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035-213-015
COMPLAINT TO INSPECTOR u A.P. , _ 213 15 F.A. Simmerly 4657..Lincoln Blvd...).. /6 CONTR: Earl Wood, 0 Vill40-2+ Permit 406-72B ( add por--ch & carport) A.P. 36-213-15 SINlMERLY, F.A. o,.�Z2_�"�� 4657 Lincoln Blvd.., _ CONTR: Earl Wood, Or lle Permit-862-72(Convert porch to living. area_) Pl"I OW'F% 35-213-15 00-ff" Permit #110l-77P.;E(uC.il.,MH)y665'Ji"C4/ SUPPCRT'STRUCTURE REQ. COMPACTION TEST REQ.+ ,D Pco-ntr:35-213-15 Wilson Mobile Home Serv.,Oro. Permit #2103'-?7MH'r" Issued'" 35-213-1l5 Permit #5984-75B(rep. EQ dam 'fireplace --class A flue /SF) Contr: Donoho Ref. Ail to I r'lle � - - - — 35-213-1 port- contr: Duralum, Inc-, Sacramento Permit #2504-77B(neew'covered deck/MH) 35-213-15 port. Permit #2e3'1-78B(remove & replace pori of roof, replace ext.door & roof on patio/SF)r_- V�" 35-213-1,5 >gQLLY SINMERLY 40 4657 Lincoln Blvd., 0 oville i11 Contr- Waibel AC, Oroville Permit#4928-80P,M(install f rnace)SF 035-213-015 05-0004 HERRRA 4657 LINCOLN BLVD, OROVILLE Cont: RC HIGGINS 6WNDWS/ELEC/HVACETC... X5,05 NOTES RESIDENTIAL PERMIT NO. _ .0;5.213-015-� -- -- OS -000- 4 �HERRRA r 4657 LINCOLN BLVD, OROVILLE W/ Cont: RC HIGGINS ) ,,9,y�/►� 6WNDWS/ELEC/HVAC ETC... . 1 hr LRA oAL SPECIAL CONDITIONS SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER OFFICE COPY Address- GAS ddress GAS Date Meter By ELECTRIC Meter By Date I JOB FINALED (Date) Signature CHECKED BY r t SPECIAL CONDITIONS SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER OFFICE COPY Address- GAS ddress GAS Date Meter By ELECTRIC Meter By Date I JOB FINALED (Date) Signature CHECKED BY J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel- Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 9. D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test Siding -Nailing Veneer 11. Water Pipe; Test -Anchors -Regulator -Service Test Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 12. Electric Underground Glazing Area -Glass Protection -Skylights -Plastic 13. Plenums & Ducts; Clearance -Material -Support -Ins. Shear Walls; Nailing -Bolts 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies Brace Interior/Exterior Wall Panels 15. Access & Ventilation Insulation -Walls -Ceilings 16. Insulation I nfi Itration-Wal Is -Windows Date Date Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Date PLUM G (PerminK except #'s Ext. Steps -Door & Sidelight Protection -Landings 1 t^ater Htr.; V -Access -Combustion Air Baffle Smoke Detector 18. ter Pipe; Test & Anchor -Nail Protection Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 1 .W.V.; Test Fittings & Anchor -Nail Protection Bedroom Exiting 20. Shower Pan; Test, First Floor -Tub Access 68. 21. Test Tub & Shower, Second Floor -Tub Access 69. 22. Gas Pipe; Sixe & Anchors 70. 23. Fire Sprinkler; Test 71. Fireplace or Stove, Clearance -Hearth Date Elec. Outlets at Wood Panel, Int. & Ext. Card B-1 Date Card B-1 Date Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral ❑ Yes ❑ No 32. Service -Riser Conductors & Ground Main Disconnect _ 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings Date 87. Card B-1 Date Card B-1 Date 88. Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Ventilation Throughout House 36. A.C. Ducts Insulation & Support Glass Protection 37. Vent Fan, Exhaust above insulation Corrections from Previous Inspections 38. Condensate Drain & Overflow, Size & Grade Gas Test -Meters Tagged, Gas -Electric 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet Water & Sewer Connected -C/O to Grade -HD Approval 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound Date 43. Bearing Walls over Girders & Floor Nailing Comments at Final: 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 46. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. I nfi Itration-Wal Is -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes _ 83. Following Instld./Drive Cl Yes ❑ No/Walks O Yes ❑ No/Planters ❑ Yes ❑ No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: J=OK 0 = Not OK . = NotReadyable DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/0 -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L 'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.netldds PERMIT NO. BPO50004 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of pedury that I am licensed under Issued Date: 01/03/2005 APN: 035-213-015-000 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: A LS: Site Address: 4657 LINCOLN BLVD ORO Map Index: Date:Contractor. F4 S C°,Un11' Description: 6Windows,elect. service up OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the grade, Plumbing, HVAC 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 Owner: HERRERA JESUS & ARMIDA to its issuance, also requires the applicant, for such permit to file a 4657 LINCOLN BLVD signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95966-6753 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 Applicant: HERRERA JESUS & ARMIDA 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, Contractor: R.C. HIGGINS CONSTRUCTION and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 85 LOMA VISTA DRIVE pp 9G1- 'I am Exempt under Article 3 of the Business and Professions Code OROVILLE CA Date: 1" 3"u.S owner: 95966 (530) 534-5210 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of pedury one of the following declarations: License #: ❑ 1 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. - Architect: ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Engineer: the work for which this permit Is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S.F. Poiicv #: Valuation: $0.00 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 Census Code: 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: 1- 3-0.5, Applicant: /`- C �( Ic,C7 isr K Lt�Cl)r/v¢ 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. oc4IIl1-Y,-5 1� CONSTRUCTION LENDING AGENCY This permit is hereby issued under the livable provisions of the Butte County CodR anNor I hereby affirm that there is a construction lending agency for the Resolutio -to d work indicated ab e f r which fees have been paid. performance of the work for which this permit Is issued (Sec 3097 Civ.) B Date: f Name: ? PERMIT EXPIRES ON: �- J -64.� Address: !—Date ❑ 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 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 enter upon the above mentioned property for inspection purposes. Print Name: /�'C" N1O��(!HS �a>i57�, 'Signature: ' •- -s��^� Date: 0 Owner K Contractor 13 Agent for Owner ❑ Agent for Contractor i BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.nettdds "PLEASE PRINT CLEARLY" CONTRACTOR OWNER Last kameirst fez City©� 01CtL Name ►- ,di Address Zip�66 City v� U b e Stat Zip Phone S3 c r a� Fax E-mail State License Number CONTRACTOR Name Address 4, D� City©� 01CtL Address State Zip�66 Phone S3 State Fax E-mail Book is Class APPLICANT NAME ARCHITECT/ENGINEER Name CityO n /'- Address Zipgs,�, City Fax State Zip Phone Book Fax E-mail Planner State License Number APPLICANT NAME Name Address s �� CityO n /'- Slat Zipgs,�, Phone y,S�IG Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning Property Address `1% U eon J� Flood Zone Cross Street SRA I Yes T No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. OS -0601i BP BIN # LOCATION APID I Property Address `1% U eon J� City Cross Street WORKER'S COMPENSATION Policy Number' RA 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: l� .r S .✓ u r Sq. Footage 9 06 ❑ Structure Built without Permits �iI2 ❑ Proposed Change of Occupancy (Note previous use): Page 1 of 2 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 fee 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. Received by ---r Amount: Receipt #/_/< � C/ �� e0i Date: /"2, A8q- 9 SRA Sheriff SMIP /n Other "' Total REV 7-27-04 d The following drawings, and s permit. INCOMPLETE SUBMI SUBMITTAL & PERMIT REQUIREMENTS ifications must be submitted to the Building Division in order to apply fora LS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper.! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations, ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. 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, ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). ❑ 13. Sanitation and site plan approval from the Environmental,Health Department. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional'plan review upon receipt of the following items.) f ; ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). 0 4. NPDES Form. ❑ 5. Encroachment Permit for -driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contract or's.license information. (Number, Name Style, Classification), ❑ 7. WorkeY's. Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). - ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530)538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one.year after date of application. In order to renew action on an application after expiration, a new application; plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years- from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits, refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. ` OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 i' L w � ,. '•_,,.; .. . _ .... Com, _ .,�.._ � goo �I y1`3 f �� �4 i r IL \ry 1 171 a 'r, COUNTY OF BUTTE - DEPARTMENT OF PUBL-IC WORKS PERMIT NO. 7 County Center Drive'- Oroville, California 95965 - T*elephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER OJ — �� �» 0/6-- Z. C, NII I�G'--•l j.-- BUILDING PERMIT OWNER- -- /,} /S ♦ `/A TEELLEEPH�ON�E 1 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING'DDRESS.° Y CONTRACT R'S -NAME . TELEPHONE CONTRACTOR'S MAILING AD Dfi ESS CONSTRUC ION LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINE _ LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS ' Permit fee $ own A64 BUILDING ADDRESS / PLUMBING PERMIT Filing Fee —3,00 Ir n Ir r Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets', •OU USE OF STRUCTURE SFY. Duplex❑ Mobilehome❑ Other j Vt SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition ❑ R)e�m�odelf Utilities/,❑ Installation'tf Other � 1 !/ ►tel /� l Describe work: �_ -�.[�d -� ��-���'/�-t'� E'-- / Permit Fee $ %S. pa Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 100V OR, LESS 100 AMPOR LESS 5•00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC, BLDGS. 20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m license is in full force and effect. y Af License No; '_ Ar%;%� Classification ' ci�0 ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with'licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR. ULTI.OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS NEW CONSTR /POWER APPARATUS & NON-RESID. %SINGLE OUTLET CIR. 50@25C OR FIXTURES BAL@100 Ex. Occup(o XED FIXED A PPLNSOR Ex. Occup.(OUTLETs (RESI.D,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 900 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to.Appiicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. HeatingsM /, Z 1 J�444 Cooling Hood 2.00 Ventilation permit Fee $ /• Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in -consequence of the granting of this permit. �= c; _ X-" _--.,,� ��-- Date ! Signature of Applicant — Owner [IContractor ElAgent❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories, in height. Mobile Home Installation Fee $ Land Development Fee $ .