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Home My WebLink About078-160-016�6 --- -_ _ 96--6,5- 6- , r LARRY PTELECH 07�• {�0-01� 5.670 Nicolai Way, Oroville Permit#435-85B,P(reroof,-stg bldg & install water heater%SF) "y=1_ D=acro PERMIT#97-0562 :MELECH TRUST 5670 Nicolai Ave., Oroville Ele Ser Ch/SF F -[LC i C(cv; `?a 5+,,e-, t�eplo� tf I re �6 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: 5670 NICHOLI WAY Owner: Permit No: B08-1899 APN: 078-160-016 FORD, KATHY Issued Date: 09/26/2008 BY TMP Permit type: MISCELLANEOUS 5670 NICOLAI AVE Subtype: Roof Re -Pitch OROVILLE, CA 95966 Expiration Date: 09/26/2009 Description: ROOF STRUCTURE REPLACEMEP (530) 534-4133 Occupancy: Zoning: RI Contractor Applicant: Square Footage: FORD, KATHY Building Garage RemdUAddn 5670 NICOLAI AVE OROVILLE, CA 95966 Other Porch/Patio Total (530)534-4133 FEE INFORMATION DBMSC Roof Structure Replaceme $421.93 Total Charged: $421.93 Fees Paid: $421.93 Balance Due: $0.00 Receipt No: B8597 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 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 X 09/26/2008 the applicant to a civil penalty of not more than five hundred dollars [$500); Please check one of the following: Contractor's Signature Date ❑ 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 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 the work himself or herself or through his or her own employees, provided that such improvements I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are notintended or offered for sale. If, however, the building or improvement is sold within one ❑I 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, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, 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 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 need not be competed if the permit is for one hundred dollars ($100) or less.) ❑IAM EXEMPT under Section B. & P.C. for this reason: MCERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS 09/26/2008 an& 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 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Sig at Date provisions. X09/26/2008 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 construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am author ed to act o the property owner's behalf. CONSTRUCTION LENDING AGENCY VWK 09/26/2008 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name Of P ittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner ❑ Contractor OR; E]Agent for Owner 1:1 Agent for Contractor FILE COPY Lender's 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 OFAPPLICA TION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY PERMIT NO. 1 'Sag -/y99' 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. OWNER INFORMATION Las,fltame Fi N e Mailing A dress ` c C. City c State Zi Phone Phone Fax E-mail APPLICANT INFORMATION CONTRACTOR Name Addres s Address State City Phone State Zip Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name Addres s Address State City Phone State Zip Phone Fax E mail State License Number APPLICANT INFORMATION Name �> Addres s City , State Zi Phone Fax E-mail APPLICANT SIGNATURE X PROJECT LOCATION AP# 6 Property Address tK�� 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: t2o✓rL � �n.a � rZ> f' 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 I Yes No Occ. Type Const. Butfe County Department of Development Services TIM SNELUNGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds "PERMIT APPLICATION DATA SHEET" Reference Number: B08-1899 Date: 09/17/2008 Location: 5670 NICHOLI WAY By: TMP Parcel Number: 078-160-016 Sub Type: Roof Re -Pitch Owner Name: FORD, KATHY Phone: (530) 534-4133 Description: ROOF STRUCT. REPLACEMENT ❑ ❑ The above permit application has the following Clearances required prior to permit issuance. Please contact each department indicated below regarding specific requirements pertaining to your permit application. Yes No SEWER DISTRICTS ❑ ❑ Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740 ❑ ❑ LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000 ❑ ❑ City of Chico, PO Box 3420, 411 Main Street, Chico CA 95927 - (530) 879-6700 PARKS & RECREATION DISTRICTS ❑ ❑ Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 ❑ ❑ Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921 ❑ ❑ Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011 ❑ ❑ Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393 SCHOOL DISTRICTS ❑ ❑ Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281 ❑ ❑ Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 ❑ ❑ Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 ❑ ❑ Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723 ❑ ❑ Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000 ❑ ❑ Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 ❑ ❑ Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext: 105 ❑ Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER ❑ ❑ Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions ❑ ❑ City of Biggs Planning Department, 3016 Sixth Stmet.Biggs CA 95917 - (530) 868-5447 Other:dp dec &� , ,/Mum f/lj ❑ ❑ Other: *"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. Signature of Applicant: Date: 09/17/2008 FILE Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 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" Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications, if the permit has not issued, but not after 180 days 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 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://municit)alcodes.lexisnexis.com/codes/butteco/ "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. Reference Number: B08-1899 Location: 5670 NICHOLI WAY Parcel Number: Owner Name: 078-160-016 FORD,KATHY Description: ROOF STRUCT. REPLACEMENT Date: 09/17/2008 Phone: (530) 534-4133 Signature of Applicant: Date: 09/17/2008 FILE Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.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 1, 1980). 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 O"DO 2.I (HAV VE 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 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 5. 1 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: ROOF STRUCT. REPLACEMENT Reference Number: B08-1899 Applicant Name: FORD, KATHY Owner's Name: FORD, KATHY AP # : 078-160-016 Signature of Property Owner: Date: i M 036-650-016 PERMIT07-0562 MELECH TRUST ' 5670 NICOLAI AVE.:, OROVILLE EL.E SER CH/SF r tJ�n,le. A-11 � ij�� Sia � � o��-- •� OFFIC OPY Address ELECTRIC Meter By `o Date '1 t • R (Rev. 12/96) COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 036--650-016 ZONING R1 BUILDINGPERMIT OWNER LAWUNCE W. TRUST 406 TELEPHONE 442-5318 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1438 CONCORD RD, HELENA MT 59601 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS ' Total Valuation $ ARCHITECT OR ENGINEER UCENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 567 N COLAI AVE OROVILLE Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 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 p. New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other 13 Describe Work: NEW EM SERVICE 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 OOOV OR LESS Main Service zooAORLESS 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.PSINGLE License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereb affirm under penalty of perjury that I am exempt from the Contractors License Y P tY P 1 rY P Law for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure i§ 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. ( 8 ACC. S. ,3 Sa So. FT. NON•RESIDT BRANcI cIgTCUTs @7.50 ATus 8 OUOWER APPARTLET CIR. Ex. Occup, OUTLET OR FD(TURES 20 BAS p I.50 Ex. Occup. DurEj TS PE61p.0EA P 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 43.W. 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.) 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' compensationprovisions of section 3700 of the Labor Code, I shall forthwith comply wit ose p ovisions. 1.� X ____ __ ate r a� _ Signature of Applicant - ❑ O, ner ❑Contractor 'R Agent An OSHA permit is required for excavations over 5'0' deep nd demolition or construction` of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 14 :3, OC) FEES IMP I FLOOD I COF PARCEL PID HD ISSUE 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. By Dater p7 PERMIT EXPIRES ON��7'��7 Date Receipt No. % WHITE-O.D.S.-B.0-. CANP;R •ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING IVISION 7 County Center Drive - Oroville, t;alifornia 95965 - Telephone (916) 5 -7541 P I N (Rev. 12'/96) APPLICATION AND PERMIT ��- 0. ASSESSOR PARCEL NUMBER 036-650-016 ZONING R1 B ILDING PERMIT OWNER LAWRENCE W. MELECH TRUST 406 TELEPHONE 442-6318 SO.FT. C. BUILDING VALUATION OWNERS MAILING ADDRESS 1438 CONCORD RD HELENA MT 59601 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 9670 NICOLAT AVE, DROVILLE Energy Plan Checking Fee $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF R7 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 Describe Work: NEW ELEC SERVICE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 920.