HomeMy WebLinkAbout073-220-01273-22-12
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION (IVR): (530) 538-4365
OFFICE: (530) 538-7541 FAX#: (530) 538-2140
ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 11894 LA PORTE RD
Owner:
Permit NO: B08-2048
APN: 073-220-012
HECKER ROBERT & ROSE,
Issued Date: 10/6/2008 By GLB
Permit type: MISCELLANEOUS
P O BOX 26
Subtype: Wall Furnace
CLIPPER MILLS, CA 95930
Expiration Date: 10/6/2009
Description: propane line and heat stove
(530) 675-2643
Occupancy: Zoning: U
Contractor
Applicant:
Square Footage:
Cliff Sasselli
Building Garage Remdl/Addn
11889 La Porte Rd
Clipper Mills, CA 95930
Other Porch/Patio Total
(530)675-2074
FEE INFORMATION
DBM Heater (Wall) $59.00
Total Charged: $59.00 Fees Paid: $59.00
Balance Due: $0.00 Receipt No: B8775
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 Contractors 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 10/6/2008
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
Contractors Signature Date
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
❑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,
❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
❑I as required by
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions 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' Compansation 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 be competed if the permit is oror on�llars ($100) or ass.
❑ I 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 emplcy 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
10/6/2008
alA&46g�L
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
Owner ignature Date
provisions.
rX r / 10/6/2008
1 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
Signa ure Date
WARNING: AILURE 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 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.
ov
County to enter the abe tioned property for inspection purposes. I hereby certify that I am the
property o era t " ed to act on the p yo wners behalf.
CONSTRUCTION LENDING AGENCY
10/6/2008
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
Name of P Ittee IGN] Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
❑ Owner ❑ Contractor OR. gent for Owner DAgent for Contractor
FILE COPY
Lenders Address City State zip
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION*
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TIME OFAPPLICATION
Website: www.buttecounty.net/dds
PLEASE PRINT CLEARLY
X68 aoa�
PERMIT
NO.
BIN #
"When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information
related to this application is subject to public inspection and will be posted on the County's website for electronic access.
APPLICANT INFORMATION
OWNER INFORMATION
Last Name
%
First Namem
Mailing Address
Address
9
City
City�
Gte
Zi �� 3d
Phone
Phone G O
Fax
E-mail
E-mail
APPLICANT INFORMATION
CONTRACTOR
Name
City
Address
6
Address
9
oz
City�
Zip
Std A
Zip��
Phone G O
E-mail
Fax
E-mail
Lic. #
T
Class
C o
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Sq FT- Living Garage
Fax
E-mail
State License Number
APPLICANT INFORMATION
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLI T SIGNATURE
X
PROJECT LOCATION
AP# 6� -'� . Z ZO , U 12
Property Address c
/4,4/ocze2s- kA
City
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than licensed 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.
Zoning
Flood Zone
SRA
Yes
I No
Occ.
Type Const.
Sq FT- Living Garage
Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
For office use only:
Zoning
Flood Zone
SRA
Yes
I No
Occ.
Type Const.
4
TO; BUTTE CO. building dept.
FROM . ROSE BECKER owner of record of parcel no. 073-220-012-000
This letter shall convey my permission for CLIFF SASSELLI .to install a gas heater and
the related propane supply system and assist me in obtaining the nessasery permits
Sincerly
---Z� A6 -----12—k- -----
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive -N UroviIle, California 95965
Telephone: 534-4541
jf APPLICATION AND PERMIT
-
BUILDING
C
Owner l-1 P,AkP -
SQ. FT. OCC. BUILDING VALUATION
Mailing Address (e)
CTelephone
�,
No.