~ TOTAL PERMIT FEE $ 3(7'00 OCcu P. GROUP I TYPE OF CONST. I PARCEL PD I HD I 1590E This permit is hereby issued under sions-;of the Butte County Code and/or indicated above for which worki DIRECTOR OF PUBLIC f _& Y �� PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Q 1 2/ I 't _Date to V L �' Receipt No. % t✓ WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive-.Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT N0. ASSESSOR PARCEL NUMBER Cl2 ZOW BUILDING PERMIT OWN a TELEPHONE SQ. FT. OCC.1 BUILDING VALUATION OWNER' AI ING NDV CONT.CT R'S NAM TELEPHONE CONTRACT R' MAILIN ADDRES - f a '� tea' C NSTRUCT10N LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEE LICENSE NO. Plan Checking Fee ,$ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUI DING ADDRES - PLUMBING PERMIT Filing Fee •^9-e8 Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SFX Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition ❑ =emodeltilities InstallationOther Describe work: \Q5:ta�L'p Permit Fee $ %�>00 Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 10ov OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.(DWELLING CP. OR ADDNS. OCU&ACC. BLDGS. 20 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. ��tc lO7%� Classification �.. ao License Nom[ ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting. with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR UL '_OUTLET NO N.RESID BRANTCH CIRC ITS 2,50 ea NEW CONSTR ( POWER APPARATUS &) NON-RESID. SINGLE OUTLET CIR, / 50@2gc Ex. OCCUp\OUTLETS OR FIXTURES BAL@IOC Ex. Occup.( OUTLETSFIXED P(RESID.)R EAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. j I have placed on file with the County of Butte Building Department f� a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject. to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 9b Heating,4m Cooling. Hood 2.00 Ventilation permit Fee $ /�; Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabil 'es, dgments, costs,,and expenses which may in any way accrue against my i e ce of the granting of this permit. / X Date o?G -- C� Si ature of A licant — Owner ❑ Contractor ❑ Agent ❑ n OSHA permit is required for excavations over S'0" deep and demolition or construct- ion of structures over 3 storie in height.(T Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ 50,00 OCCUP. GROUP I TYPE of CONST. I PARCEJ PD I HD 550E This permit is hereby issued under the applicable provi- sio of the Butte County Code and/or resolutions to do w k ndicatedgove for which fees have been paid. IfOR OF PUBLIC WORKS 9Y�',' Date PERMIT EXPIRES Date Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE. — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Forms Parapets Main Bldg. Restroom Finish Footings Windows Stemwal l Siding Slab Roof Sheathino Piers Roofing Garage Fdn. Vents Footings Garage Vents Stemwa l l Insulation Slab Prov. forph sically Carport handica ed Conformance of ex. Footin s structure Slab Final Patio FIREPLACE Footings Footing Soil Piping 1st Floor 2nd Floor 3rd Floor Topout Water Piping Sewer Fixtures Water Htr. Heaters Appliances Gas Piping & Test TemD. Gas Final Relnf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heatino Service Brown Cooling Temp. Pole Finish Ducts Under round Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec_ Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR^CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) ELECTRICAL i •T t a.; P6MIT NO 2504-77B PERMIT EXPIRES r OWNER Florice Simmerly CONTR. Duralum, Sacramento LOCATION (A.P. 35-213-15 port. .4665 Lincoln Blvd., lot 117, Oroville 1 Temp. Power Pole Called PG&E _ Temp. Elec. Ser v.. Called PG&E Temp. Gas Serv. _ Called PG&E _ JOB - FINALED i (Date) i (Signature) 0 C'OUN'1Y OF BUTTE -- DEPARTMJENT OF PUBLIC WORKS 7 County Center Drive — oroville, California 95965 v Tel ephc7he: 5341-4541 7 7 APPLICATION AND PERMIT � ��-oi autIIor I1 N' (I doves or the County or butte to enter upon the above -menti a property for inspectio purposes. X Signal re of Permitee or Ar)1615;770 t ReceiptNo./ White-D.P.W.4 o0-essor g 3_Y00r - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have bpeqpaid. DIRECTOR OF 4UBLIC WORKS BY- Date b - Bu6//in permit expires Date b - % ' BUILDING Owner SQ. FT. OCC. BUILDING VALUATION r 66 Mailing Address 4 5 LINCOLN BLVD. _ e r -4F OROVILLE, BUTTE COUNTY Telephone No. AZ 4 C7 �A16 Fireplace Contractor DURALUM, INC. Total Valuation p� Mailing Address P.O. BOX � ,2612 Permit Fee Plan Checking Fee &/or Penalty SACRAMENTO,) CALIFORNIA Kb',21 116021 T4.52 6021 Permit Fee $ IZ41 p Building Address 4665 LINCOLN BLVD. PLUMING No.1 @ I FEE PERMIT FILING FEE $3.00 OROVILLE, CALIFORNIA Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 417- _ Each gas water heater or vent 1.50 A. P. No. /�� Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 V-1/21 1!15/S Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration parcel Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 Bldg. ans Recd Parcel Apft Wal PI pprovol Permit Fee $ $ NEW jaiADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE J$3.00 Main service 600V OR LESS 5.00 100 AMP OR LESS Main service EA. AOD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 caaeno/ NEW CONST. IF DWELLING OCCUP. & OR ADDNS. ACC. BLDGS. 22sgft NEW CONSTR. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS &,, NON-RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of:Occup.FIXED DURALUV, INC • Ex. Occup(OUTLETS OR FIXTURES) BAL@1 APPLNS. OR Ex. (OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 = P.O. BOX 26124 SactO. Ca. Mobile Home Facilities 15.00 License No O Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of Califomia. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be.insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑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 Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby i TOTAL PERMIT FEE $ -� autIIor I1 N' (I doves or the County or butte to enter upon the above -menti a property for inspectio purposes. X Signal re of Permitee or Ar)1615;770 t ReceiptNo./ White-D.P.W.4 o0-essor g 3_Y00r - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have bpeqpaid. DIRECTOR OF 4UBLIC WORKS BY- Date b - Bu6//in permit expires Date b - % ' ,rna IF f 7 iW ';'401% eland do -Iddaa allna do uNno:) IM I� ,rna IF f 7 iW ';'401% eland do -Iddaa allna do uNno:) IM COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECtION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall, Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor - Stemwall Siding To out Slab Roof Sheathin -7 ` 7 Water Piping Piers Roofing — Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwal I A Insulation Heaters Slab Carport Footings zstructure Prov. for physically handica ed Conformance of ex. Appliances Gas Piping &Test Temp. Gas Slab Final _ Sanitation Patio FIREPI-4& Final Footings Footinq ELECTRICAL Relnf. Steel I Final I Fixtures Bond Beami i _ FIRE SPRINKLERS I Motors MECHANI Scratch Heatina Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MOSILEUOME INSTALLATI N - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) 2631-78B T PERMIT NO. . 1 J t ` PERMIT EXPIRES�[� OWNER Florice Simmerly t CONTR. owner LOCATION (A.P. 35-213-15 port. 4657 Lincoln ELvd., Oroville Temp. Power Pole Called PG&E _ Temp. Elec. Serv.. Called PG&E _ Temp. Gas Serv. _ Called PG&E _ JOB FINALED COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephc.;2: 534'4541 APPLICATION AND PERMIT Receipt No. It / 7 l!!:�T White-D.P.W. — Yellow -Assessor —Pink -Inspector — Goldenrod -Applicant Building permit expires Date BUILDING Owner r SQ. FT. OCC. BUILDING VALUATION L .L� Mailing AddressP ( ( tel ephon�o JJ Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee �?�>'1✓ %tom PLUMBING No.1 @ I FEE L ` 6 PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. .— 13 rtl Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 Fees W.C. `9W Fire Dept. Fire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EQA Parking Plans Parcel laration Parcel Map 60' R/W Each additional outlet' t .30 Building sewer 5.00 Parcel A al Plans proval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ IRG,yribule-4 6Ce'70YIG! ft V,pp'�% 1�.)( V7 ELECTRICAL No. @ FEE Plt^ 1'<kQ r MMMEIE�E -A PERMIT FILING FEE $3.00 Main service 60ov OR LESS 100 AMP OR LESS 5.00 Single Family Duplex Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER aoovR LESS 25.00 100 AJOUR Main service EA. ADO'L 100 AMP 1.00 NEW CONS. DWELING OOR AODNST ( ACCLBLDGS.CCUP. 7i� 20sgft LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: %� NEW -OUTLET BRANCH CIRCUITS) 12.50ea ON -RES,., (MULTICONTIRACTORS NEW CONSTR. (POWER APPARATUS 8 NON-RESID. SINGLE OUTLET CIR. Ex. Occuo(OUTLETS OR FIXTURES a �� Ex. Occup. ( FIXED APPLNS. OR p•OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 [D -T -am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. aZ 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 Workmen's Compensation Laws of California. @ MECHANICAL No. FEEPERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 1 1 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of thetCounty of Butte to enter upon the above-mentioned property for i spection purposes. C X _ �r..�y��>'y`LPQ Date - �b ' �- Signature of Permitee or Agent Land Development Fee $ TOTAL PERMIT FEE $ °� 1 This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. IR - OF P IC WORKS B Date �2,-/Z Receipt No. It / 7 l!!:�T White-D.P.W. — Yellow -Assessor —Pink -Inspector — Goldenrod -Applicant Building permit expires Date ' -0)2 , ( '"PERMIT NO. 1101-,7P,E PERMIT EXPIRES i OWNER Florice Simmerly CONTR. owner f LOCATION (A.P. 35-213-15 ) 4657 Lincoln Blvd., lot 116 & 117, Paxton Sub, Oroville t t } •x x, v t. V s • 4 d3 'i Temp. Power Pole Called PG&E Zaaw. Elec. Serv.- Called PG&E Gas Serv. Called PG&E r JOB ( FINALED (Date (Signature) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING.(Cont'd) PLUMBING ori ck F ewall S I Piping For Pahpets 1 t Floor Mai Bldg. Rest om Finish 2n Floor Fo ins WindoN 3rd Noor Stem all Siding To out Slab Roof SheaNhina Water Pi i Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwal I Garage Vents Insulation Water Htr. Heaters Slab Carport p Footings Prov. for ph sical handica ed Conformance of ex. structure v Appliances Gas Piping &Test Temp. Gas 'Slab A Final A Sanitation Patio REP ACE Final Footings Footing ECTRIC L Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Bea FIRE SPRINKI Eft Motors nal Mesh MECHANICAL Grd. Fd&It Prot. Scra h HeatIA Servl 14 B n Coo ng T mp. Pole nish D Vts rider round Interior Lath ntilation NPermanent 1.00r Closer anal ffil Final MOBILEHOME UTILITIES ------------------\Elec. Service &41Elec. Pedestal WatermumilmPiping �� Sewer �� �� Gas Piping MOBILEWOME INSTALLATI N - - - - - - - - - - - - - - Support — Elec. Continuity Water Piping Drainage Gas Piping 7 DATE REMARKS OR CORRECTIONS ` &4S A94F,< . ff,% S (!P k0 ellikP H*A/64C,0 -r6 Ilk (NOTE: An entry must be made on this form each time you visit the job site.) 'M0BTiX.1'10M ' DVSTALLAT)'ON INSPECTION CHECK LIST 1. Is the mobilehomt located wi.i.h.-equired•separation from lot lines and buildings and gen6�rilly conform to plot plan? Yes No 2, Does the mobilehome have required clearances above ground? (Sec.5085) Yes 3. Are foot.in,s and supports properly sized, spaced, and braced as per approved plans? (Note possible variaLion at spring shackles.) (Sec. 5082 & 5083) Yes_ _ No_ 4. Is the mobilehome level.? (Sec. 5088) Yes No 5.� Ire than a single unit, are crossover connections properly installed? (Sec. 5088) / ' s_ No h, Water. A. Is flex.h- e connector of adequate size and properly installed (1/2" ID min.)? (Sec. 556.6) Yes No B. Test - Does water piping withstand working pressure or 50 lbs, air test? Yes -A- �No C�Backflow - If coach is not State of California approved, does station have backflow device and pressure -relief. valve? Yes_ No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes B. Does it have minimum.,," per foot slope and is it properly supported? Yeses No 'C". Are any leaks detected in drainage system after'running 3 -cellons of water through each fixture including washing machine standpipe? Yes No '/ � *�es. f coach is not State of California approved, does station have required trap and vent? No 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector n t more than 6 ft, long? Note: All piping is to.be•at least as large as the mobi ome gas line inlet without reductions other than the mobilehome connector. Yes No B. Test OK as per following procedure? Yes a�- Tdo .I -"'-Open all appliance connector valves. 2 --"—Shut off appliance burner and pilot valves. , 3 -Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop, 4e --Connect: gas meter to mobilehorne with connector, turn. on gas, test connections with soapy water. C. Are all.appliance vents properly installed? Yes kl No 9. Jectrical A. Is service large-ellollgl. to provide adequate amperage to mobilehome (must equal ratinj,.,, of Tilobilehoiae �,iith a. -.:tin.boum of I Y.O amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes pe*' No B." Is ther,� proper clearances around panels? YesXo C. Is power supply cord or feeder assembly properly fused? Yes D. Is continuity test satisfactory as per the following procedure? Yes AO No_ De -energize electrical 'wiring, syste,,-,i of the mobilehome at the pedestal. Make sure that the power supply cord or feeder assembly conductors, -including neutral conductor, have been disconnected. switch all breakers and switches in 'the mobilehome to the "on" position. 4. Connect one It -..-id of'a test instrument to the mobilehome grounding conductor and 1--` - , Tt-1Ob--jtOyfje Supp"y CorllLictor, ijj(;JLLding ne%Aral. apply O"ie other 11c:ad to east- L.L i J- 9� All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line) , including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor.. 6e"Upon completion of the above procedure, the power supply cord or feeder assembly conductors -shall-be connected t'o the site service equipment. 'A further continuity te..:-L ,,,hall then be made between the grounding electrode and the chassis of the Mobilehome. ' UDon,saLisfacto*rx, completion of the electrical tests, the, lot or site service eqijipment'rliay be approved for energizing. (A -job card si-ned by Health Departmeat for =water and sanitation? 11. If evorything okay, sign off card and ta- services. MOBILEMME DATA TO 0 io Manufacturer and/or Namestyle rGZAZ-� - Lengti, Vehicle Serial No. State Identification No, A &�Iitional Infol-,narjan,or Comment,;: COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS • 7 COUNTY CENTER DRIVE OROVILL�, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the C ifornia Administrative Code, Title 25, Chapter 5, under permit number_ - 1103- %7 for the following location: 4 1? 4/QVC tb. L4 C14- Owner L Owner's Address SV,1122 Mobilehome Mfg. Fk �Fil�7,290b Model YearZ Insignia No. _A .'�t%O b � � Serial No. � � �� Y It is hereby certified for occupancy at the above described location and may be occupied. Dire-c-tPr of Public Works Date �"�� — $y/ XCI c THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED COUNTY OF BUTTE, — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Uroville, California 95965 Tel ephbne: 534-4541 77 APPLICATION -AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Date a Signatu a off Pe_rmitee or Agent /w Receipt No. , / IC) `3 + - White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR/0'F PUBLIC WORKS By Date -\f //-77 Bu ding permit expires Date S BUILDING Owner /1./66 jvin V" IS., (. (, SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor ry( *N .J (f / �� Total Valuation Mailing Address? �' �L aIQ� AUe� Fee Permit it Fee Planng Fee &/orPenalty ' 4 CDQJL L� jel ph a o. 3/. Permit Fee $ Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 c! Each Trap 1.50 ©2 0 of Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. S' -2 t3-- l Y- 1 Zoning & Planning Gas piping system 1 - 5'outlets 1.50 Each additional outlet .30 FAeS'10�_�FireDept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel M 60' R/W Im rov ents p Lawn sprinkler system 2.00 Bldg4RIons Recd I Parcel V proval Plans pproval Permit Fee $ $ NEW ADDITION ❑ UTILITIES ❑ OTHER [� ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 Q�C.IGW Main service 100v OR LESS 5.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ OVER 600V Main service 1100 AMP OR LESS 25.00 Main service EA. ADD'L too AMP 1.00 ' NEW CONST. DWELING OR ADDNS. ( ACCLBLDGS.CCVP. &) 20sgft NEW CONSTR MULTI -OUTLET NON.RESID, % BRANCH CIRCUITS) '2.50ea NEW CONSTR. (POWER APPARATUS &) NON.RESID. (SINGLE OUTLET CIR, CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter , Div. 3, of the State of California Business & Professions C under the name f: st le oX. y Ex. Occup(OUTLETS OR FIXTURES) BAL@j E OCCU FIXED APPLNS, OR p•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No._3 Q / G '7/ Classification �- G Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I e placed on file.with the County of Butte a certificate of orkmen's Compensation Insurance. F -1I 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 Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee � $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby 3o — TOTAL PERMIT FEE $ 3 V authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Date a Signatu a off Pe_rmitee or Agent /w Receipt No. , / IC) `3 + - White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR/0'F PUBLIC WORKS By Date -\f //-77 Bu ding permit expires Date S BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville,,CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: 2. Installer's name: 3. Is the site currently under permit? . Yes / L/i No (If yes, furnish permit number ) OR Is the site an existing site? Yes / / No (If yes, furnish two (2) plot plans.) 4. ,Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes / / No (If no, clarify 1WS—l?. ) 5. What is the mobilehome electrical rating? ----------- ------------�C) Amps 6. What is the mobilehome site service rating? --------------------- ,/ o 0 Amps 7. What is the mobilehome site circuit breaker rating? ------------- Amps 8. Is there any other electric load to be served by the mobilehome site service? -------------------------------------- .------------- Yes / / No /Lf (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pip�size�?--- -_________________ a ) (in.) 10. What is the type of gas service? ----- -- ` --� Natural /� _/LPG / / 11. What is the gas pipe length - o� m meter or tank -to t e mdbilehome?� ft. 12. What is the mobilehome gs demand? ------------------------------ /q ea (BTU) Covrrt �9Ljady (This£ information n�t equid if pipe len th essetthan 6 ft. on natural gas or less than 50 on LPG.) t /'t KI i � � MOBILEHOME SUPPORT DATA Mobilehome Mfr. 34 Qd Setup Model No �O Year 7 Width (ft.) Length ' (ft:)' Expando-Size ft.x -f t. (Draw support details below) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if.not on.file with the County of Butte).. Sin le �. Footings (check one) Mn 1. Wood either a 4 pressure treated or Center. Center Suppe t fdn. grade. Support FootiK�t, '�ies Locations (i 2. Concrete pad. 3. Other, specify ff.)(3n•) _. Supports (check one) / " 1. Concrete block ",2. Concrete piers _ I x I (10...in iin•)(in.) 3. .Steel piers / 1 / 4. Other, specify Typical Support - - - ; x' I Footing Size X i �in.)Ziii.) Max. Pier Spacing X - Max. ,% •) (in •) 4 1 i_. .�...- Overhang *If center piers are other than drawn above, BUTTE COUNTY draw in locations, spacing, and dimensions. BUILDING DEPARTMENT APPROVED lhis set of plans and AaMUST be NOTE:—,4-V;,-.'Mqjteridls &--W6rkm-'dn--shJp"-Shall Be in -xepi.- on ai.-.ail -tjj-;Zi�s�rd,)k d fii,IBWW-t6 11 Setback shall be 5 - d...... or -a PrO.- n f 'it -me -At -76 P-0 T a Ke q!l S: I n -7 id Oropertyjine and 60 f t. fr6r.y t�a,, Accorda ogh�-ed,-,Good,-Pracfices an th of a S ecified- use -ih d - �Weiiteii��g, fs§�q� .9 t eltia qua -y.presc -P . centerline f he rodd, permi Hiiig �Cf rhdxi- -ev cefife -R I from_ 6arjjca o -des abi 1 jjf& x, , 7i* - ' - ' -f 6-2.4f. ea e overhang lout entirely rnb�� Uniform BWA-ig, Plu i ilurn o' v ooht -5 ai lao; ty.* 010 0 f all easements. the Naticii i'Aw 4 -7pt; Septic SYS fe �n_a i b ;z BL�tte Coun j., (thy. quirernenfs ' Z. 70 _Im CY Zz I Z: ICL Ln E ,dl IN 66, 01 Q IV m E 7= 0 -C -C -C 4- 0 Cm 4:3 c' Q)+-:+-: C U C, 2 o -.2 3:- U IW W -C m 4- i. UE O_CC 0 0 -C J COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Orovi Ile, California 95965 Tel ephdne: 534-4541 APPLICATION AND PERMIT /&)/ — 1-7 ;7 M .� k4 Z ate 1 -_ 77 DIRECTOR PUBLIC WORKS Signature of Permitee or ent O D57� :;ilding Date d-�'-77 Receipt No. ''LL yy White-D.P.W. - Yellow7, r /sess — Pink-Inlpdtor – Goldenrod -Applicant permit expires Date BUILDING Owner `'G� '~ee & SQ. FT. OCC. BUILDING VALUATION Mailing Address r rh//XTelephone / — 9 3 Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. a Permit Fee $ Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 " r /(.1 2 1,14 Each Trap 1.50 d� 14"Water Repair drainage or vent piping 1.50 pipinge GO f Zoniny Verification On Each gas water heater or vent 1.50 A. P. �_ N g Gas piping system 1 - 5 outlets -t-13T U -- Each additional outlet .30 Fp1rsl W. bn I Fire Dept. FireZone Use Permit Building sewer 1A o ed EQA Parking Parcel Plans Declaration Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 PI c00Jarcel Approval Pla s Approval Permit Fee $ 3 �( NEW ❑ ADDITION ❑ UTILITIES '6THERW ELECTRICAL No. @ FEEPERMIT FILING FEE $3.00 1,60. A15.00 A1 0AI ��' Main service 100 AMP OR Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home rV Others ❑ Main service OVER 00 AMP OR LESS 25.00 Main service/ EA. ADD'L 100 AMP 1.00 NEW CONSTOR ADDNS. ( ACCDVIELBLDGS,CCUP. &) 2¢sgft NEW CONSTR. MULTI -OUTLET NON.RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS & NON-RESID. SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: 50 Ex. Occup(OUTLETS OR FIXTURES) @� 109 Ex. Occu FIXED APPLNS. OR p• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 2.3,00 is 3 WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Flee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property inspection purposes. n A f,NI 7e TOTAL P RMIT FEE $ / D( This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. k4 Z ate 1 -_ 77 DIRECTOR PUBLIC WORKS Signature of Permitee or ent O D57� :;ilding Date d-�'-77 Receipt No. ''LL yy White-D.P.W. - Yellow7, r /sess — Pink-Inlpdtor – Goldenrod -Applicant permit expires Date a iPERMIT NO. 5984-75B P E . t M MH UTIL. PERMIT NO. if PERMIT EXPIRES TOWNER _ Florile Simmerly ,"J,CON TR. Donoho Refrigeration, Gridley C ,, r LOCATION (A.P. 35-213-15 ,`4657 Lincoln Blvd., Oroville i. rri `i � Temp. Power Pole Called PG&E Temp. •Elec. Serv. Called PG&E a *,. T 11 Gas Serv. f Called PG&E 3• JOB Jo FINALEDfD (Dat a7jezt (Signature) f COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING I BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To pout Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. StemwaII Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE / REMARKS OR CORRECTIONS %�, ` G/ "D U �/ 141, Gdl:lam SS /'t /� l _L j COUNTY OF BUTTE — DEPARTMENT OF PUBLIC W KS 7 County Center Drive — Oroville, California 95965 ' 76 - Telephone: 53454541 APPLICATION AND PERMIT X 1 Date 2 A16 a, 7 S� ignature V 6rmilee or Agent Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant DIRECTOR 0 UB WORKS By Date Wilding permit expires Date /77� BUILDING Owner 7 SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace , l� Contractor273©l-7p2� Z� -2 / Total Valuation Mailing Addressl' 3 v' S Permit Fee Plan Checking Fee&/or Penalty — /all Telephone No. Permit Fee $ ' Building Address Js- o7H �v PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1,50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No.Gas Zoning & Planning piping system 1 - 5 outlets 1.50 Each additional outlet .30 W n Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements p ovements Lawn sprinkler system 2.00 Bldg.Plans Reck-91Parcel Approval pP Plans �pproval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 /in Cdr Ua c f% 6149 Main service incl. 1 meter .�I.,Additional a a. meters, each 1.00 - Single Family Q Duplex ❑ Mobil Home ❑ Others ❑ Sub -panel (12 or less) (more than 12) Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures b l01 Receps.., switches & fix outlets CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: c, Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap, cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Water Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability orkmen's Compensation. have placed on file with the County of Butte a certificate of w1workmen'sCompensation Insurance. 1 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 Workmen's Compensation Laws of California. MECHANICAL No.1 @ I FEE PERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mdfloned property for i spection purposes. 77 A 1 19 TOTAL PERMIT FEE This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have heen..oairi_ X 1 Date 2 A16 a, 7 S� ignature V 6rmilee or Agent Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant DIRECTOR 0 UB WORKS By Date Wilding permit expires Date /77� • - REQUEST FOR /i-MtTHQUAbT INSPECTION Date 132 ,e �vt L Telephone (la st name) (first name) Address �� S % Z"' Direct ions IT21S OF CONCERN: ------=--------------------==]TSPECTZONpate--=�=__� _%2; -2 NAT[TRE OF DAMAGE ;cam-<-�,- Danger: s�rLcryC,( Action- C, --Lfol // / /4P Inspecto� k i PERMIT NUMBER B 406-72 Y. E PERMIT EXPIRES 7,3 OWNER F.A. Simm"e'rly CONTR: Earl Wood, _proville "LOCATION (A.P. 36-213-15 4657 Lincoln Blvd-, Oroville i 0 i r COUNTY OF BUTTE i , Department- of Public Works BUILDING INSPECTION RECORD Zoning t/�'% -- %� Setback �/ �— 7 7.-� Forms Foundation Piers & Girders Fireplace. Rgh. Plumbing Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing, Plmg. Topout, Rough Elec. Wt;. Ht, Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ' ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. Final' Final Final DATE REMARKS OR CORRECTIONS i 0 i , PERMIT NUMBER _ B 862-72(B,E,) °i. i• i P E 1- PERMIT EXPIRES 73 OWNER F.A. Simmerly CONTR: Earl Wood, Oroville 'LOCATION (A.P36-213-15 4657 Lincoln Blvd.,'Oroville t ��--- C r •f COUNTY OF BUTTE ' • Department "of Public Works 111 BUILDING INSPECTION RECORD Zoning _ Setback Forms Foundation Piers & Girders Fireplace Rgh. Plumbing Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing' /— -- "% C/� Plmg. Topout Rough Elee. ( /,-2, — Wir. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary . Temporary Cert. of Occup. ^ Final Final Final z 7 DATE REMARKS .OR CORRECTIONS r e 'COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS % _;7 7 County Center deive Oroville, California 95965 (� Telephone: 533-1230, Ext. 259 7,2- APPLICATION AND PERMIT ` BUILDING Owner ` SQ. FT. OCC. BUILDING VALUATION s Mailing Address / I Fireplace /�C9 �i��.G Contractor evv 0 Total Valuation Mai I i ng Address ��� Permit Fee G o Plan Checking Fee &/or Penalty �G ` Permit Fee $ r Building Address ,2Aefz� PLUMBING No. @ FEE PERMIT FILING FEE $2.00 _` ` 2 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. 3C� — �( Zoning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept. Sanitation Planning Building sewer 5.00 Plans 4��yllL Fees '� W. C. R/W Encroachment Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ OTHER Permit Fee $ $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) USE OF STRUCTURE Single Family Duplex ❑ Others ❑ Range, dryer or water heater 1.00 Oven, Cook -top or space heater 1.00 Light fixtures Re s., switches & fix outlets f CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: /2/ 4. wddd 1J4�1�a'�°�— Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Misc. wiring License No. 3,5-3 63 Classification ❑ i am exempt from the Contractors License Laws of the State of California. Permit Fee $ -s WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor .Code which requires every employer to be insured against liability for Wor en's Compensation. have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ElI 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 Workmen's Compensation Laws of California. I certifythat I have read this application and state that the above pp information is correct. I agree to comply to all County Ordinances and State Laws relating to• building construction, and hereby MECHANICAL No. @ I FEEPERMIT FILING FEE J$3.00 Heating Cooling Ventilation Permit Fee $ (State Fee for Str�rg Motion $0.07/$1000 Evaluation nate FeeS n gram $ $ O TOTAL PERMIT FEE $ S% . uw�'�c icNicocn'ouvca ui ul0 l�uullly ul DUUe to elller upurl Lne above-mentioned property for inspection purposes. Date scP 2_ Signature of Permitee or Agent Receipt No. 9 ' 7 / 9 1 _ White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date " /' i Z Building Permit Expires Datea- ,(— 7_�l COUNTY OF BUTTE, — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive' — Orovi lie, California 95965 Telephone: 533-1230, Ext. 259 APPLICATION AND PERMIT Owner Mailing Address Contractor Mai lin dress /'2/ �C�-vim.✓ Building Address / 3✓� �� A. P. No. Zoning Fire Zone Fire Dept. Sanitation Planning Plans —�— LFees ZJW. C. R/W Encroachment NEW ❑ ADDITION JTeJ OTHER ❑ USE OF STRUCTURE Single Family ® Duplex ❑ Others ❑ CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name sty f: License No. -&r/&/ Classification &—/40 ❑ i am exempt from the Contractors License Laws of the State of Califomia. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. �I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 Workmen's Compensation Laws of California. I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and Slate Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Signature of Permitee or Agent eceipt No. ���lr-G White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant BUILDING SQ. FT. I OCC. I BUILDING VALUATION Fireplace Total Valuation Permit Fee Plan Checking Fee&/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service incl. 1 meter Additional meters, each Sub -panel (12 or less) (more than 12) Range, dryer or water heater Oven, Cook -top or space heater Light fixtures Re s., switpMes & fix outlets Hood, Ex. Fan or F.A. Furn. Motor Evap. cooler, gar. disp. or D.W. Air conditioner or heat pump Water pump Misc. wiring @ FEE $2.00 1.50 1.50 1.50 1.50 1.50 .50 5.00 2.00 @ FEE $3.00 1.00 1.00 1.00 1.00 1 1.00 Permit Fee $ .-! MECHANICAL No.1 @ I FEE PERMIT FILING FEE $3.00 Heating Coo I i Ventilation Permit Fee $ $ $tate Fee for Str�n Motion $0.07/$1000 Evaluation $ Instrumentation ro Mgot TOTAL PERMIT FEE $ This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTO OF PUBLIC WORKS By Date Building Permit Expires Date .. � � • .. 'Y� � �. . .. - - +Irk ..... ,� - , • .. •�I .. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive' Orovi Ile, California 95965 Telephone; 533=9230, Ext. 259 APPLICATION AND PERMIT �•. I+�•a a a i. uu v a , uic v --y vl UULLc w U11MI UPUII UIC above-mentioned property for inspection purposes. X.� �.�� Date Signature of Permitee or Agent Receipt No. White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIIR�tE,�-CTOR O}/FIPUBLIC WORKS ByDate Building Permit Expires Date y- V BUILDING Owner , ' SQ. FT. OCC. f3111LDIN�G7 VALUATION Mailing Address Fireplace Contractor, -r ��-'/ Total Valuation Mailing Address .? Permit Fee PIanCheckiIng Fee &/orPenal ty Permit Fee Building Address '-'' """' { "'` r""'f \ PLUMBING No.1 @ FEE PERMIT FILING FEE J$2.00 Each Trap 1.50 Repair drainage or vent piping 1.50 / Water piping 1.50 Each gas water heater or vent 1.50 / A. P. No. r� ? ... �� Zoning Gas piping system 1 - 5 outlets 1.50 / Each additional outlet .50 ' Fire Zone Fire Dept. Sanitation Planning Building sewer 5.00' Plans `'%- Fees-.- W. C. 4-- R/W Encroachment Lawn sprinkler system 2.00 NEW ❑ ADDITION Q OTHER ❑ Permit Fee / $ i2_,�.- t rv.7*I' I ELECTRICAL No. @ FEE PERMIT FILING FEE i $3.00 Ir Main service incl. 1 "meter Additional meters, each % 1.00 USE OF STRUCTURE Single Family ❑� Duplex ❑ Others ❑ Sub -panel (12 or less) (mo,rethan t2) Range, dryer or water heater 1.00 Oven, Cook -top or space heater 1.00 Light fixturesA 20MI a Receps., switches & fix outlets b CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: / LAA 4C/ Hood, Ex. Fan or F.A. Furn. Motor% 1.00 Evap. cooler, gar. disp. or D.W. \ 1.00 Air conditioner or heat pump X Water pump \ Misc. wiring f License No. 1-7 3 S.?� G�3 Classification ❑ 1 am exempt from the Contractors License Laws of the State of California. Permit Fee % \ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. r ❑tl have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 Workmen's Compensation Laws of California. MECHANICAL No. @ , FEE PERMIT FILING FEE $3.00 \ Heating / / \ Cooling �• /" \ Ventilation , 1 ;Permit Fee $ $ I certifythat I have read this application and state that the above pp information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby (State Fee for S- rg Motion $0.07/$1000 Evaluation mate Fentfor S rogMot $ TOTAL PERMIT FEE $ r 'r' �•. I+�•a a a i. uu v a , uic v --y vl UULLc w U11MI UPUII UIC above-mentioned property for inspection purposes. X.� �.�� Date Signature of Permitee or Agent Receipt No. White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIIR�tE,�-CTOR O}/FIPUBLIC WORKS ByDate Building Permit Expires Date y- V r •,�... — i ~` .,~ �. � _ -� � - - — -1 his -set-of- pians -and 3peciftca?i06 /l4l1ST i _`• ` � ' kept on the job at all times and it is unlaw'dto I r / V e vo a y make any changes or alteratians on kame without written permissor. from the Department of P#ic Works, County of Butte. I r Ou Ip ( (D N m QD At- • \ (D d NOTE:—All 4 M�reridls & Workmanship Shall Be ��, N N Q_ (D („ Accordance with Recognized Good. Practices a�d T y of a quality prescribed for the Specified use in f e �� ? 3 Uniform Building Code, Uniform Plumbing Code, and y ` cQ 5* 0 0 (o 3 3 - the National Electrical Code. '�► 1 x r�l �'\\ i " ro b � 9,4 6N 1 O Al \ N �a o C15 I 1 0 ^�^ 'l 3 n �_. 7 x r�l �'\\ i " ro b � d1� ea>�,I o C15 I 1 0 ^�^ 'l 3 n �_. 7 - . ra A � 6- ' h n x r�l �'\\ i " �P �k b � d1� ea>�,I o %. I 1 0 ^�^ 'l 1 I n - . ra A � x r�l �'\\ i _. �P �k b � d1� ea>�,I A I 1 0 ^�^ 'l 1 I n - . ra A � 6- ' x r�l �'\\ v BUTTE COUNTY BUILDING DEPARTMEN .A..PP'-. 'Ur -n _. �P �k b � v BUTTE COUNTY BUILDING DEPARTMEN .A..PP'-. 'Ur -n