HomeMy WebLinkAbout047-250-097BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) '
OFFICE #: (530) 538-7541
PERMIT NO.
BP051371
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
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
Issued Date: 05/25/2005 APN: 047-250-197-000
the Business and Professions Code, and my license is in full force and
effect.C _ 3 -77`16 `5 `
License Class : License Number:
Site Address: 3882 KEEPER RD CI -ll
Date:s)-5— a ✓ Contractor: 611? eoo AIL13 wovo %
Map Index:
Description: re roof 29 squares
OWNER -BUILDER DECLARATION •
I hereby affirm under penally 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
Owner: SNAPPER RICHARD E &BARBARA J
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 pursuant to the provisions of
3882 KEEPER RD
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
CHICO, CA
she is exempt therefrom and the basis for the alleged exemption. Any
95973
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 or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
Applicant: SNAPPER RICHARD E &BARBARA J
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
3882 KEEPER RD
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
CHICO, CA
proving that he or she did not build or improve for the purpose of
95973
sale.).
❑ 1, as owner of the property, am exclusively contracting with
licensed contractors. to construct 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.).
Contractor: FOUR COUNTIES ROOFING
❑ 1 am Exempt under Article 3 of the Business and Professions Code
3 CRUSADER COURT
Date: Owner:
CHICO, CA 95973
(530) 343-1416
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
License #: 774554
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 workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
Architect:
the work for which this permit is issued. My workers' compensation
Engineer:
insurance carrier and policy number are:
57* 7—e FUN/
Carrier:
Total Square Ft: 0 S. F.
Pony #: A-7 z o- o 0 6_7 3-0 3
C]I certify that in the performance of the work for which this permit Is
Valuation: $0.00 d
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
Census Code:
and agree that if I should become subject the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:: aZ s =6
Applicant:
;Z_
WARNING: Failure 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 attorney's fees.
CONSTRUCTION LENDING AGENCY
This per is hereby is ya d n r theaca le provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolu ' ns to do wo Indic ed above r whi fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
s 2 .�
Name:
By: Date:
'— 2 6
Address:
PERMIT EXPIRES ON:
(Date)
❑ I 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 1D827.5 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.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it Is unlawful to alter the substance of any official form or document of Butte County. I hereby
•5uthorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. n`
rev �iy X '
Print Name: !� Signature:
Date: J ✓r: O S
O, Owner Contractor ❑ Agent for Owner 0 Agent for Contractor
BUTTE COUNTY,-.. ,
DEPARTMENT OYDEVELOPMENSERVICES
.BUILDING PERMIT APPLICATION
,;.+r� :AND.SUBMITTAL'REQUIREMENTS,
24 HOUR INSPECTIONM OROVILLE:1(530).538r7636..��CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
CONTRACTOR
OWNER
Name i C /j�7
Sl7 /3 '/*Y r e . .
Address? a
�� �? R
City C c U
Fax 3S<3 �a 7y
State C/i
Zip 45:? 7 3
Phone 3� a ate y 3
Map Book
Fax
E-mail
Planner
CONTRACTOR
Namen
tCQ I _'5 I?00
Address 3 C lev SR Af
City C ,-C 0
State <� A
Zip -7 .
Phone 3 y l yf
Fax 3S<3 �a 7y
E-mail
Uc.ss
�J%yss5'
Cla
e-3
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip,
Phone
Map Book
Fax
E-mail
Planner
State Ucense Number
APPLICANT NAME
Name
Address
City
State
Zip
Phone
Fax
E-mail
. r
PERMIT
NO.
BP0 7( 377
M QUA
LOCATION
AP#.0 Y -7- Z5 -n / 4 ' -7
Property Address
Cross Street
WORKER'S COMPENSATION
Policy Number -
2,7a o� o ,S'7 -o 3
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:
7 o F Co le' A90 014
Sq. Footage act
❑ 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
AP LICANT SIGNATURE refundable.'
ix
For office use only:
Zoning
Flood Zone
SRA I Yes No
Occ.
Type Const
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS L'
K:TORMSWILDING F0RMS\BIdgApp1SubRgmts.doc Page 1 of 2
Received by:Amc
6&_.
