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033-053-003
:v 033-053-003 PERMIT#96-0286 JOHNS, Rodney 165 Lakeland Blvd., Oroville , Ele Ser Ch/SF yially 033-053-003 PERMIT#96-05 6 JOHNS, Rodney t< 165 Lakeland Blvd., Oroville f� . Demo Carport 033-053-003 PERMIT#96-1103 JOHNS, Rodney 165 Lakland Blvd., Orovillej Install Ele Wtr Ht,/SF BO _ 2 033-0533-003 MISCEL = US PrivatcGara c/Slop DI-I'ACI =D AI +(C,Ii V1� 165 LAKEL I. LAPORT'I:,S"I-:VEN I 808-1343 033-053-003 MISCELLANEOUS HVAC Change Out HVAC REPLACEMENT (DUAL PACK) 165 LAKELAND BLVD LAPORTE, STEVEN t'i1L I IvvS�,•CGi p� f • OL- SD - %fit-, C -'uv W f� (3 U 3 r.� I i, pvt�-f�i �n of i���.(cl s r I I i,�hd�►� _ � -1 r pay i1tf �. .w • .� . r� 033=053-003 ,•PERMIT#96 Q286'` 'JOHNS •Rodney y Fit tib , =M1 `•�",r a +•r �'ye x'165' Lalcel'and Blvd', Oroville EleSer' Ch/SF , �,' A f y 8 k - i a w +r. 6, i r OFFICE COPY ' ry Address OQ GAS ' Meter By [Yate- ELECTRIC ateELECTRIC Meter By -,Date 4 -► 177 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 9 6 ! (�� .. ASSESSOR PARCEL NUMBER 033-053-003 ZONING ARMBUILDING PERMIT OWNER ROANEY JOHNSTELEPHONE 532-0583 SO. FT. OCC. BUILDING VALUATION OWNERS MAIUNG ADDRESS ` 5729 VISTA DEL CERRO OPOWILE. 95%6 CONTRACTOR'S NAME OWAiER TELEPHONE CONTRACTORS MAIUNG ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN 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 ENGINEER'S MAIUNG ADDRESS Penalty $ BUILDING ADDRESS 165 LAKMANT) BIND PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LAT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF ❑. Duplex ❑ Mobilehome ❑ Other SPECIFY 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 ❑ Ublibes ❑ Installation ❑ Other 0,( Describe Work: INSTALL NEV 100 AMP MAIN ELECT SERV PANEL — Mobile Home S G W 920.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20.'00 Main Service / 000V OR LESS 200A OR LESS ) 23.00 23-00 Main Service ( 200A TO I000A ) 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 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Lathe the following reason: wlas 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. ( d ACC. BLDS. ) SD. 3.50 FT. NEW CONST.MULTI-OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 WER APPARAT (dPS NGLE OUTLET CIR. ) Ex. Occup. (OUTLET OR FURORES ) BAL 0 , 50 Ex. Occup. ( OUTLETS(REPLNSS ..OEA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PRE a PERMITFEE $ 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 9 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 of one hundred dollars ($100) or less.) ❑ 1 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 Date �y Date –may Sighature of .Apphcant -{ !owner Contractor ❑Agent / An OSHA pe�Aid is requiri for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ 63.00 HA2. I D. FEES I IMP I FLOOD I CDF PARCEL PD HD ISSJ 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. ,/ 11 ,.. � i �1 By; /J Vii/- �.A,w{'�.! W Date J �fi PERMITEXPIRESON 1t �/7 (Date) 190856 ReceiptNo. 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) 538-7541PERMIT NO. APPLICATION AND PERMIT ��-� ASSESSOR PARCEL NUMBER 033-053-003 ARi'�II-I ZONING BUILDING PERMIT . OWNER RODNEY JOHNS532-0583 TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 5729 VISTA DEL 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 ucENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAIUNG ADDRESS Penalty $ BUILDINGADDRESS 165 T " ND BIND PERMITFEE $ PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 USEOFSTRUCTURE SF GY 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 EX Describe Work: INSTALL NEW 100 AMP MAIN ELECT SERV PANEL Mobile Home S G W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service / EOOV OR LESS 200A OR LESS ) 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 f9p the following reason: 601, 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 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ( 8 ACC. BLOS. ) SO. 3.50 FT. CNS. NEW CONST. MULTI.OUTLET NON•RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET S Ex. Occup. ( OUTLET OR FOCTURES ) 20 @ 1.00 BAL.SO Ex. Occup. (OFIXED APPIJ4S. UTLETS PRESD.OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PRE INSPECTION R3.00 PERMITFEE S 63.00 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 9 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 of one hundred dollars ($100) or less.) ❑ 1 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, 1 shall h co ly with those rovisio S. Js _� X Date ©7 Aatfu4 cant - ner Contractor ❑ Agent An OSHA pe It is requir for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee is Energy Inspection Fee is OCC CONST. TYPE TOTAL FEE $ 63.00 HA2. I D. FEES I IMP I FLOOD I CDF PARCEL I PD HD ISSU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated a for which es have b n paid. BY Date /� PERMITEXPIRESON (Th- ; I (Date) Receipt No. 190856 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT .-... .-..:.,-.s+w"Oti^^.it.�.,..(�•�ri,::,.t3,"f++"L:�i�16Gei at§�.�t..l..;r�'rsT�i"�'.;,'.y"�s��;�4;�h���%�'.�,"S''?/lwtvi*g"F�71,7 'rw':,naa 1y,.�rtyT-�:ir;r,,;,-, rr -r � COUNTYOF BUTTE - DEPARTMENTOF QE),1EUORMENTSERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER 7� a�n� �01n .�J S A. P. No. 33 -0:53 -003 Proposed Building Use %� ��`�� �� S�!yi �� Building Inspectors Date At time of permit application, I was advised the following data must be submitte&p.rior to permit processing and/or issuance: DATE RECENED BY 1. All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans . ......................... . 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ........................................ 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 11. Impact fees as shown on attached schedule . ............................. . 12. California Department of Forestry plan approval/fees. ....................... . .„- -13- Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ........................................ . 16. Plot plan and business license approval from City of Biggs/Gridley, ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). . 20, Pre for '. u,spection reque�s required. . . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner, ........... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ....................................... . 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . .......................................... 28. Mobilehome utility clearance . ......................... <.. ............... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits. ..... ................. . 32. Pla hepk list. ..... �: 33. 34. A r 00 When u issue the permit )r as follows: Mail to owner. Mail to contractor. Telephone$ and hold for pickup at office. Deliver with inspector. Other .✓ Parcel Creation Acreage Applican _ Date Copy of Haz-Mat form sent Health Dept. Fire Dept. -�''Air'Po' 116ti n 'Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance 1. Index permit for above items No. 2. Additional items required': (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE - DEPARTMENT OF DEVELQPMENT SERVICES - BUILDING DIVISION 7 .County Center Drive - Oroville, California 95965 - Telephone {916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER cc)-3� zON12ivl� BUILDING PERMIT OWNER mac- So�L.N 5 TELEPHONE S.3a- 058 3 SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS I✓�! �� ,e -ro (I- CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING AGGRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Fling Fee $ 20.00 LENDER'S MAIUNG ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS // PERMITFEE S PLUMBING PERMIT Fling Fee 20.00 Q / 0 Uc (� —'L Each Trap 7.00 LOT NO.SUBDNISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent j 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK / New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other l�Y r Describe Work: NeSf� l� /yC�t� ZO0 /J.j� ; ,✓ ,p y�- S��i/,t ,(J�t �v Mobile Home IS I GI W1 920.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20.00 Main Service e00V OR LESS ( zooA OR LESS ) 23.00 A, Main Service ( 200A TO I000A ) 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 for the following reason: ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ 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 OCCUP. OR NS. ( d ACC. ) s0. 3.5¢ FT. CONST. MULTI.OUTLETLE NEW CT NON-RESIO. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL 0 .50 Ex. Occup. IF FIXED ETSPRESD.OR ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 re s e,� , d ^/ P c23°� PERMITFEE $ 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 9 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 of one hundred dollars ($100) or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shallTOTAL 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 Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ 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 $ Energy Inspection Fee Is OCC i CONST. TYPE FEE $ �3 HAZ. D. FEES IMP FLOOD CDF PARCEL PD HO ISSUE This permit is hereby issued under tale of the Butte County Code and/or indicated above for which fees have BY PERMITEXPIRESON I applicable provisions Resolutions to do work been paid. Date (Date) Receipt No. / 9a & 5 (� WHITE-D.D.S.-B.O. CANARY -ASS SOF PINK -INSPECTOR GOLDENROD -APPLICANT OWNER: J / LOCATION: CONTRACTOR: pRE-INSPECTION FOR PERMIT HISTORY: I h v� DATE: e AP.#: .