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HomeMy WebLinkAbout040-280-035040-28-0-035 6-x0$88 3 " , I LUKE, Debra B 9118 Goodspeed, Du,ha, '/ (repj"e donr).qp garage door w/slidi.g 35 a -Fill Ol 040-28-0-035 -035 88 B iL 40 LUKE, Debra 9118 -Goodspeed, Durham (replace garage door w/sliding door) SF COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 JERMITf NO. APPLICATION AND PERMIT��( ASSESSOR PARCEL NUMBER 040-280-035 ZONING SR1 BUILDING PERMIT OWNER DEBRA TELEPHONE SQ. FT. OCC. BUILDING VALUATION �j[� EST • —SOO OWNERS MAILING ADDRESS 9118 GOODSPM. DURHAM 95938 CONTRACTOR'S NAME =NM TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 15,01 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 9118 GOODSPEED DURHAM PERMITFEE $ 35.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 Water piping, 15.00 USEOFSTRUCTURE SF [R Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: REPLACE GARAGE 3OR WITH SLIDING GUSS — DDDR UNCONDITIONED SPACE Mobile Home S G Ew7 @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service EOOV OR LESS ( 200A OR LESS ) 23.00 + Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S 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. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑' 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. C] I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP. OR ADONS. ( a ACC. ) SO, 3.5¢ Fr. NEW CONST. MULTI-OUTLEUTLE T NON-RESID. ( BRANCH CIRCUITS ) @7.50 S ( POWER SINGLE APPARATUS ) b OUTLET UCIR Ex. Occup. ( OUTLET OR FIXTURES) 20 Q 1.00 BAL 0 .50 Ex. Occup. (ouT�s RES D.OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor 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 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred 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 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. • • X Date Signature of Applicant -•❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee is Occ CONST. TYPE TOTAL FEE $ 35.7' HAZ. I D. FEES IMP FLOOD I CDF PARCEL PO HO ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. , - / %' { KI By Date PERMITEXPIRESON (Date) Receipt No... '` `i U `"��-( WHITE-D.D.S.-R-D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT r 'W -Rt - § I` bENTCAL T� v,io- zoo 6,5 - VN. Vva C:t5q,36 d f :P • } , �} e JOB FINALED (Date) — Signature a_ V=OK O = Not OK -=Not Applicable =Not Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements - Setbacks - Easements 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap; / PL'ft. / /Nat. or/ /"L"ft./ /LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements- Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; SoilsSize-Dep"pacing-Connectors-Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg: Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric . 8. Frmg.; Sils-AnchorsStuds-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing it. Ext.;Steps-Doors-Landings % �t1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/6 -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5 Circulating Equip. -Pool LBhtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 i IF V OK O = Not OK Not Applicable Read Not Ready RESIDENTIAL (Single & Duplex) = Date UNDERFLOOR (Plans) OK. except N's _ Date FRAMING (Continued) 1. Zoning -Setbacks -Easements -Flood -Slope 45. Hangers Post Caps -Anchors -Connectors 2. Ftg., Main; (Soils-Elec. Grnd.-/ /" Ftg. Depth ---------___------- - 46. Cing. Joist-Rftr. ties- Purlin-root Brac-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth ------ 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth ---- 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. . 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except a's 16. Water Htr.: Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection ------ - -------------------------------- 18. D.W.V. Test -Fittings & Anchor -Nail Protection 19. Shower Pan: Test, First Floor -Tub Access ------------------ -------------------- ------- 20. Test Tub & Shower. Second Floor -Tub Access -------------- -------------- -- ----- ---- - - 21. Gas Pipe: Size & Anchors ---------------------------------------------------------------------------- Date Card B -i Date Card B-1 ------------------------ --------------------- - -- ---- -- Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except a's 22. Fixture & Transformer Clearance -Ins. Protection - 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled ---------------------------------------------------- _ .......... 