Receipt #: I�
kl�-�
Date: 2�
SRA
Sheriff
MIP
Other Other
Total
REV 4-30-04
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541
(Rev.12/96) APPLICAT-MN AND PERMIT C/
ASSESSOU^L U -Q
ZONING
BUILDINGPERMIT
OWNER ,
TE HONE-06�
z
SO. FT. OCC. BUILDING VALUATION
OWNERS,5 NG AOD2RREESSS ell . "(,o Cj ?`
COM O S NAME =- I/��
s -M
T 7NNE
�+j]
CO T R,P1rTADDRE
^ �! (v ((/�•�
TI�i
CONSTRUCON NDER �• ^ - . `A_
x•11 /✓� 7 �j
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee `$
20.00
Permit Feeon $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDINGADDRESS Z C ✓, (; n
C�$
Energy Plan Checking Fee $
3
PERMIT FEE $
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
, 7.00
USEOFSTRUCTURE
SFJV Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
tiies�zllInstall`ation ❑3 Other ❑
New ❑ Addition ❑ Remodel ❑� �Uilli-/
Describe Work: lto ► I � aJr v,(r«-
O C
Gas piping system 1 - 5 outlets
15.00
Buildin sewer
15.00
Mobile Home I S I G W
@20.00
PERMIT FEE $
ELECTRICAL PERMIT
Fling Fee 20.00
"OOV OR LE
Main Service 20..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 0-10 Lic. No. OZ'S
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.
❑ 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
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 STP—tt% FV"D
Policy Number it" & r o2
(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 should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
III,`
X Date/O 7 OZ _
Sig ature of A licant - ❑ Owner Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO tOooA
46.00
NEW CONST. DW
,"NO OCCUR
OR ADDNS. ( a acc. S.
so
3.50FT:
NEW CONST. MULTI -OUTLET @7,50
POWER APPARATUS
a SINGLE OLfTLET CIR.
OUTLET OR FDRURES 20 @ L.50
Ex. Occup.SAL @ .so
OR
Ex. Occup. ourLETsFlXED APPINS. RESID. EA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
re • t n cs
I PERMIT FEE S (o . OV
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 CDF E
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated or w ''fees have been
`:@f'.4
By :414iellifl" Date's_
PERMIT EXPIRE L.t�._�..
Gare
provisions
to do work
paid.
'
Receipt No. d
WHITE-D.D.S.-B. D. CANARY -ASSESSOR PINK -I SPECTOR GOLDENROD -APPLICANT
r : PRE -INSPECTION REPORT
LOCATION: ��� K.olI`c.r U, �
DATE: 10- 7- v a-
A.P. #
CONTRACTOR: Ady�,_O CL_01 ZONING:
PRE-INSPETION FOR elV_ —F1 o I c__
DATE TO INSPECTOR:
PERM HWORY ( NONE ( ) AS FOLLOWS:
s
Building DewwkMm:
Electric:
Gas:
BtMEJ SIG INSPBCPOR'S REPORT
CcmmctviaUUsaec f
ReddentiaW atunkc
Cmvntly Occupied
AbaadcnedIVamd
Yes No
Condition of Electric
I
k/
Electric =rently On C
Natural Propane✓ None
Obvious Problems:
Sanitation:
Cvmently ons_ Off
Plumbing Workintc 1/ �/�„
Well Worsting Potable Water �J�/��/J
Obvious Sewage�coblems
ti
ACTION RECOMMENDED:
i
t
HOLD FOR
{
Inspector: Date ;
Sketch buildings on reverse and indicate location on property.
Name ISHAFFER RICHARD E& BARBARA J
Addr1 13882 KEEPER RD
Addr2 I CHICO CA 95973
Addr3
Addr4
Comments IWAS PT N 047-250-147 SPLIT BY PMS
Creaking D oc#1 1999R P148-41 Dake 09/20/19.99
Current D oc# 1999R 0054054 Date 12/30/1999
Killing Doc# Dat e
Asmk D esc KE E FE R RD S uplCnt
Zoning D well I 1
AcreVS g Ft 15.13 N /C 047
Asmt # 047-250-197-000 Fee # 1047-250-197-000
Status ACTIVE Status Dake 09/20/1999
Tax 000 INORMAL OWNERSHIP TRA 062-106
Situs F3882 KE E FE R RD CH I CC
Base Dk
Timber Preserve
17,605
AgPres
0
E tal
W
N otes
j�
B ands
multi Situs
Flag1
Flagg
910 MH
AsryA PP Pen
Tax Pri Peri
App -60-1 Pending
j�
Split Pending
Land
S kructure
Fixtures
G roving
T otal L&I
Fix. RP
MH PP
PP
17,605
40,027
0
0
57,632
0
0
0
E xemptl 7,000
Netj 50,632
R /C#
TSR Dk
R/C Stale
I PHY I OWN I EXP I -TAX I H R N I AT T I S I T I APR. I PRL
2? Find
--.- I - -- - -- - . ---
0
ti•
RIS 61.35'
�/
a:3
Q► Jt 2� 3
n
3Q07f o
� 3:J
59 �Cc3F �•
WAC
33
3�
3.46 AC
ermlER RD
_/
1319..39
$ •PT/Y ZJ
O 359 AC. � � � O /93 G�K,.
u 48.23 AG! 69.98�cS ".• 1!
y /74 45-qAr- / 28
2 2 RS 5/-7/
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A . E�
6jxl it
arEIt PM
7 } G
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,► - . - ul 738 � F.�
�2
i
47-60 o '-
901 ss 9 IDGE
Ste•
I
4 .9396AC
28
• q
� . - S2 •� N .max � .
2aoo
i
via9.ss • 0 67 0aSIS DRIVE
' -27
Fn lPN.4A�
a
/g2 3. Ac 47-44 I59.V Ac.
593 ' ,.,•• JaN ,� �
•.�-•• �W:Z3
utYY �ANt 7 20
Pl�e�lsdnt R"^ 1 1 G
141
3oo2s,a�ti'+'85 -- � .
.*orf t Roo tt . a ,9.68AC
1" 8400r
►�- �3 60 At Mud /: � 29s 2 s
1.
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1
Split Worksheet
Today is 3/28/00 Mapper DB Key. date 3/28/00
New AP#(s) 047-250-201/205 New Doc# 99RP148-97
Assessed Owner: SHAFFER RICHARD E & BARBARA J
Care Of:
Street: 860 LORINDA LN
Bus Dir.
Doc Code: 07
City CHICO State: CA Zip 95973
Roll Status: A Event Date: 12/17/99 Ezemp: NO Label: El Land Use: 99
Su Read ❑ Sup Num: Taxibility: 000 TRA:
p
Description: TALON DR
Was: PTN (SEE MAP) SPLIT BY PM 148-97/99 AND TRA'S
Now: 047-250-201/205 SPLIT BY PM 148-97/99 AND TRA'S
Remarks:
Coordinates
'_sQ @"
23N JR1 E 129
J Etals
a: • New AP
P,aren ��a cel~ Q(C-0
047-250-151, 64R1334409
047-250-172 64R1334409
047-250-173 164R1334409
.Y.+1 K• ij!' f k Lb
c-q'.^°y'MOW j"' y�;i L� E.
047-250-201 2.47
1
047-250-151/
0&'Z- i05
047-250-202.70
2
047-250-151/
cr& 2 -/OS
047-250-203.70
2
047-250-172/
0 - / 0 (o
047-250-2041.81
3
047-250-172/
O&Z-/O6
1047-250-20519-1 r9
4
047-250-173/
L-LZ—
Split Worksheet
Today is 3/28/00 Mapper DB Key date 3/29/00
New AP#(s) 047-250-197/200 New Doc# 99RP148-4
Assessed Owner: FEDORKO STEVEN & ARLENE M
Care Of:
Street:. 3882 KEEFER RD
Bus Div:
Doc Code: 07
City CHICO State: CA Zip 95973
Roll Status: A Event Date: 9/20/99 Ezemp: HOX Label: Land Use: 99
Sup Reqd El Sup Num: Taszbility: 000 TRA:
Description: 3884 KEEFER RD
Was: PTN 047-250-147 &-150 SPLIT BY PM148-41/43 AND TRA'S
Now: 047-250-197/200 SPLIT BY PM 14841/43 AND TRA'S
Remarks:
Coordinates
�tr,
23N JR1 E 129
Etals
History New AP
Parent" ai'eel� �`�Olt'ito�c''
047-250-147 79R1334409
047-250-150 79R1334409
l 000 too
047-250-197 5.13 1
047-250-147/
047-250-1981.98 2
047-250-150/
CCe- 057
047-250-199 2.15 1
047-250-147/
CW --/0&
047-250-200.68 2
047-250-150/
0'105
i i
i i
y
NORTH SEC. 29 T.23N. R 1E. M.D.B. & A
. 12
f
47-25
Butte County Assessor's Mop
Book 47, Page 25
NOTE. • These parcels are for assessment purposes
only and may not constitute legal parcels.
4(
9
-9-7
�g
CREATED BY SDT CREATED ON 11-2-1999
REVISED BY DB REVISED ON 12-31-1999
EFFECTIVE 00-01 ROLL