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Home My WebLink About040-200-049o40-200-040 05-0195 1 WILKERSON, WALTER r -371 STANFORD L.N, DURFIAN4 CONT: GEORGE ROOFING UROOF IS SQ �f °v a J•1i ♦r?17}�Z'tt i - - ` •tom i S I1�#r i�.!`il(s �1 Ci4 sbs J s: ('4� c�liltl�.�,j3 tt{t{, ! F,� t �,�. '• 1 r r � } .-f c �s it tj � 7�t"Af�3�' i �; J•+ f r t� r r � t s �. t t r.. .Md 3�"t S jJ C. 1 , :. �� • _ 'r y t}t ate a a. 1 i _ C J� r ' �,� 'i +�?f Il N Y '.cj SYIi rt} ° "l}-�t' f �' Si`Yr i•' r j FI s ,i r i5 j 4 ztJ z r! c t r a C5 CvZ, } 1. r. � > :'t J r � r k . y:. ,. t} x'ir t=,. " •r aT si icr +I l� KrI x l i�rti,< �sy � r r .�.+ f��r;-.: -6- d�r:ir a rn ?. � { .9tt1 � � s i�' �� cr J �, {{��.. /•4t,�_p� '1 iFe 5 - + .��. Rs. r p�isyr }rn�r.� �r f rf �: ! r ii•h �� rk� ri i.°. ti!;, rA. J n 'i a+ bk i .{� i y � r,r. . �� •� i ♦S r �a Jar' 1.' #` � �3 x1a r,.,��i 1 r � ;L t 1� e i p ,#�� 'Ya {� ! � � � d 43°',ys1 s r�'t" i e � , r J L• r � �r i � ��^ at __��cc 7 s +,�,}in �• ia.,� � 11 k � ::.c � �l�C'ii E c"'?�$vl. F r'_ _ ! s r " 1. �i�1��k1 ? ��r t}��'� b'��' �r "[� ti BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION M (530) 538-7636 (OROVIL'LE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.netldds PERMIT NO. BPO50198 LICENSEDCONTRACTORS DECLARATION ffi 1 hereby ann.under penally of perjury that I am licensed under Issued Date: 01/28/2005 APN: 040-200-049-000 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 - u~ effect. p ��,�� Site Address: 9317 STANFORD LN DUR License Class: _ 3 1 License Number: Map Index: Date: Contractor...�9 & OWNER -BUILDER DECLARATION Description: RE ROOF COMP 18 SQ.' - I hereby affirm under penalty"of "perjury that I am exempt from the Contractors' Stale License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any Illy or county which requires a Owner: WILKERSON WALTER M & DORIS J LIVING permit to construct, alter. Improve, demolish; or repair any structure, prior TRUST 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 WILKERSON WALTER M & DORIS J the Contractor's Stale License Law (Chapter 9"commencing with Section TRUSTEES 7000) of Division 3 of the Business and Professions Code) or (hat he or 9317 STANFORD LN 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 DURHAM, CA 95938 applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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 (Sec. 7044, Business and Professions Code: The Contractors' State License Lew does not apply to an owner of property who builds or Improves thereon, and who does Applicant: GEORGE ROOFING 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 6810 LINCOLN BLVD 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 ; l' OROVILLE, CA 95966 sale.). r.,) (530) 533-6393 ❑ 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: GEORGE ROOFING pursuant to the Contractors' State License Law.). ❑ '1 am Exempt under Article 3 of the Business and Professions Code f 6810 LINCOLN BLVD OROVILLE, CA 95966 Date: Owner: (530) 533-6393 WORKERS' COMPENSATION DECLARATION I hereby affirm under penally of perjury one of the following declarations: License M 452266 ❑ 1 have and will maintain a certificate of consent to self -Insure for i 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 Architect: required by Section 3700 the Labor Code, for the performance of Engineer: the work for which (his permit Is Issued. My workers' compensation insurance and -policy number are: ,• ��carder Carrier. �IGGQ.Cp�Gt�✓Gd� Policy #: Total Square Ft: 0 S. F. Valuation: $0.00 O 1 certify that in the performance, of the work for which this permit Is to Census Code: issued. I shall not employ any person In any manner so as become subject to the workers' compensation laws of California. and agree that if I should become subject 10 (he workers' N 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.¢j )/� co M 19 �I /nom �jj , CONSTRUCTION LENDING AGENCY This permit Is he by issued under the livable provisions of the Butte County Cods a. nrt/or I hereby affirm that there Is a construction lending agency for the for this Is Issued (Sec 3097 Civ.) Resolutl ns to work Indlcat@d ab vet which fees have been paid. performance of the work which permit BY Date: Name: i PERMIT EXPIRES ON:_ Address: (Date) ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, aril 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. O Notification In accordance with Section 19827.5 of California Healih,8 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 Thal 1 am the owner or the duly authorized agent of the owner. I agree to comply with all county and stale 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. i Print Name: �i /�Elc� °Signature: Dale: ❑ Owner 0 Contractor XAgenl for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION APPLICANT SIGNATURE X Shirt e r w "Ag nt for Geor e R For office use only: OWNER Name Walt Wilkerson Address 9317 Stanford Lane City Durham State CA Zip 95938 Phone 343-2584 Fax E-mail Lic.# APPLICANT SIGNATURE X Shirt e r w "Ag nt for Geor e R For office use only: CONTRACTOR Name GEORGE ROOFING Address 6810 Lincoln Blvd City Oroville State CA Zip Phone (530) 533-6393 Fax (530)533-0287 E-mail dan@abcgc.com Lic.# Class dan@abcgc.com 452266 C39 APPLICANT SIGNATURE X Shirt e r w "Ag nt for Geor e R For office use only: ARCHITECT/ENGINEER Name N/A Address 6810 Lincoln Blvd City Oroville State CA Zip Phone (530) 533-6393 Fax E-mail dan@abcgc.com State License Number APPLICANT SIGNATURE X Shirt e r w "Ag nt for Geor e R For office use only: APPLICANT NAME Name GEORGE ROOFING. Address 6810 Lincoln Blvd City Oroville State CA Zip 95966 Phone (530) 533-6393 Fax (530) 533-0287 E-mail dan@abcgc.com APPLICANT SIGNATURE X Shirt e r w "Ag nt for Geor e R For office use only: Zoning Flood Zone 4 6 1 SRA Yes j No Occ. Type Const t'V Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. NO. a5-61 '?y BP BIN # LOCATION AP# Prope'lly Address 9317 Stanford Lane Durham, Ca. 95938 Cross Street WORKER'S COMPENSATION Policy Number 272-596-02 Carrier STATE FUND If hiring anyone other 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 Reroof - House - Comp Sq. Footage 18 Squares ❑ Structure Built Without Permits ❑� 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 fee 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. Received by: 7F Amount: C� Bldg r SRA Receipt #: �^r/f 9� g� Sheriff CM, <Q/%S SMIP Other Date:�, 4 :QS �`� elo Total REV: George Roofing