25. Romex Installed Close to Edge of Studs & C.J. - ---------------------------------------------- 26. Equip Ground made up wrMech. Fasiners-Bond Gas & Water --------- --------------- ------------------ -- - --......._. 27. 2 Appliance Circuts in Kitchen & Conductor SizerGFI ---------- - --•------------------------------------------ 28. Subfeed Wire Size ga. Cu or AI-A.C. Wire Size ga. Cu or AI 29. Range Circ ga. Cu or AI -Oven Circ. ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No ---------------------------------------------- .. 30. Service -Riser Conductors & Ground -Main Disconnect ---------------- --------------------------------------_........._.._ ...._... .. 31. Equip_ Clearances Panels-Motors-Mech. Equip. -- - - ........ ....... ....... .. 32. Clothes Closet Light -Shower Light -Spa Light --- -------------------------------------- -------- ---_....... -- 33. Smoke Detector -------------------------------- ---- I.................. ....... ....... ....... .. Date Card B-1Date Card B-1 -- ------------------------ ....... ... ................. ... ....... ... ... . pate Card B-1 Date Card B-1 Date MECHANICAL.(Permit) OK except P's 34. A.C. Ducts Insulation & Support -----------------...--------------------- _._...---------I .......... ... .. _... 35. Vent Fan: Exhaust above insulation ----------- ---------- - -._.... ............. .. ... ... ... .. 36. Condensate Drain & Overflow: Size & Grade -------------- --- - ...__..... ................_...... ....... .. . 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet - - .... ... .......... ... ... .. 38 Attic Access & Platform if Furnance in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except Y's 39. Sils. Proper Material & Anchors ....... ... ... ... ... ... ............ ... ... ... .. 40. Walls Studs -Nailing. Spacing & Bracing-Plates-Sopnd ...... ... ... .. ................... ...... .. . ... .. 41. Bearing Walls over Girders & Floor Nailing ....... ... ............_._ ............... 42. Draft Stop in Walls (rat proof) ...... ._. ....... ... .._.. 43. Fire Stops. Furred Ceil ngs-Stai. ..... .. .. .. ... .. 44. Headers & Beam -Size & Bearing 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles ------------ 49.- Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions ------- - 50. Garage Fire Protection Framing ----------------------------------- 51. Property Line Firewall & Openings _ 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits --------------------- 53. -------------------53. Stairs: Width -Headroom -Rise -Run -Landing -Fire Protection -------------------- ____ 54 -.-plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55.Siding-Nailing Veneer _ 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. -Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls: Nailing -Bolts ---------------- 59. Insulation -Walls -Ceilings ------------------ ---------- ------- 60. Infiltration -Walls -Windows - -- - ---------------------------------- - Date Card B-1 Date Card B-1 - - --------------------------------------- Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except a's 61. Ext. Steps -Door & Sidelight Protection -Landings -------------- - 62. Smoke Detector ----- -------------------------------------- - - 63. Furnace: Vents -Clearance -Comb. Air -Connector - In Garage: Above Floor-Ducts-Mech. Protection --------------------------------------------- 64. Bedroom Exiling ------------------------ 65. --------- ------------65. G.F.I. & Bath Fixtures & Tub Access -Spa -- --. - - - -- --- -- ---- - ------ 66. Elec. Trim & SubP anel: Breaker Sizes & Labels ------------ --------------------- --------- - 67. Stags & Rails ...... ...._. -- -------- ------------------------ 68. Fireplace or Stove: Clearances -Hearth ---------------------------------- 69 Elec. Outlets at Wood Panel: Int. & Ext. -------------------------- ------------ 70. Kit.Fixt. & Appliance: Grnd.-Air Gap -Cooking Clearance ...... _.-------------------------------------- -- 71 Elec. Outlets & Receptacles at Kit. Counter --- - - - - - - - -- ----- -- - ------------------------- 72. Garage Fire Door: Swing -Landing -Closer ._........................... ------=----- -- - 73. A.C. Duct in Garage -Damper ...--------------------------------- ---- 74. Wir. Hir.: Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage: Above Floor-Mech. Protection - - - -- -------------------------- ---- 75. Plb.. Elec. & Mech. Equip. quipListed for Location ...... _..------------- ---------------------------- - 76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection --- ---------------------------------------- 7', --------------------------------------7' Insulation -Foam -Looked in Attic ❑ Yes ------------------------------------------------ 78. Guard Rails & Deck Construction -Post Caps ... .. ----...