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HomeMy WebLinkAbout068-210-097JOE DENNIS 40 Arbol Ave, Oroville Conte: huggitt Lighting & Elect. Permit #2676-77E(ele ser ch & inst. ryer ciruit) Sk"f 068-210-097 04- 3 CLINE, JOETTA (NAL 40 ARBOL AVE, OROVILLE Cont: COMM ACTION AGENCY H2O HEATER REPLACEMENT X31 ; �� � r- 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.netWds PERMIT NO. BP041043 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 the Business and Professions Code, and my license is in full force and Issued Date: 04/14/2004 APN: 068-210-097-000 effect. License Class: License Number: <-1 7 7—dl Site Address: 40 ARBOL AVE ORO Date:"o _ Contractor. Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: WATER HEATER REPLACEMENT 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: CLINE JOETTA ETAL 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 HALL MELVILLE the Contractor's State License Law (Chapter 9 commencing with Section 2420 WHEELER AVE 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 OROVILLE, CA 95966-9019 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: COMMUNITY ACTION AGENCY OF BUTTE owner of property who builds or improves thereon, and who does COUNTY INC. 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 2640 SOUTH 5TH AVENUE 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 OROVILLE, CA 95965 sale.). (530)538-7559 ❑ 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, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: COMMUNITY ACTION AGENCY OF BUTTE COUNTY INC. O I am Exempt under Article 3 of the Business and Professions Code Date: Owner: 2640 SOUTH 5TH AVENUE OROVILLE, CA 95965 WORKERS' COMPENSATION DECLARATION (530)538-7559 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 workers' compensation, as provided for by Section 3700 of the License #' 617201 i t� Labor Code, for the performance of the work for which this permit is issued. ` t,1 I have and will maintain workers' compensation insurance, as II (i I required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Architect: (Jy\ insurance carrier and policy number are: Carrier: Engineer: (/moi f Policy #: I z7<t, otal Square Ft: 0 S. F. O 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 Valuation: $0.00 become subject to the workers' compensation laws of California, Census and agree that if I should become subject to the workers' Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: -- 13 -d Sr r Applicant: WARNING: Failure to secur orkers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and one 3475%05 Srj . 4- / hundred thousand dollars ($100,000), in addition to the cost of a/ compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions o do work indicated above for which fees have been paid. , performance of the work for which this permit is issued (Sec 3097 Civ.) = l 4-' i14 .,o+ Name: By: � Date: PER1164PIRES ON: ¢' t+ ' S Address: 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. ❑ Notification in accordance with Section 19827.5 of California Health & Safely 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 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 Cou to enter upon the above mentioned property for inspection purposes. �j Print Name: Signature: Date: ❑ Owner (Contractor 0 Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netldds PERMIT NO. BP041043 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 the Business and Professions Code, and my license is in full force and Issued Date: 04/14/2004 APN: 068-210-097-000 effect. License Class: License Number: 7 Fest Site Address' 40 ARBOL AVE ORO Date: °'10 Contractor: C Map Index' OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: WATER HEATER REPLACEMENT 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: CLINE JOETTA ETAL 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 HALL MELVILLE the Contractor's State License Law (Chapter 9 commencing with Section 2420 WHEELER AVE 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 OROVILLE, CA 95%6-9019 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: COMMUNITY ACTION AGENCY OF BUTTE owner of property who builds or improves thereon, and who does COUNTY INC. 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 2640 SOUTH 5TH AVENUE 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 OROVILLE, CA 95965 sale.). (530)538-7559 ❑ 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, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: COMMUNITY ACTION AGENCY OF BUTTE COUNTY INC. ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: 2640 SOUTH 5TH AVENUE OROVILLE, CA 95965 WORKERS' COMPENSATION DECLARATION (530)538-7559 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 License #'' 617201 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 insurance carrier and policy number are: Engineer' Carrier. 14y� �,�� n/s r E C S e i - Policy #: Z $Q ❑ I certify that in the performance of the work for which this permit is otal Square Ft: 0 S. F. issued, 1 shall not employ any person in any manner so as to Valuation: $0.00 become subject to the workers' compensation laws of California, Census and agree that if I should become subject to the workers' Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secur orkers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one 3478!2.SS 4114-10 hundred thousand dollars ($100,000), in addition to the cost of a/ compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions o do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) -_ 4-14-0+ Name: By: ''�� Date: PER1464PIRES ON: Address: Date ❑ I 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 owner or the duly authorized agent of the owner. 1 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 Cou to enter upon the above mentioned property for inspection purposes. �l Print Name: Signature: Date: 0 Owner Contractor 0 Agent for Owner ❑ Agent for Contractor o'. 1 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 a4 to 4s DATE: - -1 -o 04�y, � Q APN: J V ® 4? ZONING: OWNER'S LAST NAME: OWNER'S FIRST NAME: PHONE xl STREET ADDRESS: _ FAX: CITY, ZIP: © 9s E-MAIL: SITE ADDRESS: " oA 63 13n CITY, ZIP: © 0 s NEAREST CROSS STREET: TRACTILOT M APPLICANT NAME: � PHONE: Lk STREET ADDRESS: 46 CITY, ZIP: E-MAIL' CONTRACTOR NAME: PHONE: 5 �� STREET ADDRESS: FAX: CITY, ZIP: E-MAIL: LICENSE NUMBER LICENSE TYPE: 71, ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: FAX: CITY, ZIP: LICENSE NUMBER: E-MAIL:* DESCRIPTION OR SCOPE OF WORK: t ❑ 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: Date: Receipt number: Amount Received: f l TOE lt7l�t5 yo A��O J_ Avg i J COUNTY OF BUTTE — DEFARTMENT OF PUBLIC WORKS 7 County Center Drive — Uroville, California 95965 Tel epk)ne: 53a-4541 APPLICATION AND PERMIT Date 1,'2---77 Signature of Permitee or Agent Receipt No. L�/ Z White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By L%" Date Building permit expir/ ate BUILDING , ) Owner �� �/ iJ� j SQ. FT. OCC. BUIrDSNG VALUATION Mailing Address Telephone No. Fireplace Contractor Z)/�r�^/-� ���/���� C�f^/-•/ Total Valuation Mai I i ng Address Permit Fee PI an Checki ng Fee &/or Penal ty / �� ��� i/ /�� �, e_ lephone No. S P? �► Sar Permit Fee $ Building Address - PLUMBING No.1 @ FEE PERMIT FILING FEE J$3.00 UF_' Each Trap 1.50 / Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. 117—' Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 FPs I WC.' Sani-talion• Fire Dept. FireZone Use Permit Building sewer 5.00 EQA PPIk sg Declare ion Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 Bld Plans -Reed 9' Parcel Approval pp Plans A Approval Permit Fee NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 0 ELECTRICAL N0.1 @ FEE PERMIT FILING FEE $3.00 /, U L �+ A //+/ /� �Jr i, / �l J 0e ( ( �/� Y t /�f �' / 1111 OR 100 AMP ORLESS5.00 Main service �f * �srK �i•�r=//, Main service EA. ADD'L 100 AMP 2.50 _r I Single Family 10 Duplex ❑ Mobil Home ❑ Others ❑ OVER 600V Main service 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. DWELING OR ADDNS. ( ACCLBLDGS.OCCUP. &) 22sgft NEW CONSTR. (MULTI -OUTLET NON-RESID, BRANCH CIRCUITS) 12.50ea NEW CONSTR. POWER APPARATUS & NON-RESID. (SINGLE OUTLET CIR, 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: Ex. Occup(OUTLETS OR FIXTURES)'L@1 BAL@1 Ex. Occu FIXED APP LNS. OR p•(OUTLETS (PPEA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. " 7 Classification ' Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ /a, 00 $ 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. 13 -Whave placed on file with the County of Butte a certificate of orkmen's rCompensation Insurance. EJI 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 Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation ==F Hood 1 2.00 Permit Fee $ $ 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 . .ti„ , TOTAL PERMIT FEE $ /� p� This permit is hereby issued under the applicable Drovisions of Date 1,'2---77 Signature of Permitee or Agent Receipt No. L�/ Z White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By L%" Date Building permit expir/ ate 7 a COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Tel epho.pe: 534;4541 APPLICATION AND PERMIT auuwn ca rep eSeMatives uI ine Bounty of Butte to enter upon the above-mentioned property for inspection purposes. X Date 4�''2 "77 Signature of Permitee or Agent 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. ,.RECTOR OF PUBLIC WORKS By 01Date Building permit expir ate ��2 BUILDING Owner J0 SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone Na. Fireplace Contractor - '� Total Valuation Mailing Address -� Permit Fee Plan Checking Fee&/or Penalty a e N 1:P Permit Fee $ Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent j 1.50 A. P. � — Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Owls' Sar+40 F9FY Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel Ma P I 60' R/W L - Im rovements P Lawn sprinkler system 2.00 Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER,® ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 v S Cu C 00V OR Main service 100 AMP ORSLESS 5.00 Q% 6e Clr2e�i Main service EA. ADD'L 100 AMP 2.50 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service OVER 600V 1100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. DWELING OR ADDNS. ( ACCLBLDGS. OCCUP, &) 20sgft NEW CONSTR. MULTI -OUTLET NON-RESID. BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS &) NON•RESID. SINGLE OUTLET f_IR. 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: _ Ex. Occup(OUTLETS OR FIXTURES)50 @25¢ 101 Ex. Occu FIXED APPLNS. OR Occup. (RESID,) EA) / 2•�� Temporary service 10.00 Mobile Home Facilities 15.00 License No.,���wZ- Classification � Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ ` QG WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Wor en's Compensation. have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not em P to an employ y 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 MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ TOTAL PERMIT FEE Is 16 laG auuwn ca rep eSeMatives uI ine Bounty of Butte to enter upon the above-mentioned property for inspection purposes. X Date 4�''2 "77 Signature of Permitee or Agent 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. ,.RECTOR OF PUBLIC WORKS By 01Date Building permit expir ate ��2