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HomeMy WebLinkAbout065-180-004065-18-0-004 00-1 9 ORTIZ, BARBRA J 6644 ROS OD, MAGALI�P/ CONT CRAWFORD ROOFING R OOF ,�l dl 1 7,•pC,t�`�'t'rv{''.:_f, ,fie Y;.s�F'x � rs;:;�� <G'"Y�:.`"''�a„t,�;?,yv'1t�-b'-fir_�;'vqr-'�S`.,c.�Stn`!ais':•r.��y«t� 065-18-0-004 00-!1739 ORTIZ, SARBRA .'6644 ROSEWOOD, *AGALIA•', CONTR: CRAWFORD .ROOFING` , ` -P.E.ROOF. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541^�� ����. (Rev. 12/96) APPLICATION AND PERMIT // ,/ ASSESSOR PARCEL NUMBER 6 - I 4,Z - Lha, ) ZONING BUILDING PERMIT OWNER •'•� ��' 1 (It ,# rk t... t . 2 TELEPHONE % L) SQ. FT. OCC. BUI I VALUATION OWNERS I NG ADDRESS 9 'ZI 11 Q �<� �'1 7� I. L r CONTRACTOR'S NAME �1 ) � /'� - I L . ^. �'Y`+ 1 _ / HONE I CONTRACTOR'S MAILING ADDRESS v/ r /Ip c,4 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $MAYO 4t."O ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ -04_7k!r ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS l r, f / a Energy Plan Checking Fee $ PERMIT FEE $ LOT NO. SUBDNISIOWS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF b, Duplex ❑ Mobilehome ❑ Other SPECIFY Eac Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each Aas water heater or vent 15.00 TYPE OF WORK 1' New ❑ Addition ❑ Remodel h Utilities ❑ Installation ❑ Oth Describe Work: K r V10` Gas pl7ping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service zoOA 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. p License Class C 14 9 Lic. No. '74/ J `� 7 OWNER -BUILDER DECLARATION 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 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. `fP 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 I/ r%4) ,l L ,+ ) Main Service PGOA TO lOooA 46.00so NEW CONST. DWELLING OCCUP. 3.5QF°. NR A DON ( ACC. uBLCDC M NO REsID. 97.50 POWER APPARATUS &.M. SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 @''00 BAL @ .30 Ex. Occup. OUB RESID) EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE t MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number LA 2 ( r l Q �) =� -I (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. j�— ) _t X �.t .. _ •),1_ e 7 Date �' 1? `1' +7(% Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excava r s over 5'0" eep and demolition or construction of structures over 3 stories in h ' h Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST TYPE TOTAL FEE $ fIMP I FLOOD CDF PARCEL I PD HD ISSUE This per it is hereby issued under of the tte County Code and/or rindicat ab a for I s he By PERMIT EXPIRES ON ! the applicable Resolutions been provisions to do work paid. ife Receipt No. WHITE-D.D.S.-B.D. CANA Y -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PE IT N (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMB 5- -cam -oev 6T. BUILDING PERMIT OWNER ` [\r �� Z NE S`Q FT OCC. BUI I VALUATION OWNER5 I I�OpRE$S �/`"/) ' )i� a wu- i CONTRACTOR'S NAM^//E ( �orA ©d ; � o TELEPHONE -013 9 CONTRACTORMAILING AD Z SS 4 l CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE No. Filing Fee $ 20.00 Permit Fee $ 7 ARCHITECT OR ENGINEERS HARING ADDRESS Plan Checking Fee $ t� -Pq ` to BUILDING ADDRESS 44 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF k, Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 1 7.00 Solar or heat pump water heaterM23 Water piping Each as water heater or vent TYPE OF WORK j/ New ❑ Addition ❑ Remodel Utilities ❑ Installation ❑ Other )dl Describe Work: 9 'Q Gas piping system 1 - 5 outlets Buildin sewer Mobile Home S G WPERMIT FEEELECTRICAL PERMIT 20.00 OR LESS Main Service 20.A OR LESS 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 f0 Ce and effect. / License Class �l Lic. No. 'r `( 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. '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' mp nsation insurance�,S�arr.er an policy number are: Carrier 0 S , Co . Policy Number 0- (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 co ply with those provisio s. X, Date �' 0� �� _ Signature a Applicant - ❑ Ow*r Contractor ❑ and An OSHA permit is required for excava ' s over 5'0" eep and demolition or construction of structures over 3 stories in h ' ht{ Main Service 46.00 WEE200A NG CCU000A NEW CONST. DWELLING OCCUP. 