HomeMy WebLinkAboutB24-2705 ISSUANCE DOCSBuilding 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*
b24-2705
017-240-035
97 HORSE RUN LN
MECH ELECTRIC PLUMB
ELECTRICAL
RMV AND RECONNECT SOLAR AFTER REROOF
JULIE AND JEFFREY MARTIN
BRIAN@BJKENERGY.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
Wildfire Notice
Contractor Owner Owner/Builder
10/28/24, 12:03 PM Submission Completed
https://eforms.buttecounty.net/Forms/Form/Submit 1/6
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.
BJK ENERGY INC
955219
B
07/31/2026
10/28/24, 12:03 PM Submission Completed
https://eforms.buttecounty.net/Forms/Form/Submit 2/6
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:
STATE COMPENSATION INSURANCE FUND
9167243
08/31/2025
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.
10/28/24, 12:03 PM Submission Completed
https://eforms.buttecounty.net/Forms/Form/Submit 3/6
Notice to Builders for Over-The-Counter Permits
PERMIT EXPIRATION
Application for which a permit has not been issued will expire one year after date of application.
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). In order to reinstate action on a permit after expiration, the permittee shall pay a
new full permit fee. 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.
REFUND POLICY
Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit
applications or permits cannot be made after 180 days from the date of fee payment. 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 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.
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.
10/28/24, 12:03 PM Submission Completed
https://eforms.buttecounty.net/Forms/Form/Submit 4/6
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
10/28/24, 12:03 PM Submission Completed
https://eforms.buttecounty.net/Forms/Form/Submit 5/6
Final Page
By signing here I agree and understand the forms that have been provided to me above:
Signature *
10/28/24, 12:03 PM Submission Completed
https://eforms.buttecounty.net/Forms/Form/Submit 6/6