> 3_ 65 3'-- p p ZONING: DATE TO INSPECTOR I ]AS FOLLOWS: TYPE OF O CCUPANCY: S/ �==1 �L! r ✓�� BUMDING INSPECTOR'S REPORT iilding Description: [ ] Commercial/Usage: Mobile Home: Yes[ ] No[ ] [ ] Residential/4 of Units: [ ] Currently Occupied- [ ] Abandoned/Vacant. ectric: [ ] Yes , [ ] No Electric is currently On [ ]Off Condition of electrical'7 i as: [ yOnurrentl ] Natural [ ] Propane[ ] None[ ] C ] Off[ Obvious problems: fA F o anitation: Plumbing working Yes[ ] ° No[ ] �` Well: Yes[ ] No[ ] Potable waten;.Yes( ] No[ ] Obvious Sewage Problems: 1� ►ction Recommended: [ ]Issue [ old for: Date• 3c/- Inspector - N 13 COUNTY OF BUTTE- DEPARTMENT OF D,_VELO•PMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville,^California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONIN/, 4l lI BUILDING PERMIT OWNER I TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 1-95 1; G i - CONTRACTORS NAME TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 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 // PERMITFEE S PLUMBING PERMIT Filing Fee 20.00 Each Trap LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heatert!7.00 3.00 Water piping 5.00 USEOFSTRUCTURE SF 0-�b plex ❑ Mobilehome ❑ Other SPECIFY 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 I7-1, Describe Work: t `i < /� /t c- / L C ii • s• %� Mobile Home IS I GI W1 920.00 PERMITFEE S Contractor —1 ELECTRICAL PERMIT Filinq Fee 20.00 Main Service ( z aA OR LEss ) - 23.00 Main Service ( 200A To 1000A ) I 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 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 NEW CONST. DWELLING OCCUP. OR ADONS. ( a Bins. ) s0. 3.5¢ Fr. NEW CONST. MULTI-TI.OUTLET NON-RESIO. ( BRANCH CIRCUITS ) I I @7.50 POWER APPARATUS (a SINGLE OUTLET CIR. ) OUTLET OR FIXTURES Ex. Occup. ( ) j 20 Ca 1.00 BAL 0 .50 Ex. Occup. FIXEDAPPLNS. OR ) I 5.00 Temporary Service i 23.00 Mobile Home Facilities I 20.00 Misc. Wiring 23.00 PERMITFEE $ e -,r 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. ❑ I 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 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.)occ ❑ 1 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 comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 50" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing I 9 Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Mobile Home Installation Fee $ Energy Inspection Fee $ coNsr. TYPE - 7T TOTAL FEE $ --r p FEES IMP FLOOD I cDF PARCEL PD Ho ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON me applicable provisions Resolutions to do work been paid. Date (Date) Receipt No. / I Al ( WHITED 0 S.•B D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT `} 033 053-003r , PERMIT#96-0566,1-''l, JOHNS; "Rodney 165 LakelandBlvd.:;r Oroville ! r .i: ry'ib:,• j•1 tit r" ` �4 Demo Carport , ,,'•; :� �` ii �p� 2 "�.'q• r4•yar r i yy C COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES\�BUILDI�VG DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (9:16) 538-7541PERMIT NO., APPLICATION AND PERMIT r 9l0- 01567 tom` ASSESSOR PARCEL NUMBER S.- 033-05-3-0031 ZONING BUILDINGPERMIT X OWNER J01 JO1rN5`�-""� '� - T .i2 -b583 SO. FT. OCC. , fEM1LDING VALUATION r OWNER'S MAILING ADDRESS ' 165 LAKEL:AND BIND., Of,OVILLE CA 95965 CONTRACTOR'S NAME, 01 -MER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace r CONSTRUCTION LENDER NONE UNKNOWN Total Valuation $ Filing Fee $ 20.OD LENDER'S MAILING ADDRESS � Permit Fee $ ARCHITECT OR ENGINEER 1� UCENSE NO. Plan Checking FEE $ Energy Plan Checking Fee $ ARCHECT OR ENGINEERS MAILING ADDRESS ARCHITECT r' Penalty $ BUILDING ADDRESS' R PERMITFEE $ 355.00 PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater • 23.00 Water piping 15.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other" CARPORT SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer t 15.00 TYPE OF WORK; New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other 13 Describe Work: DT -10 16'X24' CARPORT _ — r' Mobile Home S G W (iD'20.00 PERMITFEE _ Contractor ELECTRICAL PERMIT Filina Fee 20.'00 _ - Main Service800V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO I000A ) 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 licensetisin 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 he following reason: ' = Iras 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 Professiont Code for this reason NEW CONST. DWELLING OCCUP. DR ( a ACC. BLDS. ) SO. 3.5a FT. NEW CONST. MULTI.OUTLET CNS NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS (a SINGLE OUTLET CIR. ) Ex. Occup. ( OUTLET OR FIXTURES) 20 @ 1.00 BAL 0 .so Ex. Occup. ( DunEEDTs PLINS.j ea ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 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 9 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 hof one hundred dollars ($100) or less.) ,P 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 _�.1 lj __a Date �%�AJ Sign'ature of Applicant-+ff_-bwner ❑ Contractor ❑ Agent / An OSHA permit is-roquired for excavations over 50" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ 35.00 , HAZ., D. FEES P I F O -' CDF PARCEL PD HD 7 ISS This permit is hereby issued unlder the applicable provisions the Butte County Code and/or Resolutions to do work in indicated above for which fees have been paid. By ate 3/18/96 PERMITEXPIRESON 3%18/97 (Date) Receipt No. 194673 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) 538-7541 PERMIT NO. APPLICATION ANID PERMIT g6 -OS - ASSESSOR PARCEL NUMBER 033-05-3-003 ZONING BUILDING PERMIT OWNODNEY JOHNS TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 165 LAKELAND BLVD., OROVILLE CA 95965 CONTRACTOR'S NAME 014NER TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UN104OWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS 165 TLAND PERMITFEE $ 35.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other CARPORT 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 IR Describe Work: 'DEMO 16'X24' CARPORT Mobile Home S G W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20:00 Main Service000v OR LESS ( 200A OR LESS ) 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 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law "e following reason: 121 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. ) s0. 3.52 Fr. NEW CONST. / MULTI.OUTLET NON-RESID. \ BRANCH CIRCUITS ) 97.50 ( POWER aSINGLE APOIfiPARATUS ) LET CIR. EX. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 BAL 0 .50 Ex. Occup. OUTLETS E APPLN . OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 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 Policy Number (The above sections need not be completed if the permit is for work of a valuation 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 fo I om7p1 Ith a provisions. A / X Date _ 6 Signature of pPli� wne�O Contractor ❑ Agent An OSHA permit i - red for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Mobile Home Installation Fee7l$ Energy Inspection Fee Is occ CONST. TYPE TOTAL FEE $ 35.00 HA2. I D. FEES I IMP I FLOOD I CDF I PARCEL I PD 1 HD ISS 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. By/;L,(6)14L�Erte 3/18/96 PERMITEXPIRESON 1118197 I (Date) Receipt No. 194673 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Demolition Permits Asbestos Notification Statement Date - Pursuant to section 19827.5 of the California Health and Safety Code, all - demolition permit applicants are required to fill out -this form.. "19827.5: A demolition permit shall not be issued by any city, county, city and county, or state and local agency which is'authorized to issue demolition permits as to.any building or structure except upon the receipt from the permit applicant 'of a copy of. each written asbestos notification regarding the building.-that-has..been required to be submitted to -the United States Environmental- Protection Agency or to a designated state agency, or both, pursuant.to Part 61 -=of Title 40 of the Code of Federal Regulations, or the successor to -.that part. The.permit may be issued without the applicant submitting a copy of -the written.notification:if- the .applicant declares that the notification is not applicable to. -the scheduled demolition.project. The permitting agency may require the applicant -to make the declaration in writing, or it may incorporate the applicant's response on the demolition permit appli- cation." Attached is a copy of my written asbestos notification to the United States Environmental Protection Agency for the demolition project located at Signature of Applicant 6R I hereby declare that a written asbestos notification to the United States Environmental Protection Agency is not applicab o thi demolition project. Sj�e of Applicant 2/19/91 - O.B.-1 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 nd materials for construction of the proposed grope improvement : YES[L NO[ ]• 2. I HAVE HAVE NOT[ ] signed an application fora 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: PROPERTY OWNER: SOCIAL SECURITY NUMBER: DATE: NOTE: Thisowner-Builder Verification is required by Section 19831 and 19932 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. O.B.-1 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. Sincerel Michael C. Vieiia, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California .95965 - Telephone (916) 538-7541 PERMIT YC APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER � (Q�J"'"G OWNER;z �' ` • TELEPHONE � A) BUILDING PERMIT SO. FT• I OCC. i BUILDING VALUATION OWNERS MAN .INOO ESS L_ TELEPHONE COMRACTOR'S E l:N I ComTRACTOR-S MAWNG ADDRESS Fireplace UN*,IOWN CONSTRUCTION LENDER Total Valua Filing Fee $ 20.00 LENDER'S MAIUNO ADDRESS Permit Fee $ AACNrtECT OR ENGINEER--- LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHRECT OR ENGNEER'S MAW NG ADDRESS Penalty $ eutLowc ADDRESS PERMITFEE S -- PLUMBING PERMIT I Fling Fee 20.00 PARCEL MAP LOT