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Home My WebLink About039-450-007NYSTRb�i, J. A. & Sons 39D7B 3817E - t7/3111P Lot 7, Monta Vis a 1 age, N. Durham Dayton Rd,, Durham 0-007 OS -2463 (new, single-family) BLASI— BLASINGAME, JUNE 2520 DURHAM DAYTON HWY, _ DURHAM BLASINGAME, June —114-69B Cont. OWNER 124-69E RE ROOF �... _ 9-45- � e/s Dayton Durham Hwy. SOO no. o Burdick Rd., Durham 4 (add storage room) 039-450-007 JUNE BLASINGAME 2520 DURHAM DAYTON HWY., DURH FIRE,DAMAGE REPORT 0 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) . OFFICE #: (530) 538-7541 PERMIT NO. BP052463 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjuy that I am licensed under Issued Date: 09/13/2005 APN: 039-450-007-000 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. Site Address: 2520 DURHAM DAYTON HWY DUR License Class : License Number: Map Index: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 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 signed statement that he or she is licensed pursuant to the provisions of the Contractor's State 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).): 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 such 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 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 pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code '13 Date:= Owner: t ete 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 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: Policy ❑ 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: 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. Description: RE ROOF COMP 15 SQ.'S Owner: BLASINGAME JUNE R 2520 DURHAM DAYTON HWY DURHAM, CA 95938 Applicant: BLASINGAME JUNE R 2520 DURHAM DAYTON HWY DURHAM,CA 95938 Contractor: License #: Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: CONSTRUCTION LENDING AGENCY -_ - This permit is hereby issued unde I hereby affirm that there is a construction lending agency for the Resolutions to IVwork indicpted performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By Address: PERMIT EXPIRES ON: icable provisions of the Butte which fees have been paid. Date: CU ;ode and/or ❑ 1 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. I 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 Print Name: p �J1.11�iL' IQ S� ✓� q Q1i1�� . Signature: Date: /Owner ❑ Contractor ❑ Agent for Owner 0 Agent for Contractor i BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" 9_1 (/ APPLICANT NAME CONTRACTOR Name C'h-�ccRlfA�ivl/ Address Zip City Fa0,9 x State Zip Phone Name Fax E-mail Lic. # Class APPLICANT NAME ARCHITECTIENGINEER Name C'h-�ccRlfA�ivl/ Address Zip City Fa0,9 x State Zip Phone Name Fax E-mail State License Number APPLICANT NAME Name t a e T2 S' AddressZ�.2-Q '7,Gil�/�+1� ft7 D C'h-�ccRlfA�ivl/ State /!, Zip Pho c5� 8 Fa0,9 x E-mail ' 6 -5DP h I S C APPLICANT SIGNATURE X For Wice, use on ,f ' . Zoning Flood Zone I I SRA I Yes I No Occ. I Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BP BIN # LOCATION AP# 0 — c� Property Address 2S20 ity Cross Street 91ArA -'J L WORKER'S COMPENSATION Policy Number Carrier Bhiring anyone other than license contractors, a cefcate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: 7a7e- adi ' n s—mice 4'CO w O q. Footage s ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): OVER FOR SUBMITTAL REQUIREMENTS U K:\FORMS\BUILDING FORMS\BldgAppISubRgmts.doc Page 1 of 2 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 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. Received by: Amount: Bldg SRA Receipt #: Sheriff Date: REV 7-27-04 ;: I .a FIRE DAMAGE REPORT 1 \ OWNER: ��^-� l Q S) Yom--- DATE: O LOCATION: � U ( 'vi19 Yam M �Jn]lr-�wmA.P. # 6 2P <0 C) CONTRACTOR: ZONING: DATE TO INSPECTOR: �-� \ b PERMIT HISTORY:( ) NONE ( ) AS FOLLOWS: BUILDING INSPECTOR'S REPORT Building Description: Commercial/Usage: Residential/# of Units: Currently Occupied Abandoned/Vacant Electric: Yes_ No Electric currently On Off Condition of Electric Gas: Natural Propane_ None Currently On Off Obvious Problems: Sanitation: Plumbing Working W& Well Working Potable Water f4.@.6 Obvious SewageProblems rLa Description of Damaged Area: ��/YL��" /� ��—'`� �u Estimate Valuation of Damaged Area: Condition of Foundation: Mobile Home: Condition of Utilities: — Inspector. V �3 Sketch building on reverse and indicate area of damage. Date [1fY—Uj CDF/BUTTE COUNTY FIRE INCIDENT LOG DATE 08110/2001 INCIDENT NUMBER 9433 LOGGED BY JAMC REPORT TIME 11:19 LOCAL FIRE NUMBER 108611 RO CAUDILL STATE FIRE NUMBER 1 antRMto Fim llffirorc. BI CASE NUMBER anti acw $ MEDICS LOCATION 2520 DURHAM DAYTON HWY PRA IN3 ECC ❑ RP PHONE NUMBER I REPORT METHOD, RADIO E45 WILDLAND FIRES ❑ ESTIMATED ACRESFIRE INFORMATION STRUCTURE FIRE RESIDENTIAL I FIRE INFO SENT HOW E-MAIL BY CJ TO STA45 OTHER FIRE 7 -DAY LOGGED ® INITIALS CJS MEDICAL AIDS I INCIDENT NAME STOVE FIRE PSA/OTHER I START DATE 08110120011 START TIME 05:00 HAZ MAT DIAMOND # 5.0 I COMMENTS CAUSE ELECTRICAL POWER EXTINGUISHED LAND USE DOMESTIC STRUCTURE ACRES r 0 TYPE OF ACRES DIAMOND 5 ONLY $ DAMAGE TYPE ALL OTHER DOLLAR DAMAGE. -!0j SAVE 146000.00 INJURIES/FATALITIES ❑ # CIVILIAN INJURIES # CIVILIAN FATALITIES EMD ❑ OES ❑ # FF INJURIES = �J # FF FATALITIES =J 0 ♦ ♦ I Now Incident FC-401NFORMATION FC -40 ❑ DATE OF FC -40 INC AGENCY INC # INC P# FGdO COMP DATE FC -40 COMP BY County Notifications ❑ EARS Hard Copy Recieved , ® EARS Checked Agenst EARS Computer ❑ ro• • t t • 1 00P rf h• NYSTiM, J. A. & Sons 99078 . 3817E -45-7 3111P Lot 7, Monta-Visa i age, N. Durham Dayton Rd,r Durham 1 (new, single-family) 19 BLASINGAME, June 114-69B 124-69E 9-45- 4 e/s Dayton Durham Hwy. 5001 no. o Burdick Rd., Durham ( add storage room) -6awc-e Q-Q�-�- M. D. B. 8 /V, Tax Area Code 70-02 80 (�)yyAY ,A C 9 V 39-45 I Q) i 1. Assessor's Map No. 39 -45 NOTE—ASSESSOR'S PARCEL BLOCK County of Butte, Calif. & LOT NUMBERS SHOWN w riori inz C C D T /Q90 1I1 - .ND 1