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Home My WebLink About058-510-008rB f33r"t',7058-510.008., MISCELLANEOUS - Demo-Fire08':,t DEMO DUE TO'JUNE LIGHTENING F ' 13510�GREEN FOREST LN � � �" • BLACKWEL�L GARRISON, �. 5/70 4: t 4 5 j • ire V •• rte; �� e 1 i' i { i P "\r I o � ��'� � ria. ��...,,, � �- � ' s i if " a a l t 0 H r C it i1 o � ��'� � ria. ��...,,, � �- � ' BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 13570 GREEN FOREST LN Owner: Permit NO: B08-1537 APN: 058-510-008 BLACKWELL GARRISON, Issued Date: 08/05/2008 By KEJ Permit type: MISCELLANEOUS 13570 GREEN FOREST RD Subtype: Demo-Fire08 OROVILLE, CA 95965 Expiration Date: 08/05/2009 Description: DEMO DUE TO JUNE LIGHTENINI (530) 534-0673 Occupancy: Zoning: FR5 0 Contractor Applicant: Square Footage: OWNER BLACKWELL GARRISON, Building Garage RemdVAddn 13570 GREEN FOREST RD OROVILLE, CA 95965 Other Porch/Patio Total (530)534-0673 FEE INFORMATION Total Charged: $0.00 Fees Paid: $0.00 Balance Due: $0.00 Receipt No: 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 OWNER / / 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 08/05/2008 the applicant to a civil penally 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 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 ❑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, by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED as required ❑ CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions 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' Compansation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier: Policy Number: Exp. Date: (This section nee not be competed if the permit is or one hundreddollars ($100) or 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' ompensation Laws of California, and agree that if I should become subject to the workers' X 08/05/2008 compensation provis' ns of Section 3700 of the Labor Code, I shall forthwith comply with those er's Sin re Date provisions. 08/05/2008 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building nature 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 of, or in any way connected with HUNDRED THOUSAND DOLLARS $100,000, IN ADDITION TO THE COST OF COMPENSATION, ( ) the issuance of this permit. I hereby acknowledge thatt is 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, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. Coun , to enter the above mentioned property for inspection purposes. 1 hereby certify that I am the r eroramaulhorizedtoaclonth opertyowner'sbehalf. CONSTRUCTION LENDING AGENCY t16�sa�1 1 Pl.� os/os/loos I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency fo N10fi&of Permitt [SIGN] PrinT Date the performance of the work for which this permit is issued. (3097 civ. code) Owner Contractor OR; DAgent for Owner ❑Agent for Contractor APPLICANT COPY Lender's Address City State Zip Butte 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 than your 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 carry 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. 1. I PERSONALLYYIANqp PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEME . ffrd OR NO) 2. (HAV 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: 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: DEMO DUE TO JUNE LIGHTENING FIRE Reference Number: B08-1537 Applicant Name: BLACKWELL GARRISON, Owner's Name: BLACKWELL GARRI O AP # : 058-510-7/0 Signature of Property Owner: l/ Date: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 ilt A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds c0 PLEASE PRINT CLEARLY "When filed, this application and all supporting material becomes subject to the California Public Records Act. All related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last Nam F ' t e S. p� �.' I II Mailing Address 3570 EFacJ OR7` `� eS CityLLC stat zi w96�/ Phone3 ^ / Fax b E-mail S3)/_ _3 1c2 1Ve_rqq LICANT SIGNATURE PERMIT NO. ,� 1 BIN # PROJECTLOCATION AP# G m , ) V' U Property Address City 4,)/ WORKER'S COMPENSATION' Policy Number Carrier If hiring anyone othorthan license contractors, a certiril a of worker's compensation must be shown at the time of permit i uance. LENDING A CY Name Address DESCRIPTION OR SCOPE OF WORK. .62 Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: CONTRACTOR Name I Type Const. Address Add r City State Zip Phone ax E-mail State License Numb r Lic. # E-mail Class LICANT SIGNATURE PERMIT NO. ,� 1 BIN # PROJECTLOCATION AP# G m , ) V' U Property Address City 4,)/ WORKER'S COMPENSATION' Policy Number Carrier If hiring anyone othorthan license contractors, a certiril a of worker's compensation must be shown at the time of permit i uance. LENDING A CY Name Address DESCRIPTION OR SCOPE OF WORK. .62 Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: ARCHITECT/ENG/NEER Name I Type Const. Address Add r City State Zip Phone Fax E-mail State License Numb r LICANT SIGNATURE PERMIT NO. ,� 1 BIN # PROJECTLOCATION AP# G m , ) V' U Property Address City 4,)/ WORKER'S COMPENSATION' Policy Number Carrier If hiring anyone othorthan license contractors, a certiril a of worker's compensation must be shown at the time of permit i uance. LENDING A CY Name Address DESCRIPTION OR SCOPE OF WORK. .62 Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: APPLICANT INFORMATION NameAp�-,?Pea-ooGJt'LL I Type Const. Add r 370Ea) Cityv / ` L E- State . Z PTO45/ Phone— r Fax E-mail LICANT SIGNATURE PERMIT NO. ,� 1 BIN # PROJECTLOCATION AP# G m , ) V' U Property Address City 4,)/ WORKER'S COMPENSATION' Policy Number Carrier If hiring anyone othorthan license contractors, a certiril a of worker's compensation must be shown at the time of permit i uance. LENDING A CY Name Address DESCRIPTION OR SCOPE OF WORK. .62 Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA I Yes I No Occ. I Type Const. . COMPLAINANT: ADDRESS: PHONE.NUMBER: OTHER COMMENTS: Ud E 66 OD rn 3) I DC) C, Up r .84-9.75 Ct sok �P7 .04 330.01 ljo.ol :J-- 1-7 -,3.99 1 N COO 10'5P E 1523.77 0 Cb . Ul LD ro r�l - uy ITI�,- 324.17 7(30.93 ;7\ 11 A fT