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HomeMy WebLinkAbout040-233-023ME o _ 040-23-3-023 93-1172 B HARRIS, SUSAN �,,,m,..� 2392 FLORIDA LN, DURHAM I� REROOF/SF# B07-0584 040-233-023 . f � MISCELLANEOUS Room Addn-First Stry :ADDITION BEDROOM ND BATHRO 2392 FLORIDA L HIGGINS, JEFFREY A & TANYA M r a , 0 r 0 o 0 Bio 0 mlM lm D a BUTTE COUNTY AREA DEPARTMENT OF DEVELOPMENT SERVICES 5 INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B07-0870 Issued: 4/23/2007 Address: 2392 FLORIDA LN Area: DURHAM Owner: HIGGINS, JEFFREY A &APN: 040-233-023 Applicant: HIGGINS, JEFFREY A &Map Page: Permit Type: Electric Panel Description: ELECTRICAL SERVICE UPGRADE Flood Zone: None SRA Area: No SETBACKS Front Setback: Side Setback: Rear Setback: Other Setback: Minimum Setback From Centerline of Street: ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test House 404 Gas Test Yard 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Holdowns/Straps 122 Shearwall/B.W.P.-Interior 135 Shearwall/B.W.P.-Exterior 135 Do D OFFICE COPY Signed Rouj Bldg Permit ; — /" g.- Rouj Address: Rouj Rouj Gas! GAS By: Shop' . Fire Electric By. - ` Date:4 , Fired - 1-- Fifials Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Pool Final 802 Mobile Home Final 802 Ins ection Type I IVR I INSP DATE Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Swimming Pools Setbacks 132 Pool Plumbing Test 504 Gas Test 404 Pre-Gunute 506 Pool Elec/Bonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 507 Manufactured Homes Setbacks 132 Blocking/Underpining 612 Tiedown/Foundation System 611 Site Utilities/Trench Insp. 137 Gas Test Yard 404 Manometer Test 605 Continuity Test 602 Skirting/Steps/Landings 610 Coach Info Manufactures Name: Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: Insignia: Pu c Works Fina 538-7681 Fire Department/CDF 538-7111 Env. Health Final 538-7281 Sewer District Final **PROJECT FINAL 1 801 0C— S- -o- -rrvjm anal is a ♦.erancace of occupancy for txesmenuai uniy) PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy BUTTE COUNTY t' 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: 2392 FLORIDA LN Owner: Permit No: B07-0584 APN: 040-233-023 HIGGINS, JEFFREY A & TANYA Issued Date: 05/02/2007 By KCG Permit type: MISCELLANEOUS 2392 FLORIDA LN Subtype: Room Addn-First Stry DURHAM, CA 95938 Expiration Date: 05/01/2008 Description: ADDITION BEDROOM AND BATH (530) 342-3272 Occupancy: Zoning: R1 Contractor Applicant: Square Footage: HIGGINS, JEFFREY A & TANYA M HIGGINS, JEFFREY A & TAN Building Garage RemdUAddn 2392 FLORIDA LN 2392 FLORIDA LN 518 DURHAM, CA 95938 DURHAM, CA 95938 Other Porch/Patio Total (530)342-3272 (530)342-3272 123 641 FEE INFORMATION Ag Com Building Permit Clearan $32.50 DBEH Building Review Fee $75.70 DBF Room Addition - First Stor $428.92 DBMSC Room Addition -First Stor $643.39 DBSMIP Residential $3.56 Total Charged: $1,184.07 Fees Paid: $1,184.07 Balance Due: $0.00 Receipt No: B2894 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that 1 am exempt from the Contractor's License HIGGINS, JEFFREY A & TANYA OL:CRW_00373615 / / 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 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 pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. 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 X 05/02/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; PIase check one of the following: Contractor's Signature Date 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 License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). ❑ I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ 1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier The Contractors License Law dows not apply to an owner of the property who builds or improves and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier: Policy Number: Exp. Date: (This section need not a completed if the permit is or one hundred dollars ($100) or less.) I ❑ 1 AM EXEMPT under Section B. & P.C. for this reason: 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' X 05/02/2007 compensation provisions of Sectio 3700 of the Labor Code, I shall forthwith comply with those -at provisions Owners ignure Date X 05/02/2007 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 Signature Date WARNING: FAILURE T SECURE W K COMPENSATION COVERAGE IS UNLAWFUL, 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 AND SHALL SUBJECT AN EMPLOYER O CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS $100,000, IN ADDITION TO THE COST OF COMPENSATION, ( ) injury, including death, and property damage caused arising out of, in any way connected with the issuance of this permit. I hereby acknowledge thatt is issuance of this pea rmit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the props owner or authorized to act on the roperty owner's behalf. Girn 1 II, s 05/02/2007 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of mitte [ I N) Print Date the performance of the work for which this permit is issued. (3097 civ. code) ��� /// Owner 1:1 Contractor OR. Agent for Owner Agent for Contractor FILE COPY Lender's Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" CONTRACT OWNER INFORMATION Last NameFirst i i Vl S State Mailing Address Q ' City lA.r Class State Zip P 2'�7Zr� Fax ^Uq& E-mail I CONTRACT Name Address City State Zip Phone Fax E-mail Lic. # Class ARCHITECTIENGINEER Name Address- 'EDO 415 6cm-e—S Lt _ ,-f_ City Co p ; State C t City Fax E-m t 0. State Licea Number - —a Z'7 Iw• APPLICANT SIGNATURE X C PERMIT NO. BIN PROJECT LOCATION API —2 Property Address 2, �q —`-,1,0 \r -t City WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must he shown at the time of permit issuance. I LENDING AGENCY Name d SCRIPT/ON OR SCOPE OF WORK: APPLICANT INFORMATION Name C U -1- --a CA f �. S Address t City State /1 Zipj5Aj Pho�,J1'`/�J 'NP E-mail Iw• APPLICANT SIGNATURE X C PERMIT NO. BIN PROJECT LOCATION API —2 Property Address 2, �q —`-,1,0 \r -t City WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must he shown at the time of permit issuance. I LENDING AGENCY Name d SCRIPT/ON OR SCOPE OF WORK: C" Occ. V-) Sq FT- Living FJ�� Garage Open Cov ❑ Structure Built without P ❑ Proposed Change ): nc/Q(Note previous use): �Y3164/"(W office onng tFlood Zone SRA I Yes I No Occ. Type Const. Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds PERMIT APPLICATION DATA SHEET Reference Number: B07-0584 Date: 03/23/2007 Location: 2392 FLORIDA LN By: KEJ Parcel Number: 040-233-023 Sub Type: Room Addn-First Str Owner Name: HIGGINS, JEFFREY A & TANYA M Phone: (530) 342-3272 Description: ADDITION BEDROOM AND BATHROOM (518) COV (123) District, 9447 Midway, Durham CA 95938 - (530) 345-1921 The above permit application has the following Clearances required prior to permit issuance. Please contact each department indicated below regarding specific requirements pertaining to your permit application. Yes No DRAINAGE DISTRICTS ❑ ❑ Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740 ❑ ❑ LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000 ❑ ❑ City of Chico, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 PARKS & RECREATION DISTRICTS ❑ ❑ Chico Akea Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 ❑h{��4&'Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921 ❑ ❑ Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011 ❑ ❑ Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393 SCHOOL DISTRICTS ❑ Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281 ❑4-D hico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 rh(a7 � d School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 ❑ Gr ley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723 ❑ Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000 ❑ Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 ❑ Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext: 105 Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 Other: Other: Other: Signature of Property Owner: Date: 03/23/2007 FILE • 1 BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District (/ly ka wN Un,4'4 Building Department No. � TVRatArea No.A.P. Numberr"nO. Taj • 6(i7Jurisdiction: � City nty Property Owner � r l �1 ,[ T Property Location/Address '1? 1-3 1 /; D,16( L I (-. LN I Subdivision Lot No. ........................................................................-................... Residential Development 0 0 �� , Sq. Footage No of Living Mobile Home Addition/ 'Supplemental to (Group R) Units Installation Conversion . Permit # Cr. Demo - ( ) i '(No foundation inspection) existing sq. ft. see attached Net total sq. ft. Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial Q• �P"' , Sq. Footage New Addition = (Including Exterior Roofed Areas) Building artm nt 1epresentative >l.— Date District Identification No. 6 3 T / �U PWP771 i>N/G/School District certifies that -7-9 AY /7 f (Payor) a3 g� GLo,e.r DQ 4Af �tf 2ktrn 0 A 4?593 e14 7 (Street Address) (City) (State) (Zip Code) (Phone Number) has complied with the requirements of Resolution No. d '7 - / Z by payment of $ �� • 3 representing �� square feet.1p�B 2926 $ t . FULL MITIGATION $ School District Representative Date Paid by Check # / Remarks: Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance.with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit,a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (school district), Yellow (building department), Pink (applicant) feeform.As (12/06)dmm BUTTE COUNTY DEVELOPMENT PEE CERTIFICATION FORM O FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) 0 CHICO AREA RECREATION AND PARK DISTRICT (CARD) ❑ V ADISE RECREATION AND PARK DISTRICT (PRPD) DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) Property Owner (s)k Project Location /Address Subdivision Name Building Pen -nit Number ' V Assessable Sq. Ftge (� Type of Residential Development (check one) New Development Single Family -Detached Single Family-Attached y Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling Mobile home Mobile home replacement verified by Assessor Department Demo Permit (date issued ) verified by Building Department Comments: Building Date 0 F—R�RPD ❑ CARD ❑ PRPD )( DRPD certifies that: I � qt (, a_ thlG 1►'Z 7i 42- 3 Z7 Z Ap 'ant Name Phone Number F0, BOX &11 C64 ci'S�i 3 Mailing Address City State Zip Has complied with requirements of the Butte County Board of Supervisors Resolution No. 0 y l D 7 by Payment of: Dwelling Units @ $ per unit for a total of $ Square Feet @ $ 1,4 per sq foot for a total of $ 7 30 .3 9 Remarks: Paid by Check No: Paid by Cash: W !R J.J/ Receipt No: Z%D 8 1 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: 0 Make sure your application is complete. 0 Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at hqp://municipalcodes.lexisnexis.com/codes/butteco/ Reference Number: B07-0584 Location: 2392 FLORIDA LN Parcel Number: 040-233-023 Date: 03/23/2007 Owner Name: HIGGINS, JEFFREY A & TANYA M Phone: (530) 342-3272 Description: ADDITION BEDROOM AND BATHROOM (518) COV (123) Signature of Property Owner: Date: 03/23/2007 Florida Lane Site flan BUTTE COUNTY FEE SUMMARY 7 County Center Drive Oroville, CA 75965 Department of Development Services Phone (530) 538-7541 Fax (530) 538-2140 Permit Number: B07-0584 Job Address: 2392 FLORIDA LN Contractor: HIGGINS, JEFFREY A & TANYA M 2392 FLORIDA LN DURHAM, CA 95938 Printed: 03/23/2007 1:47 pm Fee Description Account Number Fee Amount Paid Date Pmt Amt DBEH Building Review Fee 0021-540013-4614901-1010 $75.70 03/23/2007 $75.70 DBMSC Room Addition -First Stor 0010-440001-4210500-1010 $643.39 DBF Room Addition - First Stor 0010-440001-4210500-1010 $428.92 03/23/2007 $428.92 DBSMIP Residential 1001-0-280-1011298 $3.56 Printed By: Karen Jones 19151.57 $504.62 Balance Due: $646.95 At the time of permit application, I was advised the above fees are required prior to issuance of the permit. These fees may change during the plan checking process. Signature: Date: 03/23/2007 Pursuant to Government code Section 66020, you are hereby notified those items listed above may have been imposed on your project. You have 90 days from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a protest are specified in Government Code Section 66020(a). Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. 1. I PERSONALLY PLWO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. US OR NO) 2. I(gDHAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: ADDITION BEDROOM AND BATHROOM (518) COV (123) Reference Number: B07-0584 Applicant Name: HIGGINS, JEFFREY A & TANYA M Owner's Name: HIGGINS, JEFF Y A & T CA M AP # : 040-233-023 Signature of Property Owner: Date: ' 1 6 �v a v iv arcs 77VPV 700HOS llVdd 6S 6d / "VO 'bf O fV W b MYRO -4 p • NM o1 K // 6d 9/ '-y8 'y O %W J? ON OOV N/UNMY& zF O i9' Od"O w ens S'"Obe rO A37 -IPPA @W4ldsuO* #Ou 60o puo Alm sssodmd psmssmD j% 00 slsouod wu41:310N °a Oz u ® Or Y G►�!t 377VA o� J Z F t• s s 0 L O was Y r ore Af NAfOy8 O ^ s£. of - o W* ar6r >O 4 •d' I EE 'y&IW.JO NAfO.I It Name IHIGGINS ,JEFFREY A ETAL Addr1 12392 FLORIDA LN Addr2 DURHAM CA 95938 Addr3 Addr4 Comments 14023302300 CONVERTED 09/08/88 Creaking D oc# 1982R 2753148 Dake Current Doc# 200080029354 Dake 07}31 X2000 Killing Doc# I D ate Asmk D esc 12392 FLO R I DA —7:3 S uplCnk Zoning R 1 D well [F Acres 0.22 N /C 040 Asmk # 040-233-023-000 Fee # 1040-233-023-000 Status ACTIVE Status Dake Tax FOO -0 INORMALOWNERSHIP TRA 070-010 Situs 2302 FLORIDA LN D U R Base D k 107/31/2000 Land Structure Fixtures G rowing Total L&I Fix. R F MH PP PP E xempk Ned AgPres 87,500 E tal jvi N otes 0 Bonds 0 Multi Situs 112,500 Flag1 Flagg Asmk PP Pen Tax PP Pen Appeal Pending Split Pending Land Structure Fixtures G rowing Total L&I Fix. R F MH PP PP E xempk Ned 40,000 87,500 0 0 112,500 0 0 0 0 112,500 FilC#F— T!R Dt� RJC Stat PHY I OWN EXP T, HON ATT SIT APR I PCL n; Find F, -1.1. n-:1 lnr 1nnn-4 n na r%L i 040-23-3=023 93-1172 B. — `— HARRIS, SUSAN 2392 FLORIDA LN, DURHAM REROOF/SFW. o COUNTY OF BUTTE - DFWARTMENT OF PUBLIC WORKS PERMIT N0. 7 County Center Drive - Oroville, CalifolMia 95965 - Telephone: 916 '538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS ry CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER VNKNOWN Total Valuation $ Filing Fee $ 15.00 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 ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SFI_7 Duplexi,J Mobilehomel] Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JW 1 15.00 TYPE OF WORK New, Addition _ Remodel, Utilitiesl� Installation[ Other Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 18.50 200A OR LESS Main service 200ATO1000A1 37.50 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 for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& 3.64 sq.ft. oR ADDNS. (ACC. BLDGS. NEW CONST R. ULTI-OUTLET NON-RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS tr (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES20 @ 76ri Ex. Occup. OUTLETS 1PRESID.IED APLNS.REA.) I 3.00 Temporary service 15.00 Mobile Mobile Home Facilities 15.00 M Ho 15.00 9 Permit Fee $ Contractor — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ul The permit is for $100.00 (valuation) or less. I 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. MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling Hood 6.50 Ventilation pemtlt 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. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this, permit. X �� Date Signature of Applicant - Owner Contractor G Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ HA2 OFEEs� IMP FLOOD cDF PARCEL PO HD ISSUE i I This permit is hereby issued under the applicable provi sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. WRITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville,_California 95965 - Telephone: 916.'538-7541 APPLICATION,AND PERMIT PERMIT NO. 1 9 25—` / ASSESSOR PARCEL NUMBER v- 040-233-023 ZONING R-1 BUILDING PERMIT OWNER Suzan Harris /Hollister TELEPHONE 345-3605 SO. FT. OCC. BUILDING VALUATION 1,740.00 OWNER'S MAILING ADDRESS P.O. Box 770, Durham 95938 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation 1$1.740.00 Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ 34.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 49.50 PLUMBING PERMIT Filing Fee 15.00 2392 _(da Lane. Durham Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF EX Duplex[] Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G W 615.001 TYPE OF WORK New a Addition Remodel C Utilities ❑ Installation❑ Other ® Describe work: Reroof w/Comp. _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600vOR LESS 200A OR LESS 18.50 Main service 200ATO1000A) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F -1I 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 ;Jo. 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 for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP. f\ OR ADDNS. 1 ACC. BLDGS. / 3.6Q sq.tt. NEW CONSTR ULT' -OUTLET NON-RESID BRANCH CIRCUITS) ^ 5 00 POWER APPARATUS 6 (SINGLE OUTLET C,R. Ex. Occup(FIXTURES OR FIXTURE 20 7611 A FIXED APLNS. \\ Ex. OCCUp. OUTLETS PIRES, D.)REA.) j 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 E_ Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I 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 15.00 Heating Cooling g Hood 6.50 Ventilation Permit 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. I also agree to save, indemn.fy and keep harmless the County of Butte against all liabilities, judgments, c sts, and expenses which may 'n any way accrue ago" s said Count in ns q e of a ranting of thi rmit. 1 X Date Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 49.50 HAz DFEES IMP FLOOD CDF PARCEL PD HD SS E This permit is hereby issued under the applicable provi- sions of t e Butte County Code and/or resolutions to do work i dic ted ab or hich fee ve been paid. DIREC PUBLIC RKS W BY ate PER XPIRES Date Signature of Applicant — Owner contractor ❑ Agen ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. 140577 Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 7 COUNTY OF BUTTE - DEPARTMENT OF PUBLiC VJORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING - BUILDING PERMIT OWNER SU Zff 1� 6cri-s 116 /'$TCA— TELEPHONE :5q5-3WSkjSO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS, ' '_ 70 ,QU 1,1^KMl CONTRACTO�4'S NAMrr((JJ� TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ (� Filing Fee $ 15.00 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 ADDRESS / L(/ Permit fee $ .411. so PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF� Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New: Addition RemodelL Utilities/1 Installation[ Other Describe work: ilCoo� �iiJ IZ4 G�P1 42 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 200A TO 1000A1 37.50 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 LJ 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 the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.� OR AODN.S. ( ACC. BLOGS. 3.66 sq.ft. NEW CONSTFL ULTI.OUTLET NON.RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS tr (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 76d FIXED EX. Occup. OUTLETS PRESTO ILNSREA.) I 3.00 Temporary service 1 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I 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. 1 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 15.00 Heating Cooling Hood 6.50 Ventilation Permit 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. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA over 5'0" deep and demolition or construct- ion of strut urest over r 3 storiesinheight. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONSTTYPE TOTAL FEES HAz 1 DFEES IMP I FLOOD CDF I PARCEL PO HO ISSUE I This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. i WORKS Date I �o2 7 Ig No. ''77 f o27 NNITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT i. COUNTY OF BUTTE Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing Your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary ddlay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) e5 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. -I plan to provide portions of this work, but I"have hired the following person to coordinate, supervise, and provide 'the major work: Name _ Address City Phone Contractors License No. 5. I.will provide some of the work but I have contracted (hired) the following persons to provide .the work indicated: Name Address Phone Type of Work Signed: Property Owner Social Se cu ity Number Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of -the -California Health and Safety Code. - This verification must be completed and returned to our office before we are per- mitted to issue the permit. 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: 2392 FLORIDA LN Owner: Permit No: B07-0870 APN: 040-233-023 HIGGINS, JEFFREY A & TANY Issued Date: 4/23/2007 By GLB Permit type: MISCELLANEOUS 2392 FLORIDA LN Subtype: Electric Panel DURHAM, CA 95938 Expiration Date: 4/22/2008 Description: ELECTRICAL SERVICE UPGRADE (530) 342-3272 Occupancy: Zoning: R1 Contractor Applicant: Square Footage: HIGGINS, JEFFREY A & TAN Building Garage Remdl/Addn 2392 FLORIDA LN DURHAM, CA 95938 Other Porch/Patio Total (530) 342-3272 FEE INFORMATION DBE Single Phase Service-Resid $55.00 I Total Charged: $55.00 Fees Paid: $55.00 Balance Due: $0.00 Receipt No: B2767 LICENSED CONTRACTOR'S DECLARATION I OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires 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 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 pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the X basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil of not more than five hundred dollars 4/23/2007 penalty ($500); Plea check one of the following: Contractor's Signature Date 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 Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE AND the work himself or herself or through his or her own employees, provided that such improvements ❑I WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑❑ Section 3700 I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: 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; 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.). Cartier: Policy Number: Exp. Date: ( is section need not be comp eted if the permit:,sorone hundre ollars($100)or essIAM EXEMPT under Section B. 8 P.C. for this reason: ICERTIFY THATIN THE PERFORMANCEOFTRK FOR WHICH THIS PERMIT IS ISSUEDI shall not employ anypersoninanymanneas to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers'X 4/23/2007 Zii5 An&� compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owners Signatur Date provisi s. X 4/23/2007 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 Signature Date WARNING: FAILURE TO SECURE O KERS' COMPENSATION COVERAGE IS UNLAWFUL, 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 AND SHALL SUBJECT AN EMPLO TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused arising out of, or in any way connected with DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge thatt is issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter theaL(e entioned property for inspection purposes. I hereby certify that I am the prope owner or amized to act on the property owner's behalf. CONSTRUCTION LENDING AGENCY I 4/23/2007 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Nam o Pe ee S Print Date the performance of the work for which this permit is issued. (3097 civ. code) E] Owner ❑ Contractor OR. ElAgent for Owner ❑Agent for Contractor 1 FILE COPY Lender's Address City State zip Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perforin their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY PL TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. OR NO) 2. I<AAV -IAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. 1 PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: ELECTRICAL SERVICE UPGRADE Reference Number: B07-0870 Applicant Name: HIGGINS, JEFFREY A & TANYA M Owner's Name: HIGGINS, JEFFREY A & T �YAM AP ; Signature of Property Owner: JAAWODate :040-233-023 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** . ju v OWNER INFORMATION Name b vi ln,e, 1( Address ` City P one rZ State Zip Phone MOW Fax E-mail Open Cov I . ju v APPLICANT INFORMATION CONTRACTOR Name b vi ln,e, 1( Address ` City P one rZ State Zip Phone Fax E-mail Open Cov Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name LA" Address ` City P one rZ State Zip Phone Fax E-mail Open Cov State License Number APPLICANT INFORMATION Name --�'h ' nS 'w1� Address (i l©v 1 ota l LA" City State Zi P one rZ Fax �9, `1 / E-mail r t APPLICANT /GNATURE X PERMIT NO. o -5 BIN # PROJECT LOCATION API 0q0 _ _ OZ Property Address Z prr ota city WORKER'S COMPENSATION Policy Number Carrier 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: I O Flood Zone v I Yes Zoo Occ. Type Const. 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 I Yes I No Occ. Type Const. Florida Lane Site Man scam=1,_o" GATE