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Home My WebLink About079-300-006r 07t - 30 0- 000 r J � � OS -2769 ROBERTS, CLAUDIA 84 CRANE AVE, OROVILLE Cont: OWNER SIDING, ROOF STRUCT REP✓A B07-0999 079-300-006 Electric Panel MISCELLANEOUS REPLACE: ELEC PANFJ-, SIDING(19 li 84 CRANE AVE�?r�4 ROBERTS, CLAUDIA S • B08-0739 ` a�n�,f`q 079 300,00( '` MISCELLANEOUS{.; �' SidinglStuc REPLACE, SIDING ; T 111(50 LF,), WII�1 84 CRANE AVE ROBERTS, ,CA DIA 11 MORRISON, Leo H. —2321B 2288E. 1 4 s/s Crane Ave. 800' west of Oakva e,FM 1 ' 7 (addition), /0 i , i 06 j - r- BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT, 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.netWds PROJECT INFORMATION Site Address: 84 CRANE AVE Owner: Permit NO: B08-0739 APN: 079-300-006 ROBERTS, CLAUDIA' Issued Date: 04/21/2008 By KCG Permit type: MISCELLANEOUS 84 CRANE AVE Subtype: Siding/Stucco OROVILLE, CA 95966 Expiration Date: 04/21/2009 Description: 'REPLACE SIDING- T-111(50 LF), W (530) 534-9749 Occupancy: Zoning: AR Contractor Applicant: Square Footage: ROBERTS, CLAUDIA Building Garage Remdl/Addn 84 CRANE AVE ' OROVILLE, CA 95966 Other Porch/Patio Total (530)534-9749 FEE INFORMATION DBMSC Stucco/Siding-Stone/Bric $119.00 DBMSC Window/Sldng GIs Dr-Repl $119.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) - State Contractors License No. / Class / Expires 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 04/21/2008 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION 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. ❑HAVEAND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by I lSection 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compansation insurance carrier and policy number are; Cartier: Policy Number: Exp. Date: (This section need not be competed if the permit is oror one dollars ($100) or less. 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. X (.�/, 04/21/2008 Signature �D� 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 INSECTION 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 Balance Due: $0.00 Receipt No: B7095 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 OMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR 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 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 Professions Code: The Contractor's 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. 8 P.C. for this reason: L1� 04/21/2008 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 Slate laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnity, 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 property owner ram a thou d to act on the property owner's ehalf. .� r„ _ . �s Owner Contractor QR;❑Agentfor Owner Agent for Contractor FILE COPY 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 PLEASE PRINT CLEARLY PERMIT NO. "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 Last Name Name First N e Li y� !/ Mailing Addres Zip`t�.S� City. f c—L6 Fax �, StateG,, z kLT44 Phone 3 _ Fax E-mail APPLICANT INFO MATION CONTRACTOR Name City C) a_ aV L1 2 1 Address Zip`t�.S� City Fax �, State Zip Phone Fax E-mail State License Number Class APPLICANT INFO MATION ARCHITECT/ENGINEER Name City C) a_ aV L1 2 1 Address Zip`t�.S� City Fax �, State Zip Phone Fax E-mail State License Number APPLICANT INFO MATION Name C) _ Address F q� 1� L j G�G City C) a_ aV L1 2 1 g�.6 State Zip`t�.S� Phone�gp` C {{ L Fax �, E-mail Con Tyst. APPLICANT SIGNATURE X 0 - PROJECT LOCATION AP# 2 Property Address 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. r � � AV V i ZA, b Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning 7 FloodSRA Zonepe I Yes No Occ. Con Tyst. 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 FORMAS 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.R NO) 2. I OWVE 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: 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: REPLACE SIDING- T-111(50 LF), WINDOWS(4) Reference Number: B08-0739 Applicant Name: ROBERTS, CLAUDIA Owner's Name: ROBERTS, CLAUDIA AP # : 079-300-00/6 Signature of Property Owner: df Date: ,5_0'N'1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line: (530) 538-7 6 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B07-0999 Issued: 05/08/2007 Setbacks 132 Foundations / Footings d Address: 84 CRANE AVE Area: OROVILLE Grade Beams Owner: ROBERTS, CLAUDIA APN: 079-300-006 216 Applicant: ROBERTS, CLAUDIA Map Page: Do Not Pour Concrete Until Above are Signed Permit Type: Electric Panel 124 Gas Test House Description: REPLACE: ELEC PANEL, SIDING(19 If), W Gas Test Yard AREA 2 'Flood Zone: None SRA Area: Yes SETBACKS Front Setback: Side Setback: Rear Setback: Other Setback: Minimum Setback From Centerline of Street: ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type Inspection IVR INSP DATE Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test House 404 Gas Test Yard 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Holdowns/Straps 122 Shearwall/B.W.P.-Interior 135 Shearwall/B.W.P.