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042-290-011
� Ae' 57/- 60 tHINDIAR, Martin 559-66" i - - - - - 437-66.' ' 042=29�0-011 99-0405 P 600-67P 566-66,� SMITH, Daryl & Patricia 12280 Meridian Rd, Chico itn�'// e/s Meridian Rd. 17001 so. of Hwy. 32, (lP9 line/new wtr. htr)SF ��new single family) 042-290-011 _ 99-1785 SMITH, Daryl 12280 Meridian Road, Chico2i Contr: Owner Remodel C 6 1 042-290-011 02-1558 {�u� SMITH, PATRICIA & DARYL 12280 MERIDIAN RD., CHICO FAMILY ROOM, BEDROOM & OFFICE ADDITION 042-290-011 03-1316 SMITH, PATRICIA 12280 MERIDIAN, CHICO , Cont: AIR ARTV " s. HVAC 4� � I oil rx f j COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 53 -7541 3_PT N (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER OL1.1 ' L v t� - I ZONING BUILDING PERMIT OWNER NFR I CA A09 yt. SV,19W TELEPHONE —Z�� 055- SO. FT. OCC. BUILDING VALUATION �+ p,-3 . OWNERS MAILING ADORE SS �� I/�J � kO• 6j,Jr/LC.O `4 / I / / CONTRACTOR'S NAME 4.4 r TELEPHONE I a9_5-- 14120 CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS ZZgo ��n�ai�.� d Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDNISION'S NAME • PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ;?( Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Unities ❑ Installation ❑ Other ❑ Describe Work: H✓�� Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service '.".A 'ORR :s 23.00 LICENSED CONTRACTOR'S 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 Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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. l�f I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. , Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will .maintain a certificate of consent to self4nsure 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. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service 200A TO 1000A 46.00 NEW CONST. OWELLINo OCCUP. s0 OR AODNS. ( DW.".WC sins. 3.5¢FT; EW CONST. NO"Es OMULTI. . =OUTLET @7.50 POWER APPARATUS b SINGLE OUTLET CIR. Izu � ,.� EX. OCCU OUTLET OR FDRURES a20 .00 Ex. Occup. OFIxs A DOER 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating 1 Cooling 137 Hood 6.50 Ventilation _ PERMIT FEt $ 50 Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred 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 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 fo hwith comply with those provisio s X Date J Signature of Applicant - 10 ner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in hei Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 5D HAZ. p. FEES IMP I FLOOD I CDF PARCEL PD I HD I IS E 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 aid. _ Q B Date y PERMIT EXPIRES ON 4 ReceiptNo. S 7l �l�%WUU WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Dec 17 02 11:39a p.2 I OWNER -BUILDER VERIFICATION -I 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. . 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES It( NO ❑ 2. I HAVE k HAVE NOT ❑ signed an application for a building permit for the proposed work 3. I have contracte 'th the following person (firm) to provide the proposed construction: NAME: 1 r" - V1+ ADDRESS: f (1:7 Al owzvL T S - CITY: aG� ►�C.Q� . PHONE: -189S _N7 0 CONTRACTOR'S LICENSE NO. 55c) Z_ 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: -ADDRESS: - CITY: 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: PP SOCIAL SECURITY NUMBER_ __ DATE: 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 OVER Dec, 17 02 11:37a Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of 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: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials 'and other costs) is $300 or more for , the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an.employer. you must register with the State and Federal Governments 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. 0 There may be financial risks for you if you do not carry out these obligations, and these risks am especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract 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 their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an *"ownerbuilder" 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 contracting the Contractors State License Board in your community. or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we ran confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sina:rel Michail C. Vieira, C.B.O. Manager, Building Inspection' NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. p.1 4 j}. - w Request for Inspection D%e: 1/�U Permit N Location:.] ZZ�y AP##.� 641 Z90'0/l Utilities Insulation �1 F] Foundation Stucco 0 G:�_ Underfloor Pool Pre-Gunite Shear Nailing F-1 Pool Pre -Plaster ❑ Frame Final Corrections ZYhh -2[,q L • Y M Insulation Certificate RrrrT.DTNG OWNER: D A"R Yl— BUILDING LOCATION: *r, 2 9) 0 M F�,9/ Description of Installation BUILDING PERMIT 4' -4- Z/ ROOF n 64-/4Material� /�/' Brand Name Thermal Resistance (R -Value) 7 Thickness (inches) CEILING7 Batt or Blanket Type//jF�Ie 6 Ls("S s Brand Name u Thermal Resistance_(R-Value) / q Thicltness (inches) - �i /� Brand Name _ Loose Fill Type lb Minimum thickness inches _ Contractor's minimum installed weight/ft Manufacturer's installed weight per square foot to acheive Thermal Resistance (R -Value) EXTERIOR -WALL Material 18 G l hs S Thickness (inches) Brand Name G7A/� �-� - Thermal Resistance (R -Value) _ 13 RAISED FLOOR 1 C, �fi/�-v� Material Brand Name Thickness (inches) 6 � Thermal Resistance (R -Value) `1 SLAB FLOOR Material Thickness (inches) Width (inches) Brand Name Thermal Resistance (R -Value) FOUNDATION WALL Material Brand Name Thickness (inches) "-, -ermal Resistance (R -Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. General Contractor (Builder) License Number Date Signature and Title bAx YL— SM 4 % License Number .sub -Contractor (Insulacton Installer) Date Signature and Title THIS CERTIFICATE MUST'.BE PROVIDED HN SING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POS JANUARY THE COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 -/ RM O• (Rev. 12/96) APPLICATION AND PERMIT � ASSESSOR PARCEL NUMBER 042-290-011 ZONING BUILDING PERMIT OWNER SMITH PATRICIA & D,6 YL TELEPHONE 343-2055 SO. FT. OCC. BUILDING VALUATION 732 R 39,929-00 .OWNER'S MAILING ADDRESS 12280 IERIDIrM RD. CHICO Cti 95973 21 0 147.00 CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAID DRESS CONSTRUCTION LENDER [Fireplace 1500.00 LENDER'S MAILING ADDRESS Total Valuation $ 41.175.00 ARCHITECT OR ENGINEER LICENSE NO. Fee $ 20.00 -Filing Permit Fee $ 362.