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HomeMy WebLinkAbout078-280-0382yyp V-� V.Q. Orov"llt 0.0 ri 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: 2440 V-7 RD Owner: Permit No: B08-1779 APN: 078-280-038 DENNIS FAMILY LIVING TRUS Issued Date: 08/28/2008 By KCG Permit type: MISCELLANEOUS 4811 LINCOLN BLVD Subtype: Electric Panel OROVILLE, CA 95966 Expiration Date: 08/28/2009 Description: ELECTRICAL TO WELL (530) 532-0293 Occupancy: Zoning: AR Contractor Applicant: Square Footage: DENNIS FAMILY LIVING TR Building Garage Remdl/Addn i 243 CANYON HIGHLANDS Dl f{ OROVILLE, CA 95965 Other Porch/Patio Total (530)532-0293 FEE INFORMATION DBE Single Phase Service-Resid $59.00 f� f. t: �l i Total Charged: $59.00 Fees Paid: $59.00 Balance Due: $0.00 Receipt No: B8428 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 Contractors 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 08/28/2008 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractors Signature Date S 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.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED 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 Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation 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 nee not a competed if the permit is or one a hun reed dollars ($100) or less. ❑IAM EXEMPT under Section B. 8 P.C. for this reason: 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 Workers' Compensation Laws of California, and agree that if I should become subject to the workers' 08/28/2008 X_ 08/28/2008 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owners Signature Date provisions. s X 1 08/28/2008 I hereby certify that 1 have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building 'Signature Date WARNING: FAILURE 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 arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS $100,000, IN ADDITION TO THE COST OF COMPENSATION, ( 1 the issuance of this permit. I hereby acknowledge thatt is 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 authorized to act on the property owners behalf. T C. O c t -N J 15 08/28/2008 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN]. :--Print- Date the performance of the work for which this permit is issued. (3097 civ. code) rwner1P El Contractor �fZ: Agent for Owner Agent 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 OF APPLICATION Website: www.buttecounty.net/dds I�C�fiolill_K PLEASE PRINT CLEARLY "When filed, this application and all supporting material becomes subject to the California Public Records Act. All 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 �v'�, Fi amIrtie Mailing Address n„ �(t Citya 0mvillPhone Fax State Zip S 2fi `l Fax E-mail APPLICANT INFORMATION CONTRACTOR Name City Address Zip City Fax State Zip Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECTIENG/NEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X � -t- PROJECT LOCATION AP# Property Address 2)1 City ``11 PERMIT NO. BIN# WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK. Zoning Flood Zone SRA I 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 I Yes I No Occ. Type Const. 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 understate 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 -CLS13(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 IMPROVEMENTO OR NO) 2. 1(HAVEIRA V&N6T) 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. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: ELECTRICAL TO WELL Reference Number: B08-1779 Applicant Name: DENNIS FAMILY LIVING TRUST Owner's Name: DENNIS FAMILY LIVING TRUST AP 4 Signature of Property Owner: Date: :078-280-038 F'�- i�- 6l� BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 2440 V-7 RD Owner: Permit No: B07-2078 APN: 4' 078-280-038 DENNIS, FAMILY LIVING TRU Permit type: MISCELLANEOUS 4811 LINCOLN BLVD Issued Date: 10/05/2007 By KEJ Subtype: Demolition OROVILLE, CA 95966 Expiration Date: 10/04/2008 Description: DEMO SUBSTANDARD HOUSE (12 (530) 533-7007 Occupancy: Zoning: AR Contractor Applicant: Square Footage: DENNIS, FAMILY LIVING TRUST DENNIS, FAMILY LIVING TR Building Garage RemdUAddn 4811 LINCOLN BLVD 4811 LINCOLN BLVD OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch/Patio Total (530)533-7007 (530)533-7007 FEE INFORMATION DBMSC Demolition $58.00 r+ LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires DENNIS, FAMILY LIVING TRUS OL:CRW_00422457 / / I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 10/05/2007 Contractor's Signature Date I WORKERS' COMPENSATION DECLARATION I I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I 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 WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Carrier: Policy Number. Exp. Date: (This section need not be completed if the permitis oror one dollars ($100) oress. /a 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 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 �y provisions. �i^ J 10/05/2007 Ignature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR MSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip $58.00 Balance Due: $0,00 Receipt No: OWNER / BUILDER DECLARATION 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) 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]; Please check one of the following: I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE LLLSUUI COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractofs 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 are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractofs License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this reason: J T`'�af�>2 L.-• 10/05/2007 v Owner's Signature Date 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 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 injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the p r am authorized tMct on the property owner's behalf. c �e� 0 _ ___ 10/05/2007 In Owner ❑ Contractor OR. E]Agent for Owner ElAgent for Contractor FILE COPY „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 perforin 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. I PERSONALE TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEME (YE OR NO) (HAV /HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME 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: DEMO SUBSTANDARD HOUSE (1200) Reference Number: B07-2078 Applicant Name: DENNIS, FAMILY LIVING TRUST Owner's Name: DENNIS, FAMILY LIVING TRUST AP # : 078-280-038 Signature of Property Owner:X ��-� Date: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530)5-'18-7541 FAX #: (530) 538-2140 A FEE WILL BE REO UIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds *PLEASE PRINT CLEARLY" APPLICANT SIGNATURE X` PERMIT NO. �j - Pb_ BIN # WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): j For office use only: OWNER INFORMATION Last Name G y . F' Name Mailing A , City State Stat Zi Phone-7Fax Fax E-mail Lic. # 14 E-mail i APPLICANT SIGNATURE X` PERMIT NO. �j - Pb_ BIN # WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): j For office use only: CONTRACTOR Name G y . Address 2(� StaW Zi City I No State Zip Phone Fax E-mail Lic. # Class APPLICANT SIGNATURE X` PERMIT NO. �j - Pb_ BIN # WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): j For office use only: ARCHITECT/ENGINEER Name G y . Address 2(� StaW Zi City I No State Zip Phone Fax E-mail State License Number APPLICANT SIGNATURE X` PERMIT NO. �j - Pb_ BIN # WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): j For office use only: APPLICANT INFORMATION Nam G y . Address City 2(� StaW Zi Phone I No Fax E-mail APPLICANT SIGNATURE X` PERMIT NO. �j - Pb_ BIN # WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): j For office use only: Zoning Flood Zone SRA I Yes I No Occ.Type Const. I 10•.26.4)4 Irl EEOS To DULL DEN10l�EIzM I TS i 1--12 Ac'�L. ST?2t�c.GTtt12ES EXCEPT N. 012 PL4..c.L tP)G-V-M 1175 C Ta BrZl-%1 G L4LP Tp GopE . 1 I 4 6-eo S 5 -m-m Pcw-!i I r 7D 1215. 4A -a ! C MoslLe - we �o•-tT n-IEEO SSE 1 0120E12 Ta ISS" IM71-Fe PCletj,-r Bur i x.15 DEGTO2 rJEEDS -m SEE F3EFoQ.E 1 PEeM 1T - ►.i E -05 eLea SVG 3 M i SG vil - X co cru Ms's OPPI Cc— fieo�O t� 4 NOT 04GO-v, Limitic ' d Power of Attorney(With Durable P n)- Provision) ...... NOTICE: THIS IS AN IMPORTANT DOCUMENT. BEFORE SIGNING THIS DOCUMENT YOU SHOULD KNOW THESE IMPORTANT FACTS. THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON WHOM YOU DESIGNATE (YOUR "AGENT") BROAD POWERS TO HANDLE YOUR PROPERTY WHICH MAY INCLUDE POWERS TO PLEDGE, SELL OR OTHERWISE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. YOU MAY SPECIFY THAT THESE POWERS WILL EXIST EVEN AFTER YOU BECOME DISABLED, INCAPACITATED OR INCOMPETENT THIS DOCUMENT DOES NOT AUTHORIZE ANYONE TO MAKE MEDICAL OR OTHER HEALTH CARE DECISIONS FOR YOU. IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER TO EXPLAIN IT TO YOU. YOU MAY REVOKE THIS POWER OF ATTORNEY IF YOU LATER WISH TO DO SO. TO ALgPER ONS, be it known, that of 2 r _ as Principal, do hereby make and rant a limited and s ecific power of attorney to '"tJ� �- ML(: n `� ' ` b � of x,16/6 V-7-Al2 oi/ L� 3 9 and appoint and constitute said individual as my attorney-in-fact. 3 3 0 32 _ 116 My named attorney-in-fact shall have full power and authority to undertake, commit and perform only the following acts on my behalf