The URL can be used to link to this page

Home My WebLink About069-500-032BUTTE 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: 6 FERNBACH CT Owner: Permit NO: B07-0517 APN: 069-500-032 WARD, FAMILY LIVING TRUS Issued Date: 03/16/2007 By TMP Permit type: MISCELLANEOUS 6 FERNBACH CT Subtype: HVAC Change Out OROVILLE, CA 95966 Expiration Date: 03/15/2008 Description: NEW HVAC SYSTEM Occupancy: Zoning: RI Contractor Applicant: Square Footage: GALLAGHER'S HEATING & AIR JENNIFER D. GRUBER Building Garage RemdUAddn PO BOX 35 3083 WHISTLER WAY LOS MOLINOS, CA 96055 CHICO, CA 95973 (530)384-2444 (530)680-7619 Other Porch/Patio Total FEE INFORMATION DBM Heat Pump (Package Unit) $55.00 Total Charged: $55.00 Fees Paid: $55.00 Balance Due: $0.00 Receipt No: B2206 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 GALLAGHER'S HEATING & AIF 777334 / C20 C38 / 04/30/2008 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 a ct. 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 03/16/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Q'vntractor's Si tune Date ❑ I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR the 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 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.1 I}IAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Carrier: State Fund policy Number: 713-0013855 Exp. Date:05/01/2007 Contractor's License Law.). (This section nee not be competed if the permit is or one Fun red dollars ($100) or less. ❑ 1 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 03/16/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. 03/16/2007 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building PAR'Nt re Date NG: 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 HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including death, and property damage caused arising out of, or in any way connected with DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the t is 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 perty to a ton the prop _rty o efs behalf. CONSTRUCTION LENDING AGENCY �&amgthoqrized ,, r✓.ufi 03/16/2007 Ame I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for a ittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) ❑ Owner ❑ Contractor OR E]Agent for Owner ffAgent for Contractor FILE COPY Lender's Address City State zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR fNSPECSUBMITTAL REQUIREMENTS TION# O OVILLECH CO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** PERMIT ;�_3eq- (5111 BP APPLICANT INFORMATION Name GCtf4 V C C Address � City StateC q Phone Fax E-mail APPLICANT SIGNATURE F6r office use only: Zoning Flood Zone SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:IFORMSOUILDWO. FORMS1BIdgApplSubRgmts.doc Page 1 of 2 REV 8-12-05