Fireplace
Contractor\ \ l A I N PIN-
Total Valuation
Mailing Address _
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Address �% \
.{jt ,'
��, — �4 p
PLUMBING No. @ FEE
P
PERMIT FILING FEE $3.00
t�
�1 --;40—o C'1a 1C �Q teii �i� I F^� aR�
Each Trap 1.50
1C
Repair drainage or vent piping 1.50
Water piping 1.50
/�
1 f�q y /V► r �.0
Each gas water heater or vent 1.50
,� ^
A. P. No. p�
,
Zoning &Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees
W:C�
SaniFtari=on"
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Im rovements
P
Lawn sprinkler system 2.00
,tBl:d:giPtdnsjRecxd° I
Parcel Approval I
Plans Approval
Permit Fee $
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No. @ FEE
rQ�
PERMIT FILING FEE $3.000V
e � e, IC. S CW V tet `w 0y e
OR
Main service 100 AMP ORSLESS 5.00 stoo
V
Main service EA. ADD -L 100 AMP 2.50
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service OVER 600V
100 AMP OR LESS 25.00
Main service/ EA. ADD'L 100 AMP 1.00
NEW CONSDWELING
OR ADDNST ACCLBLDGS.CCUP° &) 2¢sgft
NEWCONSTR. MULTI.OUTLET
NON .RESID• ( BRANCH CIRCUITS) 2.50ea
NEW CONSTR (POWER APPARATUS &
NON•RESID. SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Ex. Occup(OUTLETS OR FIXTURES)BA@L @25Q1
FIXED APPLNS° OR
Ex. Occup. OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
r I am exempt from the Contractors License Laws of the State of California.
Permit Fee
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
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 Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
TOTAL PERMIT FEE
$
aumuritu representatives of the t,ounty of tsutte to enter upon ine
above-mentioned property for inspection purposes.
X niP ItC�YI // •x Date
Signature of Permitee or
rr}Agent
Receipt No.
White-D.P..W. — YAiow-Assessor — Pink -Inspector — Goldenrod -Applicant
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.
�-DIRECT/OWOF,,PUBLIC WORKS
By G'l '�-._._ Date Z1— 1 i
Building permit expires Date ��""
-5 S
d
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive Orov( le, California 95965 ��D-? 7
Telephone: 534-4541
APPLICATION AND PERMIT in (,�
....vva, nicn uvna.0 I+i „�,c„y ivi n�aNc�.uun NuiNuaca.
X Date 7
Signature of Permitee or Agent
Receipt No. 172o 2--
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR/OF'\PUBLIC WORKS
By Qate ,ZZ—I-- 7 2
Building permit expires Date l�'�i �-7
BUILDING
Owner ,
!etUe,a—
SQ. FT. OCC. BUILDING VALUATION
Mai I i ng Address �
\
Telephone N
I
Fireplace
Contractor�Q�
Total Valuation
Mailing Address
Permit Fee
P I an Checki ng Fee &/or Penalty
Telephone No.
Permit Fee $
Building Address S S S
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
(�Each
Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. 1 --
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
99M49tirnf
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
I Parcel
Declaration
Parcel Ma p
60' R/W
Improvements
p
Lawn sprinkler system 2.00
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
'ELECTRICAL No.1 @ FEE -
PERMIT FILING FEE $3.00 d
Main service 100 AMP ORSLESS 5.00 SOS
Main service EA. ADD'L foo AMP 2.50 1157)
Main service 1 OEAMP OR LESS 25.00
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD'L foo AMP 1.00
NEW CONST. DWELING
OR ADDNS. ( ACCLBLOGSCCUP. &) 22sgft
NEWCONSTR. MULTI.OUTLET
NON .RESID. ( BRANCH CIRCUITS)2.50ea
NEW CONSTR. POWER APPARATUS &)
NON- (
RESID, l SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
st le of:
y
Ex. OCCUp(OUTLETS OW FIXTURES) 50 BAL2fa
Ex. Occup.(FIXED APPLNS. OR
OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ ZhSb
$ /Q
WORKMEN'S COMPENSATION INSURANCE
^� I am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
(41 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 Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
+2.00,
Hood
Permit Fee $
$
. I.certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon theI
TOTAL PERMIT FEE
$ (�
This permit is herebv issued under the applicable provisions
of
....vva, nicn uvna.0 I+i „�,c„y ivi n�aNc�.uun NuiNuaca.
X Date 7
Signature of Permitee or Agent
Receipt No. 172o 2--
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR/OF'\PUBLIC WORKS
By Qate ,ZZ—I-- 7 2
Building permit expires Date l�'�i �-7