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HomeMy WebLinkAbout035-213-030.035-213-030PERMIT#96 081 - " BROWN, Luther i [4586 Virginia Ave.;'Orovi le Eley Ser Ch/SF r4586 35-213-030 99-0919 RAZIER, Charlene ' Virginia Avenue, Oroville Contr:Owner I ��` j Woodstove � nGt f f l I �l f u l G' M Q 0 X ti Lo @w- CV21, 9 �;.�•y„>9,,;.�..F'iz+v;.v�=.J<:`Es'��i%"'.S � +xx, •vat -._ , .. -- ., r 035-213-030 99-0919 FRAZIER, Charlene 4586 Virginia Avenue, Oroville Contr: Owner woodstove Al COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 035-213m-030 35213030 ZONING RN BUILDING PERMIT i.,/OWNER FRAZIERII CHARLENE TELEPHONE SO, FT, OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 4586 VIRGINIA AVENUE, OROVILLE - CONTRACTOR'S NAME OWNER t�T�ll TELEPHONE ' CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER - - Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ 1.500 ARCHITECT OR ENGINEER LICENSE NO. Felin Fee $ 20.00 Permit Fee $ 35.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 4586 VIRGINIA AVENUE, OROVILLE Energy Plan Checking Fee $ i$ PERMIT FEE $ LOT NO. SUBDNIS ION'S NAME PARCEL MAP I PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE ` SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 - - TYPE OF WORK—Gas New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: WOOD STOVE ' piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 - Main Service zoon oa v=ss 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.". 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: El 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 Main Service ( 200A TO I000A 46.00 NEW CONST. DWELLING OCCUP. SC OR ADDNS. ( 6 ACC. BLDS. 3.5¢FT. NEW MU9 NON -R SNLCoDT ANCI CT -0I�TC� @7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. 20 @ 1.00 Ex. Occup. OUTLET OR FIXTURES BAL @ ,50 Ex. OCCU OUTEIETS RESIDOEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. f, / �/`, 6� X �_a (�.� s -� J 1.4 Date < � Signature of Applicant'- ❑ Owner ❑�,Conifactor ❑ Agen_,T 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 $. Occ CONST. TYPE ^e wyr TQTAL FEE $ 55.Qp HAZ. D. FES IMP I FLOOD I CDF PARCEL 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. gg A7 By 1 , GlCeDate f �_ PERMIT EXPIRES ON Date ReceiptNo. 26392 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT' :.r COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 0/, IT O. (Rev.12/96) APPLICATION AND PERMIT �9 ASSES SORPARCELNUMBER 035-213-030 ZONING RN BUILDINGPERMIT OWNER FRAZIER, CHARLENE TELEPHONE SO. Fr, OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 4586 VIRGINIA AVENUE, OROVILLE - CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER t - f. LENDER'SMAIUNG ADDRESS Fireplace A 1,500 Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. FilingFee $ 20.00 Permit Fee $ 35.00 ARCHITECT OR ENGINEERS MAILING ADDRESS - Plan Checking Fee $ BUILDING ADDRESS 4586 VIRGINIA AVENUE, OROVILLE Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.o0' USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: WOOD STOVE Gas piping system t - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service :..A0.LEss 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class LIC. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Laws Or the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason 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 of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X _ Date / Signature of Applicant - ❑ wrier ❑ on actor ❑ Agerd r An OSHA permit is required for excavations over 5'0"deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 8 Acc, BLDs. 3.5QsSO ; NEW CONST. MULTI.OUTLET I cu @7.50 NON-RESID. ANC C'. POWER APPARATUS 8 SINGLE OUTLET CIR. 20 Ex. Occup. OUTLET OR FIXTURES BAL x':50 OLFrTXLFIXED APPLNS. OR .z Ex. Occup. ETs RESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ .0. occ coNST. nPE $ 55.00 HA2. FTOTAjLFEE D. FEESCDF 'PARCEL PO HD ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By ate PERMIT EXPIRES ON O provisions to do work paid. to Receipt No. 2.64892 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 (530) 538-7541 PE o. (Rev. 12/96) APPLICATION AND PERMIT A••Cs•OILPARcM.WM OL e/h mN►p y� BUILDING PERMIT OWNMR �U�✓/5U�^_ "!C` SO. FT. OCC. BUILDING VALUATION owN0'11 LwuNo AD • 0 <G6 l CONTRACTOR'S A '� - TCtrPIgNC . CONTRACTOR? MAUNO ADDREB•n CONSTRUCTM LMER U:MIUM ►WLHO ADDREs• Fireplace b ---� Total Valuation $ �(j ARCHITECT OR ENGINEER UCEME NO. Filing Fee E 20.00 Permit Fee $ ARCWTECT OR 040 NOM S YAAJNO ADDAMS Plan CheckingFee b xn / /)L pULDHO ADORES• v �r Y%�/�v /L Energy Plan Checking Fee E s PERMIT FEE : , Li LOT NO. ' ° '" PARc� trAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF O Duplex O Mobilehome O Other Each Trap 7.00 Solar or hent pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New O Addition O/ ,Rem//oiideelTl O Utilities /O, installation O Other O Describe Work: =/ / J 57-00 � Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home S G W Q20.00 PERMIT FEE S -ELECTRICAL PERMIT Filing Fee 20.Ob Main Service o0 oOR L 23.00 • ReceiptNo. WHITE •D.O.S.