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Home My WebLink AboutB21-1115 PERMIT INTAKE FORMS - signed5/6/2021 Submission Completed https://eforms.buttecounty.net/Forms/Form/Submit 1/7 Building Permit Intake Forms Permit Information and Form(s) Selection Permit Number * APN* Property Address Permit Type Permit SubType Permit Description Property Owner Applicant Email * Select Required Forms* Contractor or Owner* B21-1115 047-150-111 13279 TAYLOR ST MISCELLANEOUS FIRE SUPPRESSION-RES F/S FOR B03-2809 DRANE JUSTIN E & ANDREA M SQUYRESFIRE@GMAIL.COM ISSUE PERMIT FIRE RESIDENTIAL BUILDING REQUIREMENTS NPDES (<1 Acre) NPDES (>1 Acre) NOTICE TO BUILDERS NOTICE TO BUILDERS FOR OVER-THE-COUNTER PW - 26.12 Environmental Health North Chico Flood Disc Camp Fire Donation Camp Fire Notice Contractor Owner Owner/Builder 5/6/2021 Submission Completed https://eforms.buttecounty.net/Forms/Form/Submit 2/7 Licensed Contractor's Declaration Contractor (Name) State Contractors License No. Class License Expiration 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. SQUYRES FIRE PROTECTION INC 275206 B 04/30/2023 5/6/2021 Submission Completed https://eforms.buttecounty.net/Forms/Form/Submit 3/7 Workers' Compensation Declaration I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: Carrier Policy Number Expiration 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 IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY’S FEES. I have and will maintain a certificate of consent to self-insure for workers’ compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers’ compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers’ compensation insurance carrier and policy number are: FALLS LAKE FIRE AND CASUALTY COMPANY FLA015311 10/01/2021 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. 5/6/2021 Submission Completed https://eforms.buttecounty.net/Forms/Form/Submit 4/7 Notice To Builders Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: Make sure your application is complete. Be responsive to requests from County departments for any additional materials or requirements. The plan check fees collected at permit intake cover up to three reviews. Plan review time beyond the third review will be billed on a time and material basis. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit (per Butte County Code Chapter 26, Article 1, Section 263.1). A permit may be renewed (for a fee) prior to expiration a maximum of two (2) times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY** Application for which a permit has not been issued will expire one year after date of application.Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications, if the permit has not issued, but not after 180 days from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge to process the refund application will be assessed. A refund processing fee will be charged equal to the Building Division hourly rate(s).. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. 5/6/2021 Submission Completed https://eforms.buttecounty.net/Forms/Form/Submit 5/7 Fee/refund information can be read on-line at http://municipalcodes.lexisnexis.com/codes/butteco/ **When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. 5/6/2021 Submission Completed https://eforms.buttecounty.net/Forms/Form/Submit 6/7 Permit Application Declaration I am (choose one): By my signature, I certify to each of the following: I have read this construction permit application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter the above-identified property for inspection purposes. I understand approved plans with butte county stamp must be present on the job site for ALL inspections. If your plans are digital, please print the approved set with our stamp for the job site. If you have questions, contact the Permit Center prior to scheduling an inspection. A California licensed contractor The property owner Authorized to act on the property owner’s behalf 5/6/2021 Submission Completed https://eforms.buttecounty.net/Forms/Form/Submit 7/7 Final Page By signing here I agree and understand the forms that have been provided to me above: Signature* Brandon Squyres (May 6, 2021 16:10 PDT) Brandon Squyres B21-1115 PERMIT INTAKE FORMS Final Audit Report 2021-05-06 Created:2021-05-06 By:Stephanie Wright (sawright@buttecounty.net) Status:Signed Transaction ID:CBJCHBCAABAAMapbsjnG7PaxFdrK2XfgeYy8kTQyfW_5 "B21-1115 PERMIT INTAKE FORMS" History Document created by Stephanie Wright (sawright@buttecounty.net) 2021-05-06 - 10:55:02 PM GMT- IP address: 63.198.28.28 Document emailed to Brandon Squyres (squyresfire@gmail.com) for signature 2021-05-06 - 11:01:09 PM GMT Email viewed by Brandon Squyres (squyresfire@gmail.com) 2021-05-06 - 11:09:46 PM GMT- IP address: 74.125.209.57 Document e-signed by Brandon Squyres (squyresfire@gmail.com) Signature Date: 2021-05-06 - 11:10:05 PM GMT - Time Source: server- IP address: 67.174.61.24 Agreement completed. 2021-05-06 - 11:10:05 PM GMT