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 122.80 MUIDIAN M. CHICO Energy Plan Checking Fee $ 23.00 $ / PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 3 7.00 21,00 USEOFSTRUCTURE ,' SF XI Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition b Remodel ❑ Utilities O Installation O Other O Describe Work: FAAILY ROOM, BEDROOM & OFFICE ADDITION Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI G1 W1 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service "..A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION 1 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.P License Class LIC. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law f r the following reason: V1, 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( DVT.UNG S. SO 3.50 25.62 NEW CONST. MULTI.OUTLET NON R61D. 07.50 OWER APPARATUS A SINGLE OUTLET CR. E(, OCCU OUTLET OR FIXTURES 94L @ 1 0 FMAPPLNS. OR Ex. Occup. ounFTs REBID. En 5.00 , Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ 45.62 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 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. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred 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 workers' ompensation laws of California, and agree that if I should become subject to the w rkers' compensation provisions of section 3700 of the Labor Code, I shall fo ith comply with rove'o %�% 2 0/l X Date -s - V JSignature of Applicant -Owner O Contractor O Agent An OSHA permit is require for excavations over 60" deep and demolition or construction ures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation 4.50 Duct extension 15.00 PERMIT FEE $ 39.54 Mobile Home Installation Fee Is Energy Inspection Fee $ 46.00 occ CONST. TYPE TOTAL FEE $ 827.46 HAZ. D. FEES IMP I FLOOD I CDF PARCEL PD HD E This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON applicable provisions Resolutions to do work been paid. Date �f /-ea Dere tReceiptNo. D.S.-B.D. CANARY -ASSESSOR PINK-INSP TOR GOLDENROD -APPLICANT 0 07L COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT RMIT No. (Rev. 12196) APPLICATION AND PERMfT NAIL AS SESSOR PAACeL NUM5CR ZQNM- �,J A —) i> I ` BUILDING PERMIT �OWNER J� / C r A 4AJ / S M ., �`, ---'.-' - _tIv- Te"HONL 3,�3 I )S SQ. FT. OCC. BUILDING VALUATION MCHIfECT OR ENGINEER - OWNER'S AWJiq � O[ ti t 7 NT—OR. �y �✓ - -- -151 TQLlDIQN! -- JWCHITECT CR ENGINEERS WAING ADDRESS Plan Checkin Fee b t -- O ---- •..CONrRACTOAV MAMNG ADDRESS .• CONS TRVCTION LEMER —'—" ----- LENDER'S WALING ADDRESS Fireplace Q 0 Total Valuation S , MCHIfECT OR ENGINEER LICENSE NO. Fling Fee _ S 20.00 Permit Fee $ JWCHITECT CR ENGINEERS WAING ADDRESS Plan Checkin Fee b BU4oWO ADORESS L2 �.� C / Energy. Plan Checking Fee b -Lo�No. PERMIT PERMIT FEE $ . 3 C� cueoneaNaNA►IE PARCEL MAP PERMIT Fling Feel 20.00 USEOFSTRUCTURE SF Duplex O Mobilehomo O Other •FLOW Each Tr „} 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 1 G Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition O Remodel O Utilities O installation ❑ Other0 Describe Work: r �M ,j [.� �.ti 15 A, iJ %6/I (/�'" Gas piping system t - 5 outlets 15.00 Building sewer 15.00 Mobile Nome S G W - @20.00 PERMIT FEE ELECTRICAL PERMIT I Filing Feel 20.00 _ Main Service eoov OR uass aooA oR I>:cc 1 23.00 ��/ / " • " FEPAIT FEE PAM s 92 7 4;�L SRA � A SHERIFF O�t�D ' n�►'� ' �/ AMOUW RECEMb : g * 3 3 S�G A TO � KIM � CO#� Main Service ' 200A TO I000A 46.00 NEW CONo OWELLNq GCGUF. SG. L OR ADONS. %,} L ACC. BIDS. 3.5¢FT. NON -RESTS ' MULTI•oUTLET Q7.501 __..�. --. _ POWER APPAMTUS0. 6 SINGLE OUTLET qI Ex. Occup. OVTLET OR FORUREB ao 0 SAL S0. FID APP=..,0 R Ex. OCCU . OvnETO EA 5.00 Temporary Service 23.00 + Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE i MECHANICAL PERMIT Fling Foo 1 20.00 Heating Cooling Hood 6.50 Ventilation P -v - �r PERMIT FEIE S Mobile Home Installation Fee S Energy Inspectlon Fee S occ CONST." T L FEE $ Z 7 � NA` I P flOGp C P 0. HO BS VE This permit is hereby Issued under the applicable provislons of the Butte County Code and/or Resolutions to do work Indicated above for which fees have been paid. By Date _ PERMIT EXPIRES ON T-,-, - CReceiptNo. WHITE•O.O.S.•B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLO[NROO•APPLICANT .1 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your sigosum Please complete and return this information at your earliest opportunity to avoid uoneCessary delay in processing and issuing your building permit. No building permit will be isatted UUM dtis verification is received. 2. I personally plan to provide t`hepajor labor and materials for construction, of the proposed property imp vement : YES W` NO C3I HAVE HAVE NOT 0 signed an application for a building permit for the proposed WO& 3. I have cc NAME: ted with the following person (firm) to provide the proposed construcde�: ' My"IklI ADDRESS: f. Ng . CITY: PHONE: CONTRkCTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to eoordinaft, supervise, and provide the major work: NetLN E: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contacted (hired) the following persons to provide the work indicated: NAy1E ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: SOCI.kL SECURITY E : DATE: !2�-- / �- r O NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 4VA to California Health and Safety Code This verification insist be eompk d std returned to our office before we are permitted to issue the permit OVER OWNER BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of 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 ihould 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 arterials and other costs) is 5300 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 Governments as an employer and you are subject to several obligations includin- *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 for you if you do not carry out these obligations, and these risks are especially, serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, i i You wish, the G.