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HomeMy WebLinkAbout068-140-05088-�4-50 JUSTINA- BARTEL 4614 Olive Hwy, 0rcvil 3� Permit#1788-88B(reroo SF)� 04-0595 068-140-050..:: t BpRTEL� .JuST1N?•,OROVIL'LES 4614 OLIVE;xwY' CONST Corit: `JOHN `WHEELER REROQF`';' Permit#1788=88B y 1: -JUSTINA'-BARTEL 46.14 Olive Hwy, oro All".1.%- COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS, ' P R IIT/NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541Al APPLICATION*AND PERMIT n l / ASSESSOR PARCEL NUMBER J l ("A - IU �' '' " ` , ZO INC - ;BUILDING PERMIT OWNER { ;(;�if• t r'iC� j{'�^>• � �'' TELEPHONE ��� S T. OCC. BUILDING VALUATION )L7�'1� - �� - �..• OWNER'S MAILING ADDRESS LIt,l LI ()( i 11C f �iJt-1 UI L,i,' CONTRACTOR'S NAME ' nLA) r\ e r TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN C Total Valuation $ L� 6101 Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ) ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS J ( J Jr (-, Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 - USE OF STRUCTURE SF Ef] Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ©, Describe work: 'Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service OOOV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El am licensed under provisions of Chapt. 9, Div. 3 of the BuslnesS and Professions Code and my license Is In full force and effect. License No. Classification ❑Q I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW OR ACDNS. l CONST. / ACC. BLDGS. DWELLING OCCUP.51) +/i¢sgft NEW CONSTR. TI.OUTLET 2.50 ea NON.RESIC .BRANCH CIRC ITS POWER APPARATUS e SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES 200930 FIXED Ex. Occup. OUTLETS P(RESID )REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate ,of Consent to Self -Insure. t,.� I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply, with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor 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. also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County, in consequence of the granting of this permit. )(; , aJ �% /C 1 A W Date �' r Signature of Applicant — Owner Imo- Contractor ❑ Agent 11work An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $�� OCcuP. CONST.TYPE JSC.00LJ FLOOD PARCEL PD 1 HD 1 ISSUE This permit is hereby issued under sions of the But County Code and/or indicated above for which DIRECTOR70F PUBLIC %�%%/ By �� �r ►��� L��Y0 PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date f%/) �" •n Receipt No. 1 Is D WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF - vilDEPARTMENT OF PUBLIC WORKS 7 County Center Drl le, California 95965 -Telephone: 916/538-7541 A "ATION AND PERMIT ASSESSOR PAR L UMB ( ONING BUILDING PERMIT OWNE t - TE PHONE�r T. OCC. BU LDING VA UATION OW I1+�1�(-Jl/LIN Y t�� 1 t CONTRACTOR'SNAME Vv��r TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS - Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 i Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W O.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other iPermit Describe work: Iq I Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD•L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions! Code and my license is in full force and effect. icense No. Classification el, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason CCUP.N� LIN / ADDNS'/z¢sgft oR T DWELGS NEW CONSTR. MULTI -OUTLET 2.50 ea NON.RESID BRANCH CIRCUITS) POWER APPARATUS e SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES eAL030 Ex. Occup. OUTLETS P(RESID )FIXED APLNS. REA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 g Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate �f Consent to Self -Insure. 2' shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shal I be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also a Yee to save, indemnify and keep harmless the County of Butte against all 'ties, judgments, costs, and expenses which may in any way accrue ag in,s id County, in copse encs of the granting of this permit. p' %� Date ' �a Signatur f Applicant — Owner�Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 tori sin height. Mobile Home Installation Fee $ Energy Inspection Fee $ _ TOTAL PERMIT FEE $ occuP. NST.TYPEJ ISCHOOLI FLOOD PARCEL PD 7SUE This permit 'is hereby issued under sions of the Butte County Code and/or work indi ted above for which IRE OF PU Y P MIT EXPIRES Date the applicable provi- resolutions to do f have been paid. I ORKS DatLi Receipt No. WHITE-D.P.W., YELLOW -...111.111. PINE-IN9P ECTOR, C.LDENROD.APPLICANT COUNTY OF BUTTE - D"_Ar•t6ent of Public Works- 7 orks-7 County Center, -Drive, Oroville, •CEi 95965 Phone: 916-538-7541 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 will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. 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 City Phone Contractors 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 City Phone Contractors 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 Work Signed: Property Owner Ql Social Secity Nu er• u� Date NOTE: This Owner -Builder Verification is sent'to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to,our office before we are per- mitted to issue the permit. ❑ Complaint -Date ❑ Other -Date / BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECTIQN REPORT M.. ZONING Owner f A.P..�k Address: (( /�,�.2 'Date of Inspection Tenant: Inspector Building Location: lD Type of Inspection requested: 1., Housing / /. 2. Financing / / 3., Change of Occupancy to 1�L 4• Work W/O Permit / / `. Other (specify) Present use of building: A. Sanitation (Housing) 1. Water closet: 2. Lavatory: 3. Bathtub or shower: 4. Kitchen's ink : 5. Hot and cold water to fixtures: -6. Heating facilities: 7. Natural light and ventilation: 8. Room and space requirements: 9. Bedroom window or door for second exit: 10. Infestation of insects, vermin, or rodents: 11. Connection to sewage disposal: 12, 'Connection to water supply: 13. Rubbish and garbage facilities: ` 14.-Stairs:(Rise, Run, Headroom, 1HR, Tolerances,Handrails) 15. Comments: B. Structural 1. Piers and footings: 2. Floor construction: 3. Wall construction: 4. Ceiling and roof construction: 5. Fireplaces: 6. Comments: C. Electrical 1. Service and ground: 2. Receptacles: 3. Fusing: 4. Comments: C D. Plumbing E. 1. Fixtures connected and vented: 2. Gas water heater: 3. Gas heating vents: 4. Comments: Other 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: 4. Weather protection: S. Underfloor and attic ventilation: 6. Energy: 7. Comments: F. Commercial Buildings 1. Roof covering: 2. Distance to property lines: 3. Physically handicapped: _ 4. Restroom floors and walls: S. Exits: 6. Improvements: 7. Zoning: 8. Comments: G. Field Problems or Violations 1. Problem or violation (give complete description): 2. What action,taken_ (give copplp:te desqj;ipt,�on),: 3. What action recommended: / / A. Information only - file. B. Hold for ten days, then write letter. %% C. Write letter. / / D. Other: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530).538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP040695 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: 03/02/2004 APN: 068-140-050-000 the Business and Professions Code, and my license is in full force and effect. �/ License Class : License Number: i D 202 Site Address: 4614 OLIVE HWY ORO Date�0 Contractor: I /1Z1 Map Index: Description: TEAROFF AND REROOF W/30 YR COMP 19 Descrp - OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 SQ) Business and Professions Code: Any city or county which 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 Owner: BARTEL JUSTINA ANN TRUST signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section BARTEL JUSTINA ANN TRUSTEE 7000) of Division 3 of the Business and Professions Code) or that he or 4614 OLIVE HIGHWAY she is exempt therefrom and the basis for the alleged exemption. Any OROVILLE, CA 95966-5687 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 owner of property who builds or improves thereon, and who does Applicant: BARTEL JUSTINA ANN TRUST 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' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: JOHN WHEELER CONSTRUCTION pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code P O BOX 5262 Date: Owner: OROVILLE, CA 95965 (530) 534-5950 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for License #: 586797 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 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: r' d,�fzpTS—Z/ Policy#: Z q Total Square Ft: 0 S.F. ❑ 1 certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Census Code: 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: �I C`r 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 performance of the work for which this permit is issued (Sec 3097 Civ.) This per d is her under the applicable provisions of the Butte County Code and/ r a luti n o 'ntt' ed above for which fees have been paid. CI Name: B 9>1Date: J Address: PER IT EXPIRES ON: Date ❑ 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. O Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. O 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 owner 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 substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print �1 Q Name: G� h- r° t✓ :y/i Signature: Date: ` 0 Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor 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. DATE: j IVl APN: O 4,6 - bS I ZONING: NEAREST CROSS STREET: TRACT/LOT#: SITE ADDRESS: CITY, ZIP: OWNER NAME: PHONE: STRE ADDRESS: FAX / CITY, ZIP: , _ rDU E-MAIL' A LICANT NAME- PHONES ;59 (56 STREET A RESS: ' FAX: CITY, P: )-,4 C E -MAI L CONTRACTOR NAME:`j P PHONE DRESS FAX CITY, Y��P EMAIL LIC MBER: 7 LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE STREET ADDRESS: FAX: CITY, ZIP: LICENSE NUMBER: E-MAIL: DESCRIPTION OR SCOPE OF WORK: �© \ G W ❑ 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: Application Received by:b I Date: Receipt number:�G Amount Re elved: I