLET CIR. ) ' Ex. Occu 20®g0a P�o OR FIXTURES BAL®30 XED FIXED A APP LNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ Ihave placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIIng Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor 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 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in c nsequence of the granting of this permit. S� r Date s Signature pplicont — O ner & Contractor ❑ Agent ❑ An OSHA ermit is required for excavations over 5'0" deep and demolition or construct- ion of structures over3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ /O OCCUP. GROUPT TYPE OF CONST. PARCEL PD H 9 DE This permit is hereby issued under sions of the Butte County Code and/or. work indicated above for which DIREOf0a OF PUBLIC BY PEROT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS / s6 Date� — ?R� /.—Y+ V Receipt No. /� WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT B07-0361 033-025-010 MISCELLANEOUS HVAC Change Out NEW LPG TANK/LINES AND IiVAC 120 LAKELAND BLVD MOORE, WILLIAM V & MARCIA 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 INFORMATIONSite Address: 120 LAKELAND BLVD Owner: Permit No: B07-0361 APN: 033-025-010 MOORE, WILLIAM V & MARC Issued Date: 02/26/2007 By KEJ Permit type: MISCELLANEOUS 120 LAKELAND BLVD Subtype: HVAC Change Out OROVILLE, CA 95966 Expiration Date: 02/26/2008 Description: NEW LPG TANK/LINES AND HVA( (530) 534-7225 Occupancy: Zoning: ARMH Contractor Applicant: Square Footage: MOORE, WILLIAM V & MAA Building Garage Remdl/Addn 120 LAKELAND BLVD OROVILLE, CA 95966 Other Porch/Patio Total (530)534-7225 FEE INFORMATION ' DBM Heat Pump (Package Unit) $55.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 02/26/2007 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I 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. ❑I 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' Compansation insurance carrier and policy number are; Carrier: Policy Number: Exp. Date: _ (This section need not be competed if the permit is or one hundred dollars ($100) or 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 of Sectiory Q700 of the Labor Code, I shall forthwith comply with those provisions. —, X -.-( �J Y " I n CY-V,- 02/26/2007 Signature Date 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) Lender's Address { City State Zip ees Paid: $55.00 Balance Due: $0.00 Receipt No: B1960 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 ($5001; Please check one of the following: XI)AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE OMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR FFERED 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.). ❑I, 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.). ❑ 1 AM EXEMPT under Section A B. & P.C. for this 02/26/2007 Owner's Signature I " ate I I hereby certify that I have read this applica;on 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 anysid¢¢¢walk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above rr�ntmned property for inspection purposes. I hereby certify that I am the Property bwn&F camau izealft act on the property owner's behalf. Contractor OR; E]Agent for Owner Agent for Contractor FILE COPY -Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 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 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 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. 1. I PERSONALLY PC��O PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPRO=r,i(YES�R NO) 2. '/I (HAV�/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 PHONE CONTRACTORS LICENSE 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 CITY 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: NEW LPG TANK/LINES AND HVAC Reference Number: B07-0361 Applicant Name: MOORE, WILLIAM V & MARCIA Owner's Name: MOORE, W M Vet AP ; Signature of Property Own • r Date 033-025-010 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY* * OWNER INFORMATION Last Name�O NL First me Z. Mailing Address )ZZ) City O 0V ,LCEStatg � Zip ,- " J Phone5-3 41. -7 Z Z,5 -Fax State E-mail M 0DezE eetR, @ 'R lioo APPLICANT INFORMATION CONTRACTOR Name t Q 1 Address Phone City E-mail State Zip Phone Fax E-mail ❑ . Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name t Q 1 Address Phone City E-mail State Zip Phone Fax E-mail ❑ . Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): State License Number APPLICANT INFORMATION Name Address City State 71p Phone Fax E-mail ,a.i . m—, Vol, PERMIT NO. BIN # PROJECT LOCATION AP# �)'3. va, -5 0 10 Property Address r7- 0 t fl K6U� 4�)Q L City pv L LL E v 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 OF WORK: 11`L - 1 LL L f K 57L) vPtPC Flood Zone SRA I Yes I No Occ. Type Const. Sq FT- Living Garage Open Cov ❑ . Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): 4 5 For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. Nb le 112, 40 rk 77 Wf AZ;Ic71 te 'fi;g4v, 4P or 74 L 4�i A, o,� 7414 . .... . /? t4j' I7, Fit= 1A iik, VA t. f O'� I i4 if` 7, Thig se+,of plans m4 P4 all al !�(5n e orks; County dn� c'h e r 7, l�l - written permission; from f he Dep6rfni nt of PtiblIc o �74 7AIL Ir- :01 77F IT fAlEA D GA IqA�4:� a EZ Q1 �Ii VL If IfIfIfIfIfIf . . . . . . . . . . . . ......... .... 4-D, 7 ,' Z;K. 77 7, a R] .9, M `4 a A 7 d" & 41it. A, % jiAe 61, v Vc 4�) I I'D le 04 Z. A41C Z_ ell" hum COUNTY 6;,'67" d�w cv. Specificelly omitted from the sorvidea of OWING DEPARTMEN & A69ociates are a(l do,51gn and congruction. review Servic"S N-fi'�t* r IN) 'hx, contl,utor's safety precla I (Itiatl's or to mc,ns PRO' 2. o, irk 1� 0� 'e" fwfll 156 cedut t,�s required fix ti -to cortlx.ictc r +o pertorm hiswok 4� t�� ti , �' ' "' ITIC:!" �el 1�, �7, lit, ril -3r completed Structure; but r,, t r lu t iv� L,� 4 51 4;, Al ed(7 �)Ut ar,,,, not liml ad tr a & f I d 51 gA t(.j)jP0raj,y a Mmeht of 1 no Atici ;my- 6-uAloii tine-4hods and bra.cing. 01001� j1p A wi, 7- EZ Q1 VL If IfIfIfIfIfIf . . . . . . . . . . . . ......... .... 4-D, 7 ,' Z;K. 77 7, a R] .9, M `4 I lit" A 7 d" & 41it. A, % jiAe 61, v Vc 4�) I I'D le 04 Z. A41C Z_ ell" hum COUNTY 6;,'67" d�w cv. Specificelly omitted from the sorvidea of OWING DEPARTMEN & A69ociates are a(l do,51gn and congruction. review Servic"S N-fi'�t* r IN) 'hx, contl,utor's safety precla I (Itiatl's or to mc,ns PRO' 2. o, irk 1� 0� 'e" fwfll 156 cedut t,�s required fix ti -to cortlx.ictc r +o pertorm hiswok 4� t�� ti , �' ' "' ITIC:!" �el 1�, �7, lit, ril -3r completed Structure; but r,, t r lu t iv� L,� 4 51 4;, Al ed(7 �)Ut ar,,,, not liml ad tr a & f I d 51 gA t(.j)jP0raj,y a Mmeht of 1 no Atici ;my- 6-uAloii tine-4hods and bra.cing. 01001� j1p A wi, 7-