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HomeMy WebLinkAbout072-080-006072-080-006 00-0094 SIMS, JAY 1859 MT. IDA, OROVILLE CONTR: OWNER WOOD STOVE `%(JK L �/ /d B07-0560 072-080-006 MISCELLANEOUS Ag Exempt AG EXEMPT BLDG- (900) TRACTOR 1 1859 MT IDA RD SIMS, JAY & CLAUDETTE4 A�3� 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: 1859 MT IDA RD Owner: Permit NO: B07-0560 APN: 072-080-006 SIMS, JAY & CLAUDETTE Issued Date: 04/12/2007 By KCG Permit type: MISCELLANEOUS 1859 MT IDA ROAD Subtype: Ag Exempt OROVILLE, CA 95966 Expiration Date: 04/11/2008 Description: AG EXEMPT BLDG- (900) TRACTO (530) 589-4652 Occupancy: Zoning: A -R Contractor Applicant: Square Footage: SIMS, JAY & CLAUDETTE SIMS, JAY & CLAUDETTE Building Garage Remdl/Addn 1859 MT IDA ROAD 1859 MT IDA ROAD OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch/Patio Total (530) 589-4652 (530) 589-4652 FEE INFORMATION DBEH Building Review Fee $75.70 DBOMSCF Ag Exemption Permit $109.98 Total Charged: $185.68 Fees Paid: $185.68 Balance Due: $0.00 Receipt No: B2272 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 SIMS, JAY & CLAUDETTE OL:CRW_00415123 / / 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 X04/12/2007 the applicant to a civil penalty of not more than five hundred dollars [$500); Pleasecheckone of the following: Contractor's Signature Date g21"S OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE t! --: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 ❑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 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 Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compansation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier: Policy Number: Exp. Date: (This section reed not be completed if the permit is or one hundred dollars ($100) or less.) M EXEMPT under Section B. & P.C. for this reason: ❑ I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS SSUED, 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 04/12/2007 ce tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Sig atur Date p visions. r X 04/12/2007 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 Signature Date WARNING: FAILI, JIRZETSEC 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 SUBN 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 mentions property for inspection purposes. I hereby certify that I am the erty o or am authorized to ton the pr rty owner• behalf. 0.m 04/12/2007 CONSTRUCTION LENDING AGENCY N P rmittee [SIGN] Print Date 1 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) Owner ❑ Contractor OR; Agent for Owner DAgent for Contractor FILE COPY Lender's Address City State zip 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 AGRICULTURAL BUILDING EXEMPTION STATEMENT Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated or packaged, nor shall it be a place used by the public. Buildings used for purposes other than described above or that are located in a flood hazard zone are not eligible for an agricultural exemption. Authorization of an agricultural exemption permit by the Department of Development Services does not preclude any requirements and/or review by the Butte County Public Works Department, Butte County Fire Department, Butte County Environmental Health, or any state and federal agencies. Initial AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. InitialsAG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a manufactured home, and 23 feet from a commercial/industrial buildings Initis AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum 23 feet from a residence and a manufactured home, and 40 feet from a commercial/industrial buildings Site Address: 1859 MT IDA RD Permit No: B07-0560 APN: 072-080-006 Square Footage: 0 Permit Type: MISCELLANEOUS Occupancy: Permit Subtype: Ag Exempt Zoning: A -R Description: AG EXEMPT BLDG- (900) TRACTOR IRRI, Required Setbacks: Applicant: SIMS, JAY & CLAUDETTE Front: 20' 1 Side: 20' Rear: 20' 1859 MT IDA ROAD Type of Construction: OROVILLECA95966 (530) 589-4652 Type of Siding: Hardiplank Owner: SIMS, JAY & CLAUDETTE Est. Const. Cost: $ 7,500.00 1859 MT IDA ROAD OROVILLE, CA 95966 Roof Covering: Compostion (530) 589-4652 Floor Type: Concrete I declare under penalty of perjury that the building will be used as stated above, and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain the necessary permits, inspections and approvals to comply with the requirements in effec�,at that time and,p ,ior,,to occupancy. Signature of owner: FILE COPY Date: 03/22/2007 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 AGRICULTURAL BUILDING EXEMPTION STATEMENT Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated or packaged, nor shall it be a place used by the public. Buildings used for purposes other than described above or that are located in a flood hazard zone are not eligible for an agricultural exemption. Authorization of an agricultural exemption permit by the Department of Development Services does not preclude any requirements and/or review by the Butte County Public Works Department, Butte County Fire Department, Butte County Environmental Health, or any state and federal agencies. Initials AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. Initials AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a manufactured home, and 23 feet from a commercial/industrial buildings Initials AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum 23 feet from a residence and