to the same extent as if I had done so personally; all with full power of substitution and revocation in the presence: (Describe specific authority) p le r= -PA re _ R& AAO /y L &AgcTgZC104% o R ?"A'u Tu RE s 961 ro /�.4y l=ow AAiz2 � NSG V -y Rp ® oV.Z46E C �15�66 i/ "P ZV QLL oxto ,u--,-. row. _ r The authority granted shall include such incidental ads as are reasonably require or to carry out and perform the . specific authorities and duties stated or contemplated herein. Lt' ;0'-o 30 oHa A1etMt3ER5 0�6-022-03Q An/0 d36-OQ2.O39. A-7Ae rjyE/ 9. As9EssmR S PAfflcjgL My attorney -in -fad agrees to accept this appointment subject to its terms, and agrees to ad and d perform in said fiduciary capacity consistent with my best interests as my attorney-in-fact deems advisable, and I thereupon ratify all acts so carried out. I agree to reimburse my attorney-in-fact all reasonable costs and expenses incurred in the fulfillment of the duties and response bilities enumerated herein. Special durable provisions: This power of attorney shall not be affected by subsequent incapacity of the Principal. This power of attorney may be revoked by the Principal giving written notice of revocation to the attorney-in-fact, provided that any party relying in good faith upon this power of attorney shall be protected unless and until said party has either a) actual or constructive notice of revocation, or b) upon recording of said revocation in the public records where the Principal resides. Furthermore, upon a finding of incompetence by a court of appropriate jurisdiction, this Power of Attorney shall be irrevocable until such a time as said court determines that I am no longer incompetent. Other terms: www.sovates.com Page 1 © 2004, Sonates Media LLC LF240 - Rev. 04/04 Al 41 - Signed Signed under seal this day of �(�T001X�i/ . 20(? q. Signed in the presence of: / Witness: Principal: a ~ Witness: State of County of e } On bkv- before me, MayI C,.,k A • y appeared 5 A h 3 personally known to me to be the person whose name is subscribed t he within instrument and acknowledged to me tha h he executed the same i is her authorized capacity, and that by i her signature on the instrument the person, or the entity upon -behalf of which the person acted, executed the instrument. -VVITNESS my hand n official I. r Signature: , Affiant �Known' Produced ID Type of ID 'V7 data "LANA BOYER (Seal) COmmisslon # 1411251 ® Notar1! PubOc - • � � B Californiay€ MYCom Butte County Expires Apr 15, 2007 Page 2 www.socrates.com ® 2004, Socrates Media LLC LF240 • Rev. 04/04 ds Butte County Department of Development Services www.buttecounty.netldds 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538.7785 Facsimile January 14, 2005 Dennis Family Living Trust Beatrice Dennis Trustee 4811 Lincoln Blvd Oroville CA 95966 RE: Formal Warning Notice Butte County Code Violation 2440 V-7 Road, Oroville AP# 036-022-038. Dear Beatrice Dennis; Through our courtesy notice on October 11, 2004, you were notified pursuant -to Section 41-2 of the Butte County Code of the presence of code violations on your above -referenced property. According to our records, the courtesy notice has not resulted in abatement or correction of the' following specific violations: 1. The accumulation of junk in public view. 2. The accumulation of garbage for more than seven (7) days in public view. 3. The keeping of inoperable vehicles in public view. 4. Occupying a structure without a functioning disposal system. 5. Maintaining an unsafe structure. , Your failure to eliminate the stated violations is cause for the issuance of this formal warning notice. This is notice that as of this date, our records indicate that the following violations to the Butte County Code still exist: • Butte County Code Chapter 24, Section 24-65 - Applicability of zoning regulations. All uses of land within a zoned district not specifically authorized or permitted by regulations are prohibited. �:s Dennis Family Living Trust Beatrice Dennis Trustee AN 036-022-038 January 14, 2005 Page 2. • Butte County Code, Chapter 24, Section 24-95 - The AR (Agricultural -Residential) zone does not "specifically authorize" large accumulations of junk. The storing of more than 100 square feet of "junk" on a parcel is one of the items used to determine that a "junkyard" condition exists. A "junkyard" is not an allowed use in the AR zone without a Use Permit. "Automobiles and other vehicles, dismantled, in whole or in part" are considered to be "junk." Chapter 11, Section 11-4 forbids people, whether at a licensed junkyard location or not, from storing junk in public view. • Butte County Code, Chapter 31, Section 31-50 - The owner or tenant of any premises, business establishment or industry shall be responsible for the satisfactory removal of solid waste accumulated on said premises. To prevent propagation, harborage or attraction of flies, rodents or other vectors and the creation of a nuisance, solid waste, excepting non-flammable inert material, shall not be allowed to remain on the premises for more than seven (7) days. Non-flammable inert materials stored on a premises shall not be allowed to become either a harborage for rodents, insects or other vectors, nor a public nuisance. Such inert non- flammable materials which are not properly stored shall not be allowed to remain on a premises for more than thirty (30) days. • Butte County Code, Chapter 19, Section 19-3 - Sanitary Sewage Disposal System Required. It shall be unlawful for any person to maintain, occupy or use any building not provided with a sewage disposal system which disposes or sewage in a sanitary manner. • Butte County Code, Chapter 28, Section 28B-1 - State Housing Law adopted by Reference. This section adopts the State Housing Law. You are in violation of maintaining a residential building not meeting the minimum standards. In order to comply with the Butte County Code and State Housing Law, you are hereby requested to immediately contact the Department of Development Services, Building Division at (530) 538-7541 to obtain the necessary permits and inspections to bring your residential building within minimum standards. • Butte County Code, Chapter 26 - C.B.C., 1998 Addition, Section 102 - Unsafe Buildings or Structures. All buildings or structures regulated by this code which are structurally unsafe or not provided with adequate egress, or which constitute a fire hazard, or are otherwise dangerous to human life are, for the purpose of this section, unsafe. Any use of buildings or structures constituting a hazard to safety, health or public welfare by reason of inadequate maintenance, dilapidation, obsolescence, fire hazard, disaster, damage or abandonment is, for the purpose of this section, an unsafe use. Parapet walls, cornices, spires, towers, tanks, statuary and other appendages or structural members which are supported by, attached to, or a part of a building and which are in deteriorated condition or otherwise unable to sustain the design loads which are specified in this code are hereby designated as unsafe building appendages. 'es Dennis Family Living Trust Beatrice Dennis Trustee AN 036-022-038 January 14, 2005 Page 3 All such unsafe buildings, structures or appendages are hereby declared to be public nuisances and shall be abated by repair, rehabilitation, demolition or removal in accordance with the procedures set forth in the Dangerous Building Codes or such alternate procedures as may have been or as may be adopted by this jurisdiction. As an alternative, the building official, or other employee or official of this jurisdiction as designated by the governing body, may institute any other appropriate action to prevent, restrain, correct or abate the violation. • Butte County Code, Chapter 26, Section 26-6(b) - Unsafe for Human Habitation. This dwelling has been posted by the Butte County Department of Development Services, Building'Division as unsafe for human habitation. There are numerous conditions existing which are in violation of the State Housing Law and the Health and Safety Code. It is unlawful to occupy this dwelling. It shall be vacated at once and remain vacant until clearance to occupy is received from the Butte County Department of Development Services,, Building Division. It is a misdemeanor to occupy this building, or to remove or deface this notice. Butte County Code Section 26-6 (b). Failure to vacate this dwelling as required by law will result in legal action through the District Attorney's Office. The determination that this, violation exists on the property is based on the following definition in the - Butte County Code: Butte County Code, Chapter 24, Section 24-305.240 - Junk. Any worn-out and discarded material in general that may be turned to some use including, but not limited to, any old iron, wire, copper, tin, lead, rags, paper, bags, lumber, empty bottles, bones, parts of bicycles, tricycles, baby carriages, automobiles, and other vehicles, dismantled, in whole or in part, kept, stored, located, situated or piled in public view, and all other similar personal property ordinarily defined and classified as "junk" kept, stored, located, situated or piled in public view and not screened from public view by a fence. • Butte County Code, Chapter 24, Section 24-305.170 - Garbage. "Garbage" means every accumulation of animal or vegetable waste, matter that attends or results from the preparation, consumption, decay, dealing in, or storage of meat, fish, fowl, fruits, vegetables or other food products and shall include any food container in which there is putrescible material either solid or liquid. Butte County Code, Chapter 24, Section 24-305.370 - Rubbish. "Rubbish" shall mean all nonputrescible solid wastes, combustible, or noncombustible, including, but not limited to, paper, cardboard, yard clippings, grass, ashes, wood, bedding, crockery, glass, metal and other similar materials, excepting compost boxes. • Butte County Code, Chapter 24, Section 24-305.360 - Refuse. "Refuse" shall mean and include any solids or semi-solid waste other than domestic sewage, including, but not limited to, garbage, rubbish and trash. Dennis Family Living Trust Beatrice Dennis Trustee AN 036-022-038 January 14, 2005 Page 4 • Butte County Code, Chapter 19 - Sewage Disposal. Sewage, as used in this Chapter, includes any and all waste substances, liquid or solid, associated with human habitation; this includes what is commonly referred to as gray water. It is unlawful for any person to maintain, occupy or use any building not provided with a sewage disposal system which disposes of sewage in a sanitary manner. Chapter 19 requires that prior to any dwelling or building being constructed or occupied, that plans for the means of sewage disposal be submitted to the health officer for his or her approval and that a permit be obtained for any required sewage disposal work. The Building Division requires that any dwelling, building or structure that requires a building permit, whether or not it would utilize a sewage disposal system, must first receive a clearance from the Division of Environmental Health. The clearance by the Division of Environmental Health will verify, before construction, that a proper sewage system can be established or that the construction will not interfere with an existing sewage disposal system or that the construction will not take place in an area that has been designated as a replacement leach field. It is unlawful to construct, maintain or use any sewage disposal system which results in sewage overflowing any lands or into any body of water or to allow the sewage to be. _ -: :- accessible to rodents, insects or humans. Not only is a permit required for the original system, but any extensive alteration, repair, relocation addition or replacement shall also require permits, inspections and approvals from the Division of Environmental Health. In order to bring the property into compliance with the Butte County Code and avoid . further enforcement actions, you are hereby requested to take the following abatement or correction actions: 1. Remove all garbage, rubbish and refuse from your property and maintain a regular removal schedule in accordance with Butte County Code, Chapter 31, Section 31-50. 2. Remove all "junk" in accordance with the Butte County Code, Chapter 24, Section 24- 305.240. 3. Remove all inoperable/junk vehicles from the property. 4. All unsafe buildings or structures must be abated by repair, rehabilitation or demolition as per the Butte County Code, Chapter 26, CBC, Section "Unsafe Building or Structures." This is your final warning. Unless you contact this office and make the proper arrangements to correct or abate the violation(s) voluntarily, within ten 10 days from the date of this letter, enforcement shall be pursued through the issuance of a citation (ordering you to appear in court) for said violation(s) and for failing to comply with this warning letter. Dennis Family Living Trust Beatrice Dennis Trustee AN 036-022-038 January 14, 2005 Page 5 Upon conviction of said violation(s) or of failing to comply with this letter, the court shall impose penalties (fines) and a Notice of Violation shall be recorded in accordance with Butte County Code Section 41-7. The Notice of Violation will include a description of the premises, the violation concerns, a description of the violation, the date of your convictions and the action necessary to correct or abate the violation(s). Should you have any questions concerning this matter, please contact me at the address or telephone number listed above. Sincerely, Scot Johnson Code Enforcement Officer SJ:glb cc: Department of Development Services, Code Enforcement 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 ,16 17 18 19 20 21 22 23 24 25 26 27 28 PROOF OF SERVICE BY MAIL I am a citizen of the United States and employed in the County of Butte; I am, and was at the time of the service hereinafter mentioned, over the age of eighteen years and not a party to the within 0 action. My business address is Department of Development Services, Building Division, 7 County Center Drive, Oroville, California 95965. I am readily familiar with the County's practice for collection and processing of correspondence/documents for mailing with the United States Postal Service and that said correspondence/documents are deposited with the United States Postal Service in the ordinary course of business on the same day. On January 14, 2005, I served the foregoing 10 Day Notice on the person(s) named below by placing a true copy thereof in a sealed envelope, with first class postage thereon fully paid, addressed as indicated below, and by placing said envelope. In the appropriate place within the Department of Development Services where mail is collected for mailing with the United States Postal Services on the same day. X In the United States Postal Service Mail in Oroville, California. Dennis Family Living Trust Beatrice Dennis Trustee 4811 Lincoln Blvd Oroville CA 95966 I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration was executed on January 14, 2005, at Oroville, California. AM-7�.4� "�� UA 4-nevict Ois A si ant II I N. October 14, 2004 Gil Smith 460 Rio Lindo Chico, CA 95926 ,butte Count, L A N D O F NATURAL WEALTH A N D B E A U T Y DIRECTOR'S OFFICE DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7601 FAX: (530) 538-7785 www.buffecounty.net Re: HAZARDOUS ELECTRICAL CONDITIONS 2440 #A, B, C, D AP# 036-022-038 Dear Mr. Smith This department received a complaint alleging health and safety hazards at the above referenced living unit. On October 5, 2004 an inspection was conducted by this department. The owner (Beatrce Dennis) and tenants are not currently occupying the structure. The structure at this site has numerous electrical hazards including but not limited to open conductors and conductor splices, unprotected conductors, and a lack of proper grounding and bonding. The structures have been posted for nonhabitation . As Code Enforcement Officer for Butte County, I am requesting that the electrical and gas to the structure referenced above be disconnected until appropriate actions are taken to resolve the hazards..Further, I request that the electrical and gas service not be reconnected until an authorization from this Department is granted to do so. This letter shall also serve as notice to the property owner and tenants that the electrical and gas service is to be disconnected. Should you have any questions concerning this matter, please contact Scot Johnson at the number above. Sincerely Scot Johnson Code Enforcement Officer August 14, 2001 Beatrce Dennis Family Living Trustee 243 Canyon Highlands Dr. Oroville, CA 95966 RE: Forma[ Warning Notice Butte County Code Violation 2442 & 2444 V7 Rd., Oroville AP#036-022-038 Dear Dennis Family Trustee: ,butte C L A ND O F N A T U R A L W E A L T H A N D B E A U T Y PLANNING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7601 FAX: (530) 538-7785 Through our courtesy notice on June 25, 2001, you were notified pursuant to Section 41-2 of the Butte County Code of the presence of code violations on your above -referenced property. According to our records, the courtesy notice has not resulted in abatement or correction of the accumulation of garbage for more than seven (7) days in public view. Your failure to eliminate the stated violations are cause for the issuance of this formal warning notice. As of this date, our records indicate that the following violations to the Butte County Code still exist: Butte County Code, Chapter 24, Section 24-95 - The AR (Agricultural -Residential) zone does not "specifically authorize" large accumulations of junk. The storing of more than 100 square feet of "junk" on a parcel is one of the items used to determine that a "junkyard" condition exists. A "junkyard" is not an allowed use in the AR zone without a Use Permit. "Automobiles and other vehicles, dismantled, in whole or in part" are considered to be "junk." Chapter 11, Section 11-4 forbids people, whether at a licensed junkyard location or not, from storing junk in public view. Butte County Code, Chapter 31, Section 31-50 - The owner or tenant of any premises,. business establishment oi- industry shall be responsible for the satisfactory removal of solid waste accumulated on said premises. To prevent propagation, harborage or attraction of flies, rodents or other vectors and the creation of a nuisance, solid waste, excepting non-flammable inert material, shall not be allowed to remain on the premises for more than seven (7) days. Non-flammable inert materials stored on a premises shall not be allowed to become either a harborage for rodents, insects or other vectors, nor a public nuisance. Such inert non-flammable materials which are not properly stored shall not be allowed to remain on a premises for more than thirty (30) days. Beatrce Dennis Family Living Trustee August 14, 2001 Page 2 The determination that this violation exists on the property is based on the following definitions in the Butte County Code: Butte County Code, Chapter 24, Section 24-305.240 - Junk. Any worn-out and discarded material in general that way be turned to some use including, but not limited to, any old iron, wire, copper, tin, lead, rags, paper, bags, lumber, empty bottles, bones, parts of bicycles, tricycles, baby carriages, automobiles, and other vehicles, dismantled, in whole or in part, kept, stored, located, situated or piled in public view, and all other similar personal property ordinarily defined and classified as "junk" kept, stored, located, situated or piled in public view and not screened from public view by a fence. Butte County Code, Chapter 24, Section 24-305.170 - Garbage. "Garbage" means every accumulation of animal or vegetable waste, matter that attends or results from the preparation, consumption, decay, dealing in, or storage of meat, fish, fowl, fruits, vegetables or other food products and shall include any food container in which there is putrescible material either solid or liquid. Butte County Code, Chapter 24, Section 24-305.370 - Rubbish. "Rubbish" shall mean all nonputrescible solid wastes, combustible, or noncombustible, including, but not limited to, paper, cardboard, yard clippings, grass, ashes, wood, bedding, crockery, glass, metal and other similar materials, excepting compost boxes. Butte County Code, Chapter 24, Section 24-305.451 - Violator. An adult owner, tenant, occupant, resident or other person having possession, control or any other ownership interest in or the right of access to the prtmises, who is suspected or alleged to have violated or to be in violation of any Butte County Code provisions of the Chapters specified in Butte County Code Section 24-305.451. In order to bring the property into compliance with the Butte County Code and avoid further enforcement actions, you are hereby requested to take the following abatement or correction actions: Remove all garbage, rubbish and refuse from your property and maintain a regular removal schedule in accordance with Butte County Code, Chapter 31, Section 31-50. Remove all "junk" in accordance with the Butte County Code, Chapter 24, Section 24-305.240. Remove all inoperable/junk vehicles from the property. . This is your final warnine. Unless you contact this office and make the proper arrangements to correct or abate the violation(s) voluntarily, within ten LUO days from the date of this letter, enforcement shall be pursued through the issuance of a citation (ordering you to appear in court) for said violation(s) and for failing to comply with this warning letter. Upon conviction of said violation(s) or of failing to comply with this letter, the court shall impose penalties (fines) and a Notice of Violation shall be recorded in accordance with Butte County Code Section 41-7. The Notice of Violation will include a description of the premises the violation concerns, a description of the violation, the date of your convictions and the action necessary to correct or abate the violation(s). Beatrce Dennis Family Living Trustee August 14, 2001 Page 3 Should you have any questions concerning this matter, please contact me at the address or telephone number listed above. Sincerel Gary Brown Lead Code Enforcement Officer GB:pa cc: Department of Development Services, Code Enforcement '. 036-022-038 PERMIT#95-0235 DENNIS, T. 2440 V-7 Rd., Oroville Repair Gas Line/SF OFFICE COPY Address GAS Meter By Dat j EL Me COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING 01 ON 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7 1 �— _PERMIT NO. APPLICATI N AND PERMIT i "N" PARCEL '1" R 3 3 e zoriINO/�q `Z BU DING PERMIT OWNEROWNER'S MAKING AD9RESSr ♦ /Y/ CONTRACTOWSN AMMEO, / CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UENDEWS MAILING ADDRESS ARCHITECT OR ENGINEER ARCHITECT OR ENGINEERS MAILING ADDRESS BUILDING ADDRESS �7 O �/ : LOT NO. - SUBDIVISION'S NAME )(Duplex USE OF STRUCTURE SO Mobilehome O Other TELEPHONE UNKNOWN LICENSE No. 1�i4 l) d PARCEL MAP SQ. FT. I OCC. Fireplace Total Valuation $ Filing Fee Permit Fee Plan Checking Fee Energy Plan Checking Fee Penalty BUILDING VALUATION PERMIT FEE Each Trap Solar or heat pump water heater Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Building sewer Mobile Home 1 S G I W TYPE OF WORK New O Addition O Remodel O Utilities ❑ Installation O OtheI 1 /� Contractor Describe Work: yrp' 2 �r L ELEt CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) O 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification O I, as the owner, 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) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O 1 am exempt under Sec. Business and Professions Code forthis reason WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): O This permit is for $100.00 (valuation) or less. O I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. O I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to entet 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 5,�E / L/% �''L '� Date :7� S Signature of Applicant - U Owner L• Contractor U Agent An OSHA permit is required for excavations over 5"0" deep Jnd demolition or ^onstruction of structures over 3 stun :s in height. .. r,I r D.0.S.•d. D. C A N A H Y- A S SE S S 0 H P I N K - LN s P E c r O It GOLJ ENI1011 APDLI'AN F PERMIT FEE Main Service ( 600V OR LESS ) 200A OR LESS Main Service ( 200A To IOOOA ) NEW CONST. OR ADONS. ( DWELLING OCCUP. ) & ACC. BLDS. NEW CONST. NON•RESID. MULTI.OUTLET ) ( BRANCH CIRCUITS (PGWEL1APPA'IATUs ' 6 SINGLE OUTLET CIR Ex. Occup. ( OUTLET OR FIXTURES ' Ex. Occup. ( FIXED AP"S. OR I OUTLETS IRESID I EA Temporary Service Mobile Home Facilities Misc. Wiring PERMIT FEE $ Contractor Heating Fling Fee 7.00 23.00 15.00 15.00 15.00 15.00 @20.00 ng Fee 23.00 46.00 3.50 FO @7.50 5.00 23.00- 20.00 3.0020.00 23.00 20.00 20.00 20.00 Fee 1 20.00 IHood I I 6.50 Ventilation I PERMIT FEE S Contractor Mobile Home Installation Fee $ Energy Inspection Fee $ DCC cows I. tY1'E TOTAL FEES �U �� FEES IMP I FLOOD COF I PARCEL I PD I HO I ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code a d/or Resolutions to d.. work v indicated abovc.lt6r which fees hae beP,n paid. l D9te PERMIT EXPIRES ON COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIV ON 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-75 1 PERMIT NO. APPLICATION AND PERMIT `12-02 ASSESSOR PARCEL NUMBERa36-LI) . 2 2 3 8, zoNINGn v BU DING PERMIT OWNER y ^`� J ,� / TELEPHONE SQ, FT, OCC. BUILDING VALUATION OWNER'S MAILING AD REBS O 1z__D CONTRACTOR'S NAME ' , / / / v ✓ /v TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESSO �� �� PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE SF Duplex O Mobilehome O Other SPECIFY Gas piping system 1 - 5 outlets 15.00 67 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New O Addition O Remodel O Utilities O Installation O Other Describe Work: �� L� PERMIT FEE $ Q Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service`v OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BLDS. ) s0, 3.5C FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification O 1, as the owner, 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) ❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI.OUTLET •NON REBID. ( BRANCII C IRCUITS ) @7 5O ( POWERAPPARATCS ) 8 SINGLE OUTLET CIH. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. .50 Ex. Occup.FIXED APPLNS. OR ( OUTLETS IRESID.1 EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): O This permit is for $100.00 (valuation) or less. O 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. ❑ 1 shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00' Heating Cooling Hood 6.50 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 Butte County Ordinances and California 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 County in consequence of the granting of this permit. "� X S'LE %����� �VS �'�� Date lq5—This Signature of Applicant - O Owner ❑ Contractor O Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONSr. rvPE TOTAL FEE $ IHA2 0. FEES I IMP I FLOOD I CDF I PARCEL I PO HD ISSUE permit is hereby issued under the applicable provisions of the Butte County Code a d/or Resolutions to d.. work indicated above or which f es have been paid. D t 3 PERMIT EXPIRES ON I rel `� Receipt No. e;2 WHITE•D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD•APPLICANT COUNTY OF BUTTE Department of Development. Services Building Division Oroville: 7 County Center Dr., Oroville CA 95965 Ph: 916-538-7541 Chico: 1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751 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.Ypers ally plan to provide the major labor and materials for construction of the proposed property improvement no) 2. X(he/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 City Phone Contractor's License No. 5. I will provide some of the work but,I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed Property Owner Social Securr4Cy Date Z , %r DZE/VW1 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.