NO. SUBDNiSION'$ NAME I Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer I 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: �' Mobile Home ;SG i W1 i @20.00 PERMITFEE ; S Contractor ELECTRICAL PERMIT Fling Fee I 20.00 Main Service ( 2 00A OR LESS ) z0v OR LESS 23.00 Main Service ( 200A TO ioOOA ) I I 46.00 ' NEW CONST DWELLINGOCCUP. I I FT. , OR ADONS ( & ACC. SLDS 3,5C 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: ❑ 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 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 Codi I r the performance of the work for which this permit is issued. / / �// ❑ 1 have and will maintain workers' compensation insurance, as required b Siectioh 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 Policy Number--- (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars (5100) 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 _____ Date Signature of Applicant O Owner O Contractor ❑ Agent An OSHA permit is required for excavations over 50” deep and demolition or construction of structures over 3 stories in height. NEW CONST MULTI.OUTLET !+ON•RESIO ( BRANCH CIRCUITS ) I @7.50 ' —_— ,OSINWER APPARA7 U5 3 GLE OUTLET CI_ ) _— _ — i 20 g I o0 Ex. Occup._ ( OUTLET OR FIXTURES ) SAS a, , Ex. Occu FI%ED APPLNS OR p' ( OUTLETS (RESIO 1 EA ) i 5.00 Temporary Service i 23.00 -Mobile Home Facilities I 20.00 _ — Misc. Wiring 23.00 ------ PERMITFEE $ — Contractor MECHANICALPERMIT Filing Fee ; 20.00 — -- — Heating _ - Cooling —Hood 1 J 6.50 rVe tilati n r r —� - _ PERMITFEE $ Contractor Mobile Home Installation Fee J $ - - Energy Inspection Fee S occ co/+sr TYPE �C9 PO TOTAL FEE S (I„A� 1_D FEE.'•. i IMP I FLOOD 1 coF I PARCEL I PO I Ho s lu This permit is hereby issued under rile applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By —Date PERM 1TEXPIRES ON___ AO.ral Receipt No. W/u1 ;) U': N 0 CAN aN�.4:: F. :'.Cq - •A�.'•;•; 1'F'':�1P ti7L DENRfjG Ar'uUCANi J:xx��-:rRa�.yaR!v. � p•-.r�..x-+y :,, .;_„i'sy t :�s..-c K -•i �,-r� ..;.�lc; .`s•:� ., ., 'v;'=3'.i..NT Jnr s �Ln. n _..i., � }w� - �'�tiv Yet � rc.M, � '� �s '����Y 9_�.S Yt y"'•.'�`•G1' . {(` 0337'053'-003' : SIT #96 1103 t ' n JOHNS Roane ;; ;165-Lakland .-Blvd . Or,oville si ►- `r -}� ' *`Install Ele tWtrt Htr/SF" • f t .- Wit. : I .` n, *• iH � �{' ; �'�%V �//� , • e f P ' l . s f i j 4'' �h 4'' COUNTY OF BUTTE- DEPARTMENT OF DEV ELOPMENTSERVICES -BUILDINGDIVI N 7 .County Center Drive - Oroville, California 95965 - Telephone (916) 538-7 PERMIT NO. APPLICATION AND PERMIT ' ASSESSOR PARCEL NUMBER 33 53-003 ZONING AMI BU DING PERMIT , OWNER; ',) LI �il'1�Y.7iis ,� ' � Vlll�r7 T3=583 SO. FT. OCC. 0661 -DING VALUATION OWNERS MAILING ADDRESS 165 LAKELAND BLVD OROVILLE CONTRACTOR'S NAME��TnD OWER ,t TELEPHONE CONTRACTORS MAILING ADDRESS ` t Fireplace CONSTRUCTION LENDER ,M1� UNKNOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAIUNG ADDRESS - Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 165 LAKELAKD BLVD PERMITFEE $ OROV11M PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump Water heater 23.00 Water piping 15.00 USEOFSTRUCTURE Y SF ❑` Duplex ❑ Mobilehome ❑ Other SPECIFY 1- Each gas water heater or vent 15.00 piping I system 1- 5 outlets p p g y 15.00 Building sewer 15.00 TYPE OF WORK New ❑ 'Addition ❑ Remodel ❑ Utilities ❑ Installation EQ Other ❑ Describe Work: INSTALL WATER HEATER ELECTRIC — Mobile Home I S I GI W 1 920.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20.00 ' Main Service a00V OR LESS ( 200A OR LESS ) 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 i 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.FIXED OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: 1 S' 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 OCCUP. OR ( 8 ACC. BUDS. ) SO. 3.50 FT. CNS. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 POWER APPARATUS (a SINGLE OUTLET CIR. ) Ex. Occup. (OUTLET OR FIXTURES BAL (150 APPWS. OR EX. Occup. (OUTLETS (RESID.) E0.) 5.00 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ • 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 g 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 of one hundred dollars -($100) or less,) ❑ 1 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` Date 5 SigTTature—of `Applica �,C�]' Wner ❑ Contractor ❑ Agent/ Rte � — An OSHA permitis'required for excavations over 60" deep and demolition or constructionB of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 25.00 HAZ. 1 D. FEES I IMP I FLOOD CDF PARCEL I PD HO ISSUE 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. y r., Date 56 -,;7,o -9'U I� c PERMITEXPIRESON`' S V (Date) Receipt No. yS5�4 WHITE-D.D.S.-E.