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 strucrure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or throuyti their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors 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 progeny owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 10:0 N Street, Sacramento, CA. 958 14. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. rely. �CIJ�� Mic el C. Vi Ara, C.B.o. ht ger, Building Inspection NOTE: Tris Owner -Builder Information it required by Secdon 19830 of /he California Health and Safety Cade. OVER �;r`� .�Lpc'my'd�'�t�'r..c,�`��" �•ya,.�;uNtlMibii�F., z' y,�,,,t„I,�,�,,w��,pE�,...:�c..•„r,f,��'t„k , t COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 PERMIT APPLICATION DATA SHEET - t OWNER: C � 5"ASSESSOR PARCEL NUMBER: �2 ' Z 1 - o/ Proposed Building Use: &X6 Building Inspector: Date: At time of • mit application, I was advised the following data must be submitted prior to permit processing and/or issuance: Date Received 1. All items have been submitted............................................................................................................. ❑ 2. Plot plans, 3/4 sets, signed by the preparer of plans............................................................................ ❑ 3. Complete plans, 3/4 sets, signed by the preparer of plans . ............... :.................................................. ❑ 4. Engineered plans and calculations, 3/4 sets, with wet signature on plans. All engineering must be shown on plans............................................................................................. M ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ............... ❑ 6. Energy Design Compliance and supporting documentation................................................................ ❑ 7. Statement of Intent for Non -Heated and A/C Buildings...................................................................... ❑ 8. Hazardous Material Form.................................................................................................................... ❑ 9. Manufactured Home Data and Installation Instructions including ie Down S ecific tions .............. ❑ 10. Fees of $................................... �...... �... 11. ,mpact Fees as shown on the attached schedule.......... i�.♦i.a� j...... c�r,!.1..... ..........e L . CG rG California Department of Fo$ try Plan ApprovaF...... �....lood Elevation Certificate N. Sanitation and Plot Plan Approval Environmental Health Department..... OZ- E ❑ 15. City of Chico Plumbing Permit............................................................................................................. ❑ 16. Plot Plan and Business License Approval from the City of Biggs ....................................................... - ❑ 17. Planning Approval for (A) Use: (B) Parking: ........... r'ZO—©rL �( Ll 18. Contact Land Development about ❑ Improvements, Ll Drainage, Ll Legal Parcel ........................... "� ❑ 19. Encroachment Permit for Driveway (construction approval prior to occupancy) ............................... ❑ 20. Pre -Inspection for required. Request to Building Inspector (Date) ❑ 2 . Contractor's License Information (Number, Name Style, Classification) ........................................... Workers' Compensation carrier and policy number.............................................................................. Owner -Builder Verification (❑ Given to Owner, ❑ Mailed to Owner) ............ r 4. Letter of Signature Authorization............................................................................................. :�%......... jW Ll25. Recorded Copy of Agricultural Acknowledgment Statement.......................................................�... ❑ 26. Letter of Intent on Building Use/Detached Accessory Building Form .............................................. .. ❑ 27. Manufactured Home Utility Clearance................................................................................................ ❑ 28. Existing violations and/or expired permits.......................................................................................... ❑ 29. ❑ 433 A, ❑ Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D. $ ..................... ❑ 30. Other .................... Whe you issue the permit, process as follows: ❑ Mail to Owner, ❑ Mail to Contractor. elephone T4%_ 1-0 and hold for pickup at office. ❑ Delive, with Inspector. Applicant: Date: 7 Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of Plans sent ❑ Health Department, ❑ Fire Department, ❑ Other Date: By: 1. Index permit Application for the abuvexiteV numbf rAd: Q `ate f d ck s ❑ Plan Check List 2. Additional items required: Contractor, design e owner, was advised of the abov req ' ed data by: phone, L] mail, Ll Building Division counter, By Contractor, design , owner, as advised of the above required data by: EKhone, L1,6141Q1 8i Idft* 6l iem counter, By Contractor, designer, owner, was advised of the above required data by: ❑ phone, ❑ mail, ❑ Building Division counter, By Date: 7 2 67,- Date:" ?i Date:2- Date: Contractor, designer, owner, was advised of the above require dat by: (]phone, (j mail, (j Building Division counter, By: Date: Plans reviewed by: 1 Date: a . Plans reviewed by: Date: — Sets of plans on hold in ❑ Plan Cabinet,,Py❑ dfee�- Note transfer by: Date: �T/�f b2 Spl3. Yellow Copy - Department of Development Services - Building Division 8/96 / E.H. USE ONLY f Y 'Plat Plan A tachad �lia'd/Plan n !e Sant to G.D. TO: Building Department FROM: Environmental Health" SUBJECT: Sanitation Clearance vJ Chi �rrS� /� � i211�/ /�� • ��u l \ Owner Location AP# Plan Approved for: Sewage Disposal t.-- Water Supply: Public Private Well Clearance for dwelling. Other f o � Hold final for: Final clearan a O.K. for: NOTE: `' Environmental Health Specialist Date 8/96 TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance 1f t E.H. USE ONLY Plot Plan Attached t_ L `floo► Pion A ad Sont to B.D..ff s177 ��1,4 122 ?0 A'Zene s4 ai /2V y'Z — 2,96 or/ Owner Location AP# Plan Approved for: Sewage Disposal 2,e- Water Supply: Public Private Well, Clearance for --fig. Other �G-ri,,%i �'.�,. �,�s.-vy,. ,6 al,..� aAC`P aWo��h L 74o fa.! 3 Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist Date 8/96 �+ir'?'�'.'Y.,sF�'A�ri+.iP^i^...+ttFkt ��"�7ni>+Ei�tt�'y�J"C're'7�Fir'�h"ii�,�;I,Ft;,t/�f'rltl;,r�-7�r+ZiT7iM�.'r�ti�.�"++i"f�"`.5�"`}""r'�.'''�-.�`•.".z�^„+-.-r++ti..wi�'r�'yr•-'7tx._.--+ .. ... :..� - v. Oc-isse- BUTTE. COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District L US Y Building Department No. c A.P. Number � 1- Z g Q-- 6/�-Jurisdiction: City .County Property Owner Property Location/Address ! Z G `� 4--.1 /C --f- t✓//6 c .� Subdivision Lot No. .................................................................................................................. Residential Development _ Sq. Footage 7-3 No of Living Mobile Home Addition/ 'Supplemental to (Group R) Units Installation . Conversion Permit # *(No foundation inspection)i Commercial/Industrial New Addition Building Department Representative (Floor Plans reviewed by School District District Identification No. School District certifies that a2ou (Street Address) (City) has complied with the requirements of Resolution No. representing square feet. School District Representative Paid by Check # Remarks: (State) '79� �U Sq. Footage (Including Exterior Roofed Areas) Date (Applicant) � 1V3 ����� (Phone (Zip Code) by payment of $ L6-60. 6L00 J�AAB 2926 $ FULL MITIGATION $ 8 0 Date Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls 110/981dmm *,. a r BUTTE COUNTY PARKS DEVELOPMENT FSE CERTIFICATION FORM CHICO AREA RECREATION AND PARR DXSTRICT Assessor Parcel Number(s)— ;L Property Ownerp6.+- r i c j CA— De, rN 1 5,'bv1i t Project Location/Address Subdivision Lot Number(s) Residential Development: (check one) New Development teration/Addition _Mobilehome(s) _Non -Residential to Residential Total Number of Dwelling Units .Comment: i4J 0/ 8• Ii oma. - Building DepartmAnt Representative lbatef wwwwwwwwwwwwwwwwwwwwwwwwwwwwwwvrwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww�rwwwwwwww -71 Chico Area Recreati.op and Park District(CARD) certifies that _ 1'f3 (Applicant Name) (Phone Number) (Street Address) �)C,o �J �5��73 .(City) (State) ('Zip Code) has` complied with the requirements of Butte Co. Resolution No. 90-140 by payment for dwelling units @ $1,189 for total payment of $ ' tARD Representative Date PAID,B.Y CHECK NO. BANK N0. PAID BY CASH RECEIPT N0. Distribution: White --Applicant Pink --CARD park.fec (form revised 11/90) R.KS: E QS per 2SO1 U*100 -a► 09 — 661 Yellow --Butte Co. Building Dept. Goldenrod --City of Chico Building Dept. ., - - '� �� •�� � r. -` `� '''�J G Z Q.� --o -CD j,j /a-4 P�tz'naj� nN Rug 12 02 01:22p Daryl and Patricia Smith 530-343-2055 BjTI rR COUNTY PARKS DEVELOPMENT FEE CERTIFICATION FORM CHICO AREA RECREATION AND PARK DISTRICT Assessor Parcel Number(s) `7 - C/ Property Owner i 0. 4- r ; c t Project Location/Address �-!� �% b'�-�,•-: F� a. v Subdivision Lot Number(s) p.2 Residential Development: (check one) New Development VAlteration/Addition Mobilehome(s) _Non -Residential to Residential Total Number of Dwelling Units Comment: /� % t : *..•J.a -7 3 Bk'alding Departt Representative 15atel xxxxxxxxwxwwxwxwxxxxxxxxwwxxwxxxxxxxxxxxwxxxwxxxxxxxxxxwxwxxxxxxxxxxxxxvrxx Chico Area Recreation and Park District(CARD) certifies that (Applicant Name) (Phone Number) if au (Street Address) c4q, c o - C -A (City) (State) (Zip Code) has complied with the requirements of Butte Co. Resolution No. 90-140 by payment for dwelling units @ $1,169 for total payment of $` ARD Representative PAID BY CHECK NO. BANK NO. PAID BY CASH RECEIPT NO. Distribution: White --Applicant Pink --CARD park.fec (form revised 11/90 F� 2-16 Dat RKS: E ag. P� IJt lAre �0 Yellow --Butte Co. Building Dept. Goldenrod --City of Chico Building Dept. NOTES RESIDENTIAL r 042-290-011 99.1785 PERMIT NO. ._.SMITH, Daryl— ---- 12280 Meridian Road, Chico .@.B ©� �b .S��S�,�er� Contr: O%vner /l�a4f7� 1ioo,n %Zcc..o(�, Remodel / G IA 4 U AO stn t! SPECIAL CONDITIONS SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY Y + USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER CHECKED BY s i 1'/0110110" 'JOB FINALED (Date) Signature lk f •� SPECIAL CONDITIONS SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY Y + USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER CHECKED BY s i 1'/0110110" 'JOB FINALED (Date) Signature lk ENERGY INSTALLATION CERTIFICATE Building Owner? r-riZ YL- SM / I t Building Permit # / Building Location / Z 2 �-b M Fel -0 ) I/J 9-1 . DESCRIPTION OF INSULATION ROOF Material Thickness(inches) EXTERIOR WALL Material , /f� Gly SS Thickness(inches) CEILING Batt or, Blanket Type 73A I'1 Thickness.(inches) /0// Loose Fill Type Minimum Thickness(Inches) Area covered(ft.2) FLOOR, ELEVATED Material Thickness(inches) FLOOR, SLAB Material Thickness(inches) Width(inches) FOUNDATION WALL Material Thickness(inches) Brand Name Thermal Resistance (R Value) Brand Name Ci0 2.N 10 % Thermal Resistance(R Value),."/3 _ Brand Name C o 2 Ni N &- Thermal Resistance(R Value)!t_3 o _ Brand Name Number of Bags Wt. per bag 1b. Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) I hereby certify that the above insulation was installed in the above building, 1p is consistent with- approved building depart-hent--plans-and attachments and- con- forms with,requirements of Chapter 2-53 of State of California Energy Requirement 7Ag'4 — Sri --14 FIRM NAME/OWNER STATE CONTRACTOR'S LICENSE NO. SI OF INSTALLATION APPLICATOR DATE I hereby certify the required features, devices, and equipment, a Building Department plans and attachments have been installed and ante standards and Chapter 2-53 of the State of California Energy DG1 '(L A . Sri t l Y BUILDING CONTRACTOR/OWNER (Please Print) (FIRM NAME) A,A,AW J. SI OF BUI DING CONTRACTOR/OWNER HVAC FIRM NAME/OWNER (Please Print) shown on the approved .conform to the appli- .equirements. STATE CONTRACTOR'S LICENSE NO. DATE STATE CONTRACTOR'S LICENSE NO. SIGNATURE OF HVAC CONTRACTOR/OWNER DATE ..t - THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. SEPTEMBER 1988 f� COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is ?; completed. If you have any questions pertaining to this matter, or need additional- explanation, please contact this office immediately. 1 11 Oe -,e cg.v.