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HomeMy WebLinkAbout058-800-002D.B _ P.utnam off Cirby Creek Rd., near Concow Rd,Int CERTIFICATE OF COMPLIANCE/with Gond. 7/7182 B07-0287 058-800-002 MISCELLANEOUS POWER FOR WELL & FUTURE LOT E Electrical 3876 BROKEN GLASS CIR OULES, JEFFERY M BUTTE 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: 3876 BROKEN GLASS CIR Owner: Permit NO: B07-0287 APN: 058-800-002 OULES, JEFFERY M Issued Date: 02/15/2007 By KCG Permit type: MISCELLANEOUS 3876 BROKEN GLASS CIR Subtype: Electrical OROVILLE, CA 95965 Expiration Date: 02/15/2008 Description: POWER FOR WELL & FUTURE LC (530) 588-3702 Occupancy: Zoning: FR5 0 Contractor Applicant: Square Footage: OULES, JEFFERY M Building Garage RemdUAddn 3876 BROKEN GLASS CIR OROVILLE, CA 95965 Other Porch/Patio Total (530)588-3702 FEE INFORMATION DBE Single Phase Service-Resid $55.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 02/15/2007 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I I 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. ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Carrier. Policy Number. Exp. Date: (This section need not be completed if the permit is or one hundred dollars ($100) or ® 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 the 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 ! ,/0 � 02/15/2007 Signatu Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip Total Charged: $55.00 Fees Paid: Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License 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 pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) 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 the applicant to a civil penalty of not more than five hundred dollars ($500); Please check one of the following: G1 I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE f�J COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR 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 the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. ff, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. 8 P.C. for this 02/15/2007 Date 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 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 injury, including death, and property damage caused by, arising out of, or in anyway connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the pr aeow;ne or authorized to act on the property owner's behalf. _ ; UL -C 02/15/2007 em_ itt_`e IGN] --Print Date l. Owner ❑ Contractor OR. Agent for Owner El Agent for Contractor FILE COPY M! BUTTE.COUNTY 6) v c 0 DEPARTMENT OF DEVELOPMENT SERVICES 0 0 BUILDING PERMIT APPLICATION 0 0 OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 o 0 A FEE WILL. BE REQUIRES AT TIME OF .APPLICATION Website: www.buttecounty.neVdds , 015 N**PLEASE PRINT CLEARLY* OWNER INFORMATION Last NameOl.' L_ s First Name J �� Mailing Address 3$7� 020Q10 CLASS CWC i5 City © t20 V i LLC State Chi Zip �SCIG�_ Phone S�36 's88.37d z, Fax E-mail APPLICA TSIGAIATURE X PERMIT NO. BO -o2217 BIN # PROJECT LOCATION API _ r� Property Address 6 ReolCelf1i C11C ^SS Ctl 6E-17 City 020Vr(_CC 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 P200, 13 DESCRIPTION OR SCOPE OF WORK: �- C_ Sq FT- Living /,9 Garage Open Cov 0 . Structure Built without Permits 0 Proposed Change of Occupancy (Note previous use): For office use only: _ Zoning�� Flood Zone SRA Y, s Jn Occ. Type Const. V. CONTRACTOR Name Address 38,76 t3/Ze CAS _S (CI Ccz City 620 «l C CGL State Zip Phone 8 _ 3?Q.Z Fax E-mail Lic. # Class APPLICA TSIGAIATURE X PERMIT NO. BO -o2217 BIN # PROJECT LOCATION API _ r� Property Address 6 ReolCelf1i C11C ^SS Ctl 6E-17 City 020Vr(_CC 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 P200, 13 DESCRIPTION OR SCOPE OF WORK: �- C_ Sq FT- Living /,9 Garage Open Cov 0 . Structure Built without Permits 0 Proposed Change of Occupancy (Note previous use): For office use only: _ Zoning�� Flood Zone SRA Y, s Jn Occ. Type Const. V. ARCHITECT/ENGINEER Name Address 38,76 t3/Ze CAS _S (CI Ccz City 620 «l C CGL State Zip Phone 8 _ 3?Q.Z Fax E-mail State License Number APPLICA TSIGAIATURE X PERMIT NO. BO -o2217 BIN # PROJECT LOCATION API _ r� Property Address 6 ReolCelf1i C11C ^SS Ctl 6E-17 City 020Vr(_CC 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 P200, 13 DESCRIPTION OR SCOPE OF WORK: �- C_ Sq FT- Living /,9 Garage Open Cov 0 . Structure Built without Permits 0 Proposed Change of Occupancy (Note previous use): For office use only: _ Zoning�� Flood Zone SRA Y, s Jn Occ. Type Const. V. APPLICANT INFORMATION Name Address 38,76 t3/Ze CAS _S (CI Ccz City 620 «l C CGL Sta Zip9 G<� Phone 8 _ 3?Q.Z FaxCJ� E-mail APPLICA TSIGAIATURE X PERMIT NO. BO -o2217 BIN # PROJECT LOCATION API _ r� Property Address 6 ReolCelf1i C11C ^SS Ctl 6E-17 City 020Vr(_CC 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 P200, 13 DESCRIPTION OR SCOPE OF WORK: �- C_ Sq FT- Living /,9 Garage Open Cov 0 . Structure Built without Permits 0 Proposed Change of Occupancy (Note previous use): For office use only: _ Zoning�� Flood Zone SRA Y, s Jn Occ. Type Const. V. jButte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 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. I PERSONALLY PLAN TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION -OF THE PROPOSED PROPERTY IMPROVEMENT.YES R NO) 2. I (&HAVE 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 S. 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: POWER FOR WELL & FUTURE LOT DEV Reference Number: B07-0287 Applicant Name: OULES, JEFFERY M Owner's Name: OULES, JE F E AP # 1729Q Signature of Property Owner: Date: 058-800-002 RETURN T'0:' Public Works Land Development Section - ,o `�- �``'�'y .`.jf .._��i?�3� REQ: _......._.. ,i• PUBLIC WORKS AL 7 2.2.s PP' 14q' CERTIFICATE OF COMPLIANCE ELEANOR M. BECKER CLERK -RECORDER Issued to: D. B. Putnam FEE P. 0. Box 44 82-20'7 c'3 Oroville, CA 95965 This Certificate of Compliance is hereby issued by the County of Butte to certify that the land division which created the parcel of property identified below complies with the applicable provisions of the Subdivision Map Act and of Chapter 20 of the Butte County Code. 1. Property location:. off Cirby Creek Rd. near Concow Rd. intersection 2. Assessor's Parcel Number: 58-25-62 Descriptions All that certain.pronerty located in the County of -Butte, State of California, more particularly described as follows: A portion of the Northeast quarter of Section 3, Township 22 North, Range 4 East, M.D.B. & M., described as follows: COMMENCING at the Northwest corner of Lot 3 of the Northeast quarter of said Section 3; thence South 00 47'.13" West along the West boundary of.said Lot 3 a distance of 330.76.feet to the point of beginning for the parcel described herein; thence from said point of beginning, continuing South 00 47' 13" West, along the West boundary of said Lot 3, a distance of 212.28 feet to the Northwest corner of that certain parcel of land described in Deed to Larry E. O'Brien, recorded December 7, 1971 in Book -1718 of Official Records, at page 205, records of Butte County, California; thence South 520 19' 03" East along the Northerly boundary of said O'Brien Parcel, a distance. -Of 338.84 feet to a point in the centerline of a 60.00 foot road reservation; thence along said centerline, North 400 57' 00" East, 226.72 feet to the Southeast corner of that certain parcel.of land described in deed to Gregory Olster, recorded December 7, 1971; in Book 1718 of Official Records,, at page 442, records of Butte'County, California; thence North 590 03' 22" West along the South boundary of said Olster parcel a distance of 482.15 feet to the point of beginning. Together with rights-of-way of record recorded in.Book 1707 of Butte County Official Records at Page 159. Issuance of this Certificate is conditional upon the following conditions which have been imposed pursuant to the Butte County Code Chapter 20-166 and Government,Code, Section 66499.35 (b), to protect the.public health and public safety. NONE LD. 1400` CO 0 0 x County of Butte Subdivision Violation..0ommittee J tND OF DOCUh1ENT END .OP DOCUMENT