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 - EOOV OR LESS Main Service 2oonDR LESS 23.00 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter ii 9 (commencing wth 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 for the following reason: 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. ( 8 ACC. BLDS. s0 3.50FT, NEW CONST. MULTI -OUTLET NOCIRCUITS @7.50 POWER APPARATUS 8 SINGLE OUTLET CIA. Ex. Occup. OUTLET OR FIXTURES 20 Q 1.00 eAl @ .so Ex. Occup. ourLEEUSIS T RES D.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 43.00 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. ❑ I 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.) 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 rkers' compensation provisions of section 3700 of the Labor Code, I shall fo hwith c:0171 with hose povisi S. X ate _ Signature of Applicant ❑ 0 ner 11Contractor Agent An OSHA permit is required for excavations over 5'0" deep._ _ 'd demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE .$ 3_ pv HAZ. D. FEES IMP I FLOG CDF PARCEL I PD I HD I ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By Au" PERMIT EXPIRES ON 1-12$ the applicable provisions Resolutions to do work been paid. �-2 9z Date U p r% CJ Date Receipt No. WHITE-D.D.S.-13.15. CA ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Y 4 OWNER -BUILDER ,VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Tlease complete an&i-eturn this'informatioxiat-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. I I personally plan to provide the major labor and materials for construction of the proposed property improvement : YE NO 11 2. 1 HAV�t'--, HAVE NOT 13 signed an application fora building permit for the proposed. work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. 1 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. 1 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: PROPERTYOWNER: Z awsk--n C- e IkIfeler SOCIAL SECURITY NUMBER: DATE: z 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. OVER Y O.B. I OWNER BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of propeity 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 $300 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 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. ♦ 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. ♦ 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 "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 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. i rely, Mic el C. Vi ira, C.B.O. Ma ger, Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code OVER 03-20-199'7 03:2BPM FROM First Security Bank .y N { TO 19166951062 P.01 r Permit#435-85B,P Larry Melech 5670 Nicolai Way 0 I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 i APPLICATION AND PERMIT ASSESSOR PARCNUMBER , 20NING + BUILDING PERMIT - OWNER I - r'r 4t TELEPHONE S�' i SQ. FT. OCC, BUILDING VALUATION /� •�� I �� / ' OWNER'S MAILING ADDRESS .0,"� CONTRACTOR'S NAME- - 0, J i , V' e rl TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER �` 0 '' n UNKNOWN Total Valuation Filing Fee $ v 10.00 LENDER'S MAILING ADDRESS Permit Fee $ -14. ARCHITECT OR ENGINEER ' '+ t• ^ LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS / J ��„ PLUMBING PERMIT9Fee Fl lin 10.00 / Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 f el LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 t ray Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF x❑ Duplex ❑ Mobi lehome ❑ Other • SPECIFY Building sewer 5.00 Mobile Home I S I G JW 1 10.00 e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ UUti lities ❑ Installation[] Other ❑ Describe work: Mp V, r� �� ( �r^� 7/1 v )1 l00V l Permit Fee $ 9r, ,r-rl Contractor ELECTRICAL PERMIT Filing Fee 10.00 OR LES Main service 100 AMP ORS SLESS 10.00 V Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 2h0sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check One): El 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 ;❑ 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 CONSTR ULTI.OUTLET 2,50 ea NON.RESID. BRANCH CIRC ITS NEW •CONSTR POWER APPARATUS & NONRESID, SINGLE OUTLET CIR. EX. OCCup(OUTLETS OR FIXTURES 9AL®300 FIXED APPLNS, OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare 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. 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. 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 in consequence of the granting of this permit. X 1 ,' - ��. !