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HomeMy WebLinkAbout065-530-020AP NOEL COLLINS n/s Coutelenc Rd., app. .9 mi. n. of _ ' Doon" Grade;' * Pdradi:se , Contractor: ' Rodney. Kopsa� p Permit 3435=7� B,P,E,M �, r (hew single family) "�''�/_ —�y� ?3 N 065-530-020 04-0913 ' ' COLLINS,.JACQUELYN r r 15251 CRYSTAL MOUNTA iLEp , MAGALIA S" 2 CONT: N/A RE -ROOF r 1 i t r � 1 r. i l I , ' i 1 1 i s Pf. , t r t r• t r , M kf065 -'020 A '449 OIWL.C, JACQUEI 1'N;v :? ; 15251-CRYSTAL MOUNTAIN i CONT:`N/A G l i ` 1 y , • 1 � 3 1 � . T l F',4 l�"D , ou 11 C 1 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.buttecounly.nelldds rLdNlru r Ica. BP040913 LICENSED CONTRACTORS DECLARATION " 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 04/02/2004 APN: 065-530-020-000 the Business and Professions Code, and my license is In full force and effect License Class: License Number. Site Address: 15251 CRYSTAL MOUNTAIN RD MAG Date: Contractor. Map Index: Description: RE SQ.) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the -ROOF (20 Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior Owner: COLLINS JACQUELYN D to its Issuance, also requires the applicant for such permit to rile a 15251 CRYSTAL MOUNTAIN RD signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section MAGALIA, CA 7000) or Division 3 of the Business and Professions Code) or that he or 95954 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 penally of not more than five hundred dollars (8500).): 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 D Code: The Contractors' State License Law does not apply to an Applicant: COLLINS JACQUELYN pp owner of property who builds or improves thereon, and who does such 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 improvements are sold within one year of completion, the owner -builder will have the burden of proving 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 Professions Code. The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon. Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' Slate License Law,). ❑ I am Exempt under Article 3 of the Bn ss and Professions Code DatoA�-02/ Owner. License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penally of perjury one of the following declarations: O 1 have and will maintain a certificate of consent to self4nsure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ❑ I have and will maintain workers' compensation insurance. as Engineer: required by Section 3700 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. Total Square Ft: 0 S. F. Policy 0: Valuation: $0.00 1 certify that in the performance of the work for which this permit is Census Code: issued. I shall not employ any person in any manner so as to became subject to the workers' compensation laws of California, and agree that it I should became subject to the workers' compensation provisions of Section 3700 of the Labor Code. 1Shall forthwith comply with those provisions. kto Date: :2-01� Applicant: WARNING: Fifhre to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($700,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest. and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a consWclion lending agency for the Th' enni s h eb is e e Iicable provisions of the Butte Count ode aftd/or Re uti s to o i i ees a een paid. '7 / /v/�Kff�� performance of the work for which this permit is issued (Sec 3097 Civ.) Name: (/ BY Date PERMIT EXPIRES ON: Address: (Date)/ O 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, handling and use of hazardous materials. O Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. O Attached are copies of the required E.P.A. notification fortes. I hereby certify that t have read this application, that the above information is correct, and that I am the o ner or the duly authorized agent of the owner. I agree to comply with all county and slate laws relating to building construction. 1 acknowledge itis unlawful to eller the substa a of any official form or docome F01"Bytle County. I hereby authorize repres Wives of Butte County to enter upon the above mentioned property for ins action pu oses. VA Print Na ` t.a_4J /V mi=l.) CU�u N� . Signature. - Date: Winer 0 Contractor 0 Agent for Owner 0 Agent for Contractor my,. 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 PERMIT NO. BP040913 LICENSED CONTRACTORS 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 Issued Date: 04/02/2004 APN: 065-530-020-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 15251 CRYSTAL MOUNTAIN RD MAG Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: RE -ROOF (20 SQ.) Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: COLLINS JACQUELYN D 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 15251 CRYSTAL MOUNTAIN RD the Contractor's State License Law (Chapter 9 commencing with Section MAGALIA, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95954 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).): 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 Contractors' State License Law does not apply to an Applicant: COLLINS JACQUELYN D owner of property who builds or improves thereon, and who does such 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 improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Busin' ss and Professions Code Date: -0q Owner: License #: 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 Architect: is issued. ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 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: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 I certify that in the performance of the work for which this permit is Census Code: 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. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the — Thermi s h eb is i e e Iicable provisions of the Butte County Bode a d/or Re uti . s to pi c w i h ees a een paid. A / h performance of the work for which this permit is issued (Sec 3097 Civ.) !�/f/7 /V!�-'f Name: BY Date : t 41 Address: PERMIT EXPIRES ON:!/ Da e ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the o ner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substa a of any official form or docume Ile County. I hereby authorize repres tatives of Butte County to enter upon the mentioned property for ins ection pu oses. /above Print Na l L 2. i`( `SJW nlS Signature. Date: - b wner ❑ Contractor 13 Agent for Owner ❑ Agent for Contractor .zl BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP l �3 1 DATE: - � o APN: /�--` �O� O ZONING: OWNER'S LAST NAME: 0—d/.& N✓ER'S FIRST NAME: PHONE Y� 1 `% `0 STREETD A ��� l r� f�C 1�r �•y � . FAX: CITY, z �r C� �J E-MAIL: SITE AD SSSS cmr, ZIP: � C � �I• �� c7� y5 �� NEAREST CROSS STREET: I TRACT/LOT #: APPLICANT NAME: PHONE: STREET ADDRESS: FAX: CITY, ZIP: E-MAIL' CONTRACTOR NAME: PHONE: STREET ADDRESS: FAX: CITY, ZIP: E-MAIL: LICENSE NUMBER: ,LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: LICENSE NUMBER: E-MAIL: DESCRIPTION OR SCOPE OF WORK: L � ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: Notes: i Application Received by Date: Receipt number: �° //��/„ Amount Received: //� O.B.-1 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit willbe issued until this verification is received. I personally plan to provide the Ior labor and materials for construction of the proposed property Volement :YES NO ❑I HAVE_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: NAME: ADDRESS: may: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but. I have hired the following person to coordinate, supervise, and provide the major work NAME: ADDRESS: PHONE: CONTRACTOR'S 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 NOPE. This Owner -Builder Verifkation is required by Section 19831 and 19532 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. � i + I OWNER BUILDER INFORMATION 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 party ofrecord on such a permit. Building perm 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 youplan 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: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs). is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 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 contributions. ♦ There may be financial risks for you ifyou do not cant' out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ 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 contractors 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 guilder 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. rely, Ivfic 1 C. Vi ira, C.B.O. er, Building Inspection NOTE: nis Owner-Buflderinforrnadon is required by Sectwn 19830 of the California Heath and Safety Code OVER PERMIT NUMBER B 3435-73B,P,E,M P IlF E PERMIT EXPIRES q -,D OWNER -Noel Collins CONTR:,--_ Rodney Kopsa, Paradise 'LOCATION (A.P. 58-09-81 N/S.Coutolenc Rd., .9 mi. N. of Doom rr Grade Rd., Paradise DATE REMARKS OR CORRECTIONS <v� - 4L _ COUNTY OF BUTTE Department of Public Works BUILDING INSPEC ION' RECORD Zoning Setback__-;� Farms �" '9- Foundation Piers& Girders .�1 —�� r� ireploce�_ 1 R h. Plumbin g g Bond Beam Lath &Plaster Rein. Steel Gas Piping & Test Found. ,Vents Framing f -9 - �� Plmg. Topout - Rough Elec. - 7. Wtr. Htr. `L- Z Furnace - .- ' Kitchen Vent Firewall '2• Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. Final Final Final i DATE REMARKS OR CORRECTIONS <v� - 4L _ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive Orovblle, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT autho ize re resentatives of the ounty of Butte to enter upon the abov ment' ne property for ins ction purposes. Date Signature of Pe mitee or A Ant Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRECTOR OF PUBLIC WORKS BY Date Building permit expires Date? BUILDING Owner L SQ. FT. OCC. BUILDING VALUATION Mailing Address 2 Telephone No. Fireplace Contractor ne v A—. Total Valuation 3 V Mailing Address �- Permit Fee Plan Checking Fee &/or Penalty Tephone N Permit Fee $ Q, $ Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE J$2.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 —Q Each gas water heater or vent / 1.50 A. P. No. "" © Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F desl ara io Fire Dept. Fire Zone I Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements Lawn sprinkler system 2.00 Plan R c'd Parcel aaf—• /Imp �'��jans ApP o aj Permit Fee $ �)� $ SZ° 01 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No.1 @ FEEPERMIT FILING FEE $3.00 `v Main service incl. 1 meter 3 _ Additional meters, each 1.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Sub -panel (12 or less) (moreVian 12) �' V Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixturesbal 1620 ces., s tries & fix�bu3tets (� CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name S . t4pl st4pl I \ 0 D "Ey 150 P 5 A Ho Ex. F or F.A. Fu . Motor 1.00 3_ Evap. cooler, gar. dAp. or D.W. / 1.00 - Air con iti or heat pump 7- Water pump Mobil Home Facilities 5.00 iVfi"L dOPu76407 a 2 Temp. Power Pole 5.00 s� License No. �/3� �%� Classification Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ a O� WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of �! Workmen's Compensation Insurance. lecertify 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 Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating j Cooling Ventilation Hood 2.00 O, Permit Fee $ 71-00 OG $ 13 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and S e aws relating to building construction, and hereby TOTAL PERMIT FEE autho ize re resentatives of the ounty of Butte to enter upon the abov ment' ne property for ins ction purposes. Date Signature of Pe mitee or A Ant Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRECTOR OF PUBLIC WORKS BY Date Building permit expires Date? 1)1:,SC-4HTI TI014: 7111 that certain real property situate-in the County of Butte, . State of California, described as follows:'` Being a por.tion of the North half of the Soiuthe'ast quarter of Section 7, Town- ship 23 North, Range.4'East,M.D.B. & M.,•and more particularly described as follows: i COMMENCING at the Northwest corner of the Southeast quarter of said Section 7; thence along the Vast and West centerline thereof North 88° 01' 25" East, 706.73 feet; thence leaving said line, South 01, 08' 30" East, 320.62 .f_ec't to- the othe true-.. T?oi.nt o,f he inning for the cancel herein doscri.1>e.d; thence .f;r.opl true point of beginning, continuing South 0° 03' 30" 11;:ast, 423.24 feet -to the North line of Coutolenc Road; thence along a•curve to the right, whose tangent at this point bears North 890.-02' 52" East, through a central angle of 15° 04' 18", an arc length of 252.00 feet; thence leaving said North line, North .01 03' 30" West, 460.66 feet; thence South 88° 01' 2.5"West, 249.6^o feet to the true point of beginning. `1'OGr'.l'►Il:,i: WITH a non--exclusive easement for road purposes and Public utility pur- pose's over a strip of land 30.00 feet in width lying T:asterly from and contigu-- ous to the ]asterly line of the-above described 'parcel.