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Home My WebLink About079-190-057BUTTE 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.netldds PERMIT NO. BP040973 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 04/12/2004 APN: 036-580-022-000 the Business and Professions Code, and my license is in full force and effect. G d G License Class : License.Number: Site Address: 38 REGENT LOOP ORO vV� Date:�3 Contractor: Map Index: Description: ELE SER CHANGE OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: NOBEL BENDIX C & DONNA N REVOCABLE to its issuance, also requires the applicant for such permit to file a TRUST signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section NOBEL BENDIX C & DONNA N TRUSTEES 7000) of Division 3 of the Business and Professions Code) or that he or 38 REGENT LOOP she is exempt therefrom and the basis for the alleged exemption. Any OROVILLE, CA 95966 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).): r ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: NOBEL BENDIX C & DONNA N REVOCABLE such work himself or herself or through his or her own employees, TRUST provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: WHAT CHEER CO ❑ I am Exempt under Article 3 of the Business and Professions Code GEORGE CHOUINARD Date: Owner: 139 PINEDALE 95966 530-533-4453 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for License #: 610519 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 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation Engineer: 9 insurance carrier and policy number are: Carrier. Policy #: Total Square Ft: 0 S. F. I certify that in the performance of the work for which this permit is Valuation: $0.00 issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Census Code: and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: '_ i 3 j /��/ %r .�, 9V551�/J Applicant: W RNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This p9fmit V her y s e un or a app 'ca le provisions of the Butte County ode and/01 I hereby affirm that there is a construction lending agency for the Res ti to d w c o w ch ee sv been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) / Name: BY Dat PERMIT Address: EXPIRES ON: Dat ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized age he Aper. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or do me of u County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. �i l%a l �'-p /� Print Name:: — /lam Signature: Date: ❑ Owner ❑ Contractor 0 Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) W. `'W OFFICE #: (530) 538-7541 UU m -1 /0 APN:— ER'S AST NAME: OWNER'S FIRST NAME: nnacss _ 1 \ SITE ADDRESS: CITY, ZIP: 7_� 41I PERMIT NO. BP )(� U4rz�5 APPLICANT NAME: f PHONE: � 4 ,.1 /� 3 Sri STREET ADDRESS: FAX 13 CITY, ZIP: E-MAIL: CONTRACTOR NAME: PHONE: CITY, ZIP: E-MAIL: LICENSE NUMBER D� LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: DESCRIPTION OR SCOPE OF WORK: ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) DD A EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: Notes: Application Received by: Receipt number: 01 1 8 6� Date: Amount Received::)) b !� COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 nn,, f PERMIT APPLICATION DATA SHEET V OWNER: ` ASSESSOR PARCEL NUMBER j �Sv •, v�� Proposed Building Use: Counter Technicio- Date: ` Items required in order to apply for a permit Air b xes MUST be. checked OR marked NA in ord to apply. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form. ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by . ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ......... 0 20. Erosion Control Plan Required........................................................................ ....... ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ❑ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for dr veway rom the Public Works Dept ........................... 28. Pre -Inspection for Q Il ) C � required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......... .:........... ........ ........... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization......................................:............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance................................................................ ❑ 35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement o Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone % - and hold for pickup. I have been informed of the above items and-requirementsfor obtaining a building permit Applicant: 1. Index pe 2. Additional items required Date Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Plans reviewed by: Date: Plans approved by: Structural reviewed by: Date: Structural approved by: Note transfer by: Date: Yellow: Building Division Plan Check Letter Date: Date: Date Date: PRE-INSPECTI ' OWNER: S �1 LOCATION: CONTRACTOR: �J REASON FOR PRE-INIL DATE TO INSPECTOR: ON REPORT DATE: 6 A. P. ZONING: J-9, I/ " 1 V PERMIT HISTORY ( ) NONE ( ) SEE ATTACHED CJ BUILDING INSPECTOR'S REPORT Building Description: Commercial/Usage: Residential # of Units: Mobile home # of Units: Currently Occupied ( ) Yes ( ) No Abandoned/Vacant: Electric: Electric Currently ( ) On ( ) Off Condition of Electric Gas: Currently ( ) On ( ) Off Condition Sanitation: Plumbing Worldng ( ) Yes ( ) No Obvious Sewage Problems ( ) Yes ( ) No ACTION RECOM HNDED: ISSUE es Hold for permits or verify: Inspector: ( ) No Date: 13