HomeMy WebLinkAbout040-260-0881
040-260-058 05-1767
GORE; GUS
1779 DURHAM DAYTON HWYN, CHICO
Cont: BAIRD ROOFING CO
RE ROOF (34 SQ)
88
40-26---'t8 _
GUS GORE ��
._Ap.plication. for--Determiration__
11/7/90
GORE, ' Gus 180-67B,.
- - -- - - - __-- - - 421-67P
132-6'"E
0-26-
s/sl Durham-Oroville Hwy. 2351 east of Lott t
x: Durham
( new duplex)
t F
0
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.neAdds
LICENSED CONTRACTORS 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. / j /�
License Class: License Numbe % (Q��%//
Date:? a Contractor:/VA
1r%/_i o
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 issuaride;'also requires the applicant for such permit to file a
signed statement, that he or she is licensed, pursuanttorthe`.Provisions Of'
the Contractor's Siate`bcense Law (Chapter 9 commencing with Section
7000) of Division 3 of tF a Business and Professions Code) or that hefor. `
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 proffered,for. sale(Sec, 70.44 —13usinegs and,erofessions„
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, hetself or through his.or-her own employees,
provided.that,such improvements are not.intended or.offered.for.
sale. If However; tfie 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.).
❑,-.1;. as owner,.,of,the, property„ -am -exclusively contracting -with..
licensed conteactors-td.'const?uct'.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.).
❑ I am Exempt under Article 3'of the.Budinoso-and,Professions Cbde'-
Date: Owner' ''
WORKERS'. COMPENSATION DECLARATION _
I hereby alrm 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 Pworkers” 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,anddppolicy, number are:,-,
Canner:
Policy ft:�) .. `62
�
❑ , I certify that in the-p'erformance of {he 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: Fail 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 attomey's.fees... - �_.... . .
CONSTRUCTION LENDING AGENCY
I hereby affirm, that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
Address:
PERMIT NO.
BPO51767
Issued Date: 07/06/2005 APN: 040-260-088-000
Site Address: 1779 DURHAM DAYTON HWY CHI
Map Index:
Description: re roof 34 sq
Owner: GORE, GUS>. ,.......,.,...,,,.�...,.-.., n.>
t, .3Q: •'� 1779 DURHAM DAYTON HWY "-: =
i',._`.` �d.r.• �Y.:fti,DURHAM',.CA'.;'w
95938
".. - .,..... .! E.
11025 MIDWAY
CHICO, CA 95928
530-342-1631
Contractor: BAIRD ROOFING CO
11025 MIDWAY
CHICO, CA 95928
;::',`• �..._iJi="''€r, �:- `530-342-1631"
u °License4:631460 :} i
Architect:
.._.Engineer:,,_...
Total Square Ft:
Valuation:
Census Code:
0 S,F.
$0.00 tj
1
1337,
This permit is herebyfssued prideehe applicab e p visions of the Butte County Code and/or
Resolutions to do ork in ' ted bove for wh' h s have been paid. �{
By: °Date:
PERMIT EXPIRES ON: / �d
❑ 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.
1 hereby certify that I have read this application, that the above information is correct," and that I am the owner or the 5yly authorized agent of the owner. -1 agree t comply with
all county and state laws relating to building construction: .I acknow dge it is unlawful to alter the substance of any icial form or document of Butte County. I e by
authorize representativesof Butte County to enter upon the abov entioned property for inspection purposes.
Print Name: A%,L. LiA.% Signature: x IZRI�
Date:
❑ Owner ❑ Contractor ❑ Agent for Owner t4Agent for Contractor
L .
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
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
OWNER
Last Name
First Name
Address 7
City
Slate
Zip
c�.
Phone
Fax
E-mail
WON'/ 00-7,30 1 W141.w' P. I W. -M fm
For office use only:
CONTRACTOR
Name
Name
J
�.
Address
I No
State
City ,
Phone
State
Zip Q
Phone
Planner
Fax
7/ O
E-mail
Lic. #
CI
WON'/ 00-7,30 1 W141.w' P. I W. -M fm
For office use only:
ARCHITECT/ENGINEER
Name
Flood Zone
Address
SRA • I
City
I No
State
Zip
Phone
Map Bookj
Fax
E-mail
Planner
State License Number
WON'/ 00-7,30 1 W141.w' P. I W. -M fm
For office use only:
APPLICANT NAME
Name
Flood Zone
Address
SRA • I
City
I No
State
Zip
Phone
Map Bookj
Fax
E-mail
Planner
WON'/ 00-7,30 1 W141.w' P. I W. -M fm
For office use only:
Zoning
Property Address
Flood Zone
Cross Street
SRA • I
Yes
I No
Occ.
Type Const.
Subdivision Name
Map Bookj
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
KAFORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
o -S 17G
BIN #
LOCATION
AP#�U�r 7-6
Property Address
City
Cross Street
Sheriff
SMIP
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:
Sq. Footage
❑ Structure Built withoOt 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
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: _ G Bldg
SRA
Receipt #: �?/
01 /
Sheriff
SMIP
Date: ib�
Other
`�
Total
Page 1 of 2
REV 2-24-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530)538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05
F�
LAND OF NATURAL WEALTH AND BEAUTY
DEPARTMENT OF PUBLIC WORKS
WILLIAM (Bill) CHEFF, Director
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965
Telephone: (916) 538-7681
RONALD D. McELROY
November 7, 1990 Deputy Director
Gus Gore RE:- AP�40=2b=49, 51 & 52 -combined as one
P. 0. Box 360 App, for Determination
Durham, CA 95938
Dear Mr. Gore:
At the regular meeting of the Butte County Subdivision Violation
Committee meeting held on November 7, 1990, the committee granted
a Certificate of Compliance for the above -referenced property. There
are no conditions.
There is a fifteen -day appeal period before this Certificate'can be
recorded but since you have already signed the waiver waiving your
right to appeal the committee's decision, we will go ahead and record
the Certificate of Compliance.
If you have any questions regarding this matter, please contact this
office.
Very truly yours,
William Cheff
Director of Public Works
John Mendonsa
Assistant Director
JM/ds
attachment
cc: Planning Department
Environmental Health -Department
Building Department-'..'-