>✓,� dor �o y,�o �% `e w -� f v tic �✓t ./ /t%/G elf - e e D u F iv r sy 01�.vsL� x �� a.I. fi Date �v Inspector ' REV 10/, 2 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 �. CORRECTION NOTICE OWNER PERMIT NO. ff. . A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. to sof' 5.9ae i._�_ ✓�.P/ Date I h I q I 4 i Inspector REV 4/92 . t� i COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE 5�.,., , �• ZZ OWNERL PERMIT NO. �"'AA routine inspebCfdh'i(�d'&s Afelt+f(�e follc�jpg vi atib�dtt�coY O�ih�f>Eeex Fhe above address�1�� I be corre a wrease notice this office when correction of work is com leted. If yb�3 hSvean �`' p y questions perti mg to this matter, ed addi ' nal.explanation, please contact this office immediately. �T 101-0 e d�i�% "r - A&A -1y -s Inspector / /10/9 2 �y� S ./= OK 4. 0 = Not OK i - = Not Applicable MOBILE HOMES = Not Ready ' 6. Date MOBILE HOME UTILITIES (Plans) OK except #'s 3. 1. Zoning Requirements -Setbacks -Easements Well Clearance & Disconnect 2. Soils; Special MH Support Sketch 8. 3. Sewer; Location -Test -Fall -C/O -Concrete MISCELLANEOUS Date 4. Water; Location -Test -Easement Needed (Sketch) 1. 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 2. 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or / /"L"ft./ PLPG 3. 7. Well Clearance & Disconnect 4. 8. Utility Clearance 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors Date Electric - Card B-1 Date Card B-1 Date Frmg.; Sills -Anchors- Studs- Rftrs-Trusses - - Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date 5. Drain; MH Test -Fall -Flex Connector Date 6. Water; MH Test -Regulator -Connector Date 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 12. Permanent Foundation Only; License Decal 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed Date 7. Card B-1 Date Card B-1 Date 8. Card B-1 Date Card B-1 9. Health Department Approval 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- Bea ms- 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 FINAL (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 in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ./= OK 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date Underfloor (Plans) OK except #'s Date FRAMING (Continued) r-4--9erdiig- Setbacks- Ease ments-Flood-Slope 46. Hangers -Post Caps -Anchors -Connectors 2. EW., Main; Soils-Elec. Grnd.-/ r Ftg. Depth 47. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rfng. Garage; Soils-Steel-Elec. Grnd.-/ r Ftg. Depth 48. Fireplace Ties or Type A Flue -Fireplace Throat Clearance -A-E4., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles -- &.--8fefnwalls, Main; Steel-Blockouts-Wrapped 50. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 1-ua.'Hot Downs and Special Anchors , Steel -Wrapped 51. Garage Fire Protection Framiig 52. Property Line Firewall & Openings 53. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior/Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B Date Card B-1 Date FINAL ans) OK except #'s Sm.We Detector 2 In q ace Vents-clearance-Corrb, Air -Connector- _( �pe: Above Floor -Ducts -Mach. Protection ures Tub Access -Spa Q50'Elec. Trim & Subpanel, Breaker Sizes & Labels once -Hearth lec. Outlets at Wood Panel, Int. & Ext. nce; roun - -Cooking Clearance Q. tacles at Kit. Counter 7 oor; Swing -Landing -Closure arage- amper M. . ants- ranee -Comb. Air Connector-P.R.V. in_.P.Kage; Above Floor -Mach. Protection Plb., Elec. & Mech. Equip. Listed for Location 79- p ac es in Garage (F.F.I.)-Romex Protection Insu on -Foam -Looked in Attic 8 u ails & Deck Construction -Post Caps Ue-4-in. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes W-7 Fol ./Drive J Yes 0 No Walks 0 Yes 0 No/Planters 0 Yes ] No lit Disconnect, Electrical -Plumbing Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Wa ell, Disconnect, Electrical, Plumbing xt r Elec. Trim, G.F.I. Receptacle -Underground Rae<e' ation Throughout House orrectio from Previous Inspections ars Tagged, Gas -Electric er Connected -C/O to Grade -HD Approval 0i Z_Lf ner ompliance Certificate -Other Certificates 1 9A oAffdress Posted Date %3 Card B-1 Date Card B-1 Date (10c) Card B-1 Date Card B-1 Date I Card B-1 Date Card B-1 Comments at Final: E!: Fireplace Ftg.-Steel W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. U as Pipe; Size Anchors - Yard Gas Piping; Size Test Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 4. Arders-Sills-Anchor Bolts-Joists-Vents-Crippies V• Access & Ventilation 16. Insulation Date Date / 7 f h • Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21.' Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 23. 4ixture & Transformer Clearance -Ins. Protection Elec. Receptacles Spacing -Lights & Switches at Doors ize Boxes & No. of Conductors Stapled 1:5��!n Romex Installed Close to Edge of Studs & C.J. Cy' Equip. Ground made up w/Mach Fasteners -Bond Gas & Water 28. 2 Appliance Circuits in Kitchen & Conductor Size GFI 29. Subfeed Wire Size / / ga. Cu or M-A.C. Wire Size / / ga Cu or AI 30. Range Circle/ / ga Cu or Al -Oven Circ. / / ga Cu or At Insulated Neutral C) Yes O No 3t--ST-r7l`E-e-R-is-dr Conductors & Ground Main Disconnect 927"EgIIIp. CteWffhces Panels-Motors-Mech. Equip. lothes Closet Light -Shower Light -Spa Light If 34. Smoke Detector Date /9 4t Card B-1 P3 Date Card B-1 Date Card B-1" Date Card B-1 Date MECHANICAL (Permit) OK except #'s 35. A.C. Ducts Insulation & Support 36. Vent Fan, Exhaust above insulation 37. Condensate Drain & Overflow, Size & Grade 38. Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet 39. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date /F=RAMING (Permit) OK except #'s 0. Sits Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) it tops, Furred Ceilings -Stairs -Chasers -Tubs Headers & Beams -Size & Bearing 51. Garage Fire Protection Framiig 52. Property Line Firewall & Openings 53. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior/Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B Date Card B-1 Date FINAL ans) OK except #'s Sm.We Detector 2 In q ace Vents-clearance-Corrb, Air -Connector- _( �pe: Above Floor -Ducts -Mach. Protection ures Tub Access -Spa Q50'Elec. Trim & Subpanel, Breaker Sizes & Labels once -Hearth lec. Outlets at Wood Panel, Int. & Ext. nce; roun - -Cooking Clearance Q. tacles at Kit. Counter 7 oor; Swing -Landing -Closure arage- amper M. . ants- ranee -Comb. Air Connector-P.R.V. in_.P.Kage; Above Floor -Mach. Protection Plb., Elec. & Mech. Equip. Listed for Location 79- p ac es in Garage (F.F.I.)-Romex Protection Insu on -Foam -Looked in Attic 8 u ails & Deck Construction -Post Caps Ue-4-in. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes W-7 Fol ./Drive J Yes 0 No Walks 0 Yes 0 No/Planters 0 Yes ] No lit Disconnect, Electrical -Plumbing Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Wa ell, Disconnect, Electrical, Plumbing xt r Elec. Trim, G.F.I. Receptacle -Underground Rae<e' ation Throughout House orrectio from Previous Inspections ars Tagged, Gas -Electric er Connected -C/O to Grade -HD Approval 0i Z_Lf ner ompliance Certificate -Other Certificates 1 9A oAffdress Posted Date %3 Card B-1 Date Card B-1 Date (10c) Card B-1 Date Card B-1 Date I Card B-1 Date Card B-1 Comments at Final: J_ COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 042-290-011 ZONING A10 BUILDING PERMIT , OWNER DARYL SMITH ITYNk55 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 12280 MERIDIAN, CHICO CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 7.000 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ SR Sn BUILDINGADDRESS 12280 MERIDIAN, CHICO Energy Plan Checking Fee $ $ PERMIT FEE $ rig 917) LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF IQ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel X7 Utilities ❑ Installation ❑ Other ❑ Describe Work: REMODEL Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 600VOR LESS Main Service 200A OR LESS 23.00 LICENSED CONTRACTOR'S 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.PowER License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. _, Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. ( ADDNS.EW ACCO BSL Dom. 3.5Q. NOR CONST. M NoRESID. @7.50 APPARATUS a SINGLE OURET CIR. Ex. Occup. ourLEr OR FIXTURES 20 p 1.00 BAL o .50 Ex. Occup. oUTTELEfSPPLNS R D.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 911-00 PERMIT FEE S 43.00 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 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. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) j 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 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 fo h Ith comply with those provisionsn _-__7__'- i Xr 1 ` Date Signature of Applicant - Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating 16,00 Cooling Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE HAZ. D. FEES IM FLOOD __ CDF P C PD _ HD ISSU 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. By ' ate PERMIT EXPIRES ON Dae Receipt No. r WHITE-D.D.S.-B.D. CANARY -ASSESSOR P K -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NC (Rev. 12/96) APPLICATION AND PERMIT ASSESSORPARCELNu ^0 C zONNG / BUILDING PERMIT OWNER Q PERMIT FEE TELFPHWN! SO. Fr, OCC. BUILDING VALUATION OWNER'S MALJNO ADDRESS / C4(cD Main Service °o°a OR mss 23.00 Main Service 200A TO IOWA 46.00 CONTRACTORS NAME W ''7 �gCo DWE111N0 OCCUP. i ACC. eLDS. TELEPHONE N GUMT. MULTI-OUTLETNON•RESID. MAUCH caclliV � 07.50 CONTRACTOR'S MATING ADDRESS , CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation S ARCHITECT OR ENGINEER LICENSE NO. Filing Fee S 20.00 ARCHITECT OR ENGINEERS WILING ADDRESS Permit Fee Plan CheckingFee $ auLnINGADOREss Energy Plan Checking Fee S S PERMIT FEE _ 55 LOT NO. SLOONEJION'SNAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF Zuplex ❑ Mobilehome ❑ Other SPWFY Each Trap 1 7.00 Solar or heat pump water heater I 23 Water piping15.00 Each as water heater or ve 15.00 TY E OF WORK Now E3 Addition ❑ Remodel Gties ❑ Installation Describe Work: {(�4PYI 0 10 K_f, - C3 Other ❑ Gas piping stem 1 - utfets 15.00 Buildingsewer 15.00 Mobile H e I S I G I W 020.00 Ex. Occup. OUTLET OR FDmJRES PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service °o°a OR mss 23.00 Main Service 200A TO IOWA 46.00 NEW CONST. ORDDNS. A DWE111N0 OCCUP. i ACC. eLDS. 3.5Qso N GUMT. MULTI-OUTLETNON•RESID. MAUCH caclliV � 07.50 Ex. Occup. OUTLET OR FDmJRES ' N SAL .30 Ex. Occu OUn D.MP6 .0� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 �- PERMIT FEE _ :� MECHANICAL PERMIT Fling Fe 20.00 Heating Cooling Hood 6.50 Ventilation Mobile Home, laStallation Fee S Energy pection Fee .6 OC CONST. TYPE TOTAL FEE $ l c HA2. 0. FEES IMP I FLOOD I COF PARCEL PO HD I ISSU 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. By Date PERMIT EXPIRES ON (Dere) " ��. , xk•Ir�q�'t Y v t - �"' � t�ltr F ~i. +7" � � xf�tij�44"'" 41NA '�" �N410NAW COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 `t PE"IT APPLICATION DATA SHEET OWNER: I ASSESSOR PARC UMBER:2W ^�Q Proposed Bu mg se: Building Inspector. ,,.o Dater At time of permit application, I was advise the following data must be submitted prior to permit processing and/or issuance: Date Received By PTO'All iiems have been submitted.----------•--------------------------------------------------------------------------- t 02. Plot plans, 3/4 sets, signed by the preparer of plans.------------------------------------------------------------ ❑ 3. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ 06. Energy Design Compliance and supporting documentation. ---------------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------------------------- ❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------ P Manufactured Home data and installation instructions including Tie Down Specifications.------------------ Feesof $------------------------------------------------------------------------------------- . Impact fees as shown on the attached schedule. ----------------------------------------------------------------- ❑ 12. California Department of Forestry plan approval/fees. --------------------------------------------------------- ❑ 13. Flood elevation certificate. ---------------------------------------------------------------------------------------- ❑ 14. Sanitation and plot plan approval _ Health Department. ------------------ : 15. City of Chico plumbing permit. ----------------------------------------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------------------------------- ❑ 17. Planning approval for (A) Use:(B) Parking: -------------------------- ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel ------------------------- 1:119. ----------------------- ❑19. Encroachment Permit for driveway (construction approval prior to occupancy) ❑20. Pre -inspection for required.. Request to Building Inspector on ❑21. Contractor's license information. (Number, Name, Style, Classification). ----------------------- 0 22. Workers' Compensation carrier and policy number. ----------------------------------------------- ❑23. Owner -Builder Verification (Given to owner ❑, Mailed to owner 11) - -------------------------: ❑24. Letter of signature authorization. -------------------------------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. ------------------------------------- ❑26. Letter of intent on building use.