--------------------------------------------- -- 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes ---------------------------- 80. - 80. Following instld.; Drive ❑ Yes ❑ No: Walks ❑ Yes ❑ No: Planters ❑ Yes ❑ No --------------------------- 81. -------------------------81. Stucco: Brown -Finish _..._...------------------------ ---- -------- ------- 82 A C. Unit: Disconnect. Electrical, Plumbing ... ... ... ... ------------------------------------------- 83. Vents Above Roof. Plbg.-Appliance-Fireplace.-Clearance to Openings . . ............. ......... ---------------------- ------------- 84. Water Well: Disconnect. Electrical. Plumbing --------------------- --------- ----- 85 Exterior Elec. Trim. G.F.I. Receptacle -Underground . ... . ..... .---- ------ ------------------------------ 86 Ventilation Throughout House -- --------------- ------------------- 87 Glass Protection 88 Corrections from Previous Inspections 89 Gas Test -Meters Tagged: Gas -Electric --------------------------------------- 90 Water & Sewer Connected -C/O to Grade -HD Approval .---------- ------------------------------ 91. Energy Compliance Certificate -Other Certificates __.....----- ------------------------------ Date Card B-1 Date Card B-1 - ----------------------------------- Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: "COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-75gv/_� RFWNO• - ' APPLICATION AND PERMIT i(le ASSESSOR PARCEL NUMBER 040-280-035 ZGN'NG SRI BUILDING PERMIT OWNER DEBRA 9XARVVYX T,11KEEST. TELEPHONE SO. FT, OCC. BUILDING VALUATION 500 OWNER'S MAILING ADDRESS 9118 GOODSPEED DURHAM 95938 CONTRACTOR'S NAME UNKNOWN TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAIUNG ADDRESS Permit Fee $ 15.0 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 9118 GOODSPEED DURHAM PERMITFEE $ 35.00 PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF � Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 1.5.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: REPLACE GARAGE 'DOOR WITH SLIDING GLASS — DOOR UNCONDITIONED SPACE Mobile Home IS I GI W1 @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20.'00 Main Service aOaV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO IoOOA ) 46.00 LICENSED CONTRACTOR'S 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. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑' 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. JO I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. •❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCURSO. OR ADDNS. ( & ACC. BLDS. ) 3.50 FT. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 POWER APPARATUS 8 SINGLE OUTLET CIR. ( ) Ex. Occup. (OUTLET OR FD(TURES) 20 Q I.00 BAL Sa Ex. Occup. (OUFIXED APPLINS. TLETS (RES D.OR ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 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 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) �( 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 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. * _ X__ Date _L4"` I –9_6 Signature of Applicant -Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 35.00 HAZ. 1 0. FEES I IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date PERMITEXPIRESON & ' (&.) Receipt No. g WHITE-D.D.S.-B.D. ANARY-ASSE SOA PINK -INSPECTOR GOLDENROD -APPLICANT O.B.-1 F 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 delay 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: YESI)s] NO[ ]. 2._ I RAVED/] 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: ME NA: 0F7 ,9 P/ff�–ZC— • ADDRESS: / p©,Q CITY: its. PHONE: CONTRACTOR'S 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: CONTRACTOR'S 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 SECURITY NUMBER:_ .DATE: NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are'permitted to issue the permit. OVER r Dear: Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of 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: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments 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. 0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract 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 their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder" 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 contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Si Sorel ' Michail C. Vieira, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER