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HomeMy WebLinkAbout078-050-017RUTH FURNESS 03 b- 4 Sa' o 17 n � WORLEY_ `Lena l 1 6267 Lincoln Blvd, Oroville / � 336-711 Permit#1464-87B(reroof/SF) c� _ _ - 1320-711 _ ' _1264-71A I oma$-C��p_c�,�. � - :04-10834 - 6267 Lincoln Blv , Oroville new single family) G FURNESS, JIM .b� r � � � . , •,^N ( 6267 LINCOLN BLVD,;OROVIL INP►I. �- CONT: CHRISTIANSEN ROOFS ( I f , I4 � � ",'y^y_r \ qty. �,` u 4 i.k, .. ... • h - U O17 1 Lo m X 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 PERMIT NO. BP040834 LICENSED CONTRACTORS 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 l� Issued Date: 03/26/2004 APN: 036-292-00-000 the Business and Professions Code, and my license is in full force and effect. License Class : � License Number: Site Address: 62&7 Limcc-1m 5Lvc> Date: Contractor: Map Index: Description: RE -ROOF (27 SQ) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: JIM FURNESS 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 6267 LINCOLN BLVD the Contractor's State License Law (Chapter 9 commencing with Section 95966 7000) 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 the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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 Applicant: CHRISTIANSEN ROOFING COMPANY Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for P O BOX 2749 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of OROVILLE, CA 95965 proving that he or she did not build or improve for the purpose of (530) 532-9338 sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: CHRISTIANSEN ROOFING COMPANY pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code P O BOX 2749 Date: Owner: OROVILLE, CA 95965 (530) 532-9338 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 License #: 651425 workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. + ❑ I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Policy #: Total Square Ft: 0 S. F. � � I certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person in any manner so as to Census Code: become subject to the 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 l forthwith comply with those provisions. Date: 3 I moo/ 6 `, % Applicant: c3 ��2�yry/�oil7 WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. l2G/o4- CONSTRUCTION LENDING AGENCYThis permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resoluti s to do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) •.24 • ori-' Name: BY `— Date: PERMIT EXPIRES ON: 3 -10.0$ Address: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte Countytoenter upon the above mentioned property for inspection purposes.. I ��/L�—iil;dy1-1 Print Name: Z,> iiJ//��7S�p/ Signature: FAQ 4Z Date: 0 Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor X 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.netWds PERMIT NO. BP040834 LICENSED CONTRACTORS DECLARATION I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 03/26/2004 APN: 036-292-083-000 the Business and Professions Code, and my license is in full force and effect. ^ 'L License Class : License Number: Site Address: �s�7 L1ntc.cu.J SL.vo Date: Contractor: 1%av7 Map Index: Description: RE -ROOF (27 SQ) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: JIM FURNESS 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 6267 LINCOLN BLVD the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95966 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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 Applicant: CHRISTIANSEN ROOFING COMPANY Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for P O BOX 2749 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of OROVILLE, CA 95965 proving that he or she did not build or improve for the purpose of (530) 532-9338 sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: CHRISTIANSEN ROOFING COMPANY pursuant to the Contractors' Stale License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code P O BOX 2749 Date: Owner: OROVILLE, CA 95965 (530) 532-9338 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 self4nsure for License #: 651425 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 Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Policy #: Total Square Ft: 0 S. F. � -I Q certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person in any manner so as to Census Code: become subject to the 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 those provisions. %with Date: Applicant: 004�?_ WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. 3 Cj rJ 3 D O 1 iv�j CONSTRUCTION LENDING LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutis to do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) 24 By: r_ Date: 3 - - �¢ Name: -- PERMIT EXPIRES ON: 3 - -;i-%- os Address: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. thereby authorize representatives of Butte Countytoenter upon the above mentioned property for inspection purposes.. Print Name: fr'/ C�! i�"Tl�� TSe� o� Signature: Date' ❑ Owner Contractor 0 Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP X4-08 DATE: J �a� APN: '!n36.2g3•u8.3 ZONING: OWNER'S LAST NAME: OWNER'S FIRST NAME: PHONE -3�-77i9 STREET ADDRESS: FAX: CITY, E-MAIL: SITE ADDRESS: CITY, ZIP: NEAREST CROSS STREET: �i ✓ TRACT/LOT It. APPLICANT NAME: , PHONE: j3Q STREET ADDRESS: FAX CITY, ZIP: E-MAIL: ,b U! CONTRACTOR NAM-'.PHONE:3 / I 3 STREET ADDRESS: FAX: CITY, ZIP: E-MAIL' LICENSE NUMBE - / LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: FAX. CITY, ZIP: LICENSE NUMBER: E-MAIL: DESCRIPTION OR SCOPE OF WORK: a _ 27 ❑ 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 fees will be required. 