HomeMy WebLinkAbout068-341-01668-34,1-.-/b 1391-90B
HAMILTON, Ralph
4087 Hildale Ave, Oroville
(reroof/SF)
HAMILTON, RG
4087 HILDALE AVE, OROVILLE
Cont: GREENE ROOFING
C/O WATER HEATER
068-341-016 04-2256
HAMILTON, RG
4087 HILDALE AVE, OROVILLE
Cont: OWNER
RE -ROOF
HAMILTON R. G., Jr. 818
No. side Hilldale 14 mi East of Mt. Vie-
Oroville
toD
I ��
! ` �v' � � �
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.
BP042255
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Issued Date: 07/29/2004 APN: 068-341-016-000
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.
Site Address: 4087 HILDALE AVE ORO
License Class: License Number:
Map Index:
Date: Contractor.
Description: CHANGE OUT WATER HEATER (NAT GAS)
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
Business and Professions Code: Any city or county which requires a
Owner: HAMILTON R G JR & LAVERA A
permit to construct, alter, Improve, demolish, or repair any structure, prior
4087 HILLDALE AVE
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
OROVILLE, CA
the Contractor's State License Law (Chapter 9 commencing with Section
95966
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
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).):
21 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
Applicant: HAMILTON R G JR & LAVERA A
Code: The Contractors' State License Law does not apply to an
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' State License Law does
Contractor:
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.).
❑ 1 am Exempt under Article 3 of the Business and Professions Code
229 _ 0/Own
Date:
License #:
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self4nsure for
workers' compensation, as provided for by Section 3700 of the
Architect:
Labor Code, for the performance of the work for which this permit
is issued.
Engineer:
❑ I have and will maintain workers' compensation insurance, as
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.
Valuation: $0.00
Policy #•
Census Code:
18 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'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date'
�d'� y
Applicarf /1��/«,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 s provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
11 L �l
L 6's
!//�J ',Ti✓�
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the
This permit is hereby issued under the applicable provisions of the Buffe.Crunty.Co&-anry r
Resolutions t c indica ed above for which fees have been paid.
performance of the work for which this permit is Issued (Sec 3097 Civ.)
-,P-9Name: BY Date:
—7,
Address:
PERMIT EXPIRES
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. 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.
w
/- 0M / / /7 Signalurer� d l —PJz ti
Print Name: a VP >^ a �-//O
'7 — _
Date:
i Owner ❑ Contractor 0 Agent for Owner 0 Agent for Contractor
BUTTE COUNTY
0o DEPARTMENT OF DEVELOPMENT SERVICES
0 BUILDING PERMIT APPLICATION
0 AND SUBMITTAL REQUIREMENTS
0 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
0 OFFICE #: (530) 538-7541
0 A FEE WILL BE REQUIRED AT TIME OF APPLICATION
"PLEASE PRINT CLEARLY"
OWNER
Last Name irst Name y -
Address
City a1N _'n
U
Stat
Phon
Fax
E-mail
APPLICANT NAME
CONTRACTOR
Name
City
Address
Zap
City
Fax
State
Zip
Phone
Book
Fax
E-mail
Planner
Uc. #
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zap
City
Fax
State
Zap
Phone
Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name 3 V 1 `
r n
Address
limz.e,
City
State
Zap
Phone
Fax
E-mail
APPLICANT SIGNATURE
X
r office use only:
Zoning
Prope
Flood Zone
Cross Street
SRA
I Yes
I No
Occ.
Type Const
Subdivision Name Map
Book
PageT705-1
Planner
Date Approved:
PERMIT
NO.
4�_4 9-0135
BIN #
}} �Q
LOCATION
f
Prope
Addres� City
1
Cross Street
WORKER'S COMPENSATION
Policy Number
Carrier
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:
Sq. Footage
❑ 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 fee will be
REQUEST FOR REFUNDS
Refimds 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.
OVER FOR SUBMITTAL REQUIREMENTS 11
K:\FORMSWILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2
Receipt #:
ILw/?
Dater)
Amount: ✓� v-_ Bldg
SRA
Sheriff
SMTP
Other
Total
REV 6-16-04
P.
SUBMITTAL REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply
fora permit INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE
LEGIBLE AND IN INS.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER!
OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed
calculations.
❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 4. Letter from Engineer or Architect for truss design review.
❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to
mobile or modular homes)
❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 7. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 8. Sanitation and site plan approval from the Environmental Health Department.
❑ 9. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
Mobile, Manufactured, or Modular Homes:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line information.
❑ 4. 2 Floor plans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.
❑ 6. Sanitation and site plan approval from the Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑ 1. 4 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 4. Letter from Engineer or Architect for truss design review.
❑ 5. 2 Energy compliance design and supporting documentation (if required).
❑ 6. - 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 7. Statement of Intent for Non -heated and A/C (if required).
❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
❑ 9. Letter of intent.
❑ 10. Hazardous Material Form.
❑ 11. Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 6-16.04
O.B.-1
OWNER -BUILDER VERMICATION
Attention Property Owner:
An "owner-buildee' 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 NO 0
2.2. I HAVE :�1 HAVE NOtZ signed an application for a building pemnit for the proposed work
I have contracted with the following person (firm) to provide the proposed consirncdon:
NAME:
ADDRESS: CITY..
PHONE: CONTRACTOR'S LICENSE NO.
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: CONTRACTOR'S LICENSE N.O.
the work indicated:-
NAME
ndicated:NAME ADDRESS PHONE TYPE OR WORK
PROPERTYOWNEE�
DATE:_
NOTE: This Owner-Bteilder Yerocation is required by Section 19831 and 19832 of the
California Health and Safety Code. This veykation nwt be completed and
returned to our of "ice before we are permitted to issue the permit
s
OWNER BUILDER LDER IlNFORMA d IrON
Dear Property Owner.
OB -I
improvements a aPPUcabed for a bolding p� has been submitted in your name �g yourself as flee binder of property
sp
For your protection, You should be aware fl>af as "owner bm'Idei" you are tip responsible party ofrecord on such
a pew Building pennift are not req *ed to fie signed by ProPmlY owners unless they are ers
own work- rmeY P orally performing heir
If your work is being perfoed
by someone other than yonrsel4 you may Protect Yourself from possible
liability if that person applies for the proper pemut is his or her name.
Contractors are requited by law to be licensed and bonded by $ie State of Caiifomia and to have a business
license from the city or county. They are also required by Irv, to put their license number on all permits for which they
apply.
Ifyou plan to do your own wo*, with the exception of varions trades that you plan to subcontract, you should
be aware of the following h&Nmudon for your benefit and protection:
? If you employ or otherwise engage any persons other than your mediate may, and the work (Including materials
and other costs) is $300 or more for the entire Proj and sur
then You may bs an employer; h persons are not licensed as condors ar
subnran,
♦ If you are an employer, you must register wi& the State and Federal Go
subject to several obligations including state and federales wttbho employer and you are
wditrers coraP ldimg, federal social s=diy taxes,
mon ice, disability msuramae costs, and unemployment campeasatioa coafrbutions,
+ There may be financial risks far you ifyou do not carry out these obligations, with respect to workees compensation ice. and these risks are especially serious
♦ For more specific mfomiation about your obligations under Federal Law, contract tin Interna 1 REve�e
if yon wish, the U.S. S1110 Business Service (and,
Siete L aw, contact the D ). Far mare sP'�c mf�atioa about your obligations under
epmtnent ofBenefit payments and the Division of industrial Aociden.
If the strvctate is intended for sale, property owners who are not licensed
work personally or through their own employees. whhOut a licensed contractor icon allowed am
conditions. , limited
only under
'
A frequent practice of tmlicensed persons prong to be oozes actors is to secure an ¢owner builder'+ b
pemuit; =am neousIy impl»ag $tat the ProPMtY own$t is providbg her own �g
pernniis are nut required to be signed by Property
owners unless � or labor rad material personalty, Bui]ding
7non about licensed �y be obtained b �Y are Pig their own work personally.
Wmmonity cur at 1020 N S mA S Y State Ligase Board in your
PIS � � �e�to, CA. 95814.
Owners Verification" on the reverse side of this fore so burr we can confirm that you
are aware of these matters. The building P� will not be issued unl?l the veri$0ation is returned.
-Ir 1
-Ill :� � 11 • 11 I • � , , I
l
VOT 1Tiir Owner -B IRforrrtatwn is required by Section 1383D of flue CaF 'ornia HeafBi mzd Safety Codes
nXrc,,0
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.
BP042256
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Issue Date: 07/29/2004 APN: 068-341-016-000
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.
Site Address: 4087 HILDALE AVE ORO
License Class: License Number:
Map Index:
Date: Contractor.
Description: REROOF W/COMP (20)
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
Business and Professions Code: Any city or county which requires a
Owner: HAMILTON R G JR & LAVERA A
;-i;rmit to construct, alter, Improve, demolish, or repair any structure, prior
4087 HILLDALE AVE
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
OROVILLE, CA
the Contractor's State License Law (Chapter 9 commencing with Section
95966
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
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).):
41 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
Applicant: HAMILTON R G JR & LAVERA A
Code: The Contractors' State License Law does not apply to an
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
Contractor:
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.).
O 1 am Exempt under Article 3 of the Busi ass and Professions Code
Date: ' 2 `a Owner•
License #:
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 self4nsure for
workers' compensation, as provided for by Section 3700 of the
Architect:
Labor Code, for the performance of the work for which this permit
is issued.
Engineer:
❑ I have and will maintain workers' compensation insurance, as
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:
Cartier.
Tote s�Na�� �� Q s•F•
J
�t
4a ua>tio'n: $0.00
Policy #:
Census Code:
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'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applican�
WARNIIIG. 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.
�� O
CONSTRUCTION LENDING AGENCY
This perm' ' reby' sued under the applicable provisions of the Butte Cnunly CodA anm r y
fees have been
I hereby affirm that there is a construction lending agency for the
Resoluti s to 0 ork indicated above for which paid. Q 1,
performance of the work for which this permit is issued (Sec 3097 Civ.)
1
By: Date -
Name:
AN 0-5
Address:
PERMIT EXPIRES /
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 & 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. 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 theabovementioned property for Inspection purposes.
Print Name: 1. a Ve r a / /�,7 M I/ ! r) Signatu
7 — a y D
Date:
0 Owner 0 Contractor 13 Agent for Owner 0 Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQ UIRED AT TIME OF APPLICATION
"PLEASE PRINT CLEARLY"
OWNER
Last Namefirst
a
Name v^
Address IVD.
City�D
Stat
Z�p��y� .
Phon
Fax
E-mail
APPLICANT NAME
CONTRACTOR
Name
City
Address
Zp
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
Lic. #
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zp
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name Cl V 1 �
V' i7
Address
City
State
Zp
Phone
Fax
E-mail
APPLICANT SIGNATURE
X
Kr office use only:
Zoning
Prope
Flood Zone
Cross Street
SRA
I Yes
No
Occ•
Type Const
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
PERMIT
NO.
6t
BP
BIN #
LOCATION
p Q
Prope
Addres L
C�
c— I
Cross Street
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of pennit issuance.
LENDING AGENCY
Name
Address
Descinl3tion or Scope of Work:
Sq. Footage
❑ 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 -fee -will be
OVER FOR SUBMITTAL REQUIREMENTS
KAFORMS\BUILDING FORMS\BIdaADDISubRamts.doc Pana 1 of 9
REQUEST FOR REFUNDS
ReSmds 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.