3.SQF°: AD NS. ( ACC. NOR EW CONST. MUAC NON -REBID. CU 97.50 POWER APPARATUS 6 SINGLE OUTLET CIR. 20 @ 1.00 Ex. Occup. OUTLET OR FIXTURES 6AL @ .50 Ex. Occup. Gurl��°TSA REES16DEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE S MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE on TOTAL FEE $ D 17 - HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE s pit is hereby issued under thette County Code and/or linfdicatyab o a forI e s ha By PERMIT EXPIRES ON / the applicable provisions Resolutions to do work been paid. Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 70 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO. Rev. 12/96) APPLICATION AND PERMIT OD -/73 A-SESSO IPA ACEINu 5_ eo ZONING BUILDINGPERMIT OWNER ' T OCC. BUILDING VALUAT ON 971 i OWNERS0 S ' 0 TELEPHONE CONTRACTORS rADDRES9 CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuatlon $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MARINO ADDRESS Per Fee $ Plan CheckingFee $ BUILOINOADogEs I a Energy Plan Checking Fee $ $ PERMIT FEE $ —� LOT NO. _ SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex 0 Mobilehome 0 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 0 Addition 0 Re el 0 Utilities 0 Installation 0 Describe Work: PC12:4Z Other 0 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE t ELECTRICAL PERMIT Fling Fee 20.00 OVOR LESS Main Service zo A OR LESS 23.00 A ✓/�/ � ^�% J I / n ReceiptNlj 2 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUR 3 Soso. OR ADDNS. a ACC. BLOS. FT. NEW CONST. IAULTI.OUn.ET NON RFSID. @7.50 POWER APPAAATVS 8 SINGLE OURET CIR, OUTLET OR Fixrums 20 O 1.00 EX. OCCU SAL @ ,yo FIXED APNSEx. Occup. ounETs tPRES.o1EA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HAZ D. PEE- IMP F1A00 DF] PARCEL I Pp HD 65UE 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 PERMIT EXPIRES ON nta WHITE-D.D.S.•B.O. CANARY -ASSESSOR NK -INSPECT GOLDENROD -APPLICANT Jul 24 00 02:28p MICHREL J. PETKUS ACO r ODttCER .- MICHAEL J. PETKUS INSURANCE riw 6863 DOUGLAS BLVD. SUITE 131 GRANITE BAY, CA 85746 FH:1.888.644.4600 FAX•916452-2231 1-916-652-2231 p.l I I 04ro4lz000 ONLY AND CONFERS NO RIGHT$ UPON THE CERTIFICATE LDER, THIS ALTFR THE COVERAGE ICA� RDW fly THE POAMENLK;IES MOW. COAW A VILLANOVA INSURANCE COMPANY INSURED 4 1 COMPANY -- CRAWFORD ROOFING COMPANY 0 1078 BILLE ROAD t\ , PARADISE, CA 95969 , C Y Y — - _. _• i00 D Ii INWII iLISTEo BELOW HAVE BEEN ISSUEDTOTHEINSU EONAMEp OR THEPOLICY00,01ICATED,NOTYYITHS7ANINOAMY REQUIREMENT• TERAq OR CtNID1710N ip-x RTIFICATE MAY BE mq')ED OR MAY PERTAIN. THC INSURANCE AFFORDED OF ANY CONTRACTOOTHER bOCUMEN7 WRH RFCaECTToUVF11dt ntiS d Y IME POLICIES DESCRIBED HEREIN IS SUBTOALL THE TERMS, CLUSIONS AND CONDITWg OF SUCH POUCIIII UMRS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS, co LTR TYPE VitpouCY NUmm I POLICY EFFECTIVE I POLICY EXPIRATIDN f t GEN GATE tN WODWTYI DAW (UMM rvl I LIMITS CMIAIHtC1Al GENEw►L LIggRIiY FERAL AGOREGATE i CLAIMS MADE�1 OCCUR j _ _- • _ • • OOMiPIOPAGG S -- OWNER'S H CONTRACTORS PROT j CONAL 6 ADV INJURY- -_ EACH OCCURPXAM — FIRE DAMAGE (ftoirertro) S I !I E UABJ II 4i EM (Any one pms_) E -- ANYAUTO ' COM$INED SPI LIMIT I g ALL OMEDAVTM 1 SCHEDULED AUTOS I I 14Y t uRY— I S ►iMAIJTOS-- NON•OWNED AUTOS I IS I PROPERTY DAMAGE s De ANY AJTO I I AU IO ONLY • EA AN7CmENi — _ - I 07MM THIW AUTO OB.Y:— - __ EACH ACCMT i } EX AGGREGATE UMBRELLA FORM D" O=RREMM OTMER THAN UMgRg(/►FOM _ -- AGGREGATEi _ -- ... waAlseaa ooMvENsd "m ARD W04-0075433 A QfPLDYERS'LU161LITY s 04ro1roo 04/0 x ToltYlL11TS �x Twpkomlum in7Cl I 4EACHACCIDENT S—�OQO.00� � ar AR& E%CL EL DISEASE _ potlCy LIMIT S T,Ot��i00 OTHER I EL DISEASE - EA EMPLOYEE S CONTRACTORS LICENSE NUMBER 43491 ALL CALIFORNIA OPERATIONS SHOULD ANY OF THE ABOVE DEWMED POLICIES K CAN== WFOM THW ENWNRATtCN DATE TMEREOF. THE 4=N0 COMPANY WILL Elg&QW* LIME 30 DAYS VNiBTTEM NONCE TO THE CERnFICAIV MOLDER NAMW TO TIE: LEFT. EVIDENCE OF INSURANCE Ott