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HomeMy WebLinkAbout068-350-01068-35-10- JAN HILL E. 144-66B t ` 3900 Hilldale Avenue; Oroville._-. _ 115-66E, Permit#2663-82 (repair broken gas & _ - -336-66P`_— s,ewer,.line)S�� -Ave., •(4-53-1 ' Y _•Z 3900 Hilldale Ave Oroville 068-350 010+ (extend exi tin bedroom 2� 'PERMIT#95. 1781. ;r g ) •---� c.L� — / "HILL; Jan 3900 Hildale Ave c7 •,S' Orovil'le, a`� _ Cont;, Ely Roofing Inc{,fa ° *'4, Reroof/SF 1068 350 010, + 04-2532 _ nF - o HILL'FAMILY TRUSRI T, CHARD' • »_ N 3900`HILDALE,AVE, OROVILLE ,. Cont: PELLtA'WINDOW&DOOR- . k `5 NEW. WINDOWS/CHANGE OUTa' 1 } i 1 i � r t � r 1 r ' 1 I a 1 4i 7 { 1 1 {r I • 68-35-10- JAN HILL E. 144-66B t ` 3900 Hilldale Avenue; Oroville._-. _ 115-66E, Permit#2663-82 (repair broken gas & _ - -336-66P`_— s,ewer,.line)S�� -Ave., •(4-53-1 ' Y _•Z 3900 Hilldale Ave Oroville 068-350 010+ (extend exi tin bedroom 2� 'PERMIT#95. 1781. ;r g ) •---� c.L� — / "HILL; Jan 3900 Hildale Ave c7 •,S' Orovil'le, a`� _ Cont;, Ely Roofing Inc{,fa ° *'4, Reroof/SF 1068 350 010, + 04-2532 _ nF - o HILL'FAMILY TRUSRI T, CHARD' • »_ N 3900`HILDALE,AVE, OROVILLE ,. Cont: PELLtA'WINDOW&DOOR- . k `5 NEW. WINDOWS/CHANGE OUTa' 1 -10 j cfli � coca i M Y Ln1 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.netWds PERMIT NO. BP042532 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: 08/30/2004 APN• 068-350-010.000 the Business and Professions Code, and my license is' full force and effect. License Class : s Number: Site Address: 3900 HILDALE AVE ORO Date:%tllh;— 115�'Contractor. Map Index: Description: 5 NEW WINDOWS/CHANGE OUT p OWNER -BUILDER DECLARATION I hereby affirm under penaltyalty of 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 permit to construct, alter, improve, demolish, or repair any structure, prior Owner: HILL FAMILY TRUST to its issuance, also requires the applicant for such permit to file a HILL RICHARD D & JANICE L TRUSTEES signed statement that he or she is licensed pursuant to the provisions of 3900 HILLDALE AVE the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA 95966-9588 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: HILL FAMILY TRUST 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: PELLA WINDOW & DOOR COMPANY OF CA not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed INC pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code 6999 SOUTHFRONT RD LIVERMORE, CA 94551 Date: Owner: 925-245-4470 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #• 835718 . ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Architect: ❑ 1 have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. 7K Policy #: J 'T Valuation: $0.00 ❑ 1 certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. .— Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. crO //` ,2M� CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applica rovi/siorns of the Butte County Cods ?nrVor I hereby affirm that there is a construction lending agency for the Resolutions to d work i icated above for Oich Aes have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By Date: PERMIT EXPIRES ON: rte" Date) Address: ❑ 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 nstruction. I acknowledge it is unlawful to alter the substance of an off ' fo r document f Butte County. I hereby authorize represen es of Butte Cou t o iter upon th above mentioned property for inspection purposes. Print Name: Signature: �- Date: ❑ Owner ❑ Contractor ❑ Agent for Owner .Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTIONM OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REO UIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" PPLICANT NAME ARCHITECT/ENGINEER OWNER CityState Last Name t 1 City irst Nam Address 3 J � Phone Map Book Ci �l State State License Number Zp P � Fax Name E-mail Address PPLICANT NAME ARCHITECT/ENGINEER Name CityState Address Zup� 61 City No State Zip Phone Map Book Fax E-mail Planner State License Number If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. I 0A WO- PPLICANT NAME ARCHITECT/ENGINEER Name CityState Address Zup� 61 City No State Zip Phone Map Book Fax E-mail Planner State License Number PPLICANT NAME Name P' Address --l47 CityState J Zup� 61 4a No Occ. E-mail PPLICANT SIGNATURE X For office use only: Zoning Flood Zone Property Address SRA I Yes No Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: PERAUT �/- 40 L5 BP BIN # OVER FOR SUBMITTAL REQUIREMENTS It K TORMSWILDING FORMS\BIdgApplSubRgmts.doc Page 1 of 2 Description orAcope of Wo k: 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 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. Received by: _P' Amount: Bldg Receipt #: 1112-4 3� Sheriff SMIP Other 55 ///�j J� / A01 f, v Total REV 7-27-04 LOCATION Property Address City Cross Street WORKER'S COMPENSATION Policy Number er— T _ZL�_ 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 OVER FOR SUBMITTAL REQUIREMENTS It K TORMSWILDING FORMS\BIdgApplSubRgmts.doc Page 1 of 2 Description orAcope of Wo k: 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 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. Received by: _P' Amount: Bldg Receipt #: 1112-4 3� Sheriff SMIP Other 55 ///�j J� / A01 f, v Total REV 7-27-04 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paperl ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (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. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). — ❑ 13. Sanitation and site plan approval from the Environmental Health Department. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530)538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Ketunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSOUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 License Detail r California Home Page I of 2 License Detail CALIFORNIA CONTRACTORS STATE LICEN_ Contractor License # 835718 DISCLAIMER A license status check provides information taken from the CSLB license data base. Before on this information, you should be aware of the following limitations: . CSLB complaint disclosure is restricted by law (B&P 7124.6). If this entity is subject tc complaint disclosure, a link for complaint disclosure will appear below. Click on the lin button to obtain complaint and/or legal action information. . Per B&P 7071.17, only construction related civil judgments known to the CSLB are di. . Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. . Due to workload, there may be relevant information that has not yet been entered ont Board's license data base. Extract Date: 08/30/2004 * * * Business Information * * * PELLA WINDOW AND DOOR COMPANY OF CALIFORNIA INC 6999 SOUTHFRONT ROAD LIVERMORE, CA 94551 Business Phone Number: (925) 245-4470 Entity: Corporation Issue Date: 04/08/2004 Expire Date: 04/30/2006 * * * License Status * * * License is under suspension for the following reasons: License is under suspension for failure to comply with Workers Comp. A workers" compensation certificate or exemption statement may have been received by the Boai not yet processed. Once the certificate or exemption statement is processed the suspi will be lifted retroactively to the effective date of the certificate or exemption statement contractor for proof of worker's compensation and contact the insurance company to v coverage. * * * Classifications * * * Class Description 7-11 1 http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 08/30/2004 License Detail ILB _]IGENERAL BUILDING CONTRACTORII * * * Bonding Information * * * Page 2 of 2 CONTRACTOR'S BOND: This license filed Contractor's Bond number 10122616 in the an $10,000 with the bonding company AMERICAN CONTRACTORS INDEMNITY COMPANY. Effective Date: 03/03/2004 BOND OF QUALIFYING INDIVIDUAL(1): This license filed Bond of Qualifying Individual i 10122615 for JOHN GILLIN MACKALL JR in the amount of $7,500 with the bonding con AMERICAN CONTRACTORS INDEMNITY COMPANY. Effective Date: 03/03/2004 * * * Workers Compensation Information * * * This license has workers compensation insurance with the WAUSAU UNDERWRITERS INSURANCE COMPANY Policy Number: WCJZ15007114013 Effective Date: 07/01/2003 Expire Date: 07/01/2( Personnel listed on this license (current or disassociated) are listed on other licell Personnel List SalesPerson_List Other Licenses License Number Request Contractor Name Request Personnel Name Request Salesperson Request Salesperson Name Request © 2004 State of California. Conditions of Use Privacy Policy_ http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 08/30/2004 N 50-010* t- -PERMIT#95-17818' HILL, an. t' 3906'Hildale Ave.', Orovi-lle, _Cont; Ely Roofing R6roof /SF"-/gl��`. y COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, CaliforWa .95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER Uod-350-u1u ZONING BUILD PERMIT OWNER Jan dill TELEPHONE _ SO. FT. OCC. BUILDING[� VALUATION OWNERS MAILING ADDRESS 39UU ttilldale Ave Uroville CA 95966 �� G CONTRACTOR'S NAME 61Y Rootillp, Inc TELEPHONE 343-7663 CONTRACTORS MAILING ADDRESS 13291 Contractors Freplace CONSTRUCTION LENDER UNMOWN Total Valuation $ Fling Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $54.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS 39UU ailldale Ave - Uroviille PERMITFEE $ t r/ PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNISION'SNAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF CJl- Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ , Utilities ❑ Installation ❑ Other 01 Describe Work: remove & replace roofing w/30 yr arca — 34 898 Mobile Home IS I GI W @20.00 PERMITFEE S Contractor ELECTRICAL PERMIT Filina Fee 20.00 •t� Main ServiceE°°V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO I°°°A ) 46.00 LICENSED CONTRACTOR'S 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 effect. License Class �%' 14 , �%" 3 y Lic. No. 6073861 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Claw for the following reason: ❑ 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP, OR ADDNS. & ACC. BIDS. ( ) so. 3.50 FT.NEW CONST.MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FDCTURES ) 2° 0 I•50 BAL se Ex. Occup. (OUTLETS (RES D.�EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE _ Contractor 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 self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. © I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: K Carrier .ate r'und MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number 536-140 (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 become subject to 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 "e e provisions. '"• X Dete _ 7-24-95 Signat re of Applicant - ❑ Owner O Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction.! of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE ? /. .0� 1 TOTAL FEE $ / Y U HAZ. I D. FEES I IMP I FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have B + r. PERM ITEXPIRESON applicable provisions Resolutions to do work been paid. Date ., gate) Receipt No./%z WHITE-D.D.S.-B.D. ANARY-ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - 0rovil1p, CaWornia 95965 - Telephone (916) 538-7541 PE§MIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 068-350-010 ZONING BUILD G PERMIT OWNER Jan rill TELEPHONE 534-099834u0 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 3900 Hillidaie Ave Oroville CA 95966 2040 CONTRACTOR'S NAME Ely _:oofiz inc TELEPHONE 343-765 CONTRACTORS MAILING ADDRESS 13 2 1 i. O71 t ;act C` 0� S t 9' y Fireplace CONSTRUCTION LENDER �, UNMOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $54.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS 39J0 lilliCiale Ave - OrovillC PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LAT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF [1' Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other 1 �� Describe Work:-r:-LuOV.., &reDlaC.,' roofing w/30 yr arch - 34 sqs Mobile Home I S I GI W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service Oo-A OR LESS ( zoooR LEss ) 1 23.00 Main Service ( 200A To 1000A ) 46.00 LICENSED CONTRACTOR'S 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 effect. License Class C"-14, C — 3 OJ Lic. No. 607386 OWNER-BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages astheir sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR SO. OR ADONS. ( 8 ACC. ) 3.5¢ FT. NEW CONST. MULTI.OUTLET UTLE NON•RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup.(OUTLET OR FIXTURES ) BAL Oa 1:00 Ex. Occup. oFIXEeDrs PILNS..j OR ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor 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 self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier St -ate Fund MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number 538-146 (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 become subject to 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 gio§e provisions. ` - _ X Date _ / — 2 — 9 5 Signal re of Applicant - ❑ Owner ]D Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is Occ CONST. TYPE I TOTAL FEE $ 7 4.0 0 HAZ. I D. FEES I IMP I FLOOD F77r;ZCq PD HO ISSUE 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. &JQ Date BC,4 i4p , ^_ PERMITEXPIRESON A 9/." p fie) Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD.APPLICANT .;,,;r..nr ,, .. ,..-,,..'.ws.Tr J7r�•'�sr.i",�,�'»yrcrW,+car,.-te...:ty,u�,.:.ti.. ^'K�3c.3+sY/?ii�y�i .'1'1{f'"�-�:�"^r�.F''�./'4fi.LCd3.sr;:+�...iwr.N.16..�:.n,Vw,,',dVT��gii%T-i: .Y+'n{�-v+-„w.+P'.pl� .�w1^'.i.rrsrra+w:.� zAr r 4 - 4 I + COUNTY OF BUTTE - DEPARTA ENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND,PERMIT ASSESSOR PrAY1EL NUMBER " v ZONING BUILDING PERMIT OWNER ^�/� ,� TELEPHONE q -6q4_1 SO. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDR SS ' Q,L C _ CONTRACTOR'S NAME Of PHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER /i &LTotal UNKNOWN Valuation Is Filing Fee $ 10•00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER 7,4-,A LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR/) ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 " Each Trap 2.00 Repair drainage or vent piping 5.00 Q /(� Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: 1,20 b, ,,• o • r • //s.r C -ttJFk t �ti�F Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 0v OR LESS 100 AMP OR LESS 10 5•00 _ Main service EA- ADD'L 100 AMP 2.50 NEW CONST. (DWELLING OCCUP.y\ OR ADDNS. l ACC. BLDGS. / 2¢sgft 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 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 CONSTR •OU LET '2.50 ea NON.RESID BRANCH CIRC ITS NEW CONSTR.POWER APPARATUS &) NON•RESID, (SINGLE OUTLET CIR, Ex. Occup OUTLETS OR FIXTURES g @2j IXED APPLNS. OR Ex. Occup. (DUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 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 shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee S 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 against said County in consequence of the granting of this permit. X Date Signature of Applicant - Owner ❑ Contractor ❑ Agent ❑ 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 $ TOTAL PERMIT FEE $ occuP. GROUP I TYPE OF CONST, PARCEL PD F----7IsSUE This permit-is.hereby issued under sions ofi'the Butte County Code and/or work indicated abov6 for which / DIRECTOR OF PUBLIC BY f �r PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS j Date (� 1 Receipt No. 7/ �O WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chime Phone: 891-2751 7 County Center Drive, Oru�i Ile 43hone: 534-4541` Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 Co' RtRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone :74-45413APPLICAYION AND PERMIT ASSESSOR nAr^y—'RCEL NUMBER 9� ZONING BUILDING PERMIT owfxR TELEPHONE SW `-d SQ. FT. OCC. BUILDING VALUATION OWNER'S IDDR SS O ' AV CONTRA ORSNAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADD ESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGIN E MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF [I Duplex❑ Mobilehome❑ Other SPECIFY Building sewer 06 Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ tilities ❑ Installation❑ Other Describe work: / A.19 Permit Fee $ Dd Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. / DWELLING OCCUP.51 OR ADDNS. ( ACC. BLDGS. 22 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Busfiness 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 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 CONSTR. -OUTLET 2,50 ea NO N.R ESID BRANCH CIRC ITS NEW CONSTR. ( POWER APPARATUS e� NON.RESID. SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES BAL@1 IXED APPLNS. OR Ex. Occup. (o UTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 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. 1 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. 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 against said County in consequence of the granting of this permit. %� Date q ^ 3 — oL ` r Signor re of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structuresover 3 stories in height. Mobile Home Installation Fee $ TOTAL/ PERMIT FEE $ occuP. GR up TYPE OF CONST. PARCEL PO ND ISSUE This perm' hereby i sued under sions d he B tte C y Code and/or work ' dicate abo for which R O OF PUBLIC BY PER EXPIRES t the applicable provi- resolutions to do fees have been paid. WORKS Date/C3/,r. Receipt No. /�5p0 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT