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Home My WebLink About071-440-013J r c� WILLIAMS,. Irma_ 56 B { " 071.-440=013 ' 4309P B06-2263 :,' MISCELLANEOUS ` 'Re-Roof 5 8 E -564 RE-ROOF,(32 SQ) `' �, _ �, . - 4 - �• . off w/s Ponderosa Way a —45 ROCKER_FELLER RD Y PP • mi . past Ra ---- fellow School G.-7 r CR SS, BECKY DUNKER . -• . - CONTR: James M. Ladd'Const., 1363 Feather, V!, _ (new ' n$le fami g _ 6 Blvd .., Orov : i - /-aa- Of 4 i 4 4 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: 456 ROCKERFELLER RD Owner: Permit No: B06-2263 APN: 071-440-013 CROSS, BECKY DUNKER Issued Date: 09/21/2006 By KCG Permit type: MISCELLANEOUS 454 ROCKEFELLER RD Subtype: Re -Roof BERRY CREEK, CA 95916 Expiration Date: 09/16/2007 Description: RE -ROOF (32 SQ) Occupancy: Zoning: U 00 Contractor Applicant: Square Footage: FOUR SEASONS ROOFING FOUR SEASONS ROOFING Building Garage Remdl/Addn 11 COMMERCE CT. #1 11 COMMERCE CT. #1 CHICO, CA 95928 CHICO, CA 95928 Other Porch/Patio Total (530)895-0418 (530)895-0418 FEE INFORMATION Re -Roofing $192.50 Total Charged: $192.50 Fees Paid: $192.50 Balance Due: $0.00 Receipt No: B207 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 FOUR SEASONS ROOFING CSLB-659073 / / 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) inof 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 �fort.is X 09/21/2006 the applicant to a civil penalty of not more than five hundred dollars [$500]; Contractor's Signature Date Please check one of the following: ❑ 1, 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 properly, 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.). HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, by 1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED as required 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 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 1850644 07/01/2007 Carrier: STATE FUND Policy Number: Exp. Date : Contractors License Law.). (This section need not be completed if the permit is or one a hundred dollars ($100) or less. ❑ 1 AM EXEMPT under Section B. & 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 09/21/2006 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. 09/21/2006 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 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 CIVIL FINES UP TO ONE injury, including death, and property damage caused 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. 1 hereby acknowledge thatt is 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 pre wner or apr=tionzed t on the pro owners behalf. CONSTRUCTION LENDING AGENCY 09/21/2006 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] P 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 FILE Lender's Address City State Zip i A 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.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name ViW Name C_ l Mailing Address f5 lgc City State Zi �S Phone Fax E-mail CONTRACTOR Name F6 sE�4 So Addres c097 c—Q City C 4 " C Stat R sq �Lg Phonjt Fax E-mail Lic'5�o7 �' Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City ; State Address PhFax City Subdivision Name State Zip Phone Planner Fax' E-mail State License Number APPLICANT INFORMATION Name 1 �� S �� Address G C_6 c City ; State Fzi_� PhFax E-mail APPLICANT SIGNATURE X l For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BIN # PROJECT LOCATION AP# `1f�,- 3 Property Address City Cross Street SMIP WORKER'S COMPENSATION Policy Number Jig ) Ce Carrier If hiring anyone other thanlicense contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address scription or Sope of Work: Sq FT- Living Garage Open Cov El 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. IiReceivedby:i& Amount: I 2 a Bldg I1 SRA Receipt #: P)9-07 SMIP Date: /Z1� Other 'DU Total