a manufactured home, and 40 feet from a commercial/industrial buildings Site Address: 1859 MT IDA RD Permit No: B07-0560 APN: 072-080-006 Square Footage: 0 Permit Type: MISCELLANEOUS Occupancy: Permit Subtype: Ag Exempt Zoning: A -R Description: AG EXEMPT BLDG- (900) TRACTOR IRRI, Required Setbacks: Applicant: SIMS, JAY & CLAUDETTE Front: 20' 1 Side: 20' Rear: 20' 1859 MT IDA ROAD Type of Construction: OROVILLECA95966 (530) 589-4652 Type of Siding: Hardiplank Owner: SIMS, JAY & CLAUDETTE Est. Const. Cost: $ 7,500.00 1859 MT IDA ROAD OROVILLE, CA 95966 Roof Covering: Compostion (530) 589-4652 Floor Type: Concrete I declare under penalty of perjury that the building will be used as stated above, and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain the necessary permits, inspections and approvals to comply with the requirements in effect at that time and prior to occupancy. Signature of owner: INSPECTOR COPY Date: 03/22/2007 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 PAX #: (530) 538-2140 A FEE WILL BE KEQUIRED A s' t IME OF APPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** —_QPPLI( XA Nam I s _ Address City /►� o v t � � n Phone 0589 4 E-mail T-!NF•_),YAJA 00N State Fax E PERMIT NO. , 6 9 j Ul BIN # PRO.lECT LOCATION API Z 00 0 Property Addressi� City D U / /� 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, 9f WORK: OWNER INFORMATION Last Name �l First am Mailing Adcressit U 4— �Sttate/I' City / /1 ( ,'T Zip Phone 0_ `C/65 Fax T E-mail E-mail —_QPPLI( XA Nam I s _ Address City /►� o v t � � n Phone 0589 4 E-mail T-!NF•_),YAJA 00N State Fax E PERMIT NO. , 6 9 j Ul BIN # PRO.lECT LOCATION API Z 00 0 Property Addressi� City D U / /� 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, 9f WORK: CONTRACTOR Name �l Address City State Zip Phone _7q FT- Li:irig Garage J Struct , e 13uiltwith�?�ct'Fermits D Propoaed Change(40ccu�V (Note pre%iou-, use): Fax E-mail Lic. # Class —_QPPLI( XA Nam I s _ Address City /►� o v t � � n Phone 0589 4 E-mail T-!NF•_),YAJA 00N State Fax E PERMIT NO. , 6 9 j Ul BIN # PRO.lECT LOCATION API Z 00 0 Property Addressi� City D U / /� 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, 9f WORK: ` A PCHI TECTIENGI NEER Name �l Address City State Zip Phone _7q FT- Li:irig Garage J Struct , e 13uiltwith�?�ct'Fermits D Propoaed Change(40ccu�V (Note pre%iou-, use): Fax Stale License Number E-mail —_QPPLI( XA Nam I s _ Address City /►� o v t � � n Phone 0589 4 E-mail T-!NF•_),YAJA 00N State Fax E PERMIT NO. , 6 9 j Ul BIN # PRO.lECT LOCATION API Z 00 0 Property Addressi� City D U / /� 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, 9f WORK: © Q _7q FT- Li:irig Garage J Struct , e 13uiltwith�?�ct'Fermits D Propoaed Change(40ccu�V (Note pre%iou-, use): For office u I Zoning f=lood Zane I� - J Occ. ; ? / pe u, rist. Butte County Department of Public Works MICHAEL CRUMP, DIRECTOR LAND DEVELOPMENT DIVISION Storm Water Managment Program 7 County Center Drive Oroville, CA 75965 (530) 538-7266 Telephone (530) 538-7171 Fax www.buttecounty.net/dds 0 a 0 0 0 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment [LESS THAN 1 ACRE 1 Reference Number: B07-0560 Date: 03/22/2007 Location: 1859 MT IDA RD By: KEJ Parcel Number: 072-080-006 Sub Type: Ae Exempt Owner Name: SIMS, JAY & CLAUDETTE Phone: (530) 589-4652 Description: AG EXEMPT BLDG- (900) TRACTOR MUGATION SUPPLIES By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the state of California Regional Water Quality Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. Signed: Title FILE Dae: 03/22/2007 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 NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: O Make sure your application is complete. 0 Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY re one year after a e o Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at http://municipalcodes.lexisnexis.com/codesibutteco/ Reference Nwnber: B07-0560 Location: 1859 MT IDA RD Parcel Number: 072-080-006 Owner Name: SIMS, JAY & CLAUDETTE Date: 03/22/2007 Phone: (530)589-4652 Description: AG EXEMPT BLDG- (900) TRACTOR IRRIGATION SUPPLIES Signature of Property Owner: D e: 03/22/2007, FILE 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.buffecounty.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 under state law, contact the Department of Benefit 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 their 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 1-800-321 -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 11 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLT PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMP EMEN .(YES R NO) 11 (HA LVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 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 CITY PHONE CONTRACTORS LICENSE NO 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: AG EXEMPT BLDG- (900) TRACTOR IRRIGATION SUPPLIES Reference Number: B07-0560 Applicant Name: SIMS Y & CLAUDETTE Owner's Name: SIMS, & LAI: AP # :q-080-006 Signature of Property Owner: Date: "— C� 072-080-006 00-0094 SIMS, JAY 1859 MT. IDA, OROVILLE CONTR: OWNER WOOD STOVE �t J — I. /'Dj s p0 a�n_Ar" ' \f 1 072-080-006 00-0094 SIMS, JAY 1859 MT. IDA, OROVILLE CONTR: OWNER WOOD STOVE �t J — I. /'Dj s p0 a�n_Ar" ' \f COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION , 7 County Center Drive • Oroville, CaJiforniq 95965 `• Telephone (530) 538-7541 a y o�9�D• (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING BU I LDI NG P ERM IT OWNER A , t - TELEPHONE 85-4652 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS qT. IDA, DROV1131,(` r I' 1859 JNAME CO��NRACTCONTRACTOR'S, owi" TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace A I two. ou LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 35.