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HomeMy WebLinkAbout064-630-026A4 A G 064-630-026 FULLER,. ":William R. 1216-708# �--530-70B • B07 1454 0 • MISCELLANEOUS Remodel ° 62-70P,r+ f 4. 'REMODEL KITCHEN 2,50�SQ.FT. NON ,! 83870E:`(S 526-70E 5983 PILGRIM LN. t wls Humbug Rd. 1000, no. of NimsheW- umbug Rd. SWEENEY CRAIG C & CY; Intersection (new siingle family) -0.. (*add covered porch &deck) � N 1 II i y 1 i 1 a d' I i ----v P--7 I 1,111 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: 5983 PILGRIM LN Owner: Permit NO: B07-1454 APN: 064-630-026 SWEENEY CRAIG C & CY, Permit type: MISCELLANEOUS 5983 PILGRIM LN Issued Date: 07/05/2007 By TMP Subtype: Remodel MAGALIA, CA 95954 Expiration Date: 07/04/2008 Description: REMODEL KITCHEN 250 SQ.FT. N (530) 521-2253 Occupancy: Zoning: ARMA Contractor Applicant: Square Footage: DREAM MAKER BATH AND KITCHEN DREAM MAKER BATH AND : Building Garage Remdl/Addn 3247 EAST STREET SUITE A 3247 EAST STREET SUITE A 250 ANDERSON, CA 96007 ANDERSON, CA 96007 (530) 365-1710 (530) 365-1710 Other Porch/Patio Total FEE INFORMATION DBMSC Remodel -Residential $379.93 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires DREAM MAKER BATH AND KIl 880015 / B / 06/30/2008 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 for nd a act. X 07/05/2007 Contracto ture Date WORKERS' COMPENSATION DECLARATION 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. 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: State Fund Policy Number: 436,0000939 Exp. Date.09/01/2007 (This section nee not be completed if the permit is or one hundre 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 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 X 07/05/2007 Signature// Date , WARNING: IL E TO SECURE ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL 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 I VU11 k,uargcu. a3 /%!13 rees Fald: $379 Balance Due: $0.00 Receipt No: RV 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: ❑ 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 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. If, 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. & P.C. for this reason: 07/05/2007 Owner's Signature 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 Slate 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 any way 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 oun to enter Bove mentioned property for inspection purposes. I hereby certify that I am the p pe con or authorized to act on lh propert owner's behalf. rLi �t.7r- 07/05/2007 v / EOwner Contractor OR. Agent for Owner Agent for FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name First Name Mailing Address I --Zip City MO Q I L a— ateCA I S P.bo _ 3 Fax E-mail 0 p- CONTRACTOR Name Ei2_ 6A Address 3217 City , Q State ?�A Zi 7 Phone 530- S _(� I Fax ,3 b 5 _ 15 E-mail Ooh , C om Lic. # c3bI Class P APPLICANT INFORMATION ARCHITECT/ENGINEER Name ^ AddrnZC4Sti.. Address Stag City PkX0 State Zip Phone Fax E -mai State License Number APPLICANT INFORMATION Name) Occ. ^ AddrnZC4Sti.. City S Stag /_1 Zipne PkX0 E mails �*114 NIAyr` - - APPLI NT SIGNATURE Ff ULx PERMIT NO. BIN # PROJECT LOCATION AP# 0 Property Address5n I I LA AD F_ cityMa 177 a r U WORKER'S COMPENSATION Policy Number Carrier if hiring anyone other than lice se 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. 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 No Occ. Type Const. License Detail Page 1 of 2 California Home Welcoma�to(La-ITio:rFi a -7- r. 4 -- License Detail Contractor License # 880015 July 05, 2007 CALIFORNIA CONTRACTORS STATE LICENSE BOARD DISCLAIMER A license status check provides information taken from the CSLB license data base. Before relying on this information, you should be aware of the following limitations: . CSLB complaint disclosure is restricted by law (B&P 7124.6). If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. . Per B&P 7071.17, only construction related civil judgments reported to the CSLB are disclosed. .. Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. . . . Due to workload, there may be relevant information that has not yet been entered onto the Board's license data base. Extract Date: 07/05/2007 * * * Business Information * * * J T F PROPERTIES INC dba'DREAMMAKER BATH AND KITCHEN 3247 EAST STREET SUITE A ANDERSON, CA 96007 Business Phone Number: (530) 365-1710 Entity: Corporation Issue Date: 06/26/2006 Expire Date: 06/30/2008 • * * * License Status * * * This license is current and active. All information below should be reviewed. * * * Classifications * * * ClassI Description © GENERAL BUILDING CONTRACTOR * * * Bonding Information * * * CONTRACTOR'S BOND: This license filed Contractor's Bond number 6348396 in the amount of $12,500 with the bonding company SURETY COMPANY OF THE PACIFIC. Effective Date: 01/01/2007 Contractor's Bonding History http://vvww2.cslb.ca.gov/CSLB—LIBRARY/License+Detail.asp 07/05/2007 ' License Detail Page 2 of 2 BOND OF QUALIFYING INDIVIDUAL(1): The Responsible Managing Officer (RMO) JEFFREY DALE BRYANT certified that he/she owns 10 percent or more of the voting stock/equity of the corporation. A bond of qualifying individual is not required. Effective Date: 02/02/2007 * * * Workers Compensation Information This license has workers compensation insurance with the STATE COMPENSATION INSURANCE FUND Policy Number: 436-0000939 Effective Date: 09/25/2006 Expire Date: 09/01/2007 Workers Compensation HistM Personnel listed on this license (current or disassociated) are listed on other licenses. Personnel List SalesPerson List Other Licenses License Number Request Contractor Name Request Personnel Name Request ' Salesperson Request Salesperson Name Request © 2006 State of California. Conditions of Use Privacy Policy r http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 07/05/2007