•8.0., SOR PINK -INSPECTOR GOLDENROD -APPLICANT Main Service 200A To IOWA 46.00 NEW CONST. DWELUM oOCUP. so. OR ADOW. • ACC. ODs. 3.5QFT, "DtFRESID. MUI H COXIMI@7.50 POW 51 APPARAnA A SWOUE OUTIAT CIF. Ex. Occup. ounrr oR FOn xtm -00 d2* 0 I.SO FDO?D APwa. OR Ex. Occup. OUT ETB ESM. E&_L 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt: S Mobile Home Installation Fee $ Energy Inspection Fee b occ CONST' TTMK TOTAL FEE _�� NAZ D. FEES IMP FLDOO 1 COF P -CEL pp HD 65UE 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 PERMIT EXPIRES ON I MATO) OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delayi' in processing and issuing your building permit. No building permit will be issued until this _ verification is received. .; 4. I personally plan to provide th major labor and materials for construction of the proposed property im ovement : YES NO ❑ ITHAVEHAVE NOT ❑ signed an application for a building permit for the proposed Ww I have contracted with the following person (firm) to provide the proposed constructiowK, NAME• ADDRESS: CITY; PHONE: CONTRACTOR'S LICENSE NO. I plan to provide portions of this :work, but I have hired the following person to coordinate; supervise, and provide the major work:. NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide th e work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: 1 SOCIAL SECURITY NUMBER: DATE: .!�r/z Z NOTE: This Owner -Builder Verification is required by Section 198.31 and 19832 of the California Health and Safety Code. This verification must be completed Md returned to our office before we are permitted to issue the permit. OWNER BUILDER INFORMATION Dear Property Owner: Q--, --' 1 An applicarion 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. Buildin, 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 6rom,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 Califomia 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 y If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should: be aware of the following information for your benefit and protection: ♦ If you�employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is 5300 or more for the entire project, and such persons are not licensed 'as contractors or subcontractors, then you may be an employer. ♦ If you are an employer, you must recrister 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 contri'bution's:; . ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially.serious. with respect to worker's compensation insurance. ' ♦ For more specific information about'your obligations under Federal Law, contract the Internal Revenue Service. (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under. State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale; property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractprs 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" pn the reverse side of this form so that we can confirm that you.. are aware of these matters. The building permit will not be issued until the verification is returned. r rely, Mic el C. Vi iia, C.B.O. M ger, Building Inspection NOTE: This Owner -Builder Information is required by Sectlon 19830 of the California Health and Safety Code - OVER t 4 i ,035-21-3-030 PERMIT#9670811 BRAWN, Luther,. 4586 Virginia Ave., Oroville Ele Ser Ch/SF ��j/c:, OFFICE COPY Address G Deter B Date - ELECTRIC � Dat Meter. B 7- lo;I ....... .... . ... R } • i COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 RMT No. pj v APPLICATION AND PERMIT ��' �_� ASSESSOR PARCEL NUMBER 035-213-0.30 ZONING d" BUILDING PERMIT OWNER LUTtiEft BLOWN TELEPHONE �- SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS nit;' 4586,VIRGINIA AVE -. CONTRACTOR'S NAME oRovzLLr _ _ - TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER ,.4. L NXNOWN Total Valuation $ Filing Fee - $ 20.00 LENDER'S MAIUNG ADDRESS 1 Permit Fee $ ARCHITECT OR ENGINEER w LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ - ARCHITECT OR ENGINEER'S MAILING ADDRESS - Penalty $ BUILDING ADDRESS-✓ - 45'86 PERMITFEE $ PLUMBING PERMIT FilingFee 20.00 OROVIT—TE Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar Or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF m"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 ❑ Other ❑ Describe Work: AA7 `,ELEC SERV CHANGE — Mobile Home I S I G W 1 @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20:00 Main Service e00V OR LESS ( z00A OR LESS ) 23.00 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 hereb)� affirm under penalty of perjury that I am exempt from the Contractors License LawX! the following reason: B 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 OCCURSO. OR ADDNS. ( & ACC. BIDS. ) 3.50 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 POWER APPARATUS ( & SINGLE OUTLET CIR. ) Ex. Occup. (OUTLET OR FIXTURES ) 20 @ 1.00 BAL .00 Ex. Occup.(OFI ELETS (RES D.) EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 sc iriog,q -1 1. J.,0 tt t il3Y.� �o PERMITFEE g AVeb 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 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.) _ d 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 L�4�c ��}""`"4_'_ Date _ _ /v_ �� Signature of Applicant - ❑ Owner O Contractor ❑ 'Agent An OSHA permit is required for 11 icavations over 5'0" deep and demolition or construction - of structures over 3 storie% eight. Mobile Home Installation Fee $ Energy Inspection Fee $ occ ; 'I. •-111TOTAL CONST: TYPE Q FEE $ (�_6408 1 HAZ.D. FEES , IMP FLOOD CDF PARCEL PD 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.MI _ •• BY .✓ / Date PERMITEXIRESO �S r (Date) Receipt No. 7 '7 • �3 WHITE-D.D.S.-B.D. CANA Y-ASSESSO PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF GEVELO'PMENTSERVICES -BUILDING DIVISION r 7 .County Center Drive - Oroville, Califc4nia 96965 - Telephone (916) 538-7541 _OgRMIT NO. _y APPLICATION AND PERMIT��' ASSESSOR PARCEL NUMBER 035-213-030 35-2 - ZONING RN BUILDING PERMIT OWNER OWNER LUTHER BROWN TELEPHONE SO. FT. OCC. BUILDING VA TION OWNERS MAILING ADDRESS 4586 VIRGINIA AVE CONTRACTORS NAME OROVILLE TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNIOJOWN 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 $ BUILDINGADDRESS 4986 VIRGINIA ATE PERMITFEE $ 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 M 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 ❑ Other ❑ Describe Work: KKK -ELEC SERV CHANGE — Mobile Home S G W 920.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.'00 Main Service600V 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 herebx. affirm under penalty of perjury that I am exempt from the Contractors License Law Kr the following reason: go I, as owner of the property, or my employees with wages as their sole compensation,g 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 NS. ( 8 ACC. ) SO. 3.52 FT. NEW CONST, MULTI-OUUTLETLE T NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES) 20 O 1.00 aAL Q .SO Ex. Occup. (OUTLETS APPUN .OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 3. CC _zvSIS 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 9 Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number one hundred dollars ($100) or less.) /,he above sections need not be completed if the permit is for work of a valuation ,certifythat 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. _�j / �-- Date —�^ �— ! 1� Signature of Applicant - O: Owner ❑ Contractor ❑ Agent An OSHA permit is required for g c@avations over 60" deep and demolition or construction of structures over 3 storie' Dight. AAW Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $0 / HAZ. I D. FEES I IMP I FLOOD COF I PARCEL PO HO SSUE 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 PERMITEX IRESO 77 2EZ2!X_-4�7 (Date) Receipt No. -/ V�60 WHITE-D.O.S CAN Y-ASSESSO PINK -INSPECTOR GOLDENROD -APPLICANT /� Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed prop � 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: 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. 1 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: ` `7 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 per -forming their own work personally. Information about licensed contractors may be obtained by contracting the Contractors StateLicense 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 y, Michael C. Vieira, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER LOCATION: CONTRACTOR DATE: PRE -INSPECTION FOR DATE TO INSPECTOR PERMET HISTORY: [ ]NONE [ ]AS FOLLOWS: ' TYPE OF OCCUPANCY: BUILDING INSPECTORS REPORT ag Description: [ ] Commercial/Usage: [ ] Residential/9 of Units: Mobile Home: Yes[ ] No[ ] [ ] Currently Occupied. [ ] Abandoned/Vacant. ic: [ ] Yes [ ] No Electric is currently : [ ] On [ ] Off Condition of electrical? Natural [ ] Propane[ ] None[ ] Currently On[ ] Off[ ] 1 Obvious problems: ion: Plumbing working Yes[ ] No[ ] Well: Yes[ ] No[ ] Potable water: Yes[ ] No[ ] Obvious Sewage Problems: yin Issue [ ]Hold for: s �I'+ I �' 1 t �`'/N Recommended: • . [� �'