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVIS N 7 County Center Drive - Oroville:- Calffgrnia 95965 - Telephone (916) 538-7 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 33-053-003 ZONING ARMH BUeDINGPERMIT OWNER RODNEY JOHNS MM583 SO. FT. OCC. BUILDING VALUATION OWNER'S "UNG ADDRESS 165 LAKELAND BLVD OROVILLE CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNXNOWN 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 165 LAKELAND BLVD PERMITFEE $ OROVILLE PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF C� Duplex ❑ Mobilehome ❑ Other SPECIFY 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 IN Other ❑ Describe Work: INSTALL WATER HEATER ELECTRIC — Mobile Home I S I G W 1 920.00 PERMITFEE S Contractor ELECTRICAL PERMIT Filina Fee 20.'00 Main Service8000V OR LESS ( 20 A OR LESS / 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 for the following reason: CTI, 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 ADONIS.( 8 ACC. ) SO. 3.S3.51Z FT. NEW CONST. MULTI-OUTLEUTLE T NON-RESID. ( BRANCH CIRCUITS ) @7.50 WER (aPs NGLE OUTLETT CS IR. ) Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 BAL 0 .SO Ex. Occup. FIXED OUTLETS D.) R 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 25-00 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 9 Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE S Contractor 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.) ❑ 1 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 forthwiAb comply with those provisions. Date a S tura of pp a wner ❑ Contractor ❑ AgeAn OSHA permit equired for excavations over 5'0" deep and or construction vmol�ition of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is Occ CONST. TYPE TOTAL FEE $ 25.00 HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL I PO HD ISSUE 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. By Date ����� PERMITEXPIRESON 5— .7-0 — P % I (Date) Receipt No. 195584 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE BUILDING DIVISION tr DEPARTMENT OF DEVELOPMENTf3ERV4tES 1469 Humboldt Road, Chico, CA - (916) 891-2751 ;M 7 County Center Drive, Oroville, CA - (9:16) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE n oL1LvJvtK PERMIT NO. A routine inspection indicates that the following violations of. Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. o Q Date Inspector REV 10/ 2 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 1 or and materials for construction of the proposed property improvement: YES[ NO[ ]. 2. I HAVE[ ] 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: lilAi`�a: - ADDRESS: CITY: PH0NE: 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: NAI'vIE: 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: NAZIE ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: SOCIAL SECURITY NUMBER: DATE: S� NOTE: This owner -Builder Verification is required by Section 19831 and 19332 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 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 165 LAKELAND BLVD APN: 033-053-003 Owner: LAPORTE, STEVEN " Permit NO: B08-1343 Issued Date: 07/15/2008 By TMP Expiration Date: 07/15/2009 Occupancy: Zoning: ARMA Permit type: MISCELLANEOUS Subtype: HVAC Change Out Description: HVAC REPLACEMENT (DUAL PA( 165 LAKELAND BLVD OROVILLE, CA 95966 (530) 534-0883 SECO HEATING AND AIR SECO HEATING AND AIR Building Garage Remdl/Addn .4320 ANTHONY CT, SUITE 1 4320 ANTHONY CT, SUITE 1. ROCKLIN, CA 95677 ROCKLIN, CA 95677 Other Porch/Patio Total (916) 652-6755 (916) 652-6755 _---FEE INFORMATION DBM Heat Pump (Package Unit) $59.00 Balance Due: $0.00 Receipt No: B7982 T v� 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 SECO HEATING AND AIR 888629 / C20 C38 / 12/31/2008 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that n requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, I HEREBY AFFIRM UNDE (comens�}.{�g with Sec' r is in an_ ct. Contractor's Signature TY 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 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) 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 07/15/2008 the applicant to a civil penalty of not more than five hundred dollars [$500]; Date 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. ❑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' Compensation insurance carrier and policy number are; Carrier. PREFERRED EMPL(policy Number: WKN1275722 Exp. Date:05/01/2009 (This section need not be completed if the permit is or 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 the Workers' Compensation Laws of Cali a, and agree that if I should become subject to the workers' compensation provisions oqSedlion 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) Lender's Address City State Zip 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.