� X" Date -- 1 ' • �, Signature of Applicant — Owner'Q 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 $ TOTAL PERMIT FEE $ rte, Cn OCCUP. GROUP I TYPE OF CONST, PARCEL PD HD ISSUE' This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By ... ' .. PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS �Date'l 11 n � Receipt No. 'fid WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND,PERMIT �? 2 / PERMIT. ASSESSORRCE UMB �� — ZONI BUILDING PERMIT O WNEF� /�/ +6 v In C TEL NE S SO. FT. OCC. BUI _PING VALUATION 7S— feldda OWNERS M)IT AD ESS CONTR CTOR'S NA 14 TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONST TION LENDER o in e= UNKNOWN Total Valuation $ Filing Fee 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ois� 00 ARCH CT OR ENGINEER kC— LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ S - p BUILDING ADDRESS rG� S1Each PLUMBING PERMIT Filing Fee 10.00 ,0 Trap 2.00 -Sot-ar Water Heater 20.00 Oro V Water piping 5.00 S.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5,00 ,b Gas piping system 1 - 5 outlets 5.00 " USE OF STRUCTURE SFX Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S I G I W 10.00 e TYPE OF WORK New ❑ Addition ❑ 4modelq U ' 1' ies❑ Insta ation Other❑ Describe work: r — r Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service so0v OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. / DWELLING OCCUP.& OR ADDNS. r ACC. BLDGS. 2/20sgft 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. License No. Classification XI, 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 CONSTR U TI -OUTLET 2,50 ea NO N.RESID BRANCH CIRCUITS) NEW CONSTR. POWER APPARATUS &) NON.RESID. SINGLE OUTLET CIR. Occup(OUTLETS Ex. Occu zAL032 eALeao APPL NSXORRES Ex. OCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare 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. 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. 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 again aid County ' con qu ce of the granting of this permit. X t Date Signature of Applicant – OwnerContractor ❑ Agent E] An OSHA permit is required for excavate ns over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ / TOTAL PERMIT FEE $ VO1 00 OCCUP. GROUP I TYPE OF CONST. PARCEL PD HD esu This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which ECTO PU LIC By PER PIRES ate the applicable provi- resolutions to do fees have been paid. WORKS ate Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - De6artmgnt of Public Works 7 County Center Drive, Oroville, CA. 95965 Phone: 916-534-4541 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 in the envelope provided at your ~ earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing 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. City Phone Contractors 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 Contractors 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 OwnerI i Social Security number 4i; Date „2 --/ y'5 -- 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 permitted to issue the permit. Owner: 64 Address: Tenant: Building Location: BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPtCTION- REPORT 5 �`J I A.P. Date of Inspection 1 Inspector Type of Inspection requested: v ' 1. Housing / / 2. Financing / / 3. Change of Occupancy to E� ` . Other (specify) ""� n carry-0;24,eoe- Present use of building: < Fe A. Sanitation (Housing) 1. Water closet: 2. Lavatory: 3. Bathtub or shower: ,- 4, Kitchen sink: 5. Hot and cold water to fixtures: 6. Heating facilities: 7. Natural light and ventilation: 8. Room and space .requirements: 9. Bedroom window or door for second exit: 10. Infestation of insects, vermin, or rodents: 9 e •D ecd 11. Connection to sewage disposal: 12. Connection to water supply: ltpv a _ 13. Rubbish and garbage facilities: 14. Comments: D -e ..J B. C. Structural 1.. Piers and footings: 2. Floor construction: 3. Wall construction: 4. Ceiling and roof construction: 5. . Fireplaces: 6. Comments: Electrical 1. Service and ground: 2. Receptacles: 3. Fusing: 4. Comments: a Plumbing 1. Fixtures connected and vented: 2. Gas water heater: 3. Gas heating vents: 4. Comments: E. Other 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: 4. Weather protection: 5. Underfloor and attic ventilation: 6. Comments: F. Commercial Buildings 1. Roof covering: 2. Distance to property lines: 3. Physically handicapped: _ 4. Restroom floors and walls. 5. Exits: 6. Improvements: 7. Zoning: 8. Comments: G. Field Problems or Violations 1. Problem or violation (give complete description): 2. What action taken (give complete description): 3. What action recommended: A. Information only - file. Hold for ten days, then write letter. 77 C. Write letter. / / D. Other: �L � �-� Z,�,5 �' 6�A