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Home My WebLink About047-430-065BUTTE 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: ROBERTS COURT Owner: Permit No: B07-0990 APN: 047-430-065 ROBERTS, WAYNE Issued Date: 05/07/2007 By KEJ Permit type: MISCELLANEOUS 45 ROBERTS COURT Subtype: Electric Panel CHICO, CA 95973 Expiration Date: 05/06/2008 Description: TEMP POWER- FUTURE LOT DEV (530) 345-7896 Occupancy: Zoning: SR -1 Contractor Applicant: Square Footage: ROBERTS, WAYNE ROBERTS, WAYNE Building Garage RemdUAddn 45 ROBERTS COURT 45 ROBERTS COURT CHICO, CA 95973 CHICO, CA 95973 Other Porch/Patio Total (530) 345-7896 (530) 345-7896 FEE INFORMATION DBE Single Phase Service-Resid $55.00 Total Charged: $55.00 Fees Paid: $55.00 Balance Due: $0.00 Receipt No: B2962 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 ROBERTS, WAYNE OL:CRW_00384197 / / 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 05/07/2007 the applicant to a civil penalty of not more than five hundred dollars [$500); 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 OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE AND WILL the work himself or herself or through his or her own employees, provided that such improvements ❑I 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 Contractors 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 or one a hundred dollars ($100) or less. ❑ 1 AM EXEMPT under Section B. & P.C. for this reason: I CERTIFY THAT IN THE PERFORMANCE OF THE ORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any mann o as to become subject to the Workers' Compensation laws of California, and agree that if I s ould become subject to the workers'X 05/07/2007 compensation provisions of Section 3700 of the Lab Code, I shall forthwith comply with those wner's Signa Date ' provisions. X 05/07/2007 I hereby certify at I have read this application and slate that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and Slate laws relating to building Signature Date WARNING: FAILURE T 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 em loyees from any and all claims and liability for personal AND SHALL SUBJEC AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS $100,000 , IN ADDITION TO THE COST OF COMPENSATION, ( ) injury, including death, and propertya ge used t is arising out of, a in any way connected with the issuance of this permit. I hereby a owledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, st or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above me p perty for inspection purposes. I hereby certify that I am the rope wner 0 a auth a b lf. CONSTRUCTION LENDING AGENCY e propert o nets (�J \07 5 7/2007 IHEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Per ittee [SI N] tint Date the performance of the work for which this permit is issued. (3097 civ. code) Owner El Contractor OR E]Agent for Owner ❑Agent for Contractor FILE COPY Lender s Address City State zip Sent 6y: BUTTE CO €NVIRONM€NTALH€ALTH; 539 895 6512; May-7-97 5:25PM; Page 1/3 BUTTE COUNT7DENRA NT OFPUBLIC HE&TH DI P7310N.0F ENPYRONMENTAL hZ4LTH ' P.O. BOX 5384 (411 MAIN STS, CWCO, CA 95927 (330) 891-2727, FAX (530) 8956512 FAX COVER SHEET AA B,. At aER OF PAGES (Lnclu&g this one) *0•e4; A— FROM• i tea• COD EP?: FAX #.- A Sent By: BUTTE CO ENVIRONMENTALHEALTH; 530 895 6512; May-7-07 5:25PM; Page 2/3 . 3 itonmente! E:.COUtiTY. DE:PARTMENdT .OF..:HEA.Tl-i 7 Counttyy Cepter_Qrlve .4t1.Main S Orovllle CA 95985 • P o. x53 :.,.:: : 6ti/1�II Ct= Ef:Vt1O�PasiEfiTl��. HEi�LTH: 53b"53&7281 :. gp :Ica GA"9 52,E :'`! ` 1 .....:. FAX �530� 538-7785 " • 30) g61-27 :'. FAX (530) 89 '681 �• . AP�LtC ' IIV� t��RMiT T� CONSTRUCTGHir �A SMALHES L DIAMETER �19ELL 11NtYH �► CASING A CH�TER 23EETER . 5 o EXEMPT WELL Appifcation fOr : 8 all Dl r Do sails Y�►.yll Re e r oo Deepen �WST O m�(�st Pr cUon t7 FlrepSupproa to^gyp YVI Same p Capacity n 1� f emtro Other Mc Itorinp 1Mel� a Public Weser SupPlp W®110 ( y� -65 sesaor Parcol No. ( (� v' �'OMm®r Plants:' Tet. :.:.A�plteant:liliaib dress; - 7 : 8trv&b Addraw.. ;..:. •.fi tJ. DRIIlER't ?10N ..:.:...; .'............... ..:....:.. .....• WE L.L.I ORMATION P%posed:Dbpth: . • : ;=�`. M Cl�l 9E ,D Ir - - ON't'R�tCT'Qh ..►�bY. , a Husm�e^sse . Ptltt7: . �ppee�rj�t,rtyy, atrt o�fp Drgg of m ? a e: an 'my' torc,8 and:effeu.. (BX�iR95,01NE (1)'YPR FROM DATE:jSSVE D) 1 lJce gas.:;::•' Pot+' Racelvod... :. ;Uci.No .'Oats ..oe. R.oelpt ido...:.' Ihd CbMPEN ATCGN.D �i.ARATION .: __ - o 1::::hereby :urdei.: penat#y'... r:�p�i!uY��' 3iia. ot •tom ..frill ':,,... ..' .: i�hiei+s.:a ;.wilt:n'atntait►�S�:csrgl'tca�:otd6dMfioA 84 A00910 By: � t)ntto getf-insure. :: . • •• ....: _ .: �rnpeneadon•'as pro�rided.. r .by::8ectlon.:3700 'r:. n�UO . �• : •�... ,. O Uel M.r •for the perforrnence of the wont for vOWch ,, ofaitie' b, :Coria.. then •..:: 1t: �: lsaued:: ::wi{t�ma{ot_ ww�set ;� -- nstlon $on 3700 of -the. tabor', Code, "for the: t. etiotrn : of:46*;for: wtilch..this permit la :issued: ''my: :... P .:....:.:.. . . .�mpensaUan'�insurartce c8ntier:and policy.flumber.••:�m: .. : :.— .. •::.aro:; :...._ ;.: .. ..:: ... .: NOTEyS:TO WELE.'DWLLER"' Carrter' . e.'a minlerium tws IrrWour (24' hour P d nlge(' : nq .::.: iior tm finsta{. ng ' pr pacing perrhlt;: L Jseued,. L.aAall :'not-.employ any. p. •... Y. !sac !$teid.ln fess than twenty. flour (?A) Pe iected- to : :. 'rkere• cos satron.'.... hourig< BEC:2388 b 1 y that:dti: th®', rformence of : le.work :far'which: th19 sen a..a or drillin a wei{ .vxp ersan f becomo..e�b to vvo Pen . I . mt:;ff: l;_shtiuld' beoorn'a subject : : 0 :: be':. , e::. rs•'compe, tion.=pcovtsions of Sectlori 370 of '2; p sfaetory' fln�til .ins salon b the 8, or` Coded .: f hall "foftwith. comply. . with • those: - reoslpt by the :. Ho Itir... DeP..... e n P arts nt. ■ d rvvlsto s.: '.:. Hvaltti .Department: ot'a:' D.till8•r's:. Repart .or :.:.:.:..::::':' tiandonrrerit.. 6port and a :.. Irrf b s or na :.......X : approval 10 worIC(OCC 300[AD ''. : 5lpnehtre ori `. ...:. OC-sr L{oenaod W e0 Dduer ❑ Au�twnxed Agent .. 3. To' fa t:{littate• issua.nice. Of': ur .well' permit, Yo please:s4eks..and'flag .the .d�+'op osed well IOsatiOn tat the sits: . iRfARNINO::: t:Ai UitE.::..'iO..:SE:CURt: WORKERS' . COMPENSATION COVER 'GE�:i$>•_ 6d til FUL~AND SHALL. SUBJECT AN.EEYIPLOY.t R TO • ..:'Note -to Owncr" CRiOMAi. '�'t3H ' .g1ES' ANtf 'CML--011HES •-UP"TO.ONE . •HUNDRED An'ticce(ifable well' Sia .Ys.` • So a THAUSANO 00 LARS (Si oo,000), IN ADDIT10rd TO THE COST OF *ement for the well final. It COMPENSATtO DAMAGES AS PP.OVIDED FOR IN SEC'nO 9708 OF :: I� .. THE l.A®Old' C0 E, INTEREST, AND ATTORNEYS FEES. is the responsibility of the owner• Sent By: BUTTE CO ENVIRONMENTALHEALTH; 530 895 6512; May -7-07 5:26PM; Page 3/3 .JL.)UTIFE COUNTY PUBLIC I IEALTH DEPARTMENT CNvIRUNMLN'rAL NGALTI I DIVISION WELL COMPLIANCE CERTIFICATE o Less than: Inch Diameter o Greater Than 8 -Inch Diameter o Public Water Supply o Abandonm4nt o mOnitonng Well o Other: Ptopectlr_t RA, tf%.ation Property Qwnor�N/ame Assessors Parcel -No. Site Address ., "%'� _: city Well Conatl i6lon Inspection Driller Gall In *Ith 24-hour notice? o Yes 9No Time/Date/Seal ID 00w1o�o��n E.H.S. petforMed seal Inspection? i o Yes a No If yes, approval date/initials Driller's Whit Received? d Yes Approval date/initials Disinfection Rarport received? o Yes o N/A If yes, approval date6nitiats Destruction Rkport received? c Yes o N/A If yes, approval date/initials tIVsILSlab:lns�ect(on � . i Slab inspection performed? 5 o Yes o No If yes, approval date/initials • comments. . •t Well Con6trtit:tion Approval Health Specialist Well Final Approval Environmental Health Specialist Date Note: Prior to -final approval for well compliance, the property owner is responsible for construction of a concrete slab:0ighteen inches laterally in'all directions from the outside of the well casing to protect the well casing antt seal from damage and deterioration. 202 MIRA LoMA DRnn 01001e: CA 959§5 TEL- 1,5301 538=.7282 FAX- (530) 9361 211.15 411 MAIN S'rKt_ P p. Box 5364 Crum. CA .95427 TEL: f530) 891.2727 FAX: (5',C) 895-1551_ 7 COUNT(CENTER URNC OroOle. CA 95965 TEL: (5301530-72V FAX: (530) 338.7785 BtItte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the 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 thanyour immediate family, and the work (including materials and other costs) is $500 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 government 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 to you if you do not cavy out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact 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 thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor 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 contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY PLTO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. OR NO) •�VE 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: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS CITY PHONE CONTRACTORS 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 Description: TEMP POWER- FUTURE LOT DEVEL Reference Number: B07-0990 Applicant Name: ROBERTS, WAYNE Owner's Name: ROBER/TS,,W�YNE AP 4 Signature of Property Ownerbl , Date: :047-43 -065 5 `Z 0 BUTTE COUNTY O��o DEPARTMENT OF DEVELOPMENT SERVICES o , O BUILDING PERMIT APPLICATION o O OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 o -- o o o A FEE WILL BE REQUIRED AT TIME OFAPPLICATION C, y Website: www.buttecounty.net/dds Ov 1"PLEASE PRINT CLEARLY" OWNER INFORMATION Last Mi- irs V i Mailing Address ko ,ins (-q- / city Stat Zi 13 Phone? f ,5-- 4•C `TJ U Fax _-7? t� E-mail CONTRACTOR Name Address City State Zip Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City =Addtess SRA City Fax ,:5 4y --78q6 State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name \ev ( Address � C.:LJStat� City SRA Phone u Fax ,:5 4y --78q6 E-mail A 'l H TURF PERMIT NO. 0. �% BIN # PROJECT LOCATION AP# 1-22 Property Address�— City [� WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING -AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Zoning v SRA Yes No Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning I Flood SRA Yes No Occ. !IT'y pe Const. L,