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: The Contractors 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 Contractors License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this F - 07/15/2008 Owner's Signature Date 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 a sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte Coun to enter the a o mentioned property for inspection purposes. I hereby certify that I am the p o y owner o m man to a�ct ay he prop ownres behalf. orD9 /�N\ , �"4 �1, - 07/15/2008 Owner 1:1 Contractor OR Agent for Owne�SAgent for Contractor 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 OFAPPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name I _ te, First Name Mailing Address ` f+ is 1 a��1 01'y_\6rb�,,6JV 1��0 +- VZip City o ib V �� State ( �S 0 Phone G1,_O$$� J �! Fax E-mail CONTRACTOR Name , A i Address J �VI><1 I r City * Y\ Stat� CA Zip Phone Fax%"65a, �Oyl�q E-mail p Lic. # 8 p Class mo G3� APPLICANT INFORMATION ARCHITECT/ENGINEER Name cit \, t Address Zi�6 city Fax I_ State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name 11 k Address �(bD'o JI I cit \, t Zi�6 q-1� rr Phon _ � r Fax I_ E-mail PERMIT NO. �� 1301 BIN # PROJECT LOCATION API 19 S3_ 3_G&1, Property Address 1 Q h (� 1 Va City 0MV' F. E� l WORKER'S COMPENSATION Policy Number Carrier 1 M _ ` \ a 'K If hiring anyone other than license contractors, a certificate of work 's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: +► v Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning FloodZone SRA Yes No Occ. Type Const. Name STEVE LAPORTE Address 165 LAKELAND BLVD City OROVILLE a co Heating, Air Conditioning and Refrigeration Phone # 530-534-0883 Date 7/3/2008 Proposal Number R00107032008174312-1 Comfort Specialist gardener 033 - 053 x003 State CA Zip 95966 Heating. Air conditioning and Refrigeration Heating; Air conditioning and Refrigeration SYSTEM] Mi System Investment Base System $15,242.97 Optional Items Total $0.0c MATCH REBATE <$500.00> JOB FILL IN. <$1,524.97> 0% Sales Tax $0.00 System Total $13,218.00 Finance Calculation 0 Estimated Monthly Investment $0.00 Initial Investment $0.00 Balance $13,218.00 Investment Type Finance Optional Items—(Checked items are included in system total) Status Price Description E.M.I. Initials !— No optional components. v T J f� i BY signing this agreement I acknowledge that I have read and understand each page, including the terms and conditions. C� Custom\j'— oe /4a Date�13 O l) Representative �U s Date Approved by Date / Page 1 temperatures Are Fxtre Rest EASY With SECO 77, int ►yn Caurt., Rack G A 56'�� 'gne ' � : � ; �� � - - a ( 6 651' t C(3 Heating, Air Conditioning and Refrigeration Name STEVE LAPORTE Proposal Number R00107032008174312-1 Date 7/3/2008 SYSTEMI Components in Base System Investment - Inclusions Qty. Model # Description" (in Base System Investment) 1 4YCZ6036 3 TON PACKAGED GAS/ELECTRIC CONVERTIBLE-WA' 20 year heat exchange warranty 1 TCONT802 7 day programmable thermostat-WA Clean up work area before leaving worksite 1 LP Kits -WA Complete system start up 1 10 Year Parts and Labor • 10 Year Parts and Labor Warranty on all Trane Equipment. Electrical safety switch for outdoor unit 1 Statwire Install new thermostat wire. TRUCK Energy saving setback thermostat 1 New Condensate Drain run all new drain line 3/4 inch PVC. TRUCK Ensure proper amount of freon in AC or HP 1 Gas Pipe Gas Piping. Need yellow ward flex pipe and 1 male and 1 female Ensures proper drainage adapter. shop Includes Permits. 1 ELECTRICAL ADD new circuit from panel to condensor. need breaker brand put on installation instructions. shop Includes Return Airs per our duct design. 1 COMPLETE CUT-IN 3 Ton Cut-in all new ductwork per our design with High Efficient ductwork. Includes Supply Airs per our duct design. Our Exclusive Twenty Five Year Workmanship 1 Oroville Permit for the City of Oroville. Warranty. 1 MSMP3CS ADJUSTABLE ROOF CURB FOR C MODEL PACKAGE UNITS Quality assurance review UPTO 3 TONS , 21. MSMP3AP050 PLENUMS FOR MSMP3CS CURB. NEED 2 EA. Sealed connections for greater energy savings and Indoor Health. 1 HERS Rating This is a California Energy Commision requirement in Title 24 law. Cannot receive rebates without Certificate this certificate. Trane 10 year parts and labor warranty 1 CRANESET-R1 Crane Set Residential Exclusions 1 Package Unit on Rooftop w/curb. Package rooftop unit Remove/Replace with curb and downshot plenums (not included in Base System Investment) ,. s No selections. , i Installation Instructions PLACE GAS PAC ON ROOF. ATTIC ACCESS IN THE FAMILY ROOM. THERE IS A GAS LINE THAT RUNS NEAR LUNDRY ROOM. THERE ARE SMALL KITTENS AND A DOG BUT NO PROBLEMS. INSTALL TBD ' Initials—%J.ok Page 2 temperatures Are Fxtre • � � pie - . A _ .�. ~ I , Rest EASY With SECO t Name STEVE LAPORTE t Address 165 LAKELAND BLVD City OROVILLE State CA Building S�l (C--� Heating, Air Conditioning and Refrigeration Date 7/3/2008 Phone 530-534-0883 Proposal Number R00107032008174312-1 Comfort Specialist gardener Comfort Consultant Zip 95966 r. ifir, y�� J •.d � _. ` '.Ir, .i4 .