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Home My WebLink About035-211-01135-211-11 TIEDBMAN�-P.N. 37$2B Pat Fore - - 4425 Lincoln Blvd., Oroville 3751E contr: Servamatic Solar Sys, Chico N; Permit #2093-81P solar addn.to w/h - a ( _ 5-2Y1-11 SF) % 4425 Palermo Rd., Oroville `? CONTR: Wm. Garrett, 1085 Butte Ave.,Oroville (additipn) 35-211-11 r '•;�//_ :f�� Contr: Richard Paul, Oroville T � r p ,Nt)S /8 TIEDEMAN P.N „ ermit��3378-82P(replace gas lin )SF � — ' 907-70B* 852-69B o F 035-211-011 PER T#9 -2786 FORE, Pat 1 Lincoln Blvd., 35 -211 -ll g 4465 Lincoln Blvd. ,Apt 5, roville 4425 MWalyY. , Oroville 1= Repair Gas Line/SF/ CONTR: Foot is Const., 18 Jean Lane, Chiio '9 �/ 6 %7 � (reroof) � B08-0200 035-211-011 (*partial roof-CUNTR: Foothills St.) �y r MISCELLANEOUS Re -Roof i REROOF GABLE (6 SQ) ON HOME 4425 LINCOLN BLVD FORE PATRICIA A SS, , 1 B BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 4425 LINCOLN BLVD Owner: Permit No: B08-0200 APN: 035-211-011 FORE PATRICIA A SS, Issued Date: 02/05/2008 By KEJ Permit type: MISCELLANEOUS 4425 LINCOLN BLVD Subtype: Re -Roof OROVILLE, CA 95966 Expiration Date: 02/04/2009 Description: REROOF GABLE (6 SQ) ON HOME (530) 533-1540 Occupancy: Zoning: RN Contractor Applicant: Square Footage: GEORGE ROOFING GEORGE ROOFING Building Garage Remdl/Addn 6810 LINCOLN BLVD 6810 LINCOLN BLVD OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch/Patio Total (530)533-6393 (530)533-6393 FEE INFORMATION DBMSC Re -Roofing $119.00 Total Charged: $119.00 Fees Paid: $119.00 Balance Due: $0.00 Receipt No: B6280 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 GEORGE ROOFING 452266 / C39 B C43 / 02/28/2008 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busine s nd Professions Code, and my jicense pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) is in:full effgct. Q �� of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the Any Section 7031.5 l /� X/05/2008 alleged exemption. violation of by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractor's Signature Date ❑ I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: ion 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the State Fund 272-0000596 Exp. Da 01/01/2009 Policy oli cy Number. te: Contractors License Law.). (This section nee not be competed a the permit is or one undre ollars ($100) or ass. ❑ 1 AM EXEMPT under Section B. & P.C. for this reason: ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X 02/05/2008 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. I --" 02/05/2008 1 hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Si nature Date WARNING: FAILURE TOS CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), N ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the pro o erora authonzedtoa on the ProDeq owners behalf 02/05/2008 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee I N] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner F1 Contractor OR. for Owner Agent for Contractor AAgent FILE COPY Lenders Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION APPLICANT SIGNATURE X For office use only: OWNER Name PAT FORE Address 4425 LINCOLN BLVD. City OROVILLE State CA Zip • 95966 Phone 533-1540 Fax E-mail Lic.# APPLICANT SIGNATURE X For office use only: CONTRACTOR Name ' GEORGE ROOFING Address 6810 Lincoln Blvd city Oroville State CA Zip Phone (530)533-6393 Fax (530)533-0287 E-mail dan@abcgc.com Lic.# Class dan@abcgc.com 452266 1 C39 APPLICANT SIGNATURE X For office use only: ARCHITECT/ENGINEER Name N/A Address 6810 Lincoln Blvd City Oroville State CA Zip Phone (530)533-6393 Fax E-mail dan@abcgc.com State License Number APPLICANT SIGNATURE X For office use only: APPLICANT NAME Name GEORGE ROOFING Address 6810 Lincoln Blvd City Oroville State CA Zip 95966 Phone (530)533-6393 Fax (530)533-0287 E-mail dan@abcgc.com APPLICANT SIGNATURE X For office use only: Zoning Flood Zone SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. NO. BIN # LOCATION AP# Property Address 4425 LINCOLN BLVD. OROVILLE, CA. 95966 Cross Street WORKER'S COMPENSATION Policy Number 272-596 Carrier STATE FUND - If hiring anyone other than license contractors, a certificate of workers compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work Reroof - Front Gable - Com Sq. Footage 6 sq. - ❑ Structure Built Without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. ZUEST FOR REFUNDS rods can only be made upon written request by the person who paid the The request must be made prior to the expiration of the permit and no truction work has been done. Filing fees, plan check fees for work plan ked and other department costs are not refundable. Received by: Amount: Bldg SRA Receipt #: Sheriff SMIP Other Date: Total REV: George Roofing Permit#3378-82P 4 Patricia Ann Fore 0 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATIO AICA PERMIT PERMIT NO. ASSESSOR PARCEL NUMBE ?. �� . / ZONING BUILDING PERMIT OWNS LEPHO E SQ. FT. OCC. BUILDING VALUATION OWNER'SAD `T T MAILING / I V CRESS t i V CONTRACTOR'S NAME 11VC P114 --b r./I- TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LEND UNKNOWN. LENDER'S MAILING ADDRESS ARCHITECT OR ENGINE -ER LICENSE NO. l Total Valuation $ Filing Fee Permit Fee Plan Checking Fee Penalty $ 10.00 $ $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILD17, 4/- DDRES$ / �AVf _ I6, 1 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 , OU �� / USE OF STRUCTURE SF En Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New ❑ Addition ❑ Remodel Uti lities [:1Installation ❑ Other ,CC Describe work: 61", — 157 4-115G AIL-- /ELECTRICAL �� Permit Fee $ N+e Contractor PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 % Main service EA. ADD -L 100 AMP 2.50 NEW CONST.// DWELLING OCCUR.& OR ADDNS. ( ACC. BLOGS. t 2h0sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check One): ❑ I 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 CONSTR. MULTI-OUTLE2,50 ea NON-RESID. BRANCH CIRCT ITS NEW CONSTPOWER APPARATUS & NON.RESIRD. (SINGLE OUTLET CIR, Ex. Occup(OUTLETS OR FIXTURES BA (0300 FIXED APPLNS, OR Ex. OCCUp- OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. 1 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. 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. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives'. of the Countyot 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 consequence of the granting of this permit. J X �rr�i" ,_/9 -tet- C� Date / Signature of Applicant — Owner ❑J 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 $ TOTAL PERMIT FEE $ OCCOP, GROUP I TYPE OF CONST. [-IPARCELI PD I HD ISSUE This permit is hereby issued under sions,of the Butte County Code and/or work' i6d,icated above for which / �� DIRE6TOR OF PUBLIC f B ' � y PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date //~/Z S � �� `� - /7� �/ Receipt No. 75220 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 Cpunty, Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION �.kND PERMIT PERMMIIT NO. ASSESSOR PARCEL NU MBEP 80NING BUILDING PERMIT OPRRYCA M /A / 0 pf / SO. FT. OCC. BUILDING VALUATION OW E ZMAIL..INC? AD S , �/ CONTRACTTOR'�^je E� _ ^ J TELE-PIT—ONE - CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDE UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGIN ER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ Bul D y,G1,oDREs; ,,//V aLW V / �Ly/D a !� C. 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 -5,00 �� USE OF STRUCTURE SF [!J Duplex❑ Mobilehome❑ Other SP ECIFV Building sewer 5.00 Mobile Home I S I GiWJ 10.00e TYPE OF WORK New❑ Addition❑ RemmodpI R' UtiIiti s El Installation❑ Other Describe work: ��5�, Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100v OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD -L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ACDNS. ( ACC. BLDGS. I 2/zQSq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): - ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m license is in full force and effect. y 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 CONSTR MULTI -CUT LET NON-RESID, BRANCH CIRCUITS) 2,50 ea NEW CONSTR (POWER APPARATUS &) NON-RESID. SINGLE OUTLET CIR, / Ex. Occup(o XD 20@50m OR FIXTURES BAL®30C FIXED APPLNS OR Ex. Occup. OUTLETS (RESI.D.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury I (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. 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. Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor 1 certify that I have read this application and state that the above information, is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot 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 sal ounty consequence of the granting of this permit. —f Q� X �� . Date �l''�-('�v Signature of Applicant — Owne 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 $ TOTAL PERMIT FEE $ OcCUP. GROUP I TYPE OF CONST. PARCEL PD HO ISSUE This permit is hereby issued under sions f the Butte Count Code and/or wcr i ica a ve for which CTOR OF PUBLIC By i PERMIT EXPIRES Date the applicable to do resolutions to do fees have been paid. WORKS Date Receipt No. o WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT ry,.......®.,.......�.,�,..:�;...�.--...� mow.--.._..,..F-• � .... _ �. �� . . , _� _ . ...-.....� - - t� — 1 z ,� ell- COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATAON 1D PERMIT PERMIT NO. ASSESSO P RCEL NUMBER j ZONI t7/ BUILDING PERMIT OWNER�— PA 7— F&jL TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS C V�SI ✓r J7T V� TE PHONE 813 - 88'71 CONTRACTOR'S MAILING AD{gD�>RES(S, / 6/v /J/!�, [j / /D II//it� 1/ 11f��SV V lC- C, L 77 .tom Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $$ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS 1 L /� CSG L S& V D . PLUMBING PERMIT FIII Fee 10.00 ng Each Trap 2.00 Repair drainage or vent piping 5.00 ir, E Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑- Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 ��_ GG. TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities p Installation❑ Other Describe work: Sigt tax- hJ_�)a Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service DOOV OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. (DWELLING OCCUP.y) OR ADDNS. ACC. BLDGS. 2�sgft CONTRACTORS LICENSE LAW I declar under penalty of perjury (Check One): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professio s Code and my license is in full force and of a License No. GO q Classification C ❑ 1, 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 CONSTR I-Ou LET 2.50 ea NON-RESID. RANCH CIRC ITS NEW CONSTR. ( POWER APPARATUS 6) NON-RESID. SINGLE OUTLET CIR. Ex50 a 25¢ . Occup(OUTLETS OR FIXTURES BALet00 EX. OCCUp.(OUTLETS FIXED P(RESID )LNS RE A./ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare and r penalty of perjury (check one): ❑ T permit is for $100.00 (valuation) or less. 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. 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 shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee S 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 for inspection purposes. Butte to enter upon the above-mentioned p7srr I also agree to save, indemnify and keep es the County of Butte against liabilitlies, judg ents, costs, and exp es hich may in any way accrue against s d Co tyTin a nce of the ranti g of this permit. X Date — Signature of pplicant — Owner ❑ Contractor ❑ Agent OSHA permit is required for excavations over 5'0" deep and demolition or construct -D ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ 3 I oeeuP. GRouP TrPE of CONST. PARCEL Pall Thies�,,permit is hereby issued under axons of the Butte County Code and/or ate�1 above for which 1'RECTOR OF PUBLIC 4ERMITPIRES Date the applicable provi- resolutions to do fees have bee paiAn WORKS, DateG E/J/ /�f�i y/ CJWHITE-D.P.W., M.' u% A Z✓ Receipt No. 7 YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATI (WAICA PERMIT • / s A SSESSO P RC L N MBE -� — �� ZONI env BUILDING PERMI OWNER /ER/'IS"MAILING TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWN ADDRESS C OT R A C T p/ v(M/ r / •� SDV/ ' r`••, SYS r u' /A&UVA/ Ci 93 _ 7� TRA w NG ADDRESS &/0-, d 1v -16,f-1/ , tl,4 j�_V� Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEERLICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILZ) ADDRESS JA/� AvBLVD. PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 09 V/ LLE Water piping LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 O1✓4 -Q� TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installatio7❑ Other Describe work: S�%(,A-,e--- ADM/iU -7v G�/� Permit Fee $ .o Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service sDDV OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. ( DWELLING OCCUP.ai) OR ACDNS. ACC. BLDGS. I 20 sq CONTRACTORS LICENSE LAW I declar under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professio s Code and my license is in full force and of a GO License No. Classification C ❑ 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) ElI, 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 CONSTR T -OUTLET 2.50 ea NON.RESID BRANCH CIRC ITS NEw CONSTIZ ( POWER APPARATUS 6) NON-RESID. SINGLE OUTLET CIR. 50 a 250 Ex. OCCUp OUTLETS OR FIXTURES BAL@10¢ Ex. QCCUp.�OU LETS FIXED P(RESID IREA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declareand enalty of perjury (check one): ElT e permit is for $100.00 (valuation) or less. 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. 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 FiIirig Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee 3 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 prop yfor inspection purposes. I also agree to save, indemnify and keep h mles the County of Butte against all liabili es, j4dwents, costs, and expe ses Which may in any way accrue against s d Cou ty in of the anti of this permit. X Date G— — Signature of pplicant — Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ �3, 0c) OCCUP. GROUP I TYPE of CONST. PARCEL PD HD 1550E Thi permit is hereby issued under S' n of the Butte County Code and/or rk indi to above for which ;RECTOR OF PUBLIC ;ERMITEXPIRES Date the applicable provi- resolutions to do fees have /bDeen paid. WORKS Datte/ /Receipt //in No. r�(�C� WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT .^'T'a.m5o.a�..ir�S.. �+�^7:�..a%r,«r.".F �q:.-rr�•'�>:a'��''' -+LF•s. �y,• :.'.:�R'T.iyi�'_,...o>+cltra^,sir_^�:.r+.tN i�RYrrs'!'—J+;�as:'�,C:n"� �'. >`rr .r-rvY',r .>c .. r,, ,.�,..:"�,7r�"�+` � 4 � o ' ,p d — 4. OFFICE COPY i Address GAS ID)VT-- =� . Meter By 9` ELECTRIC Date Meter By 190 i COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 1 ft 7 County Center Drive - Orovillec,, Cialifornia 95965 - Telephone (916) 538-7541 APPLICAfiION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 035-211-011 ZONING BUILDING PERMIT OWNER PAT FORE TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 4425 LINCOLN BLVD., OROVILLE CA 95965 CONTRACTOR'S NAME OWER TELEPHONE CONTRACTORS MAIUNG ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE UCENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 465 LINCOLN BLVD 15. OROVILISPLUMBING PERMITFEE $ PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. S UBDNIS ION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF O Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 1g�(j0 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities 0 Installation ❑ Other ❑ Describe Work: REPAIR GAS LINE — Mobile Home I S I G W 1 @20.00 PERMITFEE $ 355.00 Contractor ELECTRICAL PERMIT Filinq Fee 20.'00 Main Service EOOV OR LESS ( 20oA 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: 4�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 ADONS. ( a ACC. BIDS. ) SO. 3.50 FT. NEW CONST.LTI-OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR_ Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 BAL 0 .50 Ex. Occup. (oFIXED urLETAPPLN . ea) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE s 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.) I certify that in the performance of the work for which this permit is issued, 1 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 �a+`�-�i•._ Signature of Applicant - [,P+' -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 Is Energy Inspection Fee $ OCC CONST. TYPE FEE $ 35.00 HAZ. I D. FEES I IMP I FLOOD CDF PARCEL PD HD 55UE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON I applicable provisions Resolutions to do work been paid. 12/16/95 Date '12/16/97Receipt (Date) 4tD`!'4l7irF No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES-BUILDINGDIVIS N 7 County Center Drive - Orovi[le, California 95965 - Telephone (916) 538-75 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 035-211-011 ZONING BU ING PERMIT OWNER PAT FORE TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 444225D LINCOLN BLVD. OROVILLE CA95965 0 OWNER TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UN194OWN 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 $ BUILDING ADDRESS 4 PERMITFEE $ PLUMBING PERMIT 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 IN Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities P Installation ❑ Other ❑ Describe Work: REPAIR GAS LINE Mobile Home S G W @20.00 PERMITFEE S 35.00 Contractor ELECTRICAL PERMIT Filina Fee 20.00 Main Service 5 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 fo the following reason: 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 OCCURSO. OR ACDNS. ( 8 ACC. BLDS. ) 3.5¢ FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 BAL Q .30 Ex. Occup. (ours PES D.) EA.) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE S 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.) 0�1 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 I&-�1��_ Signature o Applicant - "wner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction12/16/96 of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE FEE e 35.00 HAZ I D. FEES I IMP I FLOOD CDF I PARCEL PO HD I ISSUE This permit is hereby issued under of the Butte County Code and/or indicate a ova for which es have By PERMITEXPIRESON I the applicable provisions Resol Ions to do work a paid. Date 12/16/97 (Date) ReceiptNo. 209484 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ,. O.B.-1 • :y 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[K 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: - 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:_ / Q , NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER 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. :Sin'cberell ,� -. ` ` Micha4l 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