-Exterior 135 Roof Nail/Drag Trusses 129 Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Shower Pan/Tub Test 408 Fire Sprinkler Test 702 Fire Sprinkler Final 75'2-- 02 Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Pool Final 802 Mobile Home Final 802 Ins ection Type I IVR I INSP DATE Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Swimming Pools Setbacks 132 Pool Plumbing Test 504 Gas Test 404 Pre-Gunute 506 Pool ElecBonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 1 507 Manufactured Homes Set acs132 Blocking/Underpining 1 612 Tie a--=--- ==== = ==--- == =—=--- 1 OFFICE COPY Site UBldg {Perrnit: Gas T' 4 Man', Address: - Contii, , - Skirtii I -GAS By � Date: 1 Manu;. • Date i Electric By: Date: ✓ ' (f - 7 1 M MoKk-4 a,ncrivurnuer: - Serial Numbers: Length x Width: Insignia: Public Works Fina 538-7681 Fire Department/CDF 538-6837 cxt 169 Env. Health Final 538-7281 Sewer District Final "PROJECT FINAL 801 rroject anal is a %-erancate or occupancy for ixesiaennai umy) PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSI.JANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A I YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy 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: 84 CRANE AVE Owner: Permit No: B07-0999 APN: 079-300-006 ROBERTS, CLAUDIA Issued Date: 05/08/2007 By KCG Permit type: MISCELLANEOUS 84 CRANE AVE Subtype: Electric Panel OROVILLE, CA 95966 Expiration Date: 05/07/2008 Description: REPLACE: ELEC PANEL, SIDING(: (530) 534-9749 Occupancy: Zoning: AR Contractor Applicant: Square Footage: ROBERTS, CLAUDIA Building Garage Remdl/Addn 84 CRANE AVE OROVILLE, CA 95966 Other Porch/Patio Total (530)534-9749 FEE INFORMATION DBE Single Phase Service-Resid $55.00 DBMSC Stucco/Siding-All Other $110.00 DBMSC Window/Sldng GIs Dr -Rept $110.00 Total Charged: $275.00 Fees Paid: $275.00 Balance Due: $0.00 Receipt No: B2977 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 05/08/2007 the applicant to a civil penalty of not more than five hundred dollars ($500); Please check one of the following: Contractors 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 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 INSURANCE, as required by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE 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 Contractors 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 oontractor(s) licensed pursuant to the Contractors License Law.). Carrier: Policy Number: Exp. Date: (This section need not be completed if the permit is or one a hundred dollars ($100) or less.) ❑ I AM EXEMPT under Section B. & P.C. for this reason: c ERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS LLLYYYJJJ 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' the X 05/08/2007 AA4 compensation provisions of Section 3700 of the Labor Code, I shall forthwith with those provisions. Owner's Signature Date e2" 05/08/2007 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 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 a injury, including death, and property damage caused arising out of, 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 t is a 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 prop rty cone ora au ' ed to a the pro erty owners behalf. p 05/08/2007 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for a Of Ittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner ❑ Contractor OR. 11Agent for Owner ❑Agent for Contractor FILE COPY Lender's Address City State Zip �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 c y y y arty 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 -CLS13(2752) orby 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 PERSONALLY P�,41yT0 PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT/(YES R NO) G3HAVE 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 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: REPLACE: ELEC PANEL, SIDING(19 If), WINDOWS/DOOR(3) Reference Number: B07-0999 Applicant Name: ROBERTS, CLAUDIA _ Owner's Name: ROBERTS, CLAUDIA AP # : 079-3000-0006 Signature of Property Owner: —�. ,� Date:y5 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 "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name First Name J Mailing Address ge r H62,y State Zip Phone Fax E-mail APPLICANT INFORMATION CONTRACTOR Name - Address Zip City Ci City o , Phones Fax ' E Lic. # —. Class APPLICANT INFORMATION ARCHI TFCT/ENGI NEER Name City =Addrdss Zip City Fax State Zip Phone Fax E-mail State.License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICK i �IT SiGNA TUIRE PROJECT LOCATION AP# Property Address City PERMIT NO. BIN #r�__ 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 SCC'PE OF WORK. e Fe4l ( telk ILAc•r.a`11(� i �acrw Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy -,n - (Note previous use): For office use only: Zoning Flood SRA s No Occ. Type Const. /� /- Cpz-- Y SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE +=OK 0 =Nat OK - - - MANUFACTURED -HUM E.S MISCELLA-NEOUS DATE PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test;. Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat 0 or LPQ Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test -Crossovers -Breakers -Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Gride 12 Gas and Electricity Tagged 13 Tie Downs Q Foundation Q 14 Exits 15 _Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE ID EC K S'C O V E R S'C A R P O R T S'G A R A G ES 1 Zoning -Setbacks -Easements . 