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Home My WebLink About062-190-019i( 062-19-0-019 98-1932 B MORONY, Jean 300 Lakeside Way, Berry Creek (repairAeck )SF Z7 61mc4g 062-190-019 99-2504 MORONY, MR. & MRS. 300 LAKESIDE WAY, LAKE MADRONE Comm UR COUNTIES ROOPI 'G RE ROOF t r o62-190-019 99-2504 MORONY, MR. & MRS. 300 LAKESIDE WAY, LAKE MADRONE CONTR: FOUR COUNTIES ROOFING RE ROOF COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - 7 County Center Drive - Oroville, Calif ,lia 95965 - Telephone (Rev. 12/96) APPLICATION AND PERMIT BUILDING DIVISION (916) 538-75414K—PERMIT NO. ASSESSOR PARCEL NUMBER 0(./% -� 9/, /� ZONING _M BUILDING PERMIT OWNER Mr. & Mrs. Morony GLHlt3�I52 SO, FT. OCC. KilbDING VALUATION Reroof existing root W co os t OWNER'S MAILING ADDRESS 95927 shingles CONTRACTOR'S NAME Four Counties Rooting 4721416 v 20 s • x $60.00 $1,200.00 CONTRACTOR'S MAILING ADDRESS - 3 Crusader Court Chico CA 95973 CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ 1.200.00 ARCHITECT OR ENGINEER - LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 29.00 ARCHITECT OR ENGINEERS MAILING ADDRESS a Plan Checkin Fee $ BUILDING ADDRESS - 300'Lak@si Way, ke Madrona £' »r-• R Energy Plan Checking Fee $ , PERMIT FEE, .; 49':0 LOT NO. SUBDNISIONS NAME ` PARCEL MAP PLUMBING PERMIT "`g; Filing Fee USEOFSTRUCTURE, SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: reroof existing root w/composition shingieh Gas piping system 1- 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service ioov. oa Mss 23.00 r LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license isfu rce and effect. License Class 6_�� Lic. No. 489246 OWNER -BUILDER DECLARATIONEx. 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',Dode for this', reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( a ACC. sLDs. 3.5QFT: N CS NON-RESNDT MULTI.OU CLET 97,50 POWER APPARATUS 8 SINGLE OUTLET CIR. 20 Q 100 Occup. OUTLET OR FC(TURES BAL @ .50 EX. OCCU FD(E0APPLNS. OR 5.00 OUTLETS RESID. EA Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE 'S r WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declaration s: ❑ 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. I 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 worker` :,cogiRenssationnainsurance carrier and policy number are: Carrier V 111 MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood @.b0 Ventilation PERMIT FEE $ Policy Number W(;b-0WUJb75 (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 1 should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. ��' J% X rlY.f f ("�> > to 10/29/99 Signature of Applicant - ❑ Owner ❑ Contractor {J Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 49.40 NAZ. D. FEES IMP FLOOD COF PARCEL PD HO ISSUE 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. f� By Date / PERMIT EXPIRES ON TD a Receipt'No. ) i WHITE-D.D.S.-B.D. CANARY -ASSESSOR I PINK -INSPECTOR GOLDENROD -APPLICANT ,on, '•r COUNTY OF BUTTE- DEPARTMENT OF ��V`LOPMENTSERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, Ca`Iifofnia 95965 - Telephone (916) 538-7541 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT 9�- ASSESSOR PARCEL NUMBER 0(� /�� ✓ /'� %� ` (f` ZONING j 1/ BUILDING PERMIT OWNER Mr. & Mrs. Morony TE HO - 352 SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS P-0- Box 918, Chino, CA 95927 Reroof existing roof w com osit shin 1 s CONTRACTOR'S NAME Four Counties Roofing 4`T-21416 20 s . x $61.00 = $1,200.00 CONTRACTOR'S MAILING ADDRESS 3 Crusader Court Chico CA 95973 CONSTRUCTION LENDER - LENDER'S MAIUNG ADDRESS ' Fireplace Total Valuation $ 1 200.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 29.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 300 Lakeside Way, Lake Madrone Energy Plan Checking Fee $ $ PERMIT FEE t 49 . 00" LOT NO. - SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20:00" USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: reroof existing roof w/composition Shingles Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service ioon o LE S 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, ( g ) and my license is in full force and effect.POWER License Class C-39 Lic. No. 4.89246 OWNER -BUILDER DECLARATION I 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 Main Service ( 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BUDS. SO 3.5¢F{, NEW CONST. MULTI.OUTCULET NON•RESID. ANC CI @7.50 APPARATUS SSINGLE OUTLET CIR. EX. Occup. OUTLET OR FDRURES BAL 0 ED AP Ex. Occup. OUTLETSPRESIoOEEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 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. IN I 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 Villanova MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt S Policy Number WC3-0983675 (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 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 10/29/99 Sign re of Ap nt - ❑ Owner ❑ Contractor X] Agent An 06HA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TOTALFEE$ 49, 00 A D. FEES IMP FLo00 CDF PARCEL pp HD ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By ate PERMIT EXPIRES ON Da provisions to do work paid. e Receipt No. i WHITE-D.D.S.-B.D. CANARY-ASSESSORI PI K -I PECTOR GOLDENROD -APPLICANT on RESIDENTIAL PERMIT Nf 062-19-0-019 98-1932 B ~ MORONY, Jean 300 Lakeside Way, Berry Creek (repair decks)SF- - 2G-9001. PERMIT EXPIRES ,OWNER :I. CONTR. ASSESSOR PARCEL LOCATION I CHECKED SRA BY FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY ' Temp. Power Pole Called PG&E Temp. Elec. Service -P Called PGP' Temp. Gas Ser Called PG! JOB FINALED Signature V=OK - 0 = Not OK INoottReadY - MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements - Setbacks - Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/0 -Concrete 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap; / MIL / /Nat. or/ /"L"ft./ /LPG 7. Well Clearance & Disconnect 8. Utility Clearance 9. Siding; Nailing VeneerStuoco-Mesh 10. Roof; Shthg-Roofing Date Card B-1 Date Cana B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Date Date Date 1. Zoning Requirements- Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test-DemandVaMe-Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/0 to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert of Occupancy 12. Permanent Foundation Only: License Decal Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size ep"paci on s -S 3. Decks; Gi and/or J 's in ss 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns-ConnectionsSplice Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frrng.; Sils-AnchorsStuds-Rttrs-Trusses 9. Siding; Nailing VeneerStuoco-Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Date Date Card B-1 &2Date Card B-1 Card B-1 Date Card B-1 OLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5 -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/3 Circulating Equip. -Pod Lghtg. Boxes-Enclosures-Partdboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. TestWater Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ✓ = OK O = Not OK - = Not Applicable = Not Ready Date UNDERFLOOR (Plans) OK except #a 1. ZoningSetbacks-Easments-FloodSlope 2. Ftg., Main; Soils-Elec. Gmd.-/ /' Ftg. Depth 3. Ftg. Garage; Soils-Steel-Elec. Gmd/ p Ftg. Depth 4. Ftg. Porches & Decks; SoilsSteel-/ /' Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UP Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Cana B-1 Date Card B-1 Date PLUMBING (Permit) OK except #s 17. Water Htr; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 23. Fixture & Transformer Clearance -Ins. Protection 24. Elec. Receptacles Spacing -Lights & Switches at Doors 25. Size B es & No. of Conductors Stapled 26. Romex I stalled Close to Edge of Studs & C.J. 27. Equip. Ground made up w/Mech Fastners-Bond Gas & Water 28. 2 Appliance Circuts in Kitchen & Conductor Size GFI 29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or AI 30. Range Circ. / / ga Cu or AI -Oven Circ. / / ga Cu or AI Insulated Neutral 0 Yes 0 No 31. Service -Riser Conductors & Ground -Main Disconect 32. Equip. Clearances Panels-Motors-Mech. Epuip. 33. Clothes Closet Light -Shower Light -Spa Light 34. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #s 35. A.C. Ducts Insulation & Support 36. Vent Fan, Exhaust above insulation 37. Condensate Drain & Overflow, Size & Grade 38. Fumance-Vent Access -Comb. Air-Retum Air Vent 115 outlet 39. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #s 40. Sits Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 45. Headers & Beams -Size & Bearing RESIDENTIAL (Single & Duplex) Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties-Purlin-roff Brac.-Truss-Shting.-Ring. 48. Fireplace Ties or Type A Flue -Fireplace Throat clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3 -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior / Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows 90. Corrections from Previous Inspections 91. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ext Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace; Vents -Clearance -Comb, Air-Conector- In Garage; Above Floor-Ducts-Mech. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixt. & Appliance; Ground. -Air Gap -Cooking Clearance 73. Elec. Outlets & Recepticales at Kit. Counter 74. Garage Fire Door; Swing -landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. In Garage; Above Floor-Mech. Protection 77. Plb., Elec. & Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (G.FI.)-Romex Protection 79. Insulation -Foam -Looked in Attic 80. Guard rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 82. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No 83. Stucco Brown -Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throught House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BOe, I t ' � f j4 • r -j a� `] - i `F Date Inspector —V REV 101;/2 -t" COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 - I 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE 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. BOe, I t ' � f j4 • r -j a� `] - i `F Date Inspector —V REV 101;/2 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541��r p (Rev. 12/96) -- c4 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 062-19-0-019 ZONING BUILDING PERMIT OWNER TELEPHONE 589-0116 SO. FT. OCC. BUILDING VALUATION 924 6468 . OWNER'S MAILING ADDRESS 918 42-5352 'S NAM CONTRACTORE TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation Is ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 90 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 300 LAKESIDE WAY, BERRY CREEK Energy Plan Checking Fee $ $ PERMIT FEE $ 110.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑X Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other EX Describe Work: REPAIR DECKS Gas piping stem t - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W1 @20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 600VMain Service 2o.A 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 Lic. No. 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 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 (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 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/ 7Q ��T y Signa of Applicant __X Owner Contractor 13 Agent s 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 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( 8 ACC. S.3.5¢FT, NON-REOSI. MULTI -OUTLET 97,50 POWER APPARATUS a SINGLE ourLFr cIR. .00 EX. Occup. OUTLET OR FIXTURES BAL @ I. 0 Ex. Occup. O TEETS (RR. D,D� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE i MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt S Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ lint. D FEES IMP FLOOD CDF PARCEL PD HD ISSUE 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. By Date 2 PERMIT EXPIRE ON Date ReceiptNo.2e WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT __ __=_.r..=., �� ,� � �- , (Rev.12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 '+ APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER &2_—/,T0 --0/ ZONING BUILDING PERMIT OWNER,C TELEPHONE 6 SO. FT. OCC. BUILDING VALUATION . owNERS,r o DRESS CONTRACTOR'S NAME '' 11 TELEPHONE CONTRACTORS MAIUNG ADDRESS CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ �• av ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ SUILDINGADDRESS _ a ( Energy Plan Checking Fee $ C- $ PERMIT FEE $ LOT NO. SUBDIVISIONS NE PARCEL MAP ' PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF 9,Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other `9-k Describe Work: �/oc�., , !r- �� Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing' Fee 20.00 Main Service R LLEss 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 Lic. No. 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 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 (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' 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 Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0' deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. DWEUING OCCUP. SG OR A ( a ACC. BLOs. 3.5¢FT: CONS ,pp}p°�,p ' MULT60UTLEr @7,50 PS0r APPARATUS a swGLE oun tT as 00 TL Ex. OCCu OUET OR FIXTURES ekL 20 @':50 Ex. Occup. pMOAPOR =J EA5.00 Temporary Service 21.00 Mobile Home Facilities 20.00 Misc. Wirino 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FES $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ //a, o0 p FEs IMP FLOOD CDF PARCEL pp HD ISSUE This permit is hereby Issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date le Receipt No.��5 WHITE-D.D.S.-B. D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your si Please complete and return this information at your earliest opportunity to avoid unneeessat3r deer in processing and issuing your building permit. No building permit will be issued vidi ds verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property ' provement : YE$%�� NO 13 2• I HA HAVE NOT 13 signed an application fora building permit for the proposed mm& 3. I have contracted with the following person (firm) to •provide the proposed eonskiwdons •� ; ;�:4 _ ADDRESS: CITY' :-• 7 7 PHONE: CONTRACTOR'S LICENSE NO. 'YI 4. I plan to provide portions of this work, but I have hired the -folio person.* ung Pio supervise, and provide the major work: NAME: ADDRESS: CITY: -. 1;=? ay PHONE: CONTRACTOR'S 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 WOjtIC' SIGNED: PROPERTYOWNER:' S 0 CIAL SECURITY NUMBER:\ v DATE: NOTE: ^ -This Owner Builder Verification is required by Section 198.3 andlp83— California Health and Safety Code. This verification must be -completed i�d returned to our office before we are permitted to issue the permit OVER OWNER BUILDER INFORMATION I Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property, improvements specified For your protection. you should be aware that as "owner -builder" you are the responsible parry 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:771 a a ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is S300 or more for the entire project, and such persons are not licensed as eontraators`or subcontractors, then you may be an employer. ♦ if you are an employer, you must register with the State and Federal Governments 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 coatn'butiatis:'.;� ♦ There maybe financial risks for you if you do not c out these obligations; and these risks are ecwi i4i y y y airy ga esp . ly'ser ors with respect to worker's compensation insurance..A. ♦ For more specific information about your obligations under Federal Law, contract 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 their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors 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 contrac!prs may be obtained by contracting the Contractors State License Board in your . community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned u rely, Mic el C. Vi iia, C.B.O. M ger, Building Inspection NOTE: This Owner-Builder,Informadon is required by Section 19830 of the California Xealdr and Safety We. OVER