�.i t 1 1 We hereby submit specifications and proposals foi XL16C GAS PAC 7 -DAY PROGRAMMABLE THERMOSTAT. THIS EQUIPMENT INCLUDES A TRANE 10YR PARTS AND LABOR WARRANTY. THERE ALSO IS A TRANE REBATE OF $500. We hereby propose to furnish material and labor in complete accordance with the above specifications for the sum of: Thirteen Thousand Two Hundred Eighteen Dollars and No Cents $13,218.00 (Total extended Price with Tax aft Discount) . By signing this agreement / acknowledge that / have read and understand each Representative to %d page, including the terms and conditions. tCustomer/ Date Approved by Date ( ( . Page 3 temperatures Are Extra Rest EASY With SECO Ij-' -;6P r=;?ON: BE'=T T h1'=;UPAI.IC1= SEP! I '74166251902-5 P.2 Policy Number: Date Entered: 4/18/2006 AC Dom, CERTIFICATE OF LIABILITY INSURANCE 4/18/20008 ) PaoalxR 8ZST INSO'RANCi SERVICZS THIS CERTIFICATE 19 ISSUED AS A MATTER OF INFORMATION lii6s son arlatloisao stmt ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Lic ansa •0767716 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Rooklln, G 95677 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ptione 916) 625-9071 Fax X1916) 625-9023 INSURERS AFFORDING COVERAGE MAIC 6 WIC' Saco Ejeatinq, Air Conditioning INSURERA:Truck InsuranCY $zc�sa:Igo and Refrigeration Inc INSURER B' _-- — 1tt4320 Anthony Ct. NsuRERC. _ Rooklin, G 95677 INSURER D: COVEHAG THE PCILI ANY R�QU MAY PERT POLICIES. �S OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING EMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR N. THE INSURANCE AFFOROED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH OREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. rNSR POLICY Nummot 6R IrmpnoilmUABLpq}s DATE THEREOF, THE ISSUNG MWJtM WLL ENDEAVO11 To MA&3O MAYS WRITT$N E s2,000,000 ILIY COMMERCIAL GEN BILITY 02275217 15/1/2008 5/1/2009a _ (230,000 aroon MPERSONAL f5,000 CLAIMS MAGE OCCURi JURY $2,000,000 OENERALAGGR6GATE s4,000, 000 ' PRODUCTS. COMP/OP AGO S 4 , 000 , OOO OE AGGREGATE LIMIT APPLIES PER' j i 'POLICY Ir 7 i9mLOC mi I VARY jANY AUTO j 602275217 15/1/2008 15/1/2009 COMBINED SINGLE LIMIT IE°°I S1,000,000 BODILY INJURY (POD pwwh) f ...'. �ALLOWNED AUTOS SCHEDULED AUTOS I I BODILY INJURY r(Per araeant) f _. HIRED AUTOS ;NON -OWNED AUTOS ! I —_. - _ I PROPERTY DAMAGE (Perecrmerrt) f aA tiiIae IlAE1LITY AUTO ONLY - EA ACCIDENT f OTHER THAN EA ACC AUTO ONLY. AGCi I i s ANY AUTO 1 EXI —OCCURCLAIMS ftsvusReLLA LIABLITY MADE EACH OCCURRENCE 1 'AGGREGATE i OEDUCTIBLE iRETENTION f f W 1A OFM COMP/NIATtM AND ETORVARTNEwsRECUTIVE E0M8ER EXCLUDED? 05105201 5/1/2008 15/1/2009 A E.LEACH ACCIDENT s1,000,000 E.L. DISEASE - FJI PJAPLOYEE 1 1 , 000 , 000 11T�t SYPE`CIAL urdw VISIONS below E.L. DISEASE . POLICY LIMIT f 1,000,000 V HER �Pzto ty Section 602275217 5/1/2008 5/1/2009 DEWUPTION 0 OPERATIONS D LOCATIONS I VEHICLES I EACLU110N3 AMMO BY ENDOFACW-Nt I SPECIAL PROVIIIONI 1 I -- — --- BMW" ANY OF THE ABOVE DESp1111111BD POLJCEB 0 CANCELLED AP.POrtE THE EXPMATDN DATE THEREOF, THE ISSUNG MWJtM WLL ENDEAVO11 To MA&3O MAYS WRITT$N 61076E TO TIE CERTMATE HOLDER NAMED TO TIE LEPT. YUT FAILURE TO 00 SO SMALL WPME 40 OBIJDATION OR LIABHJTY OF ANY RIND UPON THE WAURN6 ITS AGENTS OR REPRBSENTATVES. - AUTHORREO REPRESENTATNE Ron Heat ACORD.2S 001108) .I PIOCIEeO uting.F I e Bow Pt" wfiware ww.Fa maBoea.mm: Ifflom& a Publishing 800208.1977 I STATE OF CALIFORNIA vj..,onta r5 *we Turtntle OT110arb Pursuant to Chapter 9 of Division 3 of the Business and Professions Code and the Rules and Regulations of the Contractors State License Board, the Registrar of Contractors does hereby issue this license to: SEGO HEATING AIR CONDITIONING AND REFRIGERATION INC to engage in the business or act in the capacity of a contractor in the following classification(s): C20 - WARM -AIR HEATING, VENTILATING AND AIR-CONDITIONING C38 - REFRIGERATION SIGNATURE OF LICENSEE SIGNATURE OF LICENSE QUALIFIER Witness my hand and seal this day, December 22, 2006 Issued December 2L 2006 Stephen P. Sands Registrar of Contractors This license is the property of the Registrar of Contractors, 888629 is not transferrable, and shall be returned to the Registrar upon demand when suspended, revoked, or invalidated License Number for any reason. It becomes void if not renewed. Awrt W: »7472 1 TL-241REV. 7011 05P 0..3 90638 Witness my hand and seal this day, December 22, 2006 Issued December 2L 2006 Stephen P. Sands Registrar of Contractors This license is the property of the Registrar of Contractors, 888629 is not transferrable, and shall be returned to the Registrar upon demand when suspended, revoked, or invalidated License Number for any reason. It becomes void if not renewed. Awrt W: »7472