2 Ftgs; Soils-Sz-Dpth-Spacing-Cnnctrs-Steel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors J Electric 8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses ' 9 Siding; Nailing-VeneerStucco-Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls DATE POOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead -Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFl 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool lghtg Bones-Enclsrs-pnlboards-Insultn to Main Conduit 9 Health Dept Apprvl • t 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr, Fencing -Alarms 13 Bonding, Diving board or Slide 41 - Pool Drawing '. 1 v=OK 0 = Not OK - RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR DATE PLUMBING 1 Zan ingSetbacks-Easements-FloodSlope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Fig Garage; Soils-Steel-Elec Grnd Ftg Dpth. 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First flr-Tub Acc 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwr, 2nd fir - Tub Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test cs �� lot0�s 11 Wtr Pipe; Test-Anchrs-RgltrService Test DATE IMECHANICAL 12 Elec Undrgrnd 61 AC Ducts Insultn & Support 13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn 14 GirdersSills-Anchr Bolts-Joists-Vnts -Cripples 62 Vent Fan, Exhaust abv lnsultn 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16 Insulation 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic O DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE IFINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage; abv-flr-Ducts-Mech Prtctn 22 Headers & Beams-Sz & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns 70 GFI & Bath Fxtrs & Tub Acc-Spa 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 71 GFI Arc Fault 25 Frplc Ties or Type A Flue-Frplc Throat Clrnc 72 Elec Trim & Subpnl, Breaker Szs & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frplc or Stove, Cirnc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door; Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-Clrnc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc Mech Prtctn; LPG Appince Undr House 3" drain 35 Glazing Area -Glass Prtctn-SkyLts-Piastic 81 Plmb; Elec & Mech Eqp Listed for Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnls 83 Insultn-Foam-Looked in Attic 38 lnsultn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑Yes ❑No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Clrnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc-Ins Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous Inspctns 44 Eqp Grnd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec 45 Grndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz ga ❑ CU or DAL 98 Address Posted AC Wire Sz Ga ❑ CU OrEl AL 99 Fire Sprinkler 48 Range Circ 9a ❑ CU or Q AL Oven Circ ga ❑ CU or Q AL Insulated Neutral ❑ Yes Q No o'" 011 o` o`s 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector o'er m BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #;.'(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 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 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Date: Contractor: - OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a 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 State 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).): • 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 such 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 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.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I amExemptunderArticle 3 of the Business and Professions Code � Date: L__0__Q5`Owner: i� � WORKERS' COMPENSATION DECLARATION 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 workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Policy ❑ 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: I Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) PERMIT NO. BPO52769 Issued Date: 10/13/2005 APN: 036-050-039-000. Site Address: 84 CRANE AVE ORO Map Index: Description: ROOF STRUCTURE & SIDING 4 SQ.'S Owner: ROBERTS CLAUDIA 84 CRANE AVE OROVILLE, CA 95966 Applicant: LLOYD F. PARKINSON 5308 DILLARD.000RT OROVILLE CA 95966 (530) 589-0947 ' Contractor: License #: Architect: Engineer: Total Square Ft: 0 S. F. Valuation:. $0.00 Census Code: is permit is hereby issued under the applicable provisions of the Butte County Code and/or solutions to do work indicate above for which fees have been paid. .. (� f i./�y\ Date: 10 — t Z) -VV Address: I PERMIT EXPIRES ON: ' ' \J 1 V (Date) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. ' I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to center upon the above mentioned property for inspection purposes. n Print Name: yl 96 -VA ' Signature: 7� r Date: ❑ Owner ❑ Contractor Agent for Owner ❑ Agent for Contractor R r. R-Iriinn Pprmit n7-lfi-04 no 1 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE (530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES T Website: www.buttecounty.net/dds OWNER PROPROSED BUILDING USE 7l/ 1. BUILDING PERMIT FEES �� •�'/ ' -=- Balance Due ..................... --- FEMA Flood elevation review ... $ A. P. # DATE L�'CCJ CSV RECEIPT # DATE REC. I -s 3,.0 --- Additional plan checking Fee.... $ t , 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. RECREATION DISTRICT FEES - (paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FEES' , COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per dwelling) Zoning $ 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 8. SMIP 9. OTHER ' 10. OTHER 11. OTI4ER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. ` APPLICANT �� ►y:��.� DATE O Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements fora protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink-Ownei (rev. 3/05) .w..a_ ,.�,_�_w . ,, ........ •�•.�...... w_,,..�, _ .. . `�-cw.'.��F•Th,�;�N3iYs:"i'�ii'r�z"'�,lT�`iGr�r..;--.��....�- ; :� 4 �� - �-_�,,.5, _, } �? COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVIS►ON rr 7 County Center Drive, Oroville, CA 95965'Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: K 4iE�� 1J 1 Liu��GL ASSESSOR PARCEL NUMBER �3� f� 6-3 Proposed Building Use:' e09(' S f UNJl1QL � Permit Technician: % 7 Date: l �S Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. O 1. Site plans, 3 or 4 sets, signed by the preparer of the plans.11 �� 5 io - I > ")� 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 faxesl ❑ 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) Installation manual, including 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. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form ❑ 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 16. Fire Sprinklers............................................................................................ b 17. - Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... ❑ 19. Erosion Control Plan Required........................................................................ 20. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 21. City of Chico Plumbing permit........................................................................ ❑ 22. Site plan and business license approval from the City of Biggs .............................. ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ............ ❑ 25. Contact Land Development about _ Improvements, _ Drainage ........................ 3 ❑ 26. NPDES Form.............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept .................:......... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier pnd Policy Number .......................................... 30. Owner -Builder Verification (_✓Given to owner, _Mailed to owner).... ................. �- 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑- 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: //;; When issued Telephone %0'71119 -Acis and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. / Applicant: Q4DI� Date: ndex permit application for s numbered: Plan Check Letter 2. Additional items required i .. ;tGontractor, designer, owner, was ed of the above data by phone, ❑ mail, ❑ counter, by Date: 07 - Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: -p-,e Date: Plans approved by: Date: t\ b Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow:,Building Division 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. I personally plan to provide the major labor and'material for construction of this proposed , 'property improvement: YES,[] . NO [ ]. 2. I HAVE [ ' ] HAVE NOT [ J signed an application for a bur ing permit for the proposed'. work. � . �. -7, 3. I have contracted with the following person (firm) .to provide.the proposed co'nstructi'on: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4.' I plan to provide portions of the work, but I have hired the following person to coordinate; supervise, and provide the majonwork: NAME: ADDRESS: ' 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: DATE: Of, 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. r Rev'd 11/4/2004 4 Butte County Department of Development Services ADMINISTRATION ` BUILDING ` GIS * PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile OWNER -BUILDER INFORMATION Dear Property Owner: 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 your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o 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. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o 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 their own employees, without a licensed 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 in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, �— AY ._ Scott Rutherford Chief Building Inspector NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. /7 v - IT- n Le (v v � N Dr _ 5 _ 0-70 y? _.L7v 51 N cv Z m oo ' C� G) �0 ® ® m<c jo nz 1� Z Z �<__ -Z CP o i c �I ; ri i i, 3W z s i � o x 3 �<__ -Z • �n2`" 1��G� Z OT WA Q Gab1�.11Q� '. 12 � vitt ; access ¢ �-- 2 X4" 14 x Ra -ter @, ((a / \ Tri ;>a no, Pad' I j 2"n Co'+ 3 ! LEVA T! Iley � ' a s _ --- - -- - --IN! _7 -, _ 2. Rpoo;o'c \A-a=n3r I Ff y'1CC'X �` R,43e. W649 1 .G e�\(,after (X6 &,/I S � a Fri + • Zhu 6Q'+I� 3� FTs ON i`t- n la tki[I ts� 0�0yrBUTTE .3 IzL �Yl►h�' S� ' TY --- .....__._.. SUIL.DiNG DIVISION No 4-(-, APPROVED 3- ► % _' SALE:"=1� u';: 4,jz X . 76 g' ldga✓ 11/4 1 Dv! Roo Sa� y 3,Si� •leo a�oh� Sime. � 2,A4 N��. ers ull2 I(oo i U ,G.`•'cl! IVIY'u. I�IC1Q.E - }-c4n.,-71o/+. < _ � ,�N ►} 2x4 W�z' l x°"`,51 t 'BUTT'S COUNTY. BUOL®8Nd DIVISIO' APPROVED'., i -S T UC TU !,1 Sa� y 3,Si� •leo a�oh� Sime. � 2,A4 N��. ers ull2 I(oo i U ,G.`•'cl! IVIY'u. I�IC1Q.E - }-c4n.,-71o/+. < _ � ,�N ►} 2x4 W�z' l x°"`,51 t 'BUTT'S COUNTY. BUOL®8Nd DIVISIO' APPROVED'., i -S T UC TU