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRE $� ' 16,59 Ni IDA, ORMUZ Energy Plan Checking Fee $_ $ PERMIT FEE $ 55.M LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Feel 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: W'0(,iD STOVE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200AORLESS 23.00 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,pjO�p°�,p and my license is in full force and effect.PSINGLE License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: El 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 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUR OR ADDNS. ( a ACC. S. SO 3.50Fr. MULTI -OUTLET @7,50 a OUTLET OWER APPARATUCIR.S Ex. Occup. ouTtEr OR FIXTURES 20 1.00 BAL .50 Ex. Occup. OFIXUTE S Aa ) E. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirin 23.00 PERMIT FEE $ '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. ❑ 1 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 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (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 those provisions. ' 11-) X Date �' Signature of Applicant - ❑ Owner - ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" dee and demolition or construction of structurs over 3 stories in height. p Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 55.00 HAz. D FEES IMP FLOOD CDF PARCEL PD HD ISSUF� V/ This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have ,�',�% ,By - �'T � .(: i _014 a PERMIT EXPIRES ON I the applicable provisions Resolutions to do work been paid. —Date — / / X00 Date Receipt No. Z656IJ t• 55.GO WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California. 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT a -Xq4 ASSESSOR PARCEL NUMBER 072-090-006 ZONING BUILDING PERMIT OWNER JAY SIMS TELEPHONE 589-4052 SO. FT. OCC. BUILDING VALUATION OWNERS MAIUNG ADDRESS 1859 MI IDA, CONTRACTOR'S VAME OWN OLt TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace A 17500.00 Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filin Fee $ 20.00 Permit Fee $ 0 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 1UI1I8!�TR , IDA, OROVI= Energy Plan Checking Fee $ PERMIT FEE $ 55-00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: WOOD STOVE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service p A OR LESS 23.00 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.PSING License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law f r the following reason: VI, 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 Main Service 200A TO 1000A 46.00NEW CONST. DWELLING OCCUP. OR ADDNS. a ACC. S. SO 3.50FT. T I.OUTLET =.ES1DMULT @7,50 a R A OUTLET CR. OWELEPPARATUS Ex. Occup. OUTLET OR FIXTURES @''00 940 @ .00 Ex. Occu .GuTE'A Ro ° 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 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. ❑ 1 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 Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 workers' compensation laws of California, and agree that if I should become subject to the workers' corripjwITaftin provisions of section 3700 of the Labor Code, I shall fo with cc ly with those provisions. X Date Signature ff pplica Owner ❑ Contractor ❑ Agint An OSHA p r t i req red for excavations over 5'0" deep and demolition or construction of structur er ries in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 55.00 HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD ISSU 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. /Q 0 PERMIT EXPIRES ON ate ReceiptNo. 285804 $55.00 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 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 wdl be issued until this verification is received. 1. J personally plan to provide the major lab r and materials for construction of the proposed grope improvement.: YES[t�J!NO[ I. �-- 2. I HAVE[ b f HAVENOT[ ] signed, an application for a.k4fiding permit for the proposed work. - 3. I have contracted with the following person (firm) to provide :the proposed construction: NAME: : f. ADDRESS: CITY: PHONE:' CONTRACTOR'S 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: CITY: PHONE: CONTRACTOR'S 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: SOCLXL SECURITY NUMBER: ��A NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. May 1995 0 / o�"' ��d-- co( 2.26 Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of 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: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments 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. 0 There may be financial risks for you if you do not carry out these obligations,'and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit 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 their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuildet" 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 contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Michael C. Vieira, C.B.O. Manager, Building Inspection NOTE: This Ovmer-Builder Information is required by Section 19830 of the California Health and Safety Code. May 1995 2.27 Ci) 0 CD c 2! co I r -I z Cl - Cl) AA -f. IDA 'i4W-0