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Home My WebLink About079-280-0111 H.W. KIRK 280-Old'Mt: 'Ida Rd, oroville" B0-7-019701�"' :0797280-0 . H- M ISCELLANEOUS - REROOF 14:SQ{ ' .280 �NELLIE GRAY 1 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: 280 Owner: Peimlt No: B07-0970 APN: 079-280-011 NELLIE GRAY Issued Date: 5/3/2007 By GLB Permit type: MISCELLANEOUS 280 OLD MT IDA RD Subtype: Re -Roof OROVILLE, CA 95966 Expiration Date: 5/2/2008 Description: REROOF 14 SQ (530) 534-5725 Occupancy: Zoning: AR Contractor Applicant: Square Footage: SANDRA GRAY Building Garage Remdl/Addn 280 OLD MT IDA RD OROVILLE, CA 95966 Other Porch/Patio Total (530)534-5725 FEE INFORMATION DBMSC Re -Roofing $110.00 Total Charged: $110.00 Fees Paid: $110.00 Balance Due: . $0.00 Receipt No: B2921 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, , also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 5/3/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractor's Signature Date rl 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 Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, byCONTRACTORS ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED ❑I as required TO CONSTRUCTTHE PROJECT (Sec. 7044, Business and Provessions 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 completed if the permit is or one a hundred dollars ($100)-6t less.) i ❑ I AM EXEMPT under Section B. & P.C. for this reason: I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS , ISSUED, I shall not 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 5/3/2007 compensation provisions of Section 3700 of the abor Code, I shall forthwith comply with those provis' n . Owner's Signature Date X 5/3/2007 " w I hereby certify that I have read this application and state that the above information is corect. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signal aDate WARNING: FAILURE ECURE WORKERS' COM NSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. pey err or a aboveto ct on the pro �ountry to ler the above mentioned property for inspe n purposes. I hereby certify that I am the . CONSTRUCTION LENDING AGENCY �If- 5/3/2007 Name of Permittee [S G Print Date 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) Owner 1:1 Contractor OR. NAgent for Owner ❑Agent for Contractor FILE COPY Lenders Address City State Zip BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION `�� OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds BIN # "PLEASE PRINT CLEARLY* n0,� APPLICANT.91 EN Ed 42TITIME, Imo'. �= _- PROJECT LOCATION AP# /)r7GI • �) A6,- n l ( Property City 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): For office use only: Zoning Flood Zone SRA Yes nJ . Occ. Type Const.' OWNER INFORMATION Last Name Name First e Mailing 9 (' City State State Zi StateCA I `7 Phone,S3 ` > Fax E-mail �' 7 '_2Z 7 � APPLICANT.91 EN Ed 42TITIME, Imo'. �= _- PROJECT LOCATION AP# /)r7GI • �) A6,- n l ( Property City 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): For office use only: Zoning Flood Zone SRA Yes nJ . Occ. Type Const.' CONTRACTOR .Name Name Address i? -Q City State Zip Phone StateCd_ Zip Fax E-mail �' 7 '_2Z 7 � Lic. # Class APPLICANT.91 EN Ed 42TITIME, Imo'. �= _- PROJECT LOCATION AP# /)r7GI • �) A6,- n l ( Property City 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): For office use only: Zoning Flood Zone SRA Yes nJ . Occ. Type Const.' ARCHITECT/ENGINEER Name Name Address. i? -Q City State Zip Phone StateCd_ Zip Fax E-mail �' 7 '_2Z 7 � State License Number APPLICANT.91 EN Ed 42TITIME, Imo'. �= _- PROJECT LOCATION AP# /)r7GI • �) A6,- n l ( Property City 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): For office use only: Zoning Flood Zone SRA Yes nJ . Occ. Type Const.' APPLICANT INFORMATION Name i? -Q Address City �` (1 1 ' V StateCd_ Zip 4? Phone �' 7 '_2Z 7 � efR E-mail APPLICANT.91 EN Ed 42TITIME, Imo'. �= _- PROJECT LOCATION AP# /)r7GI • �) A6,- n l ( Property City 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): For office use only: Zoning Flood Zone SRA Yes nJ . Occ. Type Const.' ti .,y•` � ,l, - ,� .• �, � .r _:;-+ � -'~'��` �. �� { y t� v...i�t � ri�1 f awl ;� i. f, f � _" �` _ _ � _ ._/ ,� . , - _ -. ti � �'�� U y�� i��Gj �� - �. �.