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HomeMy WebLinkAbout058-520-046STORK DAMAGE REPORT `058-52-0-00- 95-035 ' BROADWAY, Bob *95 -OM99s, 4323 Big Bend ' Road, lot .1., ..OroviVe (rieplaE� gasline-& gas wtr htr)'' (creroof./Versdtile Roofing) SUMMARY' SHEET FOR LAND IVISIONSiI 058-52OL" :RObL-T,t Broadway 6/15/931 -Big B'end Rd.., Oroville TENTATIVE PARCEL MAP h Xr'� � Q© � 1 '� �,� BUTTE COUNTY BUILDING OFFICIALS ,JURISDICTION 5 6-,?--Kc Block.-Parcel No. 17W SW000 Rapid Evaluation Safety Assessment Form BUILD G' DESCRIPTION: Name: 6e04-0We Address: No. of stories: 1 Z400r�p.�. Basement: Yes ❑ NoUnknown ❑ ,911 T. Primary Occupancy: Dwelling . Other Residential ❑ Commercial ❑ Office ❑ Industrial ❑ Public-Assembly'O School Government ❑ Emer. Serv. ❑ Historic-[] Other OVERALL RATING: (Clceck One) INSPECTED (Green) . 791, _ Exterior only . IgExterior and Interior LIMITED ENTRY (Yellow) UNSAFE (Red) INSPECTOR: Inspector ID SA o 7.14- Affiliation .1¢Affiliation S L®C INSPECTION D TE: Mo/day/ e 'r q5 --- T'irne air! pin Instructions: Review structure for the conditions listed below. A "yes" answer tot, 2, 3, or 5 is grounds for posting entire structure UNSAFE. If more review is needed, post LIMITED IRMTRY. "yes" to 4 requires posting AREA UNSAFE and/or barricading around the h.,uard. A answer Hazards such as a toxic spill or an asbestos release are covered by 6 and are to be posted and/or barricaded to indicate AREA UNSAFE. More Review Condition Yes No Neederi_ 1. Collapse, partial collapse, or building off foundation ❑ C ❑ 2: Building or story noticeably leaning ❑ ❑. 3. Severe racldng of walls, obvious severe damage and distress ❑ 4. Chimney, parapet or other falling hazard ❑ ❑ 5. Severe ground or slope movement present ❑ ❑ ❑ 6. Other hazard present ❑ Recommendations: ❑ No further action required ❑ Detailed Evaluation required (circle one) ❑ Barricades needed in the following areas: niher. Posted at this Assessment: Comments: Structural Geotechnical Other ❑ Yes No ,.;v , l �`� �� A m I 19 DATE -. I2 RS TIME I I =3a ESTIMATED DAMAGE 0000-0 BY 11 -id as.n DAMAGE REPORT FOR INITIAL ASSESSMENT FLOOD JANUARY 1995 mc; PUBLIC INFORMATION OFFICER 538-6953 Name Reporting Party )L AFRI 2.Q 14?� t.,1A Address/Location y3z3 13n; 9&,✓b 91. 0R_')V1LI-f Telephone Number 53 y - A y55 City County ✓ Type of Damage— 6r= L__EAK (Note: Emergencies Refer to 911) BuildingL Description ( ] Commercial/Usage [ v T Residential Type and # Units [a/fCurrently Occupied/Use [ ] Abandoned/Vacant Electric Any electrical submerged Yes[ ] No Obvious damage (failure, downed wires, arcing) 2eD Ei-r uZi c Ta rAn✓Gf 1I Q M4c s� :9 Y wA -rEQ Gas Natural/Propane Obvious problems (odor, leaks, leaks, propane tank floating/submerged) On L, -T Off [ ] Structure On/Off Foundation Flooding above/below floor Obvious leaning, tilting - Severe Damage/Collapse Debris Hazard Sanitation . Plumbing working Running water Well Flooded Obvious Sewage Problems Chemical/Fuel Wet, flooded, lost chemicals Type pesticide, fertilizer, other chemicals Amount Fuel tanks (above or below ground) Obvious hazards Agriculture Loss Crop Damage Livestock Lost Building Damage Roads (Public) Road Name Obvious Damage/Hazards Location/Landmarks Traversable (Sedan, 4 wheel) Involved Utilities (downed wires) Levees Public [ ] Private [ Waterway Name Location of damage/problem Obvious hazards Nearest Landmarks Overflow/freeboard covies: ] OES ( ] Agriculture ] Health ( ] Fire I ] Building 1 I Sheriff 058 -52-0-046 9595-013 Y BROADWAY, Bob -`95=0359 . 4323 Big Bend Road, lot.1, Oroville (replae gas line & gas wtr htr) (-,reroof/Versatile Roofing) WE t WE COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION 7 County Center Drive - Oroville, :California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER U /J ?0 /� 7VC U ZONING BUILDING PERMIT OWNER /� /(-moi• TELEPHONE so. Fr. OCC. BUILDING VALUATION OWN ER 'UNG ADD ESS g� CONTRACT ME� �, �i%' TELEPHUONE� 131 CO TORS IUNG DRESS Ls Fireplace CONSTRUCTION LENDER UNMOWN Total Valuation $ Filing Fee $ 20.00 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 $ BUILDINGADDRESSr, ~ PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 1 5.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ I llation ❑ Other Describe Work: — Mobile Home I S I GI W1 @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filing Feb 20:00 . Main ServiceOOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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� 6 3c. No. U .i��d Q 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 undef" Sec.'. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP. OR ) N( a ACC.T. SO. 3.5¢ FT. MULTI-OULITLETLEBLOS NEW CONST NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS ( a SINGLE OUTLET CIR. ) Ex. Occup. ( OUTLET OR FIXTURES) 20 @ 1.00 BAL .50 Ex. Occup. (oFIXEEDTs PLNS. Oea) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE' $ Contractor 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 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' compensafion'insurance carrier and policy number are: Carrier �>�/ - MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling - Hood 6.50 Ventilation A ` PERMITFEE $ . Contractor _ Policy Number i (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.)" I certify that in the performance of the work for which this permit is issued, I shall rn not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith c0m ly with those provisions. X Date 2 --Z —_�1�2'> _ _ LS _ Signature of Applicant - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or constructioof structures over 3 storvies in height. Mobile Home Installation .Fee =$ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ Q HAZ. D. FEES IMP FLOOD CDF PARCEL PDHDISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicaZabov for which s have been paid. -By }` X - /?, Pate ./ PERMITEXPIRESON , c o (Date) Receipt No. 1 70 O �4 WHITE-D.D.S.-B.D. CANA Y-1-SESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California, 95965 - Telephone (916) 538-75 1,^ PERMIT NO. APPLMATON AND PERMIT �, y�'SS ° 3-P7 ASSESSOR PARCEL NUMBER 06g.�� ZONING BUILDING PERMIT OWNER /� (i�YOL TELEPHONE Sq, FT.OCC. BUILDING VALUATION OWN ILI AD ES CONTRA ME�� TELEPHNE61 CONI TORS IUNG CRESS &�i6141-111 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAIUNG ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHRECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ' ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 132- PERMITFEE $ PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 IAT NO. SUBDrMION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Udlities ❑ 1 Ilation ❑ Other Describe Work: — Mobile HomeS G W 1 @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.'00 Main Service EOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION lehereby 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 i full force an ct. (^ ' 110 A License Class C. NO. 7 4/� J (.1 (., 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. ❑ 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 ' NEW CONST. DWELLING OCCUP. OR ADDNS. ( s ACC. BLDS. ) s0. 3.50 FT. NEW CONST. MULTI.OUTLET NOWRESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FO(TURES) 20 Q 1.00 BAL .50 Ex. Occup. OUTLETS (RES D.) E0. ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor 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 l insurance carrier and policy number are: Carrier )M=M�y MECHANICAL PERMIT Filing 9 Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) IxI 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 provisions of section 3700 of the Labor Code, I shall forthwith com ly with those provisions. — --of X _ Date 2-'Z E? `–yS Signature of Applicant - ❑ Owner X Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or constructio of structures over stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is Occ CONST. TYPE TOTAL FEE $ HAZ. 1 0. FEES I IMP I FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions the Butte County Code and/or Resolutions to do work indicated abov for which s have been paid. ate PERMIT EXPIR SON (Date) ReceiptNo./ er® G WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ASSESSOR'S PARCEL NUMBER(S) 58-52-46 ZONING FR -2 GENERAL PLAN Foothill area Resi. PROJECT CONSISTENT?. 1YES. GENERAL PLAN CONFORMANCE.REPORT.: -December 9,-1992 LAND CONSERVATION ACT CONTRACTS?- NO - DATE APPLICATION RECEIVED June 15, 1993 AGENT/SURVEYOR/CIVIL ENGINEER G.D.A. ADDRESS 220 Grand Avb., Oroville, CA 95965 DATE PLANNING DIRECTOR'S REPORT PREPARED ENVIRONMENTAL DETERMINATION AND DATE CATEGORICAL EXEMPTION - DATE FILED NEGATIVE DECLARATION - DATE ADOPTED fui�ll��IYe��L�7�1:�.7;�1M�iI►n_�I;�M��,�J`11��T7 ENV.IMPACT REPORT - DATE CERTIFIED STATE CLEARINGHOUSE NO. DEVELOPMENT REVIEW COMMITTEE HEARING DATE APPEALED BOARD ACTION APPEAL HEARING DATE COMMENTS FOR PLANNING DIRECTOR'S REPORT ASSIGNED TO RECEIPT NUMBER LD 1005 (11/92) DIS Pl" SUMMARY SHEET FOR LAND D I V I S I O=UNTY OF BUTTE BUILDING DEPT J U L 0 1993=- 2 . APPLICANT ROBERT BROADWAY ADDRESS 4323 Big Bend`Rd. Oroville, CA 95965-8018 OWNER Same - .PROJECT DESCRIPTION TENTATIVE -PARCEL MAP LOCATION 4'parcels located on the north side of Big Bend Road, 1200 ft. east of Dark Canyon Road.. Big Bend-are.a. ASSESSOR'S PARCEL NUMBER(S) 58-52-46 ZONING FR -2 GENERAL PLAN Foothill area Resi. PROJECT CONSISTENT?. 1YES. GENERAL PLAN CONFORMANCE.REPORT.: -December 9,-1992 LAND CONSERVATION ACT CONTRACTS?- NO - DATE APPLICATION RECEIVED June 15, 1993 AGENT/SURVEYOR/CIVIL ENGINEER G.D.A. ADDRESS 220 Grand Avb., Oroville, CA 95965 DATE PLANNING DIRECTOR'S REPORT PREPARED ENVIRONMENTAL DETERMINATION AND DATE CATEGORICAL EXEMPTION - DATE FILED NEGATIVE DECLARATION - DATE ADOPTED fui�ll��IYe��L�7�1:�.7;�1M�iI►n_�I;�M��,�J`11��T7 ENV.IMPACT REPORT - DATE CERTIFIED STATE CLEARINGHOUSE NO. DEVELOPMENT REVIEW COMMITTEE HEARING DATE APPEALED BOARD ACTION APPEAL HEARING DATE COMMENTS FOR PLANNING DIRECTOR'S REPORT ASSIGNED TO RECEIPT NUMBER LD 1005 (11/92) DIS 058-52-0-046 95-0351 BROADWAY, Bob '77-7779 4323 Big Bend Road, lot 1, Oroville (rep _1ae_g a sl-i-ne '&—gas wtr htt) (",reroof/Versatile Roofing) OFFICE COPY rAddress— G AS Meter By Dat �R I C Qa4e-- J COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, Cafitbrniar95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT "D- SS ASSESSOR PARCELNUMBER' ZONING BUILDING PERMIT OWNER -058-520-046 BOB BROAMAY TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 4323 BIG BEND RD OROVILLE CONTRACTOR'S NAME JIM MARAZZO ELECTRIC TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNMOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS - Penalty $ BUILDWGADDRESS 4323 BIG BEND RD LOT 1 PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 t' Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 ` USEOFSTRUCTURE SF 171" Duplex ❑ Mobilehome ❑ Other SPECIFY + Each gas water heater or vent 15.00 15.00. Gas piping system 1 - 5 outlets 15.00 15.W Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ j Describe Work: — j t Mobile Home I S I GI W 1 20.00 PERMITFEE $ 50.00 Contractor ELECTRICAL PERMIT Filina Fee 20.'00 aOV OR III Main Service ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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. ! / 1 License Class C ib Lic. No. �r C (0 4. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, 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: ❑ 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. s ❑ 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 NEW CONST. DWELLING OCCUP. s0. OR ( 8 ACC. ) 3.50 FT. NEW CCONST. MULTI.OUTNS. LELT \ NON-RESID. ( BRANCH CIRCUITS J @7.50 8 POWER APPARATUS ) SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES) 20 Q 1.00 BAL .SO \ Ex. Occup. OUTLETS PPLNS..OR / 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor MECHANICAL PERMIT Filing 9 Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) l I certify that in the performance of the work for which this permit is issued, I shall employ any person in any manner so as to become subject td workers' 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 those provisions: X �, Date 2 11 � i,� Signa t re of App (cant - ❑ Own`` t'rrr Contractor ❑ Agent An OSH permit is required for e�8avations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ (in HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE L. - This permit is hereby issued under the applicable provisions of the Butte County Code and/Or Resolutions to do work indicated above for which fees have been paid. , y r� V ' Dates+ B / I(/&, i xr-w Receipt No.��79PERMITEXPIRESON WHITE-D.D.S.-BID. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISIO 7 County Center Drive - Oroville,;walif6rlia 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 058 520 046 ZONING BUILDIffG PERMIT OWNER BOB BROADWAY TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 4323 BIG BEND RD OROVILLE CONTRACTOR'S NAME JIM MARAZZO ELECTRIC TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNIwOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 4323 BIG BEND RD LOT 1 PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF IY Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 15.00 Gas piping system 1 - 5 outlets 15-00 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities (A Installation ❑ Other ❑ ff Describe Work: ���(� �� G; Q$ IgQ5 W �1 Mobile Home S G W @20.00 PERMITFEE $ . 50.00 Contractor ELECTRICAL PERMIT Filina Fee 20.'00 Main Service OOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO I000A ) 46.00 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 C — /5 Lic. No. la G �I 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. 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 Policy Number (rhe above sections need not be completed if 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' 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 those provisions. ` X Date �_ Signa r of App icant - ❑ Ow r Contractor ❑Agent An 0 permit is required for a vations over 5'0" deep and demolition or construction of strut res over 3 stories in height. NEW CONST. DWELLING OCCUR SO. OR ADDNS. ( & ACC. BLDS. ) 3.50 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FO(TURES) 20 @ 1.00 BAL so \ Ex. Occup. (OUTLETS RES IDFIXED APPLNS. .) / 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor MECHANICAL PERMIT Filing 9 Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Mobile Home Installation Fee $ Energy Inspection Fee is Occ CONST. TYPE TOTAL FEE $ ro HA2. 1 D. FEES I IMP FLOOD CDF PARCEtHD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated bove for which fees have been paid. 1 Date PERMITEXPIRESON w ReceiptNo. �7,5IL L WHITE-D.D.S.-11D. CANARY- SESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE BUILDING.j4IVISION DEPARTMENT OF'DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA (916) 538-7541 747 Elliott Road, Paradise, CA - (91 6) 872-6307 CORRECTION NOTICE u -4J OWNER PERMIT NO. A routine inspection indicates that the following violations,of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. /� t I / Y- / c•iL.�Cr e t'J /n P� P t3 Lot I ! (. Lit 4 ✓ co 1 t�l'� �+ Q.�" U t•� � � G,) c�.l`' •P it - Y Date ��� Inspector,,� REV 10/92