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HomeMy WebLinkAbout043-730-026I I I I i 3319=91p C' 2-S- 7 -30-0 2 o ORTEGA;Joan 39 La Placita Way, Chico cont Do -4-U �� (water Beater%sf) 1A. 043-730-026 043-730-026 99-1403 ENNS, Gilbert 34 La Pacita, Chico Contr: Ow ,/1 „ KENNICOTT_ _CONST.- CO, _ 1075-69B Vents- 225-70P 1059-69P, 106-70E 34�LaPlacita Way (LOT ), Chico ( new single family) p i I l 11! A y a . i l 0 0 COUNTY OF BUTTE Oroville, California GENERAL CLAIM CLAIMANT: GILBERT C. ENNS ADDRESS: _ 34 LA PLACITA WAY CITY & STATE: _ CHIC0 _ CA 95928 DATE OF CLAIM: 7/21/99 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES IMPORTANT.- , SEE INSTRUCTIONS nN RFV=Rce eine DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT OWNER DECIDED NOT TO BUILD.'kAP4043-730-026, BP#99-1403, RECEIPT # 265230, DATED 6/23/99, OWNER: GILBERT ENNS.) TOTAL AMOUNT PAID $360.10 RETAIN REFUND PROCESSING FEE $ 25.00 RETAIN ELECTRICAL PERMIT FILING FEE $20.00 TOTAL AMOUNT TO BE RETAINED 65.00 TOTAL AMOUNT TO BE TOTAL $295. 10. the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true d correct as stated. /^//A2&:L C , jted this�4� YY day of 13 , at Cp r, .Calif. Signature of Clai the undersigned, hereby certify that, to the best of my knowledge, the services or article pecified above have b n performed 6r delivered and at there is a Budget Appropriation [ ) or Specific Board Approval [ ) (Check one) fort s 3ted this 21ST day of JULY , 19M, at OROVIL.LE , Calif. •�/�-- De artment Head or Authorized Deputy ept. Code 440-002 Exp. Code 4210500 PAYABLE FROM CONSTRUCTION PERMITS FUND ept. Code Exp. Code PAYABLE FROM FUND ipt Code Exp. Code PAYABLE FROM FUN DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. Received from The Sum of For COUNTY OF BUTTE 265230 OFFICIAL RECEIP ,;,,. ^t pF,FI`C�D EPARN/ISSUING RECEIPT IZ-19_ r N sn, Ile—e- PO JZ>"ol,� S 1 'YI 73 - 2-b Received: CASH CHECK ❑ DAVCO BUSINESS FORMS • (916) 703-8511 Received By.--, Title By vo S 3 FOR BUILDING DIVISION USE: Receipt Information: ..a Number: Date: Issued To: irL� Amount:• X11" Fees Retained: ✓ Processing Fee: $ ✓Bldg Filing Fee: $ ®" Plbg Filing Fee:- $ Elec Filing Fee: $" Mech Filing Fee: Energy P/C Fee: Plan Check Fee: Inspection Fee: SRA Fee: Total Amount Retained TOTAL REFUND DUE $ y CLAIMANT'S NAME MAILING ADDRESS ASSESSOR PARCEL #: REFUND CLAIM APPLICATION 3Y. �/?- F46a 7204 U A y --�? 67 RECEIPT NUMBER(S) 2�523d Request a refund of fees paid on the above receipt number(s) for the following reasons: Please refund any applicable fees in the following categories: (Check those. categories which you wish to have refunded.) Building Permit Fees ( ) Sheriff Fees ( ) SRA Fees (CDF Fire Planning) ( ) Urban Area Fees Disposition of Plans: ( ) Plans returned to me at counter ,r ( ) Please mail plans to me at above address. Please dispose of plans. SIGNATURE DATE Lj 7 _ 1-3" 97. PLEASE DATE AND SIGN THE ATTACHED COUNTY OF BUTTE GENERAL CLAIM FORM. DO NOT COMPLETE ANY OTHER INFORMATION ON THAT FORM. 0 important Message Time: Date: For: From: Telephone: ❑ Telephoned ❑ Please call ❑ Wants to see you ❑ Will call again ❑ Returned your call ❑ URGENT ❑ Was here to see you Message: WV Taken by: Post -807679-4 ©3M 1993 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95985 • Telephone (530) 538.7541 PERMIT N (Rev. 12/96) ,. APPLICATION AND PERMIT AssneoRFARmNumW 3 -? -21 noNr+o BUILDING PERMIT OWNER � Ts�"ONs SO. Fr. OCC. BUILDING VALUATION 660 1 75 q3 0 =4/,ate 2'p 'o CONTMCMPrS NAW Tnff"o i CONrRACTORI MQUTA MORA COMTAUQTION 1fJ001 Fireplace �� �M Aoorew Total Valuation = (0 0yo ARCNVcr0RO4104 1 No. Fign Fee $ 20.00 Permit Fee $ g0 AACW ECT OR 94ME M S MAUNO MOREss Plan Checkin Fee $ 1 allLDMADCAM Ll � EnergyPlan Checking Fee $ PERMIT FEE _ LOTNM susoNrcrrsNArre IA110eL NAP PLUMBING PERMIT Fling Fee 20.00 Each Tr 7.00 USEOF8TRUCTURE SF 0 Duplex O Moblehome 0 Other C Soba or heat pump water heater 23.00 Water Piping 15.00 Each gd• water heater or vent 15.00 TYPE OF WORK New ❑ Addition 0 Ra. all 0 Utlitles 0 Installation O other 0 Describe Work: Gas piping syslisin 1 -5 outlets 15.00 Building sawer 15.00 Mobge Home I 3 I G I W ®20.00 PERMIT FEE _ ELECTRICAL PERMIT Filing Fee 20.00 Main Service EOEO°voA OR L 23.00 LICENSED CONTRACTOR'S DECLARATIONOwairaOR I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of that 3 of the Business and PrObOdOns Code, and my license Is in full fora and effect Ucsnse Claes Lk:. No.00 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: 0owner of the property. or my employeas with wages as d"Ir sale compensation, wig do the work. and the structure Is not Intended or offend for sale. I, as owner of the property. am exclusively contracting whh licensed contractors to construct the project 0 1 am exempt under Seo. , Business and Profeselons Code for this reason . WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: 0 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 le Issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, forth* performance of work for which this permit Is Issued. My workers' compensation Insurance carrier and policy number are. Carrier Policy Number (The above sections need not be completed M 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'amo 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 th pro s. X Dat SI a re of A plcant - Owner O Contractor O Agent OS permit Is required for excavations over SO' deep and demolition or construction cturee over 3 stories In height Main Service am To i000A 40.00 oocuP. sa CONST. a Aoc. erns. 3.SCFT. F&W COM NON�o. ' hO @7.50 POIRA °ON1°� A uner ' � a �: Ex. Occup. ounsr on Fe nvm e80 IMMAFPIJt1.OR Ex. Occu amen b. a 5.00 Temporary Service 23.00 �bileHome Facilities 20.00 Wsc. Wiring23.00 PERMIT FEE _ - /O MECHANICAL PERMIT Filing Foe 20.00 Heating Coolie Hood 0.50 Ventilation PERMIT FEE S Mobge Home Installation Fee = Energy Inspection Fee = occ CONST. TYFe TOTAL FEE _E , U - co, F Fo sE This permit Is hereby Issued under of the Butte County Code and/or Indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date PAW Receipt No. WHITE-O.O.S.-S.O. CANARY•A33E39 RPINK-INSPECTOR GOLDENROD•APPLICANT ,-,y ;-�,�?'y.4' `z�:+.+i�� u � _•ezS' , �; ._ : ti. i.1S7!'ik•95:.-, c': : y.. .. .is.ta.:. �s .i, COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION M 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: G t l e PAr ri %eq�-S ASSESSOR PARCEL . ER: L'l Proposed Building Use: � Building Inspector: Date: 6 1-; � At time of permit applic tion, I was advised the following data must be submitted prior to permit processing and/or issuance: Date Received By ❑ 1. All items have been submitted --------------------------------------------------------------------------------------- 02. Plot plans, 3/4 sets, signed by the preparer of plans. ---------------------------------------------------- E13. --------------------------------------------------- ❑3. Complete plans, 3/4 sets, signed by the preparer of plans. --------------------------------------------- ❑4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! --------- ❑6. Energy Design Compliance and supporting documentation. ------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ------------------------------------------------ 118. Hazardous Material Form. --------------------------------------------------------------------------------- ❑9. Manufactured Home data and installation instructions including Tie Down Specifications .--------- ❑ 10. Fees of $---------------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule. ----------------------------------------------- ❑ 12. California Department of Forestry plan approval/fees. --------------------------------------- 1113. -------------------------------------- ❑13. Flood elevation certificate. ---------------------------------------------------------------------- Z?r4. Sanitation and plot plan approval 011(/ Health Department. ------------------------- ❑ 15. City of Chico plumbing permit.----------------------------------------------------------- ---=- ❑ 16. Plot plan and business license approval from the City of Biggs. ----------------------------- ❑ 17. Planning approval for (A) Use: (B) Parking: -------- ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ------ ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). ---------- ❑20. Pre -inspection for required Request to Building Inspector on 021. Contractor's license information. (Number, Name Style, Classification). ------------------------------------ ❑22. Workers' Compensation carrier and policy number. ----------------------------------------- ------------------ ❑23.Owner-Budder Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------------- ❑24. Letter of signature authorization. -------------------------------------------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. -------------------------------------------------- ❑26. Letter of intent on building use. ----------------------------------------------------------------------------------- ❑27. Manufactured Home utility clearance.--------------------------------------------------------------------------- ❑28. Existing violations and/or expired permits. ---------------------------------------------------------------------- ❑29. ❑433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ .--------------- 1130. -------------- ❑30. Other: ------- (Date) Whe you issue the permit, process as follows ❑ Mail to owner, ❑Mail to contractor. elephone �93 ' y Z and hold for pickup at office. ❑ Deliver with ' ector. Applicant. Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ P llution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) 1 APPLICATION AND PERMIT qT__ ASSESSOR PARCEL NUMBER g '- Ld ZONING BUILDINGPERMIT OWNER TELEPHONE 893-4552 SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS 1 ATL CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation is ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 34 LA PACITY, CHICO Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other GARAGE SPECIFY Solar or heat um water heater 23.00 WaterP�P 9 I in 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service A 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 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 s owner of the property, or my employees with wages as their sole compensation, III do the work, and the structure is not intended or offered for sale. 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 Main Service TO tOooA 46.00 NEW CONST. DWNOOCCUP. WE OR ADONS. ( 8 ACC. BLDS. SO 3.5QFT, µR6,. ' MULTI -OUTLET @7.50 POWER APPARATUS, 8 SINGLE OURET CIR. Ex. Occup. OUTLET OR FIXTURES BAS @': o Ex. Occup. oUT�sRa D) E 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: ❑ 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 Policy Number rhe above sections need not be completed If the permit is for work of a valuation P//one hundred dollars ($100) or less.) 1,_c ertify that in the performance of the work for which this permit is issued, I shall ot 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 ction 3700 of the Labor Code, I shall with comply with those ro 'Ions. X Date 0Sof Applicant ❑ Contractor ❑ AgentAermit is required for excavations over 5'0" deep and demolition or construction #OA os over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HAZ. 1 D. FEES IMP I FLOOD CDF PARCEL PO HD SSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date Date ReceiptNo.�Z 30 $360.1030 ��360• IO WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 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 delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally Ian to provide the ajor labor and materials for construction of the proposed property im ovement : YES NO 1 2. I HAVE HAVE NOT 0 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: 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: PHONE: CITY: CONTRACTOR'S LICENSE NO. 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: PROPERTYOWNER: je�o,— 2�p SOCIAL SECURITY ER: 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 OWNER BUILDER INFORMATION 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: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 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 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. ♦ 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. ♦ 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 "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 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. +Mage'rC,B2i1diirng ��, a, C.B.O. Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code OVER COUNTY OF, -BUTTE - DEPARTMENT OFw PUBLIC WORKS 7 County Center Drive - Oroville; California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. --3-0-3 z 9 -W ASSESSOR PARCEL NUMBER Y3= 42-36-26 ZONING BUILDING PERMIT OWNER Joan Ortega TELEPHONE. 343-9628 SQ. FT. OCC, BUILDING VALUATION OWNER'S MAILING ADDRESS 39 La Placita Way, Chico CONTRACTOR'S NAME Do-44Contractin , Inca TEL EPHONE CONTRACTOR'S MAILING ADDRESS P.O. Box 1010 Fireplace CONSTRUCTION LENDERUNKNOWN None Total Valuation $ Filing Fee$ 10.00 LENDER'S MAILING ADDRESS` Permit Fee $ ARCHITECT OR ENGINEER / LICENSE NO. - Plan Checking Fee $ Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESSEnergy x Penalty $ ' BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 39 La Placita Ways,taCO ` t ` Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME I PARCEL MAP 1 Water piping • 5.00 Each qas water heater or vent 1 5.00 1 5.00 USE OF STRUCTURE a� SF © DuplexDuplex[]Mobilehome❑ .; Other c ;' . 1, SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ UtilitiesET' Installation[] OtherK] Describe work`. Replace Gas Water Heater (Retrofit) Permit Fee $25. Min. Fee $ 25.00 Contractor =k ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 10.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ( am licensed under provisions of Chapt. 9, Div. 3 of the BLslness and Professi ns -C de and my license is in full force and effect. !ll License No. 240 Classification. 11,.,?.�,�D ( i / ❑ 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended o6offered for sale. (Sec. 7044) 1 1 ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Codel for this reason NEW CONST. DWELLING OCCUP.a6\/22sgft OR A.D.S. ACC. BLDGS. NEW FL MULTI-OUT NON.RESID. BRANCH CIRCU ITS 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. 20®SOS EX. OCCUp OUTLETS OR FIXTURES DAL@30 FIXED APPLNS. OR Ex. Occup. OUTLETS IRESID.I EA. 1 2.00 I Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. [9,.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. 4`, ❑ 1 shall not employ any person in any'manne�o as to become subject to the W. C. laws of California. 7 % \, Notice to Applicant: If after making this statement,' should you become subject, to the W. C. provisions of the Labor Code, you mu'st'forthwith comply with•such provisions or this permit shall be deemed revoked. ' t MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood' f 3.00 Ventilation • permit Fee. $ Contractor I certify that I have read this application and,state that the above info mation is correct. I agree to comply to`alkCounty Ordinances an&State Laws relating to building construction, and hereby'authorize`,repres'entatives of the Ccuntyot Butte to enter upon the above-mentioned property forljnspection purposes. 1 also agree to save, indemnify and keep harmless/he 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. p 1� �3�✓ 9-/�- / Date Signature of Applicant — Owner❑ Contractor ® 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 ! I� + TOTAL FEE $ 25.00 HAZ. CUA PARK SCHL FLD cDF PAR PD I HD• ISS This permit is hereby issued under the applicable provi- . sions of the Butte County. Code and/or resolutions to do work i,d'cated above for which fees have been paid. 41 DI. 'TOR OF UBLIC WORKS B, Dae PERMIT EXPIRES Date Receipt No. 101007 WNITL-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Callfornla 95965 - Telephone: 916/538.7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 42-36-26 ZONING, BUILDING PERMIT OWNER Joan Ortega TELEPHONE 343-9628 S0. FT. OCC. BUILDING VALUATION/ - OWNER'S MAILING ADDRESS 39 La Placita Way, Chico CONTRACTOR'SNAME Do -4-U Contracting, Inc. TELEPHONE CONTRACTOR'S MAILING ADDRESS P.O. Box 1010 Fireplace CONSTRUCTION LENDER NorieFiling UNKNOWN Total Valuation Is g Fee $ 10.00 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 10.00 39 La c to Way, Chico Each Trap 1 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping, 5.00 Each qas water heater or vent 1 5.00 1 5.00 USE OF STRUCTURE SF ❑X Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New❑ Addition❑ Remodel❑ Utilities[] Installation❑ Other® Describe work: Rpnl ora f;aa Water Heater (Retrofit) Permit Fee $25. Min. Fee $ 25.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6101 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 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 Professi ns Code and my license is in full force and effect. License No. Classif ication.e��e�C�C� _T FJ 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.N) OR AODNS. ACC. BLDGS. 1 yz2sgft NEW CONSTR. MULTI -OUT LET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES 200 50C B ALO 30 FIXED Ex. Occup. OUTLETS PLNS REA.) (RESID.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. �Xave 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 FiIingFee 10.00 Heating Cooling Hood 3.00 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 County of 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 gainst salmi unty in conse nce of the ranting of this permit. Date 9_��- 9l Sig Lure of Applicant — Owner E] Contractor ❑ Agentp— 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 $ HAL I CUA I PARK I sCHL I FLD I CDF I PAR I PD ) HD. ISS This permit is hereby issued unoer the applicable provi- sions of the Butte County. Code and/or resolutions to do workZi'cated above for which ees have been paid. D OR OF B l WORKS i AAA p B Date PE PE MIT EXPIRES Date Receipt No. 101007 FELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF UBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILL SCA .6RNIA 95965 -TELEPHONE: 916/538-7541 (' +_�" PERMIT APPLICATION `DATA SHEET 4 1_ Permit No. OWNER d. 0 I D. 4�2 -��Tv2 Proposed Building,UseH�� �y& Building Inspecto Date At time6fmit application, I was advised the following data must be submitted prior to permit processing 4nd/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... \2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form ............................. .......... . 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions........./.......................................... 10. Fees of'$- ........................ 11. Chico Urban Area fees paid ..................................`..... 12. Park fees paid .............. .................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit..................11 ................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required . Pre-inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .... . 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. t 27. When you issue the permit, process as follows: Mail to owner. l �Delriver ntractor. Telephone and hold fo/pi•ckup�t office. w/inspector. Other (i AppH�ant Copy of Hdz-Mat form sent Health Dept. Fire Dept. _Air Pollution Date Copy of plans sent Health Dept. Fire Dept. ©\her Date By. The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone--naii_co `ter by date Contractor, designer, owner, was advised of above required data by_phone_mall_counter'by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION OND PERMIT ASSESSOR A CEL NUMBER ZONING BUILDING PERMIT OWNER fX1 r�6�4 TELEPHONE 3 3-94a SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS L Ck1CD _ CTRACT R'S NA t7...A'L.JTOR TELEPHONE" il- .� CONTR 'S MAILING ADDRESS /o Fireplace CONSTRuu C�II�ccO�N LtyNND�ER V V L/ UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS /,)0.t,)tf, Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 3 [ c a Permit fee-. $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home G W 10.00 ea TYPE OF WORK T New ❑ Addition Remodel ❑ Utilities ❑ I/n'stallation Ot er ❑ Describe work: kola C� l � S 1� 1ateoe7 �tz Permit Fee Contractor $ ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare un penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professi s Code and my license is in full force and effect. License No. Classificatio ❑ 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.81 OR AODNS. ( ACC. BLDGS. y2¢sgft NEW CONSTR ULTI-OUTLET NON-RESID BRANCH CIRC ITS 2.50ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. OCCup(OUTLETS OR FIXTURES SAL1300 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ®�tiave 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 FiIIng Fee 10.00 Heating Cooling Hood 3.00 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 County of Butte to enter upon the above-mentioned property for inspection purposes. Cls to save, indemnify and keep harmless the County of Butte against ities judgments, costs, and expenseswhich may in any way accrue :saidunty in conseque of the gra nti g of this permit. �,—%3_ 9/ Date `` ( Signa of Applicant — Owner ❑ Contractor ❑ AgenZ�� An SHA 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 $ ;2< HAL. CUA 1 PARK SCHL FLD cDF PAR PD ; H ISSUE This permit is hereby issued unser 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. WHITE-O.P.W.. YELLOW- AS8E3SO R. PINK -INSPECTOR. GOLDENROD -APPLICANT