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Home My WebLink About035-222-008R 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.neAdds PERMIT NO. BP041290 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date'' 05/05/2004 APN: 035-222-008-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number:-� Site Address: 4774 VIRGINIA AVE ORO Date: _T Contractor. �QDa not 1 , rlnncv . Map Index: OWNER43UILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: SHETRK, 6 NEW WIN, FINISH, FIRE DAMGE Contractors' State License Law for the following reason (Sec. 7031.5 REPAIRS Business and Professions Code: Any city or county which 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 Owner: WARRENBURG JEFFERY signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 3120 CEDAR CT 7000) of Division 3 of the Business and Professions Code) or that he or ANTIOCH, CA she is exempt therefrom and the basis for the alleged exemption. Any 94509-5248 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: WARRENBURG JEFFERY such work himself or herself or through his or -her own employees, providedthat such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: CLEANRITE INC. pursuant to the Contractors' State License Law.). DBA: BUILDRITE CONSTRUCTION & ❑ I am Exempt under Article 3 of the Business and Professions Code RESTORATIO Date: Owner: 1200 W EAST AVE 95926 (530) 891-0333 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: PQ I have and will maintain a certificate of consent to self -insure for License #: 689238 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 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation Engineer: 9 insurance carrier and policy number are: Carrier: Policy #: Total Square Ft: 0 S. F. ❑ I certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Census Code: and agree that if I should become subject to the" workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.�i Date: Je- 5' - � l mwn V�IU r(,1 Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages.as provided for in Section'3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Coda anryor I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutio to o c indicat ove for which fees have been paid. C / Name: By: Date: Address: PERMIT EXPIRES 0 Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. 1 agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. 04a Print Name: i13 1,0 Signature: Date: ❑ Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP C'�-q-!2a0 DATE: � _ I � � APN: ZONING: OWNER'S LAST NAME: U'6ag-'�n bur -424 OWNER'S FIRST NAME: PHONE: I/ - V/ ' STREET ADD FAX E-MAIL: SITE ADDRESS: CITY, ZIP: -11Cie NEAREST CROSSSTREET- TRACTILOT tk APPLICANT NAME: PHONE STREET ADDRESS: / FAX CITY, ZIP: � eke .0 CA E-MAIL: CONTRACTOR NAME:t PHONE: -® 3 STREET ADDRESS:/ AL: CITY, ZIP: LICENSE NUMBER LICEN TYPE: ARCHITECT/EN (NEER NAME: PHONE STREET ADDRESS: FAX CITY, ZIP: LICENSE NUMBER E-MAIL: DESCRIPTION OR SCOPE OF WORK: Structure Built with ut pe mits ❑ Proposed Change of Occupancy (note previous use) EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: Notes: Application Received b • Dat • PP y. e. }� Receipt number: 5� g- 0713 Amount Received: ' 6 1 0 / ', OWNER: LOCATION: CONTRACTOR: DATE TO Building Description: Electric: Gas: Residential/# of Units: Currently Occupied Abandoned/Vacant Yes No. Condition of Electric FIRE DAMAGE REPORT DATE: . A.P. # ZONING: PERMIT HISTORY.(&NE ( )AS FOLLOWS: BUILD Electric currently On Off Natural Propane None Currently On Off Obvious Problems: Sanitation: Plumbing Working Well Working Potable Water Obvious SewageProblems Description of Damaged A Estimate Valuation of Damaged Area: Condition of Foundation: Mobile Home: Condition of Utilities: Inspector. Date g v Sketch building on reverse and indicate area of damage. ItI _ 'y REQUEST Location: MW owner: vV [/r/ Call Phone: o tractor: l J BLDG. P MB/MECH E CT M. H.U. RE- SP TION Form Frame/Underfloor o m s Stucco Lath a pi es S i orr io s Per RenAval Stucco Brown Temp s n and I Verify Utilities Woodstove Se g irc AL Ex Mobile Site Brace Panel W Insulation Nailing Sho an Gunig,d I Demo • / Corrections C rections C rections Final Final Final Corrections Rea Final Inspe Date: Comment: