The URL can be used to link to this page

Home My WebLink About039-080-094I{)SF / two WILLIAM NOYES� V: E/S Durham Dayton Hwy, 10001S Rod ers A Durham Contr: Bippus Rfg, Orland' Permit#866-86B(reroof/SF) :,. 039-080-094 JOHANNSEN, INGEBORG I LED r 2359 DAYTON RD. CHICO 7 PARSONS, P. M. 1118 CONT: FOUR COUNTIES RO 9_ -08 t RE ROOF 9J�Qg,�j, 039-080-094 04-0155 Dayton Road south of Rodgers Avenue, Chico DREW, JESSE 2359 DAYTON RD, CHICO cont: N. L. Walkins, 276 E. 7th Ave.,, Chico Cont: FOUR COUNTIES ROOFIN RE ROOF- 73�7Vj75 L�(I Q I (�� il C MD�-L� X) 'Y lit A)o�lo " COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS / PERAIiT Nb.' ' 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATtiON AND PERMIT ASSESSOR PARCEL NUM'. ERZONING . Jl' 1 BUILDING PERMIT OWNER , TELEPHONE SQ. FT. OCC. BUILDING VALUATION //, r� OWNER'S MAILING ADDRESS r-�'"r' CONTRACTOR',S NAME I./ TELEPHONE J� y 1 CONTRACTOR'S MAILING ADDRESS `� Fireplace CONSTRUCTION LENDER UNKNOWN / I - F Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ; D, KESS / Permit fee $ r• PLUMBING PERMITFilin 9 Fee 10.00 / i r r! r I ~ / Each Trap 2.00 , : 1 SII An Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 SF EJ Duplex❑ Mobilehome❑ Other SPECIFY Mobile Home S I G I W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel a Utilities ❑ Installation ❑ Other ® Permit Fee $ Describe work: ICY. t /� l' �< F Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 10.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.N , OR ADDNS. ACC. BLOGS. 2/20sgft 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 NEW CONSTR ULTI-OUTLET 2.50 ea NON-RESID BRANCH CIRC ITS POWER APPARATUS e SINGLE OUTLET CIR. EX. OCCUp\OUTLETS OR FIXTURES 200930 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) Mobile Home Facilities 15.00 Misc. Wiring 15.00 ❑ I am exempt under Sec. , Business and Professions Code Permit Fee $ for this reason Contractor WORKMEN'S COMPENSATION INSURANCE '1L declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g] I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate 1-f Consent to Self -Insure. ❑ I s -hall not employ any person in any manner so as to become subject to th-e W. C. laws of California. Notice to Appl"cant: If after making this statement, should you become subject to the W. C. pro�,isions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Hood 3. Ventilation Permit Fee $ Contractor Mobile Home Installation Fee I certify, that I hav:, read this application and state That the above information is correct. I agree tip comply to all County Ordinances and State Laws relating Energy Inspection Fee $ to building construcf;ion, and hereby authorize representatives of the County of Butte to enter upon tr,,e above-mentioned property for inspection.purposes. 'tom C TOTAL PERMIT FEE �.' I also ague to save, • ndemnify and keep harmless the County of Butte against all liabilities, judgme'its, costs, and expenses which may in any way accrue against said County In ;onsequence of ,the granting of this permit. XDate Signature of Applicant — Owner ElContractor ❑ Agent Elwork An OSHA permit is required + r excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories -n height. occu P, CONST*TYPFJ FLOo PARCEL PO NO 590E This permit is hereby issued Ader the applicable provi- sions of the Butte County Cod 'a and/or resolutions to do indicated above for W uCh fees have been paid. DIRECTOR'OFi'UBLIC WORKS r B ,� ►.�� — Dater/—//- I y _ — PERMIT EXPIRES Date_.' r �� fj J.i. Receipt No. WNITC-D.P.W.. YELLOW-098[9.OR, INK -INSPECTOR. GOLDENROD -APPLICANT J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS Y PERMIT NO 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND- PERMIT � As S R PAn L NU R -_ ZONING BUILDING PERMIT o NE ` c TELEPHONE S0. FT. OCC.1 BUILDING VALUATION D MAI NG D E S t COT NAME H T R S ILI G ADDR INU. Fireplace CTION LENDER UNKNOWN Total Valuation $ Filin Fee g $ 10.00 S MAILING ADDRESS Permit Fee $ 15-0 ARCHIT CT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ss Permit fee $ PLUMBING PERMIT Filing Fee 10.00 D In Each Trap 2.00 ' 'R od -,? ,A I^ 4 FL A (4Solar or heat pump water heater 20.00 LOT NO.SUBDI SION NAME ARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home is 10.00 ea TYPE OF WORK New ❑ Addition Remodel Utilities ❑ Instal I tion Other Describe work: _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. /?76 License No. _J ��_ Classification �� 19/ 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 (Sere 7044) owner, am exclusively contracting with licensed contract- ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.Id , A , h2sgft New CONSTP_ ULTB ODUTLET NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e SINGLE OUTLET CIR. / Occup(OUTLETS OR FIXTURES a20050e Ex. Occu o AL030 FIXED APLNS. EX. Occup. OUTLETS P(RESID,)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): �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. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation penult Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilit.i.es.judgments, costs, an penses which may in any way accrue agains a; €y in*.o sequen o e granting of this permit. %� Date 6 A Signature of p Owner Contractor F!:3—Agent An OSHA permit is required for excavations over 5'0" deep and d. molition or construct- ion of structures over 3 storiesin height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ �`�� occuP.CONST.TYPE I FL000 PARCEL I PD I No I 1390E � � This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT OF PUBLIC BY PER E PIKES Date the applicable provi- resolutions to do fees have been paid. WORKS Date —�� Receipt No. �_�) WHITE-D.P.W.. YELLOW-ASSE9iOR, PINx-INSPECTOR, GOLD ENROO-APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIF,(�Fv.A6,9§965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET Permit No. OWNER f Cf vo l t/ o S A. P. No. J9 -a&' 4 Proposed Building Use C'✓O F Permit Fee Based Upon: Complete Contract Price DPW Valuation Otheyf(Expl ) Building Inspector / Date At time of permit application, I was advised the following data must be submitted prior to permit processing and./or issuance: 1 DATE RECEIVED APPROVED 1. All items.have been submitted. . . . . . . . . . . . 2.. Plot plans in duplicate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate/triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD "Fees Paid" Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorizat on. . . . . . . . . . . 10. nitat ion approval from Health Dept. 1X Planning approval for (A) Use: (B) Parking: IjT_142. Certificate of Workmen's Compensation Insurance. . . . . . ��/� Y16,13. Contractor's License Information•(no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . , . . . . , , 16. Mobilehome Installation Data. . . . . . . .. • 17. Pre -Inspection for dPre-Inspec. request to Require . Building Inspector (pole) 18. Record—4 �f u a1 Acknowledgment State ent . _ 19. Other 'Dxl�'��JAY Nk t&nstructi.on approval required prior to occupancy When you issue the permit, procesE- as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other -- -----_ Applic n Date �,X/0 /-�Fz Copy of plans sent Health Dept., Fire Dept., Other /' Date During the plan checking procesE, the following data must,be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit foi above Items No. 2. Additional items required: f (Contractor, Designer, Owner) was advised of above required data by By Plans checked by Plans approved by_ Other Copy—DPW .Telephone Date Date Mail Other Date COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT o4-- 2 1 ASSESSOR PARCEL NUMBER /�Ol 3cl a /� /�J) 90 e 19 ZONING BUILDING PERMIT - OWNER Jesse Drew TELEPHONE 345-8567 SQ. FT. OCC. BUILDING VALUATION 40 squares o composition OWNERS MAILING ADDRESS 2359 Dayton Road Chico CA 95973 shingles at $60.00 = $21400.00 CONTRACTOR'S NAME Four Counties Roofing343-1416 TELEPHONE CONTRACTORS MAILING ADDRESS 3 Crusader Court CHico CA 95973 CONSTRUCTION LENDER LENDERS MAILING ADDRESS Fireplace Total Valuation $ 2-400.00 ARCHITECT OR ENGINEER LICENSE NO. Filin Fee $ 20.00 Permit Fee $ 54.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 2359 Dayton Road Chico Energy Plan Checking Fee $ $ PERMIT FEE $ 74. 00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling 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 as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: _reroof existing; roof wJcomposition Shingles Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S1 GI W1 920.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 800VMain Service 200. OR 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.P License Class C-39 Lic. No. 774554 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 Main Service 200. TO 46.00 CCU000A NEW CONST. DWEWNG OCCUP. SO OR ADDNS. ( 8 ACC. S.3.5¢6. N"ONRESDT MULTI.OUTLET @7,50 OWER APPARATUS BSINGLE OUTLET CI R. 1.00 Ex. Occup. OUTLET OR FIXTURES SAL p .50 FIXED Ex. Occup. Ourrs Aa D°� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 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 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 State Fund Policy Number 573-2003 (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 forthw' h c mply with those provisions. X Date 1/20104 Si ature f A Iii ant - ❑ Owner ❑ Contractor EXAgent A OSHA ermit is required for excavations over 5'0" deep and demolition or construction o struct res over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 74 00 HA2. 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. By Date PERMIT EXPIRES ON I Date RecelptNo. 3d?+*3 ? *'74 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 039-080-094 01-0763 t JOHANNSEN, INGEBORG 2359 DAYTON RD. CHICO CONT: FOUR COUNTIES ROOFING • RE ROOF s 4. . COUNTY OF -BUTTE - DEPARTMENT OF'DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT /. ' ASSESSOR PARCEL NUMB ZONING BUILDINGPERMIT OWNER s+ T TELEPHONE SO, FT. OCC. BUILDING VALUATION OWNER'S MAI ADDRESS 0 $60,C0 pe square CONTRACTOR'S NAME TELEPHONE Fatir Cmintipx Rnnfingd CONTRACTORS MAILING ADDRESS q CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $9-400,00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ BUILDING ADDRESS 9 Energy Plan Checking Fee $ PERMIT FEE $ 74.00 LOT NO. SUBDNISIONSNAME PARCEL MAP PLUMBING PERMIT Fling 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 New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: reroof existing roof W/CoMpO83tion shingles Gas piping system 1- 5 outlets 15.00 Buildina sewer 15.00 Mobile Home I S I G I W I@20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service ".A' OR LESS 2o0A OR 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 Qforce and effect. License Class C—A9 Lic. No. 774554 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 undef Sec. Business and Profissions Code for this reason Main Service TO 46.00 ccu000A WEE200A NEW CONST. DWELLING Acc. OCs. ( 3.5Qs. NEW CONST. MULTIC-ODUTLET NOFLRESID. @7.50 POWER APPARATUS & SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FocruRES zp I. 00 SAL 9 .SO50 Ex. Occup. OUTLEtDTSAAEESID.OEEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 w„ PERMIT FEE _ 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 Villanoya MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number WC4_()983675 (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 % � 4�4�01 /r' t-----..�... For Sign�a'ture of Applicant - ❑ Owner ❑ Contractor E] Agent An OSHA permit is required for excavations ovgr 5'0" deep and demolition or construction ,`of structures over 3 stories in height' 10. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 74.00 HAZ. D. FEES IMP I FLOOD I CDF PARCEL I PD I HD I ISSUE This permit is hereby issued under of the Butte County Code and/or Indic ted .16ove for which fees have - A By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date) /� O / 4fe ReceiptNo.I WHITE-D.D.S.-B.D. CAN ARWAZSESSOR___PWK SPECTOR GOLDENROD -APPLICANT N COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT o/ n 76.2 3 ASSESSOR PARCEL NUMBERZONING_t)F� ZI JZq BUILDING PERMIT OWNER Johannsen TELEPHONE 894-2017 SO. FT. OCC. BUILDING VALUATION OWNERS MAIUNG ADDRESSg 2359 Dayton Road, Chico, CA 95Q26 0 squares oE composition shin 1 @ $60.00 pek square CONTRACTOR'S NAME Foiir Countips Roofing I TELEPHONE 342-1416 CONTRACTORS MAILING ADDRESS CONSTRUCTION (ENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 Permit Fee $ 54 . ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 2359 a Energy Plan Checking Fee $ $ PERMIT FEE S -, IAT NO. SUBDNIS ION5 NAME PARCEL MAP PLUMBING PERMIT Filing Fee 1 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 1 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: reroof existing roof w/composition shingles Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I GI W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 a00OR LESS Main Service 20OAORLESS 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 C-39 Lic. No. 774554 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 1 hereby affirm under penalty of perjury one of the following declarations: 0 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 X performance of the work for which this permit is issued. Q 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 VillanoVa Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( a ACC. erns. so 3.5¢FT; NEW NON- a1DT MULTI.OUTLET 97,50 POWER APPARATUS 6SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES aq Q �. 0 Ex. Occup. oFIXED ur PM.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number WC4–Q-g93675 (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' 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 f rthwith comply with those provisions. X---�Date 4/4/01 Si ure of A ant - ❑ Owner ❑ Contractor IX Agent HA permit is required for excavatio er 60" deep and demolition or construction f ructures over 3 stories in hei Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 74-00 HAZ DFEES 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 ind ed a ve for w ich fees have been paid. `L By Date C1 PERMIT EXPIRES ON Date Receipt No. 6 1 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PIN SPECTOR GOLDENROD -APPLICANT S