HomeMy WebLinkAbout073-040-0078
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?3�040-007 t } PERMIT#97=0998„ CHRISTENSON; Rudolph -- _69E
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30 Milol`Featther.xFalls v tv
�mn'��SF:ShedCarport+"&Woodshed; ^�t
a� Feath'er Falls
u a ,,, , F.jar,I�• x= r (I'wire existing dwelling)
3072562 ',` 'f;073 0401007.
vIISCEL-LANEOUSDemolitton 4.
)EMO 2 SF `SHED CARPORT (PE
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780 MILL'RD '#'.i >'�
Se
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FENNETT,
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COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES-BUILDINGDIVIS N
7 County Center Drive - Oroville, � aliforriia 95965 - Telephone (916) 538-75 P RMIT 'V0.
(Rev. 12/96) APPLICATION AND PERMIT �_
ASSESSOR PARCEL NUMBER
073-04-0-007
ZONING
tml60
BUILG PERMIT
OWNER
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
1180 MIDDIF14OFF LANE. DROVILLF 9596151
CONTRACTOR'S NAME
TELEPHONE '
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
'
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
15.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
780 MILL ROAD, FEATHER FALLS
Energy Plan Checking Fee $
$
PERMIT FEE S
35.00
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 gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other IN
Describe Work: DEMO 2 DWELLINGS, SHED, CARPORT, WOOD—
SHED 1082 SQ. FT LIVING AREA PER ASSESSOR
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home ISI GI W1
920.00
PERMIT FEE S
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service ioono.�sS
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.
License Class LIC. No.
OWNER -BUILDER DECLARATION
affirm under penalty of perjury that I am exempt from the Contractors License
Lathe following reason:
I h;�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 OCCUP.
OR ADDNS. ( 8 ACC. BIDS.
So
3.5¢FT.
NEW CONST. MULTI.OUTLET
NON-RES'.D c
@7.50
POWER APPARATUS
8 SINGLE OUTLET CIR.
Ex. Occup. ouTIfTOR FIXTURES
20 p 1.00
BAL Q .50
FIXED APPWS. OR
Ex. Occup. ourizT. RESID. OR
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE S
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 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 Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE S
Policy Number
e 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
com tion laws of California, and agree that if I should become subject to the
rkers' om 'on provision of section 3700 of the Labor Code, I shall
forthwit c ply with hose ns.
Date _S'/ f —�_
i a ica ner ❑Contractor ❑ Agent
An OSHA per It is re ired for excavations over 60" deep and demolition or construction
of structures o stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ qr� nn
HAZ.
D. FEES IMP
FLOOD
COF
PARCEL
PD
HD
..UE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do wolik
indicated above for which fees have been paid.
/1
By rDaJe
'
PERMIT EXPIRES ON
Date
Receipt No.
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 will
be issued until -this verification is received.
Q
. I personally plan to provide the major la r and materials for construction of the
proposed prope improvement : YES[ V1 NO[ ]. '
(29..-1 HAVE[ -V- 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: 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: CTI'Y•
PHONE: . CONTRACTOR'S LICENSE NO.
S. I will provide some of the work but I have contracted (hired) the following persons to
provide•the work indicated: _
NAIN E. ADDRESS PHOYE TYPE OF WORK
IGNED:
PROPERTY .OWNER:
SOCIAL SECURITY NUMBER:
DATE: 2:
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.
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 perits they are not required to be signed by property owners unless are pe
mrsonally
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
required by law to put their license number on all permits
business license from the city or county. They are also
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: I _
0 If you employ or otherwise engage any persons other than your immediate family, and the work (including
materials and other costs) is 5300 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 tar 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 employe -,s, without a licensed. contractor or subcontractor, only
undef limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder"
building permit, erroneously implying that the property owner is providing his or he: o�vn 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 tray be obtained by contracting the Contractors State License
Board in your communiry or at 1020 N Street, Sacramento, CA. 95314.
Please complete the Owner Builder Verification" on the reverse side of this form so that we can confirm
that you are ay. -are of these matters. The building permit will not be issued until the verification is returned.
Sin � rely, ? '
Michael C..Vieii-a, C.B.O. .
Manager, Building Inspection
NOTE: This 0%%aer-Builder Information is required by Section 19830 of the California Health and Safety Code.
OVER
Demolition Permits
Asbestos Notification Statement
Date
f
AP#
Pursuant to section 19827.5 of -the California Health and Safety Code, all
demolition permit applicants are required to fill out this form.
"19827.5. A demolition permit shall not be issued by any city, county,
city and county, or state and local agency which is authorized to issue
demolition permits as to any building or structure except upon the receipt
from the permit applicant of a copy of each written asbestos notification
regarding the building that has been required to be submitted to the United
States Environmental Protection Agency or to a designated state agency,,or
both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations,
or the successor to -that part. The permit may be issued without'the applicant
submitting a copy of the written notification if the applicant declares that
the notification is not applicable to the scheduled demolition project: The
permitting agency may. require the applicant to make the declaration in 'writing,
or it may incorporate the applicant's response on.the demolition permit appli—
cation."
Attached is a copy of my written asbestos notification to the United States
Environmental Protection Agency for the demolition project located at
Signature of Applicant.
OR
I hereby declare that a written asbestos notification to the United States
Environmental Protection Agency is not. applicab to s demolition proje
1
Signature o pplica
May 1995 3.27
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, Califorhia 95965 - Telephone (916) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSORPARCELNUMeER 9 I O ^�
l/
ZONING /
BUILDINGPERMIT
OWNER
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADORESS '
CONTRACTOR'S NAME #V
TELEPMONE '
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ (J . &o
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
SUILDINGADDRESS O rrl� I
Energy Plan Checking Fee
$
$
PERMIT FEE
$
,20.00
LOTNO. SUBDIVISIONS NAME PARCEL MAP
PLUMBING PERMIT
Fling Fee
Each Trap
7.00
USEOFSTRUCTURE
SF 0 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 d� 21 1 t1 �/,'� C�� ,
o® !. t�a`r'r �IVIYIQGLl9A_.
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
PERMIT FEE
S
K
ipQf aSSeScny
ELECTRICAL PERMIT
Fling Fee 20.00
00. OR LESB
Main Service tow oa 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.PO
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:
❑ 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 offered for sale.
❑ 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
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.)
❑ 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.
X Date
Signature of Applicant - ❑ Owner ❑ Contractor Cl Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service ZDOA TO 1000A
46.00
NEW CONST. %WELLING OCCUP. s0
OR ADONS. ( d ACC. BLDS. 3.50T..
NO"ON.gESID. MUITI.OUTLET @7.50
APPARATUS
8 SINGLE OVTLET C.R.
p. OUTLET OR FDTTURes
Ex. Occup. BAL I.w
FUCED AFPLNS. OR
Ex. Occu . ouTLETs RESID. EA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee
$
occ
CONST. TYPE ��
TOTAL FEE $
Z. 10. FEES IMP I ROOD
I COF
PARCEL I P% I HD I ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date
(Dsta)
ReceiptNo.
WHITE-D.D.S.-B.D. CANAR •ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541,PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT = -ZQ`7-06ze,—s;
ASSESSOR PARCEL NUMBER
OWNER
4 MIR
ZONING
t ,l An
BUILD a G PERMIT
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
_ —M
OWNERS MAILING ADDRESS
rH0 pmr F o-50-1;5
r
CO CTO R'S -NAM - -E --.TELEPHONE
COWm
'
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER ,
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER �I �,, iiW
OW,
UCENSE'NO.
Filing Fee
$ 20.00
Permit Fee
$ 15.W
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
780 MILL ROAD, FEATHER FALLS
Energy Plan Checking Fee
$
$
PERMIT FEE
$ 35,00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap7.00
Solar or heat um 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 O.
Describe Work: DR10 2 DTA MINGS, SHED, CARPORT, ',',TWD—
SHED 1082 SO. FT LIVING AREA PER ASSESSOR
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S I G I W
920.00
PERMIT FEE
$
ELECTRICAL PERMIT
Filing Fee 20.00
`
Main Service CO'v OR LESS
20.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.
License Class LIC. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law �6r the following reason:
Wo 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. d ACC. BLOS.
3.5QSO
s.
N N'(
NON-RESIDT MNLCTI CUTLET
UIS
97.50
POWER APPARATUS
a SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FIXTURES
20 @''50
8AL Q .SO
Ex. Occup. oUrELEDTSAPREs U.OEA
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
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
`
Hood
6.50
Ventilation
PERMIT FEE
$
Policy Number
he above sections need not be completed if the permit is for work of a valuation
p p
�of one hundred dollars ($100) or less.)
0 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.
X "e �� .. !%= _ Date _-S'- /•o( -`�� _
Signature'of Applicant 11`❑�'Ow`rier ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction)lilt--iI
of structures over,3 stories in height.
Mobile Home Installation Fee Is
Energy Inspection Fee Is
OCC
CONST. TYPE
TOTAL FEE $ .�
HAZ.
D. FEES IMP
FLOOD
CDF
PARCEL
PD
HD
ASSUE
n
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By v - w r
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date
fDele 1
Receipt No. 1/t
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
073-040-007 PERMIT#97-0998 ,
F JENNETT , Rene . "
r !
: 780 Mill Rd.,,Feather Falls
r Demo 2 SF,Shed,Car'port & Woodshed
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