Received by: Amount 1.0 O Bldg
'��v SRA
Receipt #: Q Sheriff
4b-1 6� ---SMIP
Date:I I -)a I ] Other
l Total
OWNER -BUILDER VERIFICATION'
Attention Property Owner:
An "owner-builderf " building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to' unnecessary delay
in processing and issuing your building permit No building permit will be issued until this
verification is received.
(ZI personally plan to provide the major labor and materials for construction of the proposed
property improvement: YES 9 NO ❑
I HAVE M' HAVE NOT ❑ signed an application for a building permit for the proposed work -
I have contracted with the following person (firm) to provide the proposed constV tion:
NAME:
ADDRESS: CITY..
PHONE: CONTRACTOR'S LICENSE NO.
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: CONTRACTOR'S LICENSE NO.
T —_11
tbz work indicate&
NANM ADDRESS PHONE TYPE OF WORK
DATE:_
NOTA: This O�lner-Builder ler ficadon is required by ,Section 19831 and 19831 of the
California Health and Safely Code. Mis vazfxation must be completed and
returned to our office before we are permitted to irsue the verrnit.
ti
OWNER SU LDER INFORMATION
Dear Property Owner.
O.B.— L
An aPPlication imProvements specified.�r a bm'Iding pew has been sabnuitted in your name listing yourself as the builder of property
For yourprote 604 You should be aware that as "owner-bm'Idee you are the responsible pally ofrecord on such
a Pew Buffift pemaits are not regaued to be signed by property owners one unless they are personally p rfo
own wort- If your work is being performed by someother than you may Protect yourself from their
liability if that person applies for the Proper permit m his or her name.
Contactors are required by law to be licensed and bonded by the Slate of California. and to have a business
license from the city or county. They ate also mqaimd by law to put their license number on all permits for which they
apply.
WYou plan to do your own work, with the exception of various trades that you plan to sobcontract you should
be aware of the following iaformaifon for your benefit and protection;
i
a If yon employ or otherwise engage any p== other than your immediate tam fiy, and the work
and other costs) is $300 or more for the entire Prajec% and such persons are nong ma rias
t licensed as c (including
or
sub then. en yon may be an employer.
♦ If you are an employer. You mast reguster wi& the State and Federal Go
vernments as an subject to sevei-A obligations iaclndmg s � =tax wi8�ho employer and you are
mnsmance, disabmliiy insiaamce co Idmg, feral social s
workers cou�easation ' ecunity taxes,
+ There may be financial risks for �' � umenzpl compensaiioa eons.
with to worm's You mfyou do not canq otmf these obligations, and these risks are especially serious
P' compensation ice.
♦ Fon more specific mon about your obligations under Federal Law
if yon wish; tame U.S. Small Business • conttart the Intem�al Re;venne Service (and.
Stale Law, contact the D ). For mare specific inmation about your obligations under
eP of Benefit Payments and the Division of iadnstrial Accidents.
If the StrUCture is intended for sale, property openers who are not licensed conftwtors are allowed to
work personally or through their own employees, WhhOut a licensed contraciar or subcontractor, p�o� their
conditions. , only under limited
A frequent practice of unlicensed persons professing to be contactors is to secure an now= builder" building
PMM% eaaneausly hE pbbg $at the property owner is providing his or her oven labor and
permits are not required to be signed Penally. Building
Ic on about licensed by ProP�Y oR'ners unless �Y am Pig them own wofic
c�mmrmity or at 1020 N �Y be obtained by the yrs State Liceasep personally.
your
PIe� � � �� S�� CA. 95814.
P Bm7der Verification" on tame reverse side of this fi= so that we can cont= that you
are aware of Breese matters, The bmldmg Permit will not be issued Dahl the veafficatioa is returned.
VOTE 2115 0Wn17 ar7d�Inforntafon is r
. Begtzfred by Seaiarr 1383D oftfie California HeahSit mzd Safety Codes
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68-342-11 1391-90B
HAMILTON, Ralph
4087 Hildale Ave, Oroville
(reroof/SF)
' CO�U�' Y'OF BUTTE - DEPARTMENT OF PUBLIKS
County "Center Dhv'e' Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION'AND PERMIT
ASSESS0,%:. (�C fL1t�UMBER : t J,
3[j(' j
ZONING
-
BUILDING PERM
OWNER Ralph Hamilton -
Tj .=�$7jg
SO. FT. OCC. BUILDING VALUATION
60 1 ffl
OWNER'4,111,/t'Jf fJaRRaT4 _ Oroville 9596620
ff,,����JJ�� j�,�, J,Q J�
i
CONTROwnerS NAME r
TELEPHONE
_
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Vok
Filing Fee ._
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$200-50
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDI Zb8J�D �lldale
��:llJJa/
Permit fee
$ 30.50
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Oroville
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_RfP—ROOF
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home TSTG W
10.004
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other g
Describe work: Re—Roof _
Permit 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.SINGLE
License No. Classification
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 CONST. DWELLING OCCUP.&
OR ACDNS. ACC. BLDGS.
,
2/z¢sgft
NEW CONRES, RANC.UTLET
NO N•RESID BRANCH CIRC ITS
2,50 ea
POWER APPARATUStr
OUTLET CIR.
Ex. Occu
Occup(OUTLETS OR FIXTURES
2AL@50C30
.200030
Ex. Occup. OUED PIRESID.IREJ
OUTLETS
2.00
Temporary service
10.00
Mobile Home Facilities
15.00 A
Misc. �Virin g
15.00
Permit Fee
$
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.
® 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.
Contractor
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.
I 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
agasaid County in consequence f the granting of this permit.
X f Date S.3 ' 1D
Signature o Applicant — Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $
ALSCHE
3(?•50
HAz
CUA
PARK
PAR
HD
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work ated above or whic fees
�
Dip OF P
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
have been aid.
� p
WORKS
:10.nC
,OLf
pt No.66201D.,
W.. YELLOW -055 CS BO R, PINK -INSPECTOR, GOLDENROD -APPLICANT
I
J
-- —
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.�
ASSESS06�P, 4CtLl1t�UMBER
ZQ�J.ING
BUILDING PERM
OWNER
Ralph Hamilton
TfilPIM
SO. FT. OCC. BUILDING VALUATION
90 60 i,gnn
OWN ER *46ft 1i11 11�aae Oroville 95966
CONTRACTOR'S NAME
owner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 20.50
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDI`4b0DMil ldale
Permit fee
$ 30.50
PLUMBING PERMIT
FiIingFee 10.00
Each Trap
2.00
Oroville
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 Re—RQQEBuilding
5 PECIFY
Gas piping system 1 - 5 outlets
5.00
sewer
5.00
Mobile Home S TGTW1
0.00e
TYPE OF WORK
New❑ Addition ❑ Remodel❑ Utilities❑ Installation[:] Other
Describe work: Re—Roof _
Permit Fee
$ct
Contraor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADO'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.
License No. Classification
1, 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-
ontract
ors.
ors.(Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. / DWELLING OCCUP.tr
OR ADONS. ( ACC. BLDGS.
/20sgit
NEW CONSTR ULTI-OUTLET
NO N•R ESID BRANCH CIRCUS
2.50 ea
POWER APPARATUS tr
(SINGLE OUTLET CIR.
Ex. Occup( OR FIXTURES
2ALO 30
BL@
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.I EA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
g
15.00
Permit Fee
$
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.
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.
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
Heating
Coolin 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 agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
aga' said County in consequence f the granting of this permit.
-
%� Date S �3 -9B
Signature of Applicant — OwnerContractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST TYPE
TOTAL $
AL FEE
E
30.50
F{qZ
CUA
PARK
E
PAR
PD
HD ISSUE
This permit is nereby issued under
sions of the Butte County Code and/or
work ated above or &PWORKS
OI OFion
PER IT EXPIRES Date
the applicable provi-
resolutions to do
s have been paid.
ate
Receipt No. 66201
WHITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATmN ANn PFRUIT
PERMIT NO.
ASSESSOR PARCEL NUMBERZO'N
—/ 0
I NG
BUILDING PERMIT
OWNER A ,
,/V
TELEP O
3i`
J ,v ,
S0. FT. OCC. BUILDING VALUATION
OWNER'S ILING ADDRESS
O 7 14/ L�
CONTRACTOR'S NAME,
))
C/wL
TELEPHONE
I
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total VaIUaIIOh Is
'
LENDER'S MAILING ADDRESS
ARCHITECT OR ENGINEER LICENSE NO.
Filing Fees
10.00
Permit Fee
Plan Checking Fee
$
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
S
Penalty
$
BUILDING 17 ESS� I^,^D
IC//1,L/l � � �'�✓_
Permit tee I $ 3O ,5
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
1 20.00,1— -
LOT NO.SUBDIVISION
NAME
P4RC EL MAP
Water piping
5.00
Each Das water heater or ven
5,00
USE OF STRUCTURE /�
SF ❑ Duplex❑ Mobilehomel� Other ��
SPECIFY
Gas piping system 1 - utlets
5.00
Building sewer
5.00
Mobile Ho I S I G VJ
10.00 eat'
TYPE OF WORK
New ❑ Addition ❑ Remodel.LL, Utili s ❑ Installation E! Other
Describe work:�f�_ t
^
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 800 VAMP OR01 SLESS
10.00 _
CONTRACTORS LICENSE LAW
1 declare under penalty of perjury (check one):
J am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
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 safe. (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
Main service EA. ADO'L too AMP
2.50
NEW CONST. DWELLING OCCUP.p
OR ADONS. A.CC. SLOGS.
sgft
NEW CONSTR. MULTI -OUTLET
NON-RESID. BRANCH CIRC I
2.50 ea
(POWER APPA US s�
SINGLE Du ET CIR.
Ex. OCCU OUTL OR FIXTURES
p�
20'Ot
I*50
1. 1*
FI D APP LNS. OR
EX. OAup. TLETS IRESIO.I EA.)
t.5'3
2.00
Temporary service
110.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
F-1 The permit Is for 5100.00 (valuation) or less.
I—, I have placed on file with the County of Butte Building Department
LJ a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ 1 shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: 11 after making this statement, should you become subject
TO the W. C. provisions of the Labor Code, you must forthwith comply with Such
or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee _10:00
Heating
I
:I
Cooling
d
HEPermit
300
lation
Fee /provisions
aGt•or
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 Countyoi
Butte to enter upon the above-mentioned property for Inspection purposes.
I also agree to save. Indemnity 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.
X Date
Signature of Applicant — Owner I
9 PP ComroctoriJ Agent [J
An OSHA Dermlt ;s required for excavations over 5'0" deep and demolition or construct-
Ion of structures over 3 stones in neiant.
Mobile Home Installation Fee $
Energy Inspection Fee
"occ' '6" ,E --- ___S g
— —
TOTAL FEE S
-AZ
CUA PARI( SCHL I FLP
I aAR P' i HD ISSUE i
Tn;s permit Is nereoy Issued uraer
sions or the Butte Ccunty Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
Date
Receipt No.
��E•D.�.w.. CLLr-ASSESSOW- >.- '-S-EC,o-. GOLDE"000-Ao-LIC—T
COUNTY OF BUTTE - Department of Public Works
7 County Center Driva.;,Orovil,le, CA 95965 Phone: 916-538-7541
t
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 I 1 11 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
Social Security Number
Date g �3--?%)
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.