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HomeMy WebLinkAbout066-420-016-66--42- Arnold Staat S/S Incian Dr.,app.750'W.of Skyway, lot #13, I.M.#J, Magalia Permit #6394-76B,P,E,M(new single family) r%101Q 1307-2422 066-420-016 MISCELLANEOUS . HVAC Change Out CHANGE OUT HVAC 6760 INDIAN DR KING, KAREN 19 E 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 INFORMATIQN. Site Address: 6760 INDIAN DR Owner: Perinit NO: B07-2422 APN: 066-420-016 KING, KAREN Issued Date: 11/29/2007 By KEJ Permit type: MISCELLANEOUS 6760 INDIAN DR Subtype: HVAC Change Out MAGALIA, CA 95954 Expiration Date: 11/28/2008 Description: CHANGE OUT HVAC (530) 877-2568 Occupancy: Zoning: RT -1 Contractor Applicant: Square Footage: GALLAGHER'S HEATING & AIR ALL ABOUT PERMITS Building Garage Remdl/Addn PO BOX 35 3083 WHISTLER LOS MOLINOS, CA 96055 CHICO, CA 95973 (530)384-2444 (530)680-7619 Other Porch/Patio Total FEE INFORMATION DBM Heat Pump (Package Unit) $58.00 Total Charged: $58.00 Fees Paid: $58.00 Balance Due: $0.00 Receipt No: B5449 LICENSED CONTRACTOR'S DECLARATION OWNER /;BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License GALLAGHER'S HEATING & AIF 777334 / C20 C38 / 04/30/2008 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 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 pursuant to the provisions of the Contractors 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 mj�� basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects 11/29/2007the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: C actor's S�a re Date -11, 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 WORKERS' COMPENSATION DECLARATION - I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: Law does not apply to an owner of the property, who builds or improves thereon, and who does HAVE AND WILL the work himself or herself or through his or her own employees, provided that such improvements ❑I MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). �� l /I i HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by LJ Section 3700 ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: 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; 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 Carrier. State Fund Policy Number: 713-0013855 Exp. Date:05/01/2008 Contractors License Law.). (This section need not be completed if the permit is or one hundred dollars ($100) or less. ❑ I AM EXEMPT under Section B. & P.C. for this reason: ❑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'X 11/29/2007 compensation provi ions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date visions. X 11/29/2007 I hereby certify that I have read this application and slate that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building S attire Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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 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, injury, including death, and property damage caused arising out of, or in any way connected with DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge thatt is issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to ant he above mentioned property for inspection purp , as. I hereby certify that I am the o erty r m aut ri d to act o the property ers ehalf. CONSTRUCTION LENDING AGENCY _ 1/29/2007 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for ame oPermittee (SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) 11 Owner El Contractor OR; Agent for Owner Agent for Contractor FILE COPY Lender's Address City State Zip BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION-1, OFFICE #: (530) 538-7541 FAX #: (530) 538-21406OBJ A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds BIN # "PLEASE PRINT CLEARLY* ►?,- h,:_, PROJECT LOCATION AP# OQ p , d Property Address 0,0 1 City _Maon ho WORKER'S COMPENSATION Policy Number 113 0013 Carrier SW e , d 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 DESCRIPTION OR SCOPE OF WORK: 1.=q V0 or i3or Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: OWNER INFORMATION Last Name -� C t are £ a r C' Mailing Address lf�� t CityState a,l t" �. c n zip,51 ,51 - S Phone ^ of Fax E-mail E-mail ►?,- h,:_, PROJECT LOCATION AP# OQ p , d Property Address 0,0 1 City _Maon ho WORKER'S COMPENSATION Policy Number 113 0013 Carrier SW e , d 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 DESCRIPTION OR SCOPE OF WORK: 1.=q V0 or i3or Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: CONTRACTOR Nam�1 C Address , o O Address City W �— State - ,:� Zip Phone Zip Fax E-mail Lic. #-7 J 234 E-mail Class C ►?,- h,:_, PROJECT LOCATION AP# OQ p , d Property Address 0,0 1 City _Maon ho WORKER'S COMPENSATION Policy Number 113 0013 Carrier SW e , d 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 DESCRIPTION OR SCOPE OF WORK: 1.=q V0 or i3or Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: ARCHITECT/ENGINEER Name Flood Zone Address Address City City State Zip Phone Zip Fax E-mail State License Number ►?,- h,:_, PROJECT LOCATION AP# OQ p , d Property Address 0,0 1 City _Maon ho WORKER'S COMPENSATION Policy Number 113 0013 Carrier SW e , d 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 DESCRIPTION OR SCOPE OF WORK: 1.=q V0 or i3or Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: APPLICANT INFORMATION Nam Flood Zone S (J i+ Address �) City Occ. Type Const. State Zip Phone Fax E-mail ►?,- h,:_, PROJECT LOCATION AP# OQ p , d Property Address 0,0 1 City _Maon ho WORKER'S COMPENSATION Policy Number 113 0013 Carrier SW e , d 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 DESCRIPTION OR SCOPE OF WORK: 1.=q V0 or i3or 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. PERMIT N0. 639,4-76B,P,E,M 'r1113 19/1 ,. PERMIT EXPIRES OWNER Arnold Staat '4CONTR. owner 1; LOCATION (A.P. 66-42-16 S/S Indian Dr.,'app. 750'W.o.f.Skyway, lot 413, I.M.#l, Magalia ilk PSS . r 1 i t ( Temp. Power Pole f Called PG&E . Temp. Elea Serv. Called PG&E r Temp. Gas Serv. -ailed PG&E OB FINALED (Date) (Signatur COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback (p Firewall Soil Piping Forms, Parapets 1st Floor Main Bldg.. Restroom Finish 2nd Floor Footings, .2 i Windows 3,rd Floor Stemwall Siding To out �� 1 Slab Roof Sheathing Water Pi in 7 Piers Roofing Sewer Garage Fdn. Vents Fixtures Foot in s Stemwa Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physically handica ed Conformance of ex. f structure Appliances Gas Piping &Test Tem ..Gas Slab Final ,�- - `� Sanitation Patio FIREPLA69 FinalFootings FootingAo ELECTRIqKK .17 Masonry Walls Throat Rou h Reinf. Steel Final, Fixtures Bond Beam FIRE SPRINKLERS Motors- Framing 2:j -22 Test Water. Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling. Temp. Pole Finish Ducts Underground Interior Lath Venti.lation., Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS 11'A(10 1�% /-7 A/7 (NOTE: An entry must be made -on this Iform each time you visit the job site.) v COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS , 7 County Center Drive — _ Oroville, California 95965 9y/ 76 Tel Ephone:y 34-4541 APPLICATION AND PERMIT ?3 BUILDING Owner 14f V/,/0I- S J 1447 SO. FT. OCC. BUILDING VALUATION Mailing Address L,/ yo bqG, P,A,-A Contractor Mailing Address I Building Address Sl >e V1 e LJ "C) V-. Telephone No. 1 e �7�` ��'T 1-' Fireplace Total Valuation hf .Q Permit Fee _ Plan Checki ng Fee &/or Penalty Telephone No. permit Fee PLUMBING PERMIT FILING FEE 7— e J� SAC y4/ yy Each Trap 6,.;G ). Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets A. P. No. Zonin & P Hing ach additional outlet Fe on F' eDept. Fire Z a Use Permit Building sewer EOA IParking Parcel P I 60' R/W Im r Lawn sprinkler system Plans Declarationp ovements Bldg. Plans Recd I// �rcel royal Pla pprovol Permit Fee NEW I& ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL Single Family ® Duplex ❑ Mobil Home ❑ Others ❑ 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 style of: License No. Classification PERMIT FILING FEE Main service 600V OR LESS 100 AMP OR LESS Main service EA. ADD'L 100 AMP Main service OVER 600V 100 AMP OR LESS Main service EA. ADD'L 100 AMP NEW CONST. DWELLING 0 P-99 OR AD NS. ACC. BLOGS, JJ NON•RESI Ex. OCCUp(OUTLETS OR FIXTUR Ex. Occup ( FIXED APPLNS, OR • OUTLETS (REBID.) E Temporary service Mobile Home Facilities Misc. Wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee WORKMEN'S COMPENSATION INSURANCE MECHANICAL PERMIT FILING FEE I am aware of the provisions of Section3700 of the California Labor Heating /aa,�pQ, 97 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. rj I certify that in the performance of the work for which this Ll 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. I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X I Date X23-74 Signature orPermitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Cooling 3 T ,r/ Ventilation Hood Permit Fee rove , v 2 % 6. O O 73-0 , ny '1.5q1;7_s 60 yb,©v @ FEE $3.00 3 A90 1.50 2-,pC 1.50 1.50 (� U 1.50 1.50 .30 5.00 2.00 $3.00 5.00 2.50 25.00 1.00 ?Osq ft ?.50ea 2.00 10.00 15.00 6.25 $3.00 2.00 L2 FEE Ur O O W TOTAL PERMIT FEE Is O kIr 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 P B IC WORKS Rv Date %L3C 2_(_ Bt4ding permit expires Date _ j� " 3Z "7 7