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. For office use only: Notes: 1 Application Received by: KJ -1 Date: Receipt number: 3953 Amount Received: t &S-, Permit #1464-87 Ruth•Furness 6267 Lincoln Blvd, Oro COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, Catifornia 95965 - Telephone: 916/538-7541 1,41 G APPLICATION AND PERMIT r+' !" ASSESSOR PAR`GE,l1. UMBER 4 l r d r. ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCG`. BUILDING VALUAJION /J /�� dWNENER'S MAILING ADDRESS yy CONTRACTOR'S NA�M�E/ TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTR {TION LENDER. ,_' - - 1 PK. UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDE`R'S MAILING A DRESS Permit Fee $ �) ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ . ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 C Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF LTJ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00ea TYPE OF WORK New ❑ Addition ❑ Remodel GUtilities ❑ Installation Other © Describe work: D i / ) /E% Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service aoov OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW of perjury I declare under penalty p jy (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification _+<'11 as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure Is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. / DWELLING OCCUP.&\ OR ACDNS. \ACC. BLDGS. +/22sgft NEwCONSTR ULTI.OUT LET NO N.R ESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS tr SINGLE OUTLET CIR. Ex. OccupOUTLETS OR FIXTURES ?ALO 30 ?ALO FIXED APP LNS. OR EX. Occup. OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I dee under penalty of perjury (check one): The permit is for $100.00 (valuation) or less. E]1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. - I shall not employ any person in any manner so as to become subject a to the W. C. laws of California.% Notice, to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee Contractor $ 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 authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County i ,consequence of the granting of this permit. �- 6 ji X Date Signature of Applicant - Owner❑ Contractor ElAgent❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE . $ _Q, S OCcUP. 'CONST.T7 I I FLOOD PARCEL PD I ND I ISSUE This permit is hereby issued under sions of the Butte County.Code and/or work indicated above for which IRE�C;TO "OF PUBL B ..r.✓% !, +% �-� �� PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date ���'Ie Receipt No. (� .J WHITE-D.P.W-. YELLOW-ASDE330M, PINK -INSPECTOR. GOLDENROD -APPLICANT J 4 s3 _ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 .11-21 APPLICATION ANDS PERMIT [� ASSESSOR PARA UMBER ZONING BUILDING PERMIT O ER --OWNER TELEPHONE SO. FT. OCC, BUILDING VALUA ION S MAILJNG ADDR s r CON ACTOR'S A�M�EE .+ TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONST R CTION LENDER, f� C«i UNKNOWN Total Valuation $ Filing Fee $ 10.00 LEND S MAILING A DRESS Permit Fee $ �Q ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee Energy Plan Checking Fee E$. $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 1 2.00 �© Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF [� Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G JW I 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel PGUti lities ❑ In illation Other X Describe work: / k4&2 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 11001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check -one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BuSIneSS and Professions Code and my license is in full force and effect. (cense No. Classification I, as the owner, Or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.e± , New CONSTR.� AMULTI-OUTLET ) h¢sgft NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS el SINGLE OUTLET CIR. / Ex. Occu 20050: Occup(OUTLETS OR FIXTURES eAL030 FIXED APPLNS, OR Ex. Occup. OUTLETS IRESID.I EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I de tare under penalty of perjury (check one): The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notic to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor 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 the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said,09Unty i consequence of the granting of this per nit. ri X Date Signature o Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ �Q.s 0ccuP. CONST,TYPIJ I I FLOOD PARCEL PD I NO ISSUE This permit is hereby issued under sions of the Butte County. Code and/or work Indic 4 above for which IRE PV B P MIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS `� Date Receipt No. WHITE-O.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT .✓.. COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538=7541 OWNER -BUILDER VERIFICATION 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. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/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 al City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, superv' e, and provide the major work: Name Address 4 1 U City Phone Contractors License No. 5. I will providelsome of the work.but I have contracted (hired) the following persons to provide the work indicated: Signed: Property Owner Social Security Nu ber Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit.