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Home My WebLink About039-370-012o/12 'RURGT62 Stanley _ 296 -66B 240 -66E 1 1257Stanley ve., Chico 9'37-1 (addition) 607-2148 039-370-012 UUU MISCELLANEOUS Re -Roof RE -ROOF SF (31.5 SQ) _ 1247 STANLEY AVE WILLIAMS, JANICE REVOCABLE I V 1 7 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: 1247 STANLEY AVE Owner: Permit No: B07-2148 APN: 039-370-012 WILLIAMS, JANICE REVOCAB Issued Date: 10/16/2007 By KCG Permit type: MISCELLANEOUS 1247 STANLEY AVE Subtype: Re -Roof CHICO, CA 95928 Expiration Date:' 10/15/2008 Description: RE -ROOF SF (31.5 SQ) (530) 896-0523 Occupancy: Zoning: SRI Contractor Applicant: Square Footage: BAIRD ROOFING CO BAIRD ROOFING, CO Building Garage Remdl/Addn 11025 MIDWAY 11025 MIDWAY CHICO, CA 95928 CHICO, CA 95928 Other Porch/Patio Total (530)342-1631 (530)342-1631 FEE INFORMATION DBMSC Re -Roofing $201.50 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires BAIRD ROOFING CO 631460 / C39// 10/31/2007 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I a icensed under provisions of Chapter (commencing wit Section 7000) of Division 3 -of- a Business nd Professions Code, and my license is in full force a effect. X 10/16/2007 Contract is ig ature Date WORKERS',COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Carrier. State Fund Policy Number: 238-0000367 Exp, Date:04/01/2008 (This section need not be competed it permit is or once human red 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 the Workers' Compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor -Coo I shall�orthwith comply with those provisions. / ��j CJti11G1L•JL�. � � . - WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip iotaf t-nargea: 3i2U1.5U rees rata: s2UL5U Balance Due: $0.00 Receipt No: B5002 OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License 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 pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]; - Please check one of the following: ❑I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. 8 P.C. for this IX 10/16/2007 Owner's Signature Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County o enter the above mentioned pr periy for inspection purposes. I hare?b certify that I am the prop y owner or am aulhoriz to ac}�on the roperty owner's behalf. B_�.1,YyG ��i�v7nv �J� 0/16/2007 V Owner ❑ Contractor QR; Agent for Owner Agent for Contractor FILE COPY - BUTTE COUNTY o��TTF0 DEPARTMENT OF DEVELOPMENT SERVICES O , ° BUILDING PERMIT APPLICATION ° OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 o -= =aa -•j c A FEE WILL BE REQUIRED AT TINIE OFAPPLICA TION Website: www.buttecounty.net/dds OUN **PLEASE PRINT CLEARLY** ARCHITECT/ENGINEER OWNER INFORMATION Last Name inS.j First Narnaf Mailing Address 1"11,41)— City City State Zip � Phone U I U ` _ Fax E-mail E-mail ARCHITECT/ENGINEER CONTRACTOR Name City State Address Phone E-mailto Fax License Number City n ,i States n f Zip Phone / Fax0 E-mail Lic. # / '� Q Class ARCHITECT/ENGINEER Name Address City State Zip Phone E-mailto Fax License Number APPLICANT SIGNATUR X/ I PERMIT NO. B.1N # PROJECT LOCATION AP# 21 Property Address G— City G G WORKER'S COMPENSATION Policy Number C23 Carrier K, If hiring any e )[her than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. \ LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: W_ �-- Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): , For office use only: APPLICANT INFORMATION Name �/ t, A14zF7 Address ., —In I) I !� City n ,i State j Zi Phone Fax tI7 oC E-mail APPLICANT SIGNATUR X/ I PERMIT NO. B.1N # PROJECT LOCATION AP# 21 Property Address G— City G G WORKER'S COMPENSATION Policy Number C23 Carrier K, If hiring any e )[her than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. \ LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: W_ �-- Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): , For office use only: Zoning Flood Zone SRA Yes I No Occ. Type Const.