-------------------------------------1-------------------------------_ ❑27. Manufactured Home utility clearance. ---------------------------------------------------- ----------- ❑ 28. Existing violations and/or expired permits. --------------------------------- ------------------------. ❑29. ❑433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ --• E130. Other: WhV you issue the permit, process as follows ❑ Mail to owner, ❑Mail to bontractor. L211elephorie ��j and hold for pickup at C G 0 office. 11 Deliver with ector. (Date) �I Applicant: Date:C,/ I Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: lob VPlanCheck List 2. Additional items required: Contractor, designerj2MDwas advised of the above required data by ❑ phone, jWmail, ❑ Building Division counter, by ZA Date: /#—(7' Contractor, designer, owner, was advised of the above required data by 13phone, ❑ mail, ❑ Building Division counter, by Date: IF Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner,advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: w Plans reviewed by: Date: R47,177 Plans approved by: Date.- -3--Sets ate:-3—_Sets of plans on hold in WPlan Cabinet, ❑ A.P. folder. Note transfer by: Date: Voll.,.,, !'.,.... Tle...,.+...,...� ,.r r�,._.,.i__--__• r------- ^--', � ,-. 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. 1. I personally plan to provide the major labor and materials for construction of the proposed property im rovement : YESA . NO ❑ 2. I HAVE 1 ' HAVE 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: NAME: pf. Vc ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, -but I have hired.the following person to coordinate, supervise, and provide the major work: NAME: -. t ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. j 5. I will provide some of the woik'but I'have contracted (hired) the following peisons to provide the work indicated: „ NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: SOCIAL SECURITYER: DATE: 71 q9 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. OWNER BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of 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 yo k, with the exception of various trades that you plan to "subcontract, you should be aware of the followinggijiformation i8tVour benefit and protection: ♦ If you employ otherwise engage any ersons other than your immediate family, and the work (including materials and other co ts) is $300 or more fo the entire project, and such persons are not licensed as contractors or subcontract rs, t�You b employer. If you are 1 emmust register with the State and Federal Governments as an employer and you .are subject to se s 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 for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. :, ♦ For more specific information about your obligations under Federal Law, contract 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 contractors 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 contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. rely, Mic el C. Vi ira, C.B.O. Ma ger, Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and SafetyCode OVER V__ -1-1 _ BEAUTY BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7541 FAX: (530) 538-2140 August 17, 1999 Daryl Smith 12280 Meridian Chico, CA. 95926 Assessor Parcel Number: 042-290-011 Building Permit Number: 99-1785 This office reviewed the above referenced building plans. Please respond in writing to each comment by creating a response letter. Indicate which detail, specification, or calculation shows the requested information. Your complete and clear responses will expedite the re -check and approval. of this project. Provide additional information and/or make revisions to plans, specifications and calculations as follows: 1. Point loads are created with the installation of the new micro -lam beam. Provide verification about the transfer of these loads and the required pier sizes. 2. Indicate the spacing of the 2 x 6 c.j. 3. Plan review will continue upon receipt of the above items. Additional items may be required when plan review is resumed. 4. Balance of Building Permit fees = $55.00. If you wish to discuss any requirements, you may contact me at (530) 538-7541 between the hours of 1:00 p.m. and 4:00 p.m., Monday through Friday. Sincerely, Glenn Gibbons Plans Examiner 042-29=0-011 99-0405 P + 'SMITH,.Daryl.&'Patricia 4 12280 Meridian-Rd, Chico (lpg line/new.wtr htr)SF w . i l� we-fl faj •/`�f N�/lofrv� p�e5f d E 4 OFFICE COPY • Address Date 1 meter ABY ELECTRIC �� Date Meter BY COUNTY OF BUTTE - DEPARTMENT OF,DEVELOPMENT SERVICES - BUILDING DIVISION14 7 County Center Drive • Oroville,"California 95965 • Telephone (530) 538,77541 PERMIT NO. (Rev. 12/96) f .APPLICATION AND PERMIT % �� ASSESSOR PARCEL NUMBER ,. ,.,� �� I' ZONING B ILDING PERMIT O ER G J�Yv1 f TELEPHONE 3 y 20 5 SO. FT. OCC. BUILDING VALUATION`. .OWNERS MP141 NO ADDRESS � L 3 is C &TRACTOR'S NAM TEIFPXONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER ' I Fireplace LENDER'S MAILING ADDRESS 1 Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS Energy Plan Checking Fee $ (n 1 $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP � PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTUREEach SF ®O"Douplex ❑ Mobilehome ❑ Other ' '. E SPECIFY Trap • 7.00 Solar or heat pump water heater 23.00 Water piping . - 15.00 C Each aas water heater.or vent 15.00 TYPE OF WORK New 11Addition ❑ Remodel ❑ Utilities ❑ Installation ®- Other ❑ Describe Work: C . •� �`f/ T �� ! Gas piping system 1 - 5 outlets 15.00 15, Building sewer 15.00 Mobile Home I S I G I W I -,V , ' I+ ' r' @20.00 PERMIT FEE $ ' 4 -' ELECTRICAL PERMIT 1 Fling Fee 20.00 r Main Service zo.LE 23.00 LICENSED CONTRACTOR'S 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. y License Class Lic. No. _ OWNER -BUILDER DECLARATION �� _ I hereby affirm Linderl,penalty of perjury that I am exempt from the Contractors License Law Jor the following. reason: y, t .• 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. t ❑ 1 am exempt under Sec. Business and Professions 'Code for this reason. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLINGoccuP. so. OR ADDNS.3 So ( NEW CONST. MUAiCTICO LET NON-RESID.BRAMH CIRCUITS 97.50 POWER APPARATUS 8 SINGLE OUTLET CIR. OUTLET OR FIXTURES 20 Q 1.00 Ex. OCCU BAL @ .50 FIXED APPINS. OR Ex. Occu , ounFTs R=. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self-insur4or workers' compensation, asrprovided for by section 3700 of the Labor Code, for the performance of.the work for which this permit is issued. + %. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier + I Policy Number I (The above sections need not be completed d the permit is for work of a valuation of one hundred 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 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 rtith comply with those provisions. 7.�rrfl-,l%�Wof .t (�1 t ,( . c./ � VCt_1A Date � - f 1 Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ r OCC , CONST. TYPE C +d TOTAL FEE $ 45-& HAZ. I D. FEES I IMP I FLOOD I CFF PARCEL PD HD I ISSU This permit is hereby issued under the applicable provisions the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By RakDater PERMIT EXPIRES ON V % fit' D I I IDate ReceiptNo. i '% WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF'DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE 51 OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and sh d be corrected. Please notice this office when correction of work is completed. If you a any questions pertaining to this matter, or need additional explanation, please contact s office immediately. Date U / / / - Inspector REV 10/9 _CgUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING D ISION y " 7 County Center Drive • Oroville, California 95965 • Telephone (530) 53 541PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ...i I ZONIN % � ILDING PERMIT SJJ .1/ TELEPHONE3 q'3 20 5 SO. Fr. OCC. BUILDING VALUATION .OWNERS ADDRESS C RACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS S CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ BUILDINGADDRESS Energy Plan Checking Fee $ (n 1 C v $ PERMIT FEE $ - LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF Eroo Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 r Each as water heater or vent 15.00 , TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation e<. ❑ Describe Work: / �~ Gas piping system t - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2o0A OR LESS 23.00 LICENSED CONTRACTOR'S 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.POWER License Class LIC. NO. . OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Lawlor the following reason: 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR( so 3.5Q cooks MUALCCC. mEr L. AEs,D, @?7.50 APPARATUS 8 SINGLE OUTLET CIR. Ex. Occu OUTLET OR FIXTURES SAL @ 1.500 FIX Ex. Occup.OUTLETS R p,OEp 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 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. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) —)4 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 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 fort with comply romply with those provisions. r � �� � 'c//� / X l Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. "4 Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE] TOTAL FEE $ 4, 5 t HAZ. I D. FEES IMP I FLOOD CDF PARCEL PO HD ISS? 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. By Date3 PERMIT EXPIRES O IDefe ReceiptNo. AS -7 C WHITE-D.D.S.-B.D. CANARY -ASSESS PINK -INSPECTOR GOLDENROD -APPLICANT IV 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 ddW in processing and issuing your building permit. 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 : YES ;6 NO O 2. I HAVE 4 . HAVE NOT O signed an application for a building permit for the proposed W6& 3. I have contracted with the following person (firm) to provide the proposed c--t:votioo;' , NAME: .: ADDRESS; PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to. provide portions of this work, but I have. hired the foliowing-person to coa di r&6 supervise, and provide the major work: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons topr vide the work indicated:- NAME ndicated:NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: SOCIAL SEC�, Y qUMER: ��" DATE: /6 I NOTE: This Owner -Builder Ver flcation is required by Section 19831 and 19832 of dw California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER ,. IL OWNER BUILDER INFORMATION I Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified For your protection. you should be aware that as "owner -builder" you are the responsible party ofrecord on such a permit Building permits are not required to be signed by property owners unless they are personally performing thein 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. Contraciors 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 plant to do your own work, with the exception of various trades that you plant to subcontract, you should . be aware of the following information for your benefit and protection: ♦ Ifyou employ or otherwise engage any persons other than your immediate family. and the work (including ma wials and other costs) is 5300 or more for the entire project, and such persons are not licensed as contraib6ij or subcontractors, then you may be an employer. ;� ♦' If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, Sederd social security goes, . workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are aDftildlY serious with respect to worker's compensation insurance. ' ♦ For more specific information about your obligations under Federal Law, contract 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 their own employees, without a licensed contractor or subcointractor, only tinder limited conditions. .�A frequent practice of unlicensed persons professing to be contractors, 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 hot required to be signed by property owners unless they are perfortning their own work personally. Infoimation about licensed contracps may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complewthe "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned PBuilding /C�1 IM Vi ira, C.B.O. Inspection NOTE. This Owner-Bullder.Injormadon is required by Section 19830 of the California Health and Safety Code - OVER �:..:. $. A: _ J f } T k.� Il e_. x `�•°.. � rz :+i` T+4 'f'.YM'ATs .. ... .,_ 'T+'°s'h�tN+zrx ... �. ._.,�. .......