Loading...
HomeMy WebLinkAbout069-430-013B06-2813 069-430-013 MISCELLANEOUS Re -Roof RE -ROOF 18 SQ'S COMP- OMP1l0 ELECTRIC SERVICE PAN 110SKYLINE BLVD 1 10 SKYLINE BLVD HARRY HANSEN HARRY HANSEN d� 1306-2847 ' 069-430-013 MISCELLANEOUS Remodel REMODEL 1500 SQ.F'T. ( 110 SKYLINE BLVD f ; HARRY V. HANSEN S_ TAMFIELD_, P_ .----- - - -- . 3;6248 -_ DO 110 Skyline Blvd., Oroville 34-45-13 CONTR: Alum. Builders, 707-D Sutter St., Yy (alum. siding & new windows) CI a � f 1 B07-0090 069-430-013 MISCELLANEOUS Electric Panel ELECTRIC SERVICE PAN UP GRAI 1 10 SKYLINE BLVD HARRY HANSEN d� S_ TAMFIELD_, P_ .----- - - -- . 3;6248 -_ DO 110 Skyline Blvd., Oroville 34-45-13 CONTR: Alum. Builders, 707-D Sutter St., Yy (alum. siding & new windows) CI a � f 1 t C� � � � ..r � :. V �? . C� � � � ..r � :. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES INSPECTION CARD 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B06-2813 Issued: 12/08/2006 Address: 110 SKYLINE BLVD OROVILLE APN: 069-430-013 Permit Subtype: Re -Roof Owner: HARRY HANSEN Applicant: HARRY HANSEN Description: RE -ROOF 18 SQ'S COMP MUST BE ON JOB SITE JOB SHALL BE READY PRIOR TO CALLING FOR INSPECTION. THE INSPECTION CARD AND APPROVED PLANS MUST BE AVAILABLE FOR EACH INSPECTION OR THE INSPECTION WILL NOT BE MADE AND A RE -INSPECTION FEE MAY BE ASSESSED. ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setacs 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Roof Nail 129 Shower Pan/Tub Test 408 Fire Sprinkler 702 Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Gas Test 404 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Project Final 801 1 TZ X, 11,16,9 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 110 SKYLINE BLVD Owner: Permit NO: B06-2813 APN: 069-430-013 HARRY HANSEN Issued Date: 12/08/2006 By TMP Permit type: MISCELLANEOUS P.O. BOX 168 Subtype: Re -Roof OROVILLE, CA 95965 Expiration Date: 12/08/2007 Description: RE -ROOF 18 SQ'S COMP (530) 589-1997 Occupancy: Zoning: AR1 Contractor Applicant: Square Footage: HARRY HANSEN Building Garage Remdl/Addn P.O. BOX 168 OROVILLE, CA 95965 Other Porch/Patio Total (530)589-1997 FEE INFORMATION Re -Roofing $110.00 Total Charged: $110.00 Fees Paid: $110.00 Balance Due: $0.00 Receipt No: B1135 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. 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 X 12/08/2006 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractors Signature Date , f I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE �J COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements 0 1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, ❑ 1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED as required by 11I CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law down not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). Carrier. Policy Number: Exp. Date: (This section need not a comted if the permit is or dollars ($100) or ess. pleon ❑ I AM EXEMPT under Section B. & P.C. for this reason: rVKCERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS l�J ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X)Lld�12/0$/2006 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owners Signature Date provisions. X 12/08/2006 1 hereby certify that I have read this application and state that the above information is con.ct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Si nature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused arising out of, o,o in any way connected with HUNDRED THOUSAND DOLLARS $100,000 , IN ADDITION TO THE COST OF COMPENSATION, ( ) the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the t is a DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the roparty owner or a uthorized to act o the propertyr behalf. 1//08/2006 /\12 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner Contractor OR E]Agent for Owner Agent for Contractor 1:361 0 FILE COPY Lenders Address City State Zip ,Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: '13 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. C If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal C income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations unders state law, contact the Department of Benerit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform thier work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons prefessing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not requir3ed to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. / 1 / I PERSONALLY PL O PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY l/ IMPROVEMENT�OR NO) 2. (HAV VE 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: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS CITY, PHONE CONTRACTORS LICENSE NO 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: RE -ROOF 18 SQ'S COMP Reference Number: B06-2813 Applicant Name: HARRY HANSEN Signature of Property Owner: !/ Date t 2006-0055641 .. RECORD4\G REQUESTED BY Recorded I FEC FEE Ito Bidwell Title & Escrow Company Official yRecords I TRX 228.88 . � ��tta f I AND WHEN RECORDED MAIL TO ( t 6111.110 1 N"" Harry V. Hansen County Clerk-Recorderl s„m Addnm P.O. Box 168 1 NP 69188181 25-Oct-M 1 Page 1 of 2 cuy•s"" Orovllle,Ca95965 Ordr* 00229426-001 SPACE ABOVE THIS LINE FOR RECORDER'S USE fame] No. 069-430-013 GRANT DEED THIS FORM FURNISHED BY BIDWELLTTTLE & ESCROW COMPANY The Undersigned Grantors) Declarc(s) Documentary Transfer Tax is $220.00 O City/Town of 0 computed on full value of interest or property conveyed. or 0 Unincorporated Area D full value less value of liens or encumbrances remaining at ' the time of sale O Monument Fee of S 10.00 FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Juanita M. Pierson Successor Trustee of the Alvis D. and Juanita M. Pierson Joint Living Trust DTD 11-5-96 hereby GRANT(s) to Harry V. Hansen an unmarried man the following real property in the 0 City of 0 Unincorporated Area County of Butte, State of California: SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF Alvis D. and Juanita M. Pierson Joint Living True DTD 11-5-96 Ju to M. Person, Successor Trustee Document Date: October 17, 2006 State of California CountyofButte } SS. On October 17, 2006 before me, Ga la Wilder Notary Public, personally appeared Juanita M. Pierson• r proved to me on the basis of satisfactory FOR NOTARY SEAL OR STAMP evidence) to be the person(y) whose namc{r4 isltyb subscribed to the within instrument and acknowledged to me that I)e/she/tbey executed the same in t$s/her/t*ir authorized capacity(igo, and that by hiVhcr/thelr signature(s) on the instrument the person(p), or the entity upon behalf of which the person(!) acted, executed the instrument. GAYLA wilm SCOMM.EXRFEIL22,2007-A COMM,* 1399916 WITNESS myhan of ii all seal. ` OTARTPOBUGCAIIFORMIA0 8COl1MY O Cin _ ur MAIL X4ATEMENTS TO: Same as Above BTECIGPANTDEED r ab Order No. 00229426-001 EXHIBIT A THE LAND REFERRED TO HEREIN 1S DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: PARCEL 1: A PORTION OF LOT 71, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "OFFICIAL MAP OF OROVILLE-WYANDOTTE FRUIT LANDS UNIT NO. 3" WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, OCTOBER 10, 19271N BOOK 11 OF MAPS, AT PAGES 19 AND 20, MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE NORTHWEST CORNER OF SAID LOT 71, SAID POINT BEING ALSO A POINT IN THE CENTERLINE OF SKYLINE BOULEVARD, AS SHOWN ON SAID MAP AND RUNNING THENCE ALONG SAID CENTERLINE OF SKYLINE BOULEVARD, SOUTH 77' 24' EAST 204.42 FEET; THENCE LEAVING SAID CENTERLINE, SOUTH 0" 40' WEST 227.32 FEET; THENCE NORTH 890 20' WEST 200.00 FEET TO A POINT IN THE WEST LINE OF SAID LOT 71; THENCE ALONG SAID. WEST LINE OF LOT 71, NORTH 0° 40' EAST 269.59 FEET TO THE:POINT OF BEGINNING. --• AP NO. 069430-013 PARCEI; 2: A PORTION OF LOT 71, OROVILLE-WYANDOTTE FRUIT LANDS UNIT NO. 3, MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE NORTHWEST CORNER OF SAID LOT 71, SAID POINT BEING ALSO A POINT IN THE CENTERLINE OF SKYLINE BOULEVARD AS SHOWN ON SAID MAP; THENCE ALONG THE LINE BETWEEN LOTS 70 AND 71, SOUTH 0° 40' WEST, 269.59 FEET TO THE TRUE POINT OF BEGINNING OF THE PARCEL OF LAND HEREIN DESCRIBED, SAID POINT BEING ALSO THE SOUTHWEST CORNER OF PARCEL 1 AS DESCRIBED IN THE DEED FROM NINA HILTON TO PAUL M. STANFIELD AND HILDA E. STANFIELD, HIS WIFE, DATED APRIL 21, 1950 RECORDED APRIL 25,1950, IN BOOK 537 OF BUTTE COUNTY OFFICIAL RECORDS, AT PAGE 494; THENCE FROM SAID TRUE POINT OF BEGINNING AND CONTINUING ALONG THE LINE BETWEEN LOTS 70 AND 71, SOUTH 0.40' WEST,198.89 FEET TO THE NORTHWEST CORNER OF THE PARCEL OF LAND DESCRIBED IN THE DEED FROM NINA LEE HILTON AND ELBERT B. HILTON, HER HUSBAND, TO GEORGE H. ROBINSON AND JUANITA L. ROBINSON, HIS WIFE, DATED DECEMBER 8, 1945, RECORDED JANUARY 8, 1946 IN BOOK 390 OF BUTTE COUNTY OFFICIAL RECORDS, AT PAGE 14; THENCE ALONG THE NORTH LINE OF SAID ROBINSON PARCEL, NORTH 88° 53' EAST, 200.10 FEET TO A POINT; THENCE NORTH 00 40' EAST, 192.67 FEET TO THE SOUTHEAST CORNER OF SAID STANFIELD PARCEL; THENCE ALONG THE SOUTH LINE OF SAID PARCEL, NORTH 89° 20' WEST, 200 FEET TO THE TRUE POINT OF BEGINNING. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" APPLICANT INFORMATION OWNER INFORMATION Last Name U5. �/� irst Name Mailing Address �D � D� ! t�5 6 City��� st Sta� Zp�s 'I&. -mail Fax E-mail Class APPLICANT INFORMATION CONTRACTOR Name City Address Zip City Fax st P U- —/57 Fax -mail E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Date Approved: Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGIYATURE X el For office use only: Zoning Flood Zone I I SRA L Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERAUT NO. 11t►in; PROJECT LOCATION AP#(D _�DO Property Address �l/ City Cross S,tregt j SRA 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: C (� Sq FT- Living Garage Open Cov ❑ 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: Amount: /Ili• Bldp SRA Receip Sheriff SMi? Data: Other G / O (/ //► �L - cu Total (J BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 110 SKYLINE BLVD Owner: Permit No: B06-2847 APN: 069-430-013 HARRY V. HANSEN Issued Date: 12/14/2006 By TMP Permit type: MISCELLANEOUS P.O. BOX 168 Subtype: Remodel OROVILLE, CA 95965 Expiration Date: 12/14/2007 Description: REMODEL 1500 SQ.FT. (530) 589-1997 Occupancy: Zoning: ARI Contractor Applicant: Square Footage: OWNER HARRY V. HANSEN Building Garage Remdl/Addn P.O. BOX 168 1,500 OROVILLE, CA 95965 Other Porch/Patio Total (530) 589-1997 1,500 FEE INFORMATION Remodel - Residential $1,154.79 cs Total Charged: $1,154.79 Fees Paid: $1,154.79 Balance Due: $0.00 Receipt No: B1206 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License OWNER / / Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, , also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) 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. 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 X 12/14/2006 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractor's Signature Date I` 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED HAVE ❑CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law down not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). Carrier: Policy Number. Exp. Date: (This section nee not a completed if the permit is or one hundred dollars ($100) or ess. ❑ 1 AM EXEMPT under Section B. 8 P.C. for this reason: CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X 12/14/2006 compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those Owners Signa re Date provisions. X 12/14/2006 I hereby certify that I have read this application and state that the above information is coned. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless its o Butte County, officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the pr p rly owneror m uthorized to ado a property owners ehalf. CONSTRUCTION LENDING AGENCY 0/14/2006 Name o Pe mittee [SIGN] Print r Date I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) EI ,( Owner Owner � Contractor OR. Agent for Owner Agent for Contractor COPY Lenders Address City State 7,pEl /#- Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations unders state law, contact the Department of Benerit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform thier work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons prefessing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not requir3ed to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY P[ 4NXTO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. OR NO) 16?/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 THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME CITY PHONE CONTRACTORS LICENSE NO 5. 1 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 Description: REMODEL 1500 SQ.FT. Reference Number: B06-2847 Applicant Name: HARRY V. HANSFN Signature of Property Owner: Date: .BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.nettdds "PLEASE PRINT CLEARLY* OWNER INFORMATION Last Name 5 ,p ,� / first N Mailing Address P—hC v� ox /�� City Zip City P o b__5 fl-'Gf 7 Fax E-mail APPLICANT INFORMATION CONTRACTOR Name QWAeC City Address Zip City Fax State Zip Phone TLot # Fax E-mail Date Approved: Uc. # _T Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone TLot # Fax E-mail Date Approved: State License Number APPLICANT INFORMATION Name fit' Address City State Zip Phone Fax E-mail APPLICANT IGNATURE X &rz For office use o PROJECT LOCATION Zoning I Flood Zone I _JSRAJ Yes No., Occ. Type Const. Subdivision Name e �� Map Book Page TLot # Planner Policy Number Date Approved: PERAUT NO. BIN # Description or Scope of Work: q FT- Livin SOO Garage Open Cov ❑ 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 b Amount: %�S� 7 Bldg SRA Receipt #: (�t Sherif SMIP 1� Other Dat1'q Jy :S_ "< 1 Total PROJECT LOCATION Propert�yAds ec:: �i Cross Street' e �� 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: q FT- Livin SOO Garage Open Cov ❑ 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 b Amount: %�S� 7 Bldg SRA Receipt #: (�t Sherif SMIP 1� Other Dat1'q Jy :S_ "< 1 Total BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 110 SKYLINE BLVD Owner: Permit No: B07-0090 APN: 069-430-013 HARRY HANSEN Issued Date: 01/17/2007 By TMP Permit type: MISCELLANEOUS P.O. BOX 168 Subtype: Electric Panel OROVILLE, CA 95965 Expiration Date: 01/17/2008 Description: ELECTRIC SERVICE PANEL UP G1 (530) 589-1997 Occupancy: Zoning: ARl Contractor Applicant: Square Footage: OWNER HARRY HANSEN Building Garage Remdl/Addn P.O. BOX 168 OROVILLE, CA 95965 Other Porch/Patio Total (530) 589-1997 FEE INFORMATION Single Phase Service - Res $55.00 Total Charged: $55.00 Fees Paid: $55.00 Balance Due: $0.00 Receipt No: B1515 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License OWNER / / Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) is in full force and effect. 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 X 01/17/2007 the applicant to a civil penalty of not more than five hundred dollars ($500]; Please check one of the following: Contractor's Signature Date j 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). Cartier. Policy Number. Exp. Date: (This section nee not competed if the permit is or one hundred dollars ($100) or ess. ❑ I AM EXEMPT under Section B. 8 P.C. for this reason: I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X 01/17/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signatu Date provision . X kAl 01/17/2007 I hereby certify that I have read this application and state that the above information is coned. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE udi injury, including death, and property damage caused by, arising out of, or in any way connected with o,o HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the grope V owner or a thorizedtoact gnt property owners ehalf. 1/17/2007 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency forName of erm ee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner ❑ Contractor OR; Agent for Owner ❑Agent for Contractor FILE COPY Lender's Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name first a y� / v Mailing A dress /p, �?o r g6 s/ S City (/ (�/ t L5 Occ. Phone -Fax E-mail APPLICANT SIGNATURE X For office use only: CONTRACTOR Name )___ Address Occ. City Type Const. State Zip Phone Page Fax E-mail Lic. # Class APPLICANT SIGNATURE X For office use only: ARCHITECT/ENGINEER Name _ Flood Zone SRA I Yes Address Occ. City Type Const. State Zip Phone Page Fax E-mail State License Number APPLICANT SIGNATURE X For office use only: APPLICANT INFORMATION Name _ Flood Zone SRA I Yes Address Occ. City Type Const. State Zip Phone Page Fax E-mail APPLICANT SIGNATURE X For office use only: AP# Zoning _ Flood Zone SRA I Yes No Occ. Policy Number Type Const. Subdivision Name LENDING AGENCY Map Book Page Lot # Planner Date Approved: PERMIT NO. Bo&- 27 BIN # PROJECT LOCATION AP# Pro erty Add e s L City Cross WORKER'S COM ENSAT/ON 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 S ope o Work: Sq FT- Living Garage Open Cov ❑ 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: Amount: SSS5, Bldg SRA Receipt #: Sheriff SMIP Date: Other Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° if you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. G If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal G income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations unders state law, contact the Department of Benerit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform thier work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at I-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY PLN�IITO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. OR NO) IHAV /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 THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: ADDRESS 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 Description: ELECTRIC SERVICE PANEL UP GRADE Reference Number: B07-0090 Applicant Name: HARRY HANSEN / 7 Signature of Property Owner: Date: