HomeMy WebLinkAbout042-100-030042-100-030 00-0546
RENTZ, Estelle
2965 Kennedy Ave., Cldco
Cont: Universal Roofing Systems
RerooUSF`��jJ
B06-2484 042-100-030
MISCELLANEOUS Window/Glass Door
8 WINDOWS 3 GLASS DOORS, SHOW
2965 KENNEDY AVE
RENT``Z,ESTELLE REV TRUST
`^ 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: 2965 KENNEDY AVE
Owner:
Permit No: B06-2484
APN: 042-100-030
RENTZ, ESTELLE REV TRUST
Issued Date: 10/20/2006 By TMP
Permit type: MISCELLANEOUS
2965 KENNEDY AVE
Subtype: Window/Glass Door
CHICO, CA 95973
Expiration Date: 10/20/2007
Description: 8 WINDOWS 3 GLASS DOORS, SH(
(530) 343-1057
Occupancy: Zoning: A5
Contractor
Applicant:
Square Footage:
RENTZ, ESTELLE REV TRUS
Building Garage Remdl/Addn
2965 KENNEDY AVE
CHICO, CA 95973
Other Porch/Patio Total
(530)343-1057
FEE INFORMATION
Window/Door - Replacement $330.00
r '
Total Charged: $330.00 Fees Paid: $330.00
Balance Due: $0.00 Receipt No: B601
LICENSED CONTRACTOR'S DECLARATION
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
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
X 10/20/2006
the applicant to a civil penalty of not more than five hundred dollars ($5001;
Please check one of the following:
Contractors 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
WORKERS' COMPENSATION DECLARATION
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
I 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
E]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
I, 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.
The Contractor's License Law dows not apply to an owner of the property who builds or improves
My Workers' Compensation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
Carrier. Policy Number. Exp. Date:
(This section need not be completed if the permit is oror on�llars ($100)-6r less.)
❑ I 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 10/20/2006
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
Owner's Signature Date
provisions.
X ` 10/20/2006
I hereby certify that I have read this application and state that the above information is cored. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Signature Date
WARNING: FAILURE TO SECURE WORKERS' 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 TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
injury, including death, and property damage caused arising out in any way connected with
HUNDRED THOUSAND DOLLARS $100,000 , IN ADDITION TO THE COST OF COMPENSATION,
( 1
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
t is is pe
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
propeV owner or am authorized to act on the property owners behalf.
CONSTRUCTION LENDING AGENCY
E — 10/20/2006
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
Name of Perrnitte"SIGU Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
rM Owner EJ Contractor OR; Agent for Owner ❑Agent for Contractor
FILE COPY
Lender's Address City State Zip
si BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buftecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last N ne
ir$t ,Nae -
V a CY7 C_
Address
�h
City „ ' ^
S ted
Zip? 7
Phone 3 0 S7
Fax
E-mail
APPLICANT INFORMATION
CONTRACTOR
Name
City C�
Address
Zi ,,r Z
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City C�
Address
Zi ,,r Z
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT INFORMATION
Name �e
Address
a i; r
City C�
Stake _
Zi ,,r Z
Phone
S3 0 —,3-y3 -/ O
Fax
E-mail
APPLICANT SIGNATURE
X l/
For office use only:
Zoning
Property Address
Flood Zone
Cross Street
SRA
I Yes
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.'��
BIN #
PROJECT LOCATION
AP#
Property Address
City
Cross Street
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.
SMTP
LENDING AGENCY
Name
Address
Description or Scope of Work:
Sq FT- Living Garage Open Cov
❑ 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
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.
Page 1 of 2
REV 8-12-05
Received by: Amount:
Bldg
SRA
Receipt #:
Sheriff
SMTP
Date:
Other
Total
Page 1 of 2
REV 8-12-05
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042-100=030
00-0546
t RENTZ, Estelle.
2965 Kennedy Ave., Chico stems
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COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 PER NO.
(Rev. 12/96) APPLICATION AND PERMIT bo -o ` 0-(a
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER A"
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
! .�
OWNERS MAIUNG ADDRESS
y /% e C
A (10
Cd D
CONTRACTOR'S NAME jj
! : 'A .0 -4 'A.0 Tt71rY S
TEL�EPjHONE
,7
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
, 0-0ARCHITECT
OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ v�'O
ARCHITECT OR ENGINEERS "UNG. ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
Energy Plan Checking Fee
$
$
e
PERMIT FEE
$
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
-23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other 01/
Describe Work: 12.0011"02 C V C- I L. „ - r s Al e r„Ir,J
i i' Owi 1 -?6 e2:kj ✓f t Ca ra t 4, iy /
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I SG W
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service 200A OR LESS
23.00
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 �� 7 Lic. No. G
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason: i
❑ 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),fL%Lpale'.
❑ I, as owner of the property, am exclusively contracting w ILcensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason (,_�.,...3r'a'i���
Main Service TGLING
46.00
NEW CONST. DWELEE OCCUP. CU
DW
OR ADDNS. ( & ACC. BLDS.
SO
3.50FT.
t1TLET
I, ,'I DT- MULT- _or
@7.50
POWER APPARATUS
8 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FDCTURES
20 @ 1.00
SAL o .50
Ex. Occup. OFlx� s R=.DREti
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
$
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by sectio6 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:
CarrierPERMIT
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
FEt
$
m
Policy Nuer
(The above sections need not be com eted 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'HAZ
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 with4h'ose provisions.
X ''� Date�-(
Signatur6 of Applicant - ❑ Owner rContractor ❑ 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 $ 133, v --a
.
D� IMP
FLOOD
COF
PARCEL
PO
HD
ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
B Y --
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date /�
a
Dat
ReceiptNo. nl VS -799
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
6OUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541®�®PERMIT �NO.
(Rev.12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER ,� y O
ZONING
BUILDING PERMIT
OWNER// N
�
�7 ONE
SO. FT. OCC. BUILDING VALUATION
�D
OWNERS MAIUNG ADDRESS
.9945 r
pIf (o
D
CONTRACTOR'S NAME TELEPHONE
Je12a ,,. Si4 54"C'iIV,
CONTRACTORS MAIUNG ADDRESS
30411-5 %o"
CONSTRUCTION LENDER
Fireplace
LENDER'S MMUNG ADDRESS
Total Valuation $
, C�
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ v—a
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
to/ K
Energy Plan Checking Fee
$
$
C c,
PERMIT FEE
$ e ao"a
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF VeeDuplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑�Remodel ❑ Utilities ❑ Installation ❑ Other
Describe Work: 2.e/yYJ D V -C- cl `g iE G S
141)
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home ITI G W
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service 200A OR LESS
23.00
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 (�- 3) Lic. No. /��r
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.
❑ 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Bu sinegs and Professions Code for this
reason
Main Service 200A TO I000A
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. a ACC. BLDS.
SO
3.5¢FT:
UTLET
qNEW °�ID MULTI.ORcuTS
@7,50
POWER APPARATUS
3 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FIXTURES
20 Q I'�
BAL @ .50
Ex. Occup. IxuETS PEES p GEA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
$
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
I 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' Com ensation insurance carrier and policy number are:
Carrier d(.C>PERMIT
Policy Number — 70C� a-& 111 _ 71
(The above sections need not be completed 0 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 rovisions of section 3700 of the Labor Code, I shall
forthwith comply wi o provisions.
X Date ���
Si a App' ant - ❑Owner Jr Contractor ❑Agent
ffi OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
C. TY
TOTAL FEE $ Q
:.A]I:DFdEIMP
FLOOD
COF
PARCEL
PO
HD
SSUE
This permitis hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By .'0=2Date
PERMIT EXPIRES ON
I
the applicable provisions
Resolutions to do work
been paid.
3 3 � O
k3da
IDat
ReceiptNo. r2 19 S7 cf
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT