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061-440-003
61-4-03 1848-89B,P,E,Msow v RUBANOFF, Barry . Z_��6 Mirrage Lake Rd, Berry Creek (new single family & retaining walls) FINALED _ 61-44-03 Permit#3549-90B (1st renewal/1848-89) Permit#3206-91B 61-44-03 1 (2nd renew) 1061-44-0-003 92-3183B �RUBANOFF, Barry 180 Mirage Lake Rd, Berry Creek 3rd renewal/89-1848 061-44-0-003 92-4162 B RUBANOFF, Barry 11-41 ,,, ' 4-- // 180 Mirage Lake Road, Berry Creek IS3 .-(add 2 open decks/SF) 061-44-0-003 � - TH RENEWAL/89-1848 93-3100 B 0 1-440-003 PERMIT#94-2857 BANOFF BARRY & CAROLINE 1 0 MIRAGE EN.,' BERRY CREEK L OMPLETE BP#1848-89 061-440-003 PERMIT#95-2324 RUBANOFF, Barry 180 Mirage Lake Rd-, Berry Creek Complete BP#1848-89 061-440-003 PERMIT#96-2021 RUBANOFF, Barry 180 Mirage Lake'Rd,Berry Creek 1st Renewal BP#95-2324 061-44-0-003` 97-2106 B RUBANOFF, Barry 180 Mirage, Berry Creek (2nd renewal/95-2324) 061-44-0-003 #98-2392 RUBANOFF, BARRY 180 MIRAGE, BERRY CREEK OWNER _3RD RENEWAL OF#95-2324 061-440-003 99-2481 RUBANOFF, BARRY 180 MIRAGE, BERRY CREEK CONTR: OWNE 3RD RENEWAL OF BP# 95-2324 B07-2593 061 -440 -003 - MISCELLANEOUS Ag Exempt AG EXEMPT BLDG (26 X 34) (884) 180 MIRAGE LAKE RD RUBANOFF BARRY S & C, BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES AGRICULTURAL BUILDING EXEMPTION PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION, Site Address: 180 MIRAGE LAKE RD Owner: Permit No: B07-2593 APN: 061-440-003 RUBANOFF BARRY S & C, Issued Date: 01/16/2008 By TMP Permit type:MISCELLANEOUS P O BOX 1123 Subtype: Ag Exempt BERRY CREEK, CA 95916 Expiration Date: 01/15/2009 Description: AG EXEMPT BLDG (26 X 34) (884) (530) 589-4102 Occupancy: U-3 Zoning: U Contractor Applicant: Square Footage: RUBANOFF BARRY S & C, RUBANOFF BARRY S & C, Building Garage Remdl/Addn P O BOX 1123 P O BOX 1123 BERRY CREEK, CA 95916 BERRY CREEK, CA 95916 Other Porch/Patio Total (530) 589-4102 (530) 589-4102 FEE'INFORMATION DBEH Building Review Fee $75.70 DBOMSCF Ag Exemption Permit $115.98 LICENSED CONTRACTOR'S. DECLARATION Contractor (Name) State Contractors License No. / Class / Expires RUBANOFF BARRY S & C, OL:CRW_00401591 / / I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 01/16/2008 Contractor's Signature Date F . "WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Carrier. Policy Number: Exp. Date: (This section need not be completed if the permit is or 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 the Workers' Compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. X 01/16/2008 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip total Charged: $191.68 Fees Paid: $191.68 Balance Due: $0.00 Receipt No: B5715 OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500); Please check one of the following: I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are notintended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractors License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this reason: Owner's 01/16/2008 Date I hereby certify that I have read this applil onU state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorized to act on the property owner's behalf. T U' A k,_1 QV � 01/16/2008 Name of Permitte [SIGN] Print Date Owner 1:1 Contractor OR. Agent for Owner Agent for Contractor FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION V J Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY PERMIT NO m BIN # "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. APPLICANT INFORMATION OWNER INFORMATION Last Name Address 186 First.Name T5,42rz Mailing Address 4s;- Fo Zok 113 i9a rikAl'b L-6 j& 20 City C,4, State Zip 9S.2,I, !41 Phone 530 S$ 9 4 I p y Fax E-mail APPLICANT INFORMATION CONTRACTOR Name Address 186 Address CityState City C,4, State Zip Phone Fax Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name Address 186 Address CityState City C,4, State Zip Phone Fax Fax E-mail State License Number APPLICANT INFORMATION Name Address 186 I To -A#K / la.; Air./.vc�) G __ QA/C-& CityState rpt;€/�.. C,4, Zip X95 9� Phone53O st9 by Fax E-mail I APPLICANT SIGNATURE I X PROJECT LOCATION API I O— C)() Property Address l City WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits �n ❑ Proposed Change of Occupancy V (Note previous use): For office use only: Zoning Flood Zone SRA I Yes No Occ. Type Const. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net/dds AGRICULTURAL BUILDING EXEMPTION STATEMENT Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated or packaged, nor shall it be a place used by the public. Buildings used for purposes other than described above or that are located in a flood hazard zone are not eligible for an agricultural exemption. Authorization of an agricultural exemption permit by the Department of Development Services does not preclude any requirements and/or review by the Butte County Public Works Department, Butte County Fire Department, Butte County Environmental Health, or any state and federal agencies. Initials. AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. Initials 6,_,/ AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a manufactured home, and 23 feet from a commercial/industrial buildings Initials 612 AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum 23 feet from a residence and a manufactured home, and 40 feet from a commercial/industrial buildings Site Address: 180 MIRAGE LAKE RD Permit No: B07-2593 APN: 061-440-003 Square Footage: 0 Permit Type: MISCELLANEOUS Occupancy: U-3 Permit Subtype: Ag Exempt Zoning: U Description: AG EXEMPT BLDG (26 X 34) (884) Required Setbacks: Applicant: RUBANOFF BARRY S & C, Front: Side: 20' Rear: 20' P O BOX 1123 BERRY CREEKCA95916 Type of Construction: (530) 589-4102 Type of Siding: Masonite Owner: RUBANOFF BARRY S & C, Est. Const. Cost: $ 9,000.00 P O BOX 1123 BERRY CREEK, CA 95916 Roof Covering: Compostion (530) 589-4102 Floor Type: Concrete I declare under penalty of perjury that the building will be used as stated above, and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain the necessary permits, inspections and approvals to comply with the requirements in effect at that time and prior to occupancy. Signature of owner: Date: 12/19/2007 ODFILE COPY Butte County Department of Public Works J. MICHAEL CRUMP, DIRECTOR LAND DEVELOPMENT DIVISION Storm Water Managment Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 Telephone (530) 538-7171 Fax www.buttecounty.net/dds Wno� g rc , National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and -Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment [LESS THAN 1 ACRE 1 Reference Number: B07-2593 Date: 12/19/2007 Location: 180 MIRAGE LAKE RD By: KEJ Parcel Number: 061-440-003 Sub Type: A2 Exempt Owner Name: RUBANOFF BARRY S & C, Phone: (530) 589-4102 Description: AG EXEMPT BLDG (26 X 34) (884) By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the state of California Regional Water Quality Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. Signed: Title: FILE Date: 12/19/2007 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY PLAN TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. (�SE OR NO) I 69/HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: I►/10ri1� ADDRESS Cl PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS CITY. PHONE CONTRACTORS LICENSE NO 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: AG EXEMPT BLDG (26 X 34) (884) Reference Number: B07-2593 Applicant Name: RUBANOFF BARRY S & C, Owner's Name: RUBANOFF BARRY S & C, AP # : 061-440-003 Signature of Property Owner: Date: s COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES-BUILDINGDIV ON 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538- 41 PER IT NO. (Rev. 12/96) APPLICATION AND PERMIT g7-Q,l ()L ASSESSOR PARCELNUMBER 61-44-003 ZONING U ILDING PERMIT OWNER BARRY RUBANOFF TEnI E4102 SO. FT. OCC. BUILDING VALUATION OWNER'S MAIUNG ADDRESS p0 BOX 112 BERRY CREEK 95916 CONTRACTOR'S NAME OWNER TELEPHONE ' CONTRACTORS MAIUNG ADDRESS CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Feb $ 20.00 Permit Fee $ 15.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 180 MIRAGE Energy Plan Checking Fee $ BERRY CREEK $ PERMIT FEE $35-00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF CR 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 ❑ Utilities ❑ Installation ❑ Other It Describe Work: . RENEWAL 95-2324 Gas piping system t - 5 outlets 15.00 Building sewer . 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service zoo oa mss 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�Business and Professions Code, and my license is in full force and effect. /�i License Class j LIC. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License 4w for the following reason: �A 1, 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 OCCUR OR ADDNS. ( d ACC. BLDS. SO 3.5¢FT. NEW CONST. MULTI -OUTLET NO..C cl c @7.50 aPOWic EOUTLRATCIR. Ex. Occup. OUTLET OR FIXTURES 20 @ I'0°BAL @ .50 Ex. Occup. our TS (R IEsoOEA. 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 Filing 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.) 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 forthwith comply with those provisions. X�. Date _ _ Signature o Applicant n r ❑ Contractor ❑ Agent An OSHA permit is requir vations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 35.00 HAZ. D. FEES IMP FLOOD I CDF PARCEL I Po HD ISSUE 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. - �� g By Date ,_ PERMIT EXPIRE ON 9` -2-/ `– .9'g> Date ReceiptNo. 224650 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT (Rev. 12/96) COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER'DO ` ✓ ' z% ZONING BUILDINGPERMIT OWNER /l TELEPHONE Q2 SO. Fr, OCC. BUILDING VALUATION OWNERS MAILING ADORES 0 1'v© -2— 9 / CONTRACTOR'S NAME w �. TELEPHONE ' CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER UCENSE NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $ 9#'m Plan Checking Fee $ BUILDING ADDRESS To e Energy Plan Checking Fee $ �f4,'rcek $ PERMIT FEE $ , d O LOT No. SUBDIVISIONS NAMEPARCEL I MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ErDuplex ❑ 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 ❑ Utilities ❑ Installation ❑ Other 1 �� .2 1 Describe Work: Alme GVGt- 7 Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main ServiceeoOV OR LESS 2ooA 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,NEW and my license is in full force and effect. License Class Lic. NO. OWNER -BUILDER DECLARATION I herebyaffirm under penalty of perjury that I am exempt from the Contractors License P nY P 1 rY P Law for the following reason: ❑ 1, 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. ❑ 1, 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 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.) ❑ 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 f I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X 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. Mein Service 200A TO 1000A 46.00 NEW CONST. DWEILNG OCCUP. s0 OR ADONS. ( a . OCCS 3.5QFT: gESID I. MuLT,',% LET @7.50 POWER APPARATUs & SINGLE OUTLET CIR. Ex. Occup.OUTLET OR FDRURES BA2000 ®':0050 Ex. Occup. FIXEDA CIRES, OR OLmETs UNS EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE 9 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ �6, 1wz. D. FEES IMP FLOOD CDF PARCEL Po HD ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By Date PERMIT EXPIRES ON provisions to do work paid. to ReceiptNo. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 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. [ personally plan to pro�id: the major labor and materials for construction of the proposed property improvement : NO ❑ 2. I HAVE HAVE NOT ❑ signed an application for a building permit for the proposed work. 3. I have contracted with the fol owing person (firm) to provide the proposed construction: NAME: L I t ADDRESS: PHONE: CITY: 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 wgrl�: NAME: k I ADDRESS: PHONE: CITY: 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: P R 0 P E RTVFOWNS! Zs t �y r ` 1 -4 +.�®i��- SOCIAL SECURITY NUMBER: DATE: O - 2 S - 9 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 OWNER BUILDER INFOIUMATION Dear Property Owner: . B. - 1 ,- .. .. 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 id his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is 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 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 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 "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 contractprs 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. 4ae ly, l C. Vi ira, C.B.O. r, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Healt/i and Safety Code- OVER ode OVER 61-44-03 UBANOFF, Barry Mirrage Lake Rd,�Berry Creek (new single family & retaining walls) PERM. k FINALED e OWNER CONTR. w, ASSESSOR PARCEL LOCATION 4,� ✓ i ' R ��� `< a �--- OFFICE COPY = Address OFFICE Address I GAS Eeter By Dat L� J G MC e�— { ELECTRIC - t II Meter By Date / 2 Celled PG&E 91 Temp. Gas Service Called PG&E JOB FINALED (Date) e Signature ate, � � n �{ � ��.c,9J- — •�-� ..,.--��..-.:r._.-:-�S`+i"a<�%':r��:�`+'Fs=-:r:s-`�.»$ai+.�-�';'^1i.�`+�,:�u.: ��,..-v'••.�`-.C`�' '-i.^i'i'-�:-�*,r...1 COUNTY OF BUTTE BUILDING DIVISION DEPARTIMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE J� U is 6� 5 = r�? OVMER / ---' PERMIT NO. A rourtine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work iscompla a ffyou have any questions pertaining to this matter, or need additional explanation, please ontact this office immediately. Ir t /0' L1 Dade Z.0 Inspector REV 10M2 PPP71 106UNTY�OF BUTTE BUILDING DIVISION s k DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE HERMIT N0. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is complete 1. If you have any questions pertaining to this matter, or need additional explanation, please contagvidiiisofffice immediately. - I t V ; Date!—/5-- Inspector REV 10/92 `:.:;:Y.'"+.�::��`_"�'`ie•.;.srn,��t�,�'��,�.Fri.wl�,^'�[+-r::':sY.....t.;:.n,"Sa .,�3�'?%F'_%��'��"t'�5 COUNTY OF BUTTE ti DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 s CORRECTION NOTICE QAE R NO. A routine inspection indicates that the following violations of County Ordinance exist a�the ove address and should be corrected. Please notify this office when coof work is completed. If you have any question pertaining to thismatter, additional explanation, please contact this office immediately. h F 'k A� 2 .<i Yu aR t` 'z Date Inspector ��� .Y:, .e afrj`ys'"'�'{:' �.= "yt 4.+��'3T _"ice'. '^Iri, � .r :T •'�".��h`i/� i� COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 MLemorial Way, Chico — Phone: 891-2751 7 County Centbr Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 1 CORRECTION NOTICE A routine inspection indicates that the following violations of County Ordinance exist at the;above address and should be corrected. Please notify this office when corre_c`tion of work is completed. If you have any question pertaining to this matter, or need additiona'I explanation, please contact this office immediately. Date /•_& Inspector f �mR+•'-+��sslta�ai�E.�' � ,rry„ �^ _ ,.. ,a._ tin' ,. _ y�c-�'�"+r�E'+y` COUNTY OF BUTTE R BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERV S # 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Eirive, Oroville, CA - (916) 538-7541 747.Elliott; Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE OWNER / PERMIT NO. i A routine ipsoction indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. i you have any questions pertaining to this matter, or need additional explanation, please ontaci this office immediately. ►-c. -j - o of — e L„1/> A /Y / Al 4- c •ca _ s a ►. .I, n Date Inspector, , REV 10/927 9 COUNTY OF BUTTE BUILDING DIVISION 6EPARTMENT OF DEVELOPMENT SERVICES = 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE OWNER PERMIT N0. ' A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work 1 - is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. /b vii C✓ �C. �Sa4t f K tia 9 I�Gri/ Date Inspector REV 10/ 2 I 061-440-003 99-2481 RUBANOFF, BARRY 180 MIRAGE, BERRY CREEK CONTlt: OWNE 3RD RkNEWAL OF BP# 95-2324 Ad 1�4sT �4Eu�C� �Of COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7354 PERMIT,NO. (Rev. 12/96) APPLICATION AND PERMIT ' ° ' � 02 ASSESSOR PARCEL NUMBER —A4 ZONINGBUILDING PERMIT OwWRY RUBANOFF TE°jbHH%g4102 SO. FT. OCC. BUILDING VALUATION O u Wr1ris BERRY =EX 95916 CONTRACTOR'S TELEPHONE CONTRACTORS MAIMG ADDRE CONSTRUCTION LENDER Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ Ism ARCHITECT OR ENGINEERS "UNG ADDRESS Plan Checking Fee $ BUILDINGADDRESS 180 MAZE, BERRY Energy Plan Checking Fee $ i PERMIT FEE $ ffX tom LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 e USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other sPECIPY 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 ❑ Utilities ❑ Installation ❑ Other ❑�{±t�� :. Describe Work: 21= 3RD REMAL 95-2324 b ' Gas piping stem 1 - 5 outlets 15.00 Buildin sewer . 15.00 Mobile Home I S G I W @20.00 PERMIT FEE _ ELECTRICAL PERMIT Fling Fee 20.00 'OOVOR LESS Main Service zo.A OR LESS 23.00 r. 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 �;,�'� License I hereby affirm under penalty of perjury that I am exempt from the Contractors License Craw for the following reason: mpensation, I, as owner of the property, or my employees with wages as their sole co will do the work, and the structure is not intended or offered for sali: ❑ I, as owner of the property, am exclusively contracting with licensed, contractors to construct the project. R ❑ 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. ( 8 A.C. BLDS. 3.5QFT. HEOSID. T. MULTI- OUTLET 97.50 APPARATUS 8 SINGLE OUTLET CIR. 20 @ I00 OUTLET OR PDRURES EX. OCCU BAL @ .SO OR FU(ED APPLNS6.)o Ex. Occup. oR)ED RESID. EA 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 permitis issued. My workers' compensation insurance carrier and policy number are: Carrier I Policy Number (The above sections need not be completed 0 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 forthwith comply with those provisions. X — a Date A' Sigrfature Applicant ZD `Ow'ner ❑ Contractor ❑ A en An OSHA permit is required for e�2cavations over 5'0"deep and demolition or construction of structures over 3 stories in>ight. MECHANICAL PERMIT Fili4Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FET= $ Mobile Home Installation Fee $ PA Energy Inspection Fee $ occ CONST. TYPE .0 TOTAL FEE $ HAZ. I D PEES IMP FLOOD I CDF PARCEL I PO HDL 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 _ / bate IA� PERMIT EXPIRES ON C DeB Receipt No. WHITE-D.D.S.-B.D. CANARY -ASS SSOR PINK -INSPECTOR GOLDENROD -APPLICANT _�--- �— _,.•a -•.� .. �� n....r.r.:�rrvFy'v�4wnc�'�:�c-y�,�.,:t-y'"�aqd►'^s!.vr„ry�s^-y.a+--a'.arsw err• n h 1� 061-44-0-0,03f #98-2392 RUBANOFF, BARRY 180 WRA GE, BERRY CREEK OWNER 3RD RENEWAL OF#95-2324 .• G 1 r i •e COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING"DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538 -'9541/ -PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT i. ASSESSOR PARCEL NUMBER 061-44-0-003 ZONING ',BUI G PERMIT + OWNER RUBANOFF, BARRY `GWNFA'S T589 4102 SO' FT. OCC. BUILDING VALUATION MMLfNG ADDRE$$_ 'BOX 112 BERRY CREEK, CA 95916 lIX{Jl CONTRACTOR'S NAME i TELEPHONE CONTRACTOR'S ESS _ J . { j CONSTRUCTION LENDER y Fireplace LENDER'S ADDR ^^ - �� -1 Total Valuation $ Filing Fee $ 20.00 ARCHITECT OR ENGINEER LICENSE NO. Permit Fee $ 15.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 180 MIRAGE Energy Plan Checking Fee $ BERRY CREEK PERMIT FEE s35.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE k SF 0 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 ❑ Utilities ❑ Installation ❑ , Other ❑ Describe Work: 3RD RENEWAL OF 95-2324 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 0OV OR LESS Main Service 000AORLESS 23.00 ` '`r �y+ • l 1ICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of`perjurar that I am licensed under provisions4 f`Chapter 9 (commencing with Section 7000) of Divisioh,3 of the Business and Professions Code, and my license is in full force and effect. , License Class LIC. NO. —."''" OWNER -BUILDER DECLARATION ;cam i' I hereby affirm under penalty of perjury that I am exempt from the Contractof`s'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. ❑ - I am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO +conA 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. & ACC. BUDS. SO 3.5QFT: N ONS MULTI.OUTLET NDN RESID. @7.50 POWER APPARATUS 8 SINGLE OLRLET CIR. Ex. Occup.OUTLET OR FocruREs 20 @ 1.00 BAS @ ,50 FIXED ALNS. OR Ex. Occu . ounETs PPRESID. EA 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 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 should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. / h /� _ /tAl X ' �'da" Date (! 74r.>— Signature o plicant -Ow a Contractor ❑ Agent An OSHA per d is required for c ns 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 FEIE $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 35.00 HAZ. O. FEES IMP HOOD CDF PARCEL PD HD ISSVE 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. ` 1 / By i L'4 s / Date PERMIT EXPIRES ON } Date i Receipt No. 2MM WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT • t. e E(2nd • • -0=003 97-2106 B • f a F Barry rage, Berry Creek ~9E' enewal/95-.2324) eo_ . f d COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 CountyCenter Drive -_Oroville, California 95965 - Telephone (916) 538-75r41 r'• PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT - �- ASSESSOR PARCEL NUMBER 61--44-'003 ZONING U ,,B ILDING PERMIT OWNERBARRY RUBANOFF TEfOA102 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS PO BOX 112 BERRY CREEK... 95916 ` �•- CONTRACTOR'S NAME 0IM TELEPHONE CONTRACTOR'S MAI 5ADDRESS CONSTRUCTION LENDER—_ • v"-"•-"' ^" �-` ----�^�' Fireplace LENDER'S MAILING ADDRESS . � 'N'\ , A\ � � ^ � � �- Total Valuation $ Filing Fee /11 $ 20.00 ARCHITECT OR ENGINEER' ' ' ` j '- LICENSE NO. Permit Fee $ -15.00 ARCHITECT OR ENGINEERS MAILING ADDRESS- Plan Checking Fee $ B1IkStoJGAgDRESS - Energy Plan Checking Fee $ $ 1717YM\� .may° BURY CR -�N� - ��, PERMIT FEE $ J-) - UU LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE ' SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY 9 Each Trap 7.00 Solar or heat -pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 I TYPE OF WORK New ❑' Addition ❑ `Remodel ❑ Utilities 11 Installation ❑ Other .f] »` Describe Work: ��_,i . RMEWAL 95-�2324 Yt Gas piping system 1 - 5 outlets 15.00 v Buildingsewer 15.00 Mobile Home, S G W 920.00 PERMIT FEE $ ' ELECTRICAL PERMIT Fling Fee 20.00 eoov DR mss 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 �. - +1'• 9 (commencing with Section 7000)'of Division 3 of the Business and Professions Code, and m license is in full force and effect. Y _ License Class I Lic. No. " � OWNER•-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contrac�tori, License Law for the following reason: -- f C; 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.: ' O l,'as owner of the property, am exclusively contracting with licensed.contractors to construct the project. ❑ I am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO IMOA 46.00 NEW CONST. DWELLING OCCUP. OR'ADDNS. ( A AOC. BMS. so. 3.5¢FT. NEW CONST. MULTI.OUTLET NON -REBID. B ANc , c 97.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. ourLEr OR FocruREs 20 @ 1-00 SAL @ .50 FIXED APPLNS. ORA, Ex. Occup. ourLETs RESID. E5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ "4 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 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 Filing 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.) 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 forthwith comply with those provisions. XR=g�..�. _____ Date _�'%.. �� a Signature o Applicant - bwngr ❑ Contractor ❑ Agent An OSHA permit is requir d fo xeavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee s occ CONST. TYPEI TOTAL FEE $ 35.00 FEES IMP I FLOOD I CDF I PARCEL I PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRE ON 9- the applicable provisions' Resolutions to do work been paid. Date !►�`� � J�'� Date Receipt No. 2124650 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENTOF DEVELOPMENT SERVICES - BUILDINGP DIVIS�ON County Center Drive - Oroville, California 95965 - Telephone'(916�, 538.-7541- PERMIT NO. ,A APPLICATION AND PERMIT 9 tel? =0001 ASSESSO P C 6. UMBER -4" _ ZONING BUILDING PERMIT O NE-Rp }'yU y�1L+-• , u 1 wi- my 11VAi�J�cVc ' 1 TELEPHONE 1� SQ. FT. OCC. 4� 'BUILDING VALUATION R S %S � -J12x'y t�L OWNIL�NO ADD, I CzTRgC1iNAME ` `� �/'`� TELEPHONE 1 CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER lIzz,�- -q-,,UNKNOWN LENDER'S MAILING ADDRESS Total Valuation $ Fling Fee $ 20.00 Permit Fee $ 15.00 ARCHITECT OR ENGINEER - LICENSE NO. 1 Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ SUILDINGADDRESS jr 180 Mira I.B�rn Rd., Bury Greer _ } PERMITFEE $ 35,( PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME ' PARCEL -MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF OL Duplex ❑ Mobilehome ❑ Other ; SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other q, - Describe Work: 1st Rer;Iewal W- 951-2324 — Mobile Home S G W @20.00 PERMITFEE g Contractor ELECTRICAL PERMIT Filinq Fee 20:00 -. a V OR LESS Main Service ( 2ooA OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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: y 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 , ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. 1 y1 ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ADDNS. ( & ACC. BLDS. ) SO. 3.50 FT. NEW CONST, MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWERAPPARATUS (8 SINGLE OUTLET CIR. ) Ex. Occup. (OUTLET OR FIXTURES) BA20 L .50 a 1.00 PUNS.) OR Ex. Occup. OUTLETS . ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring09 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION y - : I 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.Hood ❑ 1 have and will maintain workers' compensation insurance, as requiredlby 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 Filing Fee 20.00 9 Heating Cooling 6.50 Ventilation PERMITFEE $ Contractor 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 permitUis issued, I shallTOTAL not employ any person in any manner so as to become subject't"o workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, 'I shall forthwith comply with those provisions. X _� Date 9- 4 -960 =_ Signature 6 - Applicant }weer ❑ Contractor ❑ Agent An OSHA permit is require for, /xCa ations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee $ occ CONST. TYPE FEE a 35,0!1 HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL' PD I Ho ,tea UE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have B /V IN � `� y f PERMITEXPIRESON i applicable provisions Resolutions to do work been paid. s Date r/ ` 9/41/97 (Date) AX045-% ` t•% % r--- Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT it ti . 061-440-003 PERMIT#95-2324 RUBANOFF, BAr=ry. 4 w.----- — 180 Mirage Lake Rd., Berry Creek Complete •.BP#1848=89, G cls- 31�be Q 3� 3100,. cm ;Ivs� U ! 'r „?fr-�4r.+„ � .. _ ... t�•� • ..w�. ,.,N.r \ i . t. ;,�1'j �+ rs•---•'I l; rf,-.�•Iar w f ( ir• COUNTY OF BUTTE- DEPARTMENTOF DEVELOPMENT SERVICES -iBUILDING.DIVISION •7-L:odnt Center Drive - Oroville, California 95965 - Telephone• (916)'•538-7541 A PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 061-440-003 ZONING U BUILDING PERMIT 3'"`—(Z)1UC.-E iTj eSTn f II02 SO. FT. OCC. P BUILDING VALUATION �`�:" D ,. CREBII:+,S91b OWNERS MAILING ADDRESS, . ry �/ „ CONTRACTOR'S UWE __-`R TELEPHONE i\ CONTRACTORS MAILING ADQRESS - - Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Fling Fee $ 20,00 Permit Fee $ 15.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 280 MIRAGE LAKE RD PERMITFEE $ 35.00 - - BERRY CREEK, 95916 * ' .IN _ PLUMBING PERMIT Filing Fee 20.00 Each Trap 1 7.00 LOT No. SUBDIVISIONS NAME ` PARCEL MAP Solar or heat pump water heater 1 23.00 _ USEOFSTRUCTURE - " SF ❑K Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 - TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑K Describe Work: PERt11T TO C( XPLETE #184$-89 Mobile Home S G W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filing Fee 20:00 1 f Main Service 600V OR LESS \ 200A OR LESS J 23.00 _ Main Service ( 200A TO 1000A I 46.00 _ 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 _ r 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License L4Lwjor 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 NEW CONST. DWELLING OCCUP. OR AD DNS. a ACC. BLDS. 3.5Q FT. i , F. NEW CONST. MULTI -OUTLET NON-RESID. BRANCH CIRCUITS % @7.50 a BOINGLE OUTLEETTCIa Ex. Occup. OUTLET OR FIXTURES) 1•� 6AL SO Ex. Occup. FIXED APPLNs. OR OUTLETS (RES1D.) EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring` 23.00 . PERMITFEE $ Contractor 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 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 PERMITFEE S Contractor 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 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•thp- workers' compensation provisions of section 3700 of the Labor Code, I shall. forthwith comply with those provisions. X ?3_ _ __ Signature of p t - w/� r ❑Contractor ❑t Agent7 An OSHA p�cRTit is required for eke vations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 35,00, HA2. D. FEES IMP FLOOD CDF PARCEL PD ND ISSU ;This permit is hereby issued under the of the Butte County Code and/or indicated for which fees have • By PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Date �- '? /' (Date) Receipt No. 1 ?!5 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR __GOLDEN AOD-APPLICANT I I/ 061-1440-OQ3 -PERMIT#94-2857 ;.RUBOOFF�,. BARRY, CAROLINE - ;180 MIRAGE LN'- -, -',,BERRY CREEK-' COMPLETE B P # 1848M,-89 1 311 93. 3�4 - tt 061-1440-OQ3 -PERMIT#94-2857 ;.RUBOOFF�,. BARRY, CAROLINE - ;180 MIRAGE LN'- -, -',,BERRY CREEK-' COMPLETE B P # 1848M,-89 1 311 93. 3�4 - COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION • 4 --*wj 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT �& — e;� k1_3 !Z ASSESSOR PARCEL NUMBER ZONING IT BUILDING PERMIT OWNER — SRR TELEPHONE 589-4102 SQ- FT. OCC. BUILDING' VALUATION OWNERS MAILING ADDRESS RAGB E jLC S ONO EST 1000.00 CONTRACTOR'S NAME _/ 0 N V z OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS 41 • FireplaceCONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS t Filing Fee $ 20,00 Permit Fee $ 25.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 180 LK RD MIRAGE PERMIT FEE $ 45.00 - 3; PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL,MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE v �} 1 SFXT Duplex ❑ Mobilehome ❑ Other SPECIFY ^yJ TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ anon - I erTO Describe Work: PERMIT TO #�1848�-89 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 I _- Main Service ( 1IOOVOR LESS 200A ) 23.00 200A OR LESS Main Service ( 200A To IODOA ) 46.00 NEW CONST, DWELLING OCCUP. g0, OR ADDNS. ( & ACC. BLDS. ) 3.50 FT. CONTRACTORS LICENSE LAW declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 3 of the Ss and Professions Code and my license is in full force and effect. License No. Classification "' I I, as the owner, or my employees with wages as their sole compensat will do the work, and the structure is not intended or offered for sale. (Sec 4) ❑ I, as the owner, am exclusively contracting with licensed contractors. Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET . NON.RESID. ( BRANCH CIRCUITS I @7.50 ( POW ER APPARATUS ' & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. 0 .50 Ex. Occup.FIXED APPI NS. OR (OUTLETS IRESID.1 EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. 1 agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of 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. X Date —9 Signature o plicant 0 e"r CO) Contractor ❑ Agent An OSHA permit is require excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 45.00 HAZ• I D. FEES I IMP I FLOOD I CDF PARCEL I PD HD 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. By 1�1;.f/ /1_/� Date PERMIT EXPIRES ON (Da re! Receipt No. Q U WHITE-D.D.S.-B. . CANA Y -ASS SOR PINK -INSPECTOR GOLDENROD -APPLICANT Insdiation Certificate •,R BUILDING OWNER: Description of Installation ROOF Material Thickness (inches) BUILDING PERMIT /J - "a r i i Brand Name Thermal Resistance (R -Value) CEILING "Batt or Blanket Type T T1p� L��j Bund Name; - - Thickness (inches) Thermal Resistance (R -Value) IR --S a Loose Fill Type Brand Name Contractor's minimum installed weight/& lb Ntutimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance (R -Value) /-EXTERIOR WALL Material - ?j , ,T T f' A 3GRG LAA Thickness (inches) ° RAISED FLOOR t Material Fl &,AS4 Thickness (inches) i 2 to SLAB FLOOR Material Thickness (inches) Width (inches) _ FOUNDATION WALL Material Thickness (inches) _ Declaration Br�sttd Name f_� Thermal Resistance (R -Value) B a td Name WAY t L_ LC Thormal Resistance (R -Value) •? - 4 Brand Name Thermal Resistance (R -Value) r Bibnd Name Thermal Resistance (R -Value) - T•: ti • w IN I hereby certify that the above insulation was installed in the,huilding 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) Signature and Tide X 2 2L j Bw0Fi� /Sub -Contractor (Insulation Installer) S'Mand Title License Number Date a� Licensee Number -' Date THIS CERTIFICATE MUST .BE PROVIDED TO THE BUILDING DEPARTKW PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. JANUARY 1993 OK 6=No'tOK = Not Readyable MOBILE HOMES MISCELLANEOUS 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/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / /"L"ft. / /"Nat. or/ PV'ft./ /"LPG 7. Utility Clearance Card -B1 Date Card -131 Date II Card -131 Date Card -131 Date Date MOBILEHOME 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 ; 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. Exits; Insp.-Sketch 10. Cert. of Occupancy Card -131 Date Card -131 Date Card -Bi Date Card -131 Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -131 Date Card -61 Date Card -131 Date Card -131 Date • r a R 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.-Connec.- Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Card -131 Date Card -61 Date Card -131 Date Card -131 Date 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, Distances-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.;Ground ing; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes -Enc losures-Panel boards- Ins. to Main in Conduit UK 0 = Not Not Applicable RESIDENTIAL (Single and Duplex) - = = Not Ready Date UNQERFLOOR (Plans) OK except #'s ,or Lon ing-z)etDacKs;-tasements-i-i000-Slop rig., Main; Soils-Steel-Elec. Grnd.-Q2 / Ftg. Oe garage; Soils -Steel-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Del A-Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 7. Slab; Steel -Wrapped Piers -Fireplace Ftg.-Steel W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 10. Gas Pipe; Size -Anchors :ffWater Pipe; Test -Anchors -Regulator -Service Test 12. Electric; Underground . Plepums & Ducts; Clearance-Material-Supprt-Ins. §A -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Card -131 - Date ZY,7IFOCard-B1 Date Card -B1 Date // 410ard-B1 Date Date PLUMBING Permit OK except #'s 16. " ater Ht. Vent -Access -Combustion Air -Baffle ater Pipe; Test & Anchors -Nail Protection W.V.; Test-Fttngs & Anchors -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas PiDe: Size & Anchors Card -B Date •IPand-B1 Date Card -131 Date Card -131 Date Date ELECTRICAL (Permit) OK except #'s Fixture & Transformer Clearance -Ina. Protection p-,Oec. Receptacles Spacing -Lights & Switches at Doors 2-4� iie Boxes & No. of Conductors -Stapled 25. omex Instal Close to Edge of Studs & C J. 6. Equip. -round ma p w/Meeh. Fasteners on as & Water 27 Appliance Circuts in Kitchen & Conductor Size/G.F.I. 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. f Cu or Al Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. insulated Neutral Yes No .yService-Riser Conductors & Ground -Main Disconnect .,,Eq ip. Clearances Panels-Motors-Mech. Equip. . Clothes Closet Light -Shower Light -Spa Light 3 Smoke Detector Card -131 Dat S6 Card -131 Date Card B1 Dater Card -B1 Date Date MECHANICAL (Permit) OK except #'s AC. Ducts Insulation & Support Fan; Exhaust above insulation .Condensate Drain & Overflow; Size & Grade furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnace in Attic Card -B1 Date and -81 Date Card -B1 Date Card -131 Date Date FRAMING (Plans) OK except #'s . %ills, Proper Material & Anchors _4e'_ally Studs -Nailing, Spacing & Bracing—Plates-Sound 4.• Fearing Walls over Girders & Floor Nailing graft Stop in Walls (rat proof) Fire Stops; Furred Ceilings -Stairs -Chases -Tub A4. Header & Beam -Size & Bearing Date FRAMING (Continued) " 4 angers -Post Caps -Anchors -Connectors Ing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. ,99_7;*ireplace Ties or Type A Flue -Fireplace Throat Clearance Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles drm. Windows or Exiting Doors -Sill Hgt. & Dimensions ,5 . re Protection Framing .11rio erty Line Firewall & Openings xt. Doors -One T -Check Garage -3rd story, 2 exits -Itairs; Width -Headroom -Rise -Run -Landing -Fire Protection 5 ood on Roof Overhang -Attic Vents -Rafter Outriggers iding-Nailing Veneer 5 . ucco s - .ip-Screed-Fd. Vents-Underflr. Access �ag�Area-Glass Protection -Skylights -Plastic 58 -Shear Walls; Nailing -Bolt 59. Insulation- - g. 60. Infiltration-Walls-Wndws Card -B Date ` Card -B1 Date Card -131 Date Card -B1 Date Date IN tans) OK except #'s x . Steps -Door & Sidelight Protecti in t, -62 -Smoke Detector . rnace; Vents -Clearance -Comb. Air -Connector - In rage; Above Floor -Ducts -Meeh. Protection B4&oom Exiting t I F.I. & Bath Fixtures & Tub Access 1 lec. Trim & Suboanel: Breaker Sizes - =fireplace or Stove; Clearances -Hearth 1.-�6�Eiec. Outlets at Wood Panel; Int. & Ext. {�fi-Kit" Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance lec. Outlets & Regepfacles at Kit. Counter —72 -Gavage Fire Door; Swing -Landing -Closer "Duct in Garage -Damper tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Meeh. Protection lec. & Mech. Equip. Listed for LocationO7 '/ Q� c- Receptacles in Garage; (G.F.I.)-Romex Protec. .. �ulation-Foam-Looked in Attic es 8. Guard Rails & Deck Construction -Post Caps n. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor o Y s ollowing instid.; Drive -oYes o; Walks O Yes & Planters O Yes O No tucco; Brown-Finish --82-W.'G-. nit; Disconnect, Electrical, Plumbing 11_Ventsl ove Roof; Plbg.-A ante-Firepl.-Clearance to 'f ems' Op ngs. Exterior Elec. Tr Y-eatilation throu Glass Protection PI n; G.F.I. Receptacle -Underground shout House ,yt3,L_Gorrections from Previous Inpections I/ 89. Gas Test -Meters Tagged; Gas -Electric ater & Sewer Connected -C/O to Grade -HD Approval 1. E ergy. Compliance Certificate -Other Certificates oofing Certificate Card -81 Qatd-131 Date2.6 Card -81 Date ( and -131 Date Card -131 ate and -B1 Date Comments at Final: COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION .7 County Center Drive Oroville, California 95965 • Telephone (530) 538-754 PERMIT NO. (Rev"1/96) - APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 061-440-003 ZONT BUILDING PERMIT 1WRY RUBANOFF TELMTE4102 SO. FT. OCC. BUILDING VALUATION BERRY CREEK 95916 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 2 0.0 0 Permit Fee $ 5.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 180 MIRAGE, BERRY CREEK Energy Plan Checking Fee $ $ PERMIT FEE $ XXX .00 LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobitehome ❑ 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 ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: gXXX 3RD RENEWAL 95-2324 Gas piping system i - 5 outlets 15.00 Building sewer . 15.00 Mobile Home ISI GI WF-'4T" PERMIT FEE _ ELECTRICAL PERMIT Fling Fee 20.00 R UES a00Main 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.PSINGLE License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License 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 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 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 Main Service To 46. NEW CONST. DWECU. so SO W WNG OCCUP OR ADDNS. a ACC. BLDS. 3.5¢FT. HOµRESID. M."T OUTLET CIRCUITS 97.50 APPARATUS a OUTLET CI IR. 20@'.00 Ex. Occup. OUTLET oRFIXTURES BAL o .50 Ex. Occup. ounFTs PM.) E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ 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.) 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 forthwith comply with those provisions. X _ Date Sig ature A pplicant icant❑ 'ner ❑Contractor ElAgent An OSHA permit is req Ired f e cavations over 5'0" deep and demolition or construction10 of structures over 3 st I h Igh Mobile Home Installation Fee $ Energy Inspection Fee $ I occ CONST. TYPE 0 75 HAZ. I D. FEES IMP I FLOOD I CDF PARCEL I PD HD I ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for wh' h fees have been - B ate PERMIT EXPIRES ON Dae provisions to do work paid. ' Receipt No. WHITE-D.D.S.-B. . CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT IC 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. _X11. I personally plan to provide the m ' r 1 bor and materials for construction of the proposed ro. erty improvement : YES .1 NO[ ]. .2. I HAVE HAVE NOT[ ] si ed an application for a budding, permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: 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: 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 SIG . /PROPERTY OWNER:ON SOCLA,L 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. May 1995 ` 2. 26 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 riskslor you if you do not carry out these obligations,''and these risks are 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 can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Michael 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. May 1995 2.27 IN _ r .-,..:,,:�-'� •'w�v,.n c,t"as>Lk�osprc�.::.p.?r.�.... •� yti� . 'r COUNTY OF BUTTE- DEPARTMENTOF DEVELOPMENT SERVICES- BUILDING DIVt9JON 7 County Center Drive '- Oroville, California 95965 - Telephone (916) 538- 41 PERMIT 'NO.., (Rev.12/96) APPLICATIONAND PERMIT 1; ' . ASSESSOR PARCEL NUMBER 6I-44-003 ..: , ... ZONING U , •...,+y ILDIN_G PERMIT .. DNNER�' TE HONE BARRY' .RUBANOI�F X89--4102' ' ; g(� , �," ' . I" " 1 r. `BUILDING VALUATION OWNERS MAI UNO ADDRESS PO BOX ,;1123. ' BERRY,;:C 'EK: -:'':.. 95.916 -- t •� ,, - ;,. CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS -,, f " • .'r _ CONSTRUCTION LENDER - LENDER'S MNUNG ADDRESS `tet. Fireplace _ _ Total Valuation $ ARCHITECT OR ENGINEER j " 10ENS NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS i Permit Fee Plan Checkirig Fee ? $ BUILDINGADDRESS 180 MIRAGE _ .. Energy Plan Checking Fee $ - • BERRY CREEK " , r' , $ : `{ 1• •, PERMIT FEE $ •. �', '` L01 No. SUBDNISION'S NAME - '- PARCEL MAP PLUMBING PERMIT = ..�::= Filirid.Fee 20:00" USEOFSTRUCTURE �i;. Each Trap ' 7.00 Solar' or heal.pump water heater 23.00 SF IX Duplex ❑ Mobilehome ❑ Other '* Water piping 15:00 Each gas water.heater or vent 15.00 TYPE OF WORK ;t; .. Gas piping system 1 - 5 outlets 15:00. New ❑ Addition E3' Remodel 13 Utilities 0 Installation ❑ Other b] . ' ' Buildin sewer 15.00 Describe Work: 1. RENEWAL, 95-2324 - - , Mobile.Home S dl W -@20.00 . PERMIT FEE $ ELECTRICAL PERMIT ".' I Filing Fee 20.00 �- Main Service z�oon oR LEss 23.00 LICENSED CONTRACTOR'S DECLARATION Main Service sooA TO �o'doA 46.00 I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter NEW CONST. DT NO OCCUP. OR ( a Aca Bl os. sD ' 3.5¢FT: 9 (commencing with Section 70007 f Division 3 of th Business and Professions Code, I and my license is in full force and ffect. /�,/�� �" cod MULTI•ouTLET . NON•RESID. @7.50 S POWER APPARATUS License Class LIC. NO. 8 SINGLE OUT. CIR. OWNE BUILDER DECLARATION '��., Ex. Occup. OUTLET OR FIXTURES 20 O 1'0° ' 6AL ® .50 I herebyaffirm under penalty of perjury that I am exempt from the Conti cto ' License P nY P I N P q SA Ex. Occup. FIXED APPINS. oR ounETs REBID. EA 5.00 for the following reason: + Temporary Service 23.00 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. Mobile Home Facilities 20.00 ❑ I, as owner of the property, am exclusively contracting with licensed contractors Misc. Wiring 23.00 to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason ' PERMIT FEE $ WORKERS' COMPENSATION DECLARATION ' i MECHANICAL PERMIT Fling' Fee 20.00 I hereby affirm under penalty of perjury one of the following declarations:. - Heating ❑ 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 Cooling performance of the work for which this permit is issued. Hood 6.50 ❑ 1 have and will maintain workers' compensation insurance, as required by Section Ventilation 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 PERMIT FEE $ Policy Number Mobile Home Installation Fee $ (The above sections need not be completed if the permit is for work of a valuation Energy Inspection Fee $ of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shalt occ CONST. TYPE TOTAL FEE $ 3'5.00 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 subj.pct to the HAZ. D. FEES IMP FLOOD CDF PARCEL HD 6SUE PD workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. This permit is hereby issued under the applicable provisions' -fyof the Butte County Code and/or Resolutions to do work X _ Date 9 - indicated above for which fees have been paid. Signature o Applicant - r ❑ Contractor ❑ Agent f r` An OSHA permit is requir fo vations over 5'0" deep and demolition or construction 9 of structures over 3 stories in height. By Date �'�� Receipt No. PERMIT EXPIRE ON 9— -a/ " WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT (Dato COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive. - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT -Jy9a,( ASSFUgj , EA ZONING BUILDING PERMIT OWNER BARRY TUJW1 OFF TELEPHONE TELEPHONE 589-4102 SO. FT. OCC. BUILDING VALUATION OWNERS MAIUhG ADDRESS PO Box 112, Berry Creek CA 95916 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTIONCLENDER UNKNOWN Total Valuation Is Fling Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 15.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS 180 Mirage Lake Rd. BerryCreek PERMITFEE $ 35.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF Illi Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe 'Mork: 1st Renewal B095-2324 Mobile Home S I GI W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20.'00 Main Service000v OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commercing 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 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law.for the following reason: I, asowner 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 NEW CONST. DWELLING OCCURSO. OR ADONS. ( 8 ACC. BLOS. ) 3.5¢ FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES) 20 Q 1.00 BAL a .SO EX. Occup. FIXEDAPPLN . OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 ha-ve 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 Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Poli,y Number (The above sections need not be completed if the permit is for work of a valuation of me 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 forthwith comply with those provisions. Q X_G Date �" p� _ Signature o Applicant ❑ Contractor ❑ Agent An OSHA ermit is re uire/jer, tions over 5'0" dee and demolition or construction P qP of structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee Is OCC CONST. TYPE I TOTAL FEE $ 35.00 HAZ. I D. FEES IMP FLOOD CDF PARCEL PD HD -, LZCIIF ?.7 This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON I applicable provisions Resolutions to do work been paid. Date � v 9/21/ I (Date) Receipt Ne. 206045 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTYOF BUTTE - DEPARTMENTOFDEVELOPMENT SERVICES -BUILDING DIVISION 7 COUNTYCENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 OWNER / Proposed Building Use PERMIT APPLICATION DATA SHEET a Building Inspector A. P. No. 06 / 1/'/(o Date At time of permit application, I was advised the following data must be submitted prior to permit processing and!or issuance: 1. All items have been submitted. 2. Plot plans, 3/4 sets, signed by preparer of plans. 3. Complete plans, 3/4 sets, signed by preparer of plans. 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans. 5. Hazardous Material Form. 6. Energy Design Compliance and supporting documentation. 7. Statement of Intent for Non -Heated and A/C Buildings. 8. Engineered truss details and layout in duplicate (required prior to plan check). 9. Mobilehome data and manufacturer's installation instructions, 2 sets. 10. Fees of $ 11. Impact fees as shown on attached schedule. 12. California Department of Forestry plan approval/fees. 13. Flood elevation letter (100 year flood) by California Engineer. 14. Sanitation and plot plan approval Health Department. 15. City of Chico plumbing permit. 16. Plot plan and business license approval from City of Biggs/Gridley. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. 19. Driveway permit (construction approval required prior to occupancy). 20. Pre -inspection for required. 21. Contractor's license information. (No., Name Style, Classification). 22. Certificate of Workmans Compensation Insurance. 23. Owner -Builder Verification (Given to owner , Mail to owner 24. Recorded copy of Agricultural Acknowledgement Statement. 25. Letter of signature authorization. 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. 27. Letter of intent on building use. 28. Mobilehome utility clearance. 29. Documentation of legal access. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements. 31. Existing violations/expired permits. Plan ch M' list. 34. J� Wh you issue the it, process as follows: Mail ownerf. . Mail to contractor. Telephone t 3 d hj�d f - r pickup at ✓n© I/- _ office. Deliver with inspector. Other C � r^ Applicant Date EXPIRATION OF APPLICATION Applications for which a permit has not been issued; will expire by limitation 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. FEE REFUNDS Refunds can only be made upon writtten request by the person who paid thefee. The request must be made within one yearfrom the date of fee payment on permits not issued, and one yearfrom the date of permit issuancefor permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan checking fees for work plan checked and other department costs are not refundable. Original - Applicant 6r6' - 7f. ,.,,:'Y:.r:a?s�,q'ci�;4S�NwwMi'"T`� 7r:"='+�'`.:�r«•.n -nom r •.....-�.- _ V 'COUNTYQF,BUtTE - DEPARTMENTOF DEVELOPMENT SERVICES - BUILDING DIVISION ' 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916) 538-7541 PER OWNER _ u a Y1O t� Proposed Building Use APPLICATION DATA SHEET Building Inspector A. P. No. Date At time of permit. application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED By 1, All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans. ......................... . 3. Complete plans, 3/4 sets, signed by preparer of plans . ..................... . 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form...........................:a........... , .... . 6. Energy Design Compliance and supporting documentation. . } ................ 7. Statement of Intent for Non -Heated and A/C Buildings. ................. 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructionst,2 sets. ........... 10. Fees of $......................................... 11. Impact fees as shown on attached schedule. .................:........... . 12. California Department of Forestry plan approval/fees......................... 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . .......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: ......... 18. Contact Land Development about (A) Improvements (B) Drainage. ...... . . 19. Driveway permit (construction approval required prior to occupancy). .. .. .. . 20. Pre -inspection for Prey"v.e ti."'eQ°�- required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner Mail to owner . ......... . 24. Recorded copy of Agricultural Acknowledgement Statement, .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road..... . 27. Letter of intent on building use . ...................:.................... . 28. Mobilehome utility clearance . ......................................... 29. Documentation of legal access . ..................... :......... :........ 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 'Al. Existing violations/expired permits . ....................... 32. Plan cl,�c!'ICi G/� .... . ) ..�. �S . . 33• C.� �I . e: ..-. :9. 34. Wh you issue the�Per itt�,pj�ocess as follows: Map, Mail to contractor. Telephone u�-0000 d pfd f r pickup at ©v office. Deliver with inspector. Other Q /'r C -7 06?VOJe p n1 , Parcel Creation Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone - mail Counter by Date Contractor, designer, owner, was advised of above required data by - phone- mail Counter by„_ Date Plans checked by Date Plans approved by/?" Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works 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. ma'or labor and materials for construction of the proposed property improvement : YE ] NO[ ]. 2. I HAVE[) HAVE NOT[ ] si d 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: 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: 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: PROPERTY OWNER: ' 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 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 are 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 can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerel , Michael C. Vieiia, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754 PERMIT PERMIT NO. APPLICATION AND PERMIT ��" ASSESSOR PAR/CEL /7'BER - O� LO [ v ZONING BUILDING PERMIT OWNER r ano TELEPHONESO. 9-�!! FT. OCC. BUILDING VALUATION OWNER ILING ADDRESS {� Y 16 CONTRA 'S NAME 0�/J TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCn N ;DER yl UN04OWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAIUNG ADDRE - Permit Fee $ ARCHITECTOR (NEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR,ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS �r/� �a PERMITFEE $ ' PLUMBINGPERMIT Filing Fee 20.00 eae Each Trap 7.00 LOT NO. SUBDNISIONS NAME PARC L MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Ublities ❑ Installation ❑ Other K Describe Work: 19t 0 C yl C_LA") a — ^ 9�_ 1P Mobile Home I S I G1 W 1 @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20:00 600V OR LESS Main Service ( 200A OR LESS ) 23.00 Main Service ( 200A To 1000A ) 46.00 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. ❑ 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 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 NEW CONST. DWELLING OCCUR OR ADDNS. ( a ACC. BUDS. ) s0. 3.50 FT. NEW CONST. MULTI -OUTLET NON•RESID. ( BRANCH CIRCUITS ) @7.50 ( p NGL APPARATUS ) a SINGLE OUTLET CIR. EX. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 BAL a .SO EX. Occup. FIXED 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor 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.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shallTOTAL 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 forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 50" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is occ CONST. TYPE R7 w\ FEE $ HA2. D. FEES IMP FLOOD CDf PARCEL pD HD SUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have BY PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Date (Date) ReceiptNo. d 0 / 47— WHITE-D.O.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION 7 County, Centc* Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO/ APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 061-440-003 U BUILDING PERMIT OWNER BARRY RUBANOFF TZO�NIIpNNGo� p .JOyNE4102 SO' FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 180 MIRAGE LAKE RD B. CREEK, 95916 �© CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S "UNG ADDRESS Eyepiece CONSTRUCTION LNDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ 1 0 ARCHITECT OR ENGINEER LICENSE N0. Plan Checking Fee $ ARCHITECT OR EPGINEER'S MAIUNG ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS T 180 MIRAGE LAKE RD PERMITFEE $ 35.00 BERRY CREEK, 95916 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 USE OF STRUCTURE SF DX Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Unities ❑ Installation ❑ Other ❑X Describe Work: PERMIT TO COMPLETE #1848-89 Mobile Home ISI G1 W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20:00 Main Service' --v OR LESS OEN ( 200A ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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 licerse is in full force and effect. License less Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Jfor 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 reaso i NEW CONST. DWELLING OCCUP. OR ADONS. ( & Acc. Bms. ) So. 3.5¢ FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 POWER APPARATUS (8 SINGLE OUTLET CIR. ) Ex. Occup. ( OUTLET OR FIXTURES) 20 @ 1.00 BAL .50 Ex. Occup. FIXED APRES, OR p (OUTLETS (RESID.) EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor 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 Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor 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 worke-s' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Si gnaturpplicant - w r ❑ Contractor ❑ Agent An OSHA p It is required for ovations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ oer CONST. TYPE TOTAL FEE $ 35.00 HAZ. 1 D. FEES I IMP I FLOOD I CDF PARCEL I PD HD ISSU This permit is hereby issued under the ofthe Bu a Count Code and/or indicate Count for which fees have s /,a� BY PERMITEXPIRESON applicable provisions Resolutions to do work been paid. _ 9 Z p Date / Z /- (Y� (Date) �y Receipt No. a WHITE-D.D.S.-BI.D CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT S� ` '+.....�...ii`;r;.,.'«�,(�.Kr...irr°"•,,;Z:Ra..+hy'"1"•`r%..-.�-.�:,...w.�'^I'-'`_....^+.lam7.+.,.N +/1 >t '�..J' ,,�. t,+i.? -r•:7ti.ri:.V7k... o :n.,. 7r' .i1'r�r7 .,a +r �'✓�!'SM J"r'w5...'ti'At �.-�Y'.... r"' .. ,..ri. . t1F'IM•H�+Ya.< ",COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION 'M ` 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORMA95965 - TELEPHONE (916) 538-7541 E MIT APP (CATION DATASHEET OWNER Proposed Building Use BuildingnspectorDate S At time71. it application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECENED BY All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3. Complete plans, 3/4 sets, signed by preparer of plans . ..................... . 4. Engineered plans and callus, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/G,Buildings. ...................... 8. Engineered truss details and layout in duplicate (required prior_to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ . .......................................... 11. Impact fees as shown on attached schedule. ....... . 12. California Department of Forestry plan approval/fees. ..................... 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit.. .......................................... . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ......... 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). ... Pre -Inspection requ� 20. Pre -inspection for required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner _). ........... 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . .................................... * ' *- 26. .26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28- Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . .... ................................................ . 33. 34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: -(Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder. Copy - Department of Public Works 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 maikK labor and materials for construction_ of the proposedproperty improvement: YES[ NO[ ]. 2. I HAVE HAVE NOT[, ] si d 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: 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: 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: PROPERTY OWNER: DATE: l - NOTE: This owner -Builder Verification is required by Section 198.31 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 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 pe'rson 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 are 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. fe"sling to be contractors is to secure an "ownerbuilder" A frequent practice of unlicensed persons pro 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. Singel 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. OVER COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION 7 County_Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER D _ , ZONING BUILDING PERMIT OWNER O ��,"f�"'� / SO. FT. OCC. BUILDING VALUATION OWNERS Mnn CONTRACTORS P& TELEPHONE S CONTRACTORS MAULING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDERS Ma LNG ADDRESS Permit Fee $ D ARCHITECT OR ENGINEER .. LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS PERMITFEE $ PLUMBING PERMIT : Filing Fee 20.00 (� Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF�(Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORKt New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ sr_j Oth Describe Work: ^� Mobile Home S G W 920.00 PERMITFEE t Contractor ELECTRICAL PERMIT Filinci Fee 20:00 Main Service 000V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, 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 NEW CONST. DWELLING OCCUP. OR ADONS. ( a ACC. BLDS. ) so. 3.5¢ FT. NEW CONST. MULTI -OUTLET NON•RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS ( a SINGLE OUTLET cm ) Ex. Occup. (OUTLET OR FIXTURES) 20 Q 1.00 BALI FIXED APPLNS. OR Ex. Occup. ( OUTLETS (RESID.) EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor 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 Filing Fee 20.00 g Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor 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.) ❑ 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 forthwith comply with those provisions. X _ 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. Mobile Home Installation Fee Is Energy Inspection Fee Is occ CONST. TYPE TOTAL FEE $ 3 Q HAZ, I D. FEES I IMP I FLOOD I CDF PARCEL PO HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have BY PERMITEXPIRESON the applicable provisions Resolutions to do work been paid. Date (Date) ReceiptNo. �� WHITE-D.O.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541a�PERMITNO. n APPLICATION AND -PERMIT - q` / ASSESSOR PARCEL NUMBER 61-44-003 ZONING IT IQ BUILDING PERMIT OWNER BARRY.& CAROLINE RUBANOFF TELEPHONE 589-4102 80, FT, OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 180 MIRAGE LAKE RD EST 11000.00 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LeIDER UNKNOWN Total Valuation $ LENDER'S MAILING:ADDRESS Filing Fee $ 20.00 Permit Fee $ 25.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS, 180 MIRAGE IX RD PERMIT FEE $ 45.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE SF &(Duplex 13Mobilehome ElOther SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition O Remodel CJUtilities ClInstallation ❑ Other] Describework: PERMIT TO COMPLETE #1848-89 PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main ServiceBOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( & ACC. BLDS. ) 3.50 SFT0,, CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, 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) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ 1 am ex:mpt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET •NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( P.0WEREAPPARAS ) 8 .No LOUTTULET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. @ .50 Ex. Occu FIXED APPWS. OR p' (OUTLETS IRESID.1 A. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. rI shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Arplicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisiDns or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certifytha.- I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. I 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. X �l. L Date lO. ®^'i — �� Signature oL_ plicant O e ❑Contractor ❑ Agent An OSHA permit is equire excavations over 5"0" deep and demolition or of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ GCC CONST. TYPE TOTAL FEE $ 45.00 HAZ• I D. FEES I IMP I FLOOD TDF PARCEL I PO HD ISS This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By PERMIT EXPIRES ON � ID tel provisions to do work paidconstruction ;Xv Receipt No. �j o WHITE-D.D.S-B.D. CANA Y-ASSE SOR PINK -INSPECTOR GOLDENROD -APPLICANT Q OUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION $ 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORI�A`9696 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER V `t�/� � �T A. �R�9. Proposed Building Use M 01 Building Inspector Date :77 't�•application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY All items have been submitted........................................ . 2. Plot plans, 3/4 sets, signed by preparer of plans. .......................... 3. Complete plans, 3/4 sets, signed by preparer of plans. ...................... 4, Engineered plans and calcs, 3/4 sets, with wet signature on plans. ............. 5. Hazardous Material Form............................................. 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non-Heated and A/C Buildings. .... ................. ` 8. Engineered truss details and layout in duplicate (required prior-to plan check). ... . 9. Mobil home data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ ...................I. ........ . 11. Impact fees as shown on attached schedyle..... / ..........'............... 12. California Department of Forestry plan approval/fees. .........:............. . 13. Flood elevation letter (100 year flood) by California Engineer................... 14. Sanitation and plot plan approval ti. Health Department . ............ 15. City of Chico plumbing permit. . ........................... . 16.. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: 5 (B) Parking: ' 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. . . Preanspedion requ� 20. Pre-inspection for required. . to BuiI'ding Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification). .............. 22. Certificate of Workmans Compensation Insurance. .......................... .23. Owner-Builder Verification (Given to owner , Mail to owner _)........... . 24. Recorded copy of Agricultural Acknowledgement Statement. ................. . 25. Letter of signature authorization........................................ . 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ...... 27. Letter of intent on building use.......................................... 28. Mobilehome utility clearance............................................ 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and•(B) Parcel meets zoning area and frontage requirements. ............... 31. Existing violations/expired permits....................................... 32. Plan check list . ..................................................... 33. 34. When you issue the permit, process as follows: ail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Cre2tion Acreage Applicant 2 Date Copy of Ha?-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. y 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sats of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. AssEssoR PARCEL NUMBER ZONING BUILDING PERMIT r^ �EPMON; t,.2 `T SQ. FT. OCC. BUILDING VALUATION OWNEWSM ESS, CA 4Y CONTRACTOR'9ry E TELEPHONE CONTRACTOR'S MAILING ADDRESS - Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE SF Duplex O Mobilehome O Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New O Addition O Remodel O Utilities El Installation Installation O Other Describe Work: C!i 1 //�� FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service( BDOV OR LESS 200A OR LESS I 23.00 Main Service ( 200A TO IODOA ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( & ACC. BLOS. I SO 3.50 FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification O I, as the owner, 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) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI.OUTLET NON RESID. ( BRANCH CIRCUITS I @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES I BA20 L. @ I.000 Ex. Occu FIXED APPLNS. OR p' (OUTLETS IRESIO.1 EA. I 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): O This permit is for $100.00 (valuation) or less. O I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. O I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 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 Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. I 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. X Date Signature of Applicant - O Owner O Contractor ❑ Agent � An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ �• 4Z� HA2. Pes I IMP I FLOOD I CDF I PARCEL PO HD ISSUE This is hereby permit P Y Issued under of the Butte County Code and/or Indicated abo%�,, for which fees have BY PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date !De tel Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE Department of Development Services. Building Division Oroville: 7 County Center Dr., Oroville CA 95965 Ph: 916-538-7541 Chico: 1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751 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 improvement (yes or no) Lr 2. I (have/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 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 Address -_C , ity Phone Contractor's License No. 5. 1 will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed Property Owner � Social Security Nuirlber Date /U — i - NOTE: This Owner -Builder Verification is sent to you as required by Sections 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. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVne(� LDING DIVISION 7 County Center Drive - Oroville, G3IifOrni'6 95965 - Telep538-7541 PERMIT NO. APPLICATION AND PERMI 93-3100 ASSESSOR PARCEL NUMBER 061-440-003 ZONING U BUILDING PERMIT OWNER BARRY RUBANOFF TELEPHONE 589-4102 SQ. FT, OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 180 MIRAGE LAKE RD BERRY CREEK 95916 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee @ - FEE $ 206.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 180 MIRAGE LAKE RD, BERRY CREEK PERMIT FEE $ 226.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SFU Duplex ❑ Mobilehome O Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20'00 TYPE OF WORK New ❑ Addition C]Remodel ❑ Utilities ❑ installation ❑ Other Q[X Describework: 4TH RENEWAL/89-1848 PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 ORD RENREAL/92-3183 Main Service ( 101V OR LESS 200AORLESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCC P. OR ADDNS. ( & ACC. BLOS. ) SO, 3.5, so CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed underrovisions of Chapter 9, Division 3 of the Business and P P �IProfessions Code and my license is in full force and effect. License No. Classification T " as the owner, 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) ❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) El am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NDN.RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS ) B SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES ) 20 @ 1.00 BAL. .50 Ex. Occup. FIXED APPLNS. OR OUTLETS (RESID.1 EA. ) 5.00 Temporary Service ry 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of 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. X I�l/l Date �CJ Sigf,ature of Applicant - ❑ 0 ElContractor ❑ Agent An OSH ermit is requi d excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 226.00 HAZ. I D. FEES IMP I FLOOD I CDF PARCEL PD HD ISSUE 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 ry By Gid"'� V Dateyl G19-3 p,L PERMIT EXPIRES ON 7 `y (Dad) Receipt No. 11,RSQ(1 WHITE-D.D.S.-e.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT '"`ti.['�^i":-;,-.,�r,(r..r...---'''--••rT'':;�v-�"1�[r`!�rt""'q.!'Y-1.`'Yr` 4�}Ayer'`"')w^r..s.t"YT.�N�r..,y�-l••r'1/`..�.fdy.,.f...,,,'^'i....-.ar*' > COUNTYOFBU TE - DEPARTMENTOFJNALOPMENTSTE E - BUILDING DIVISION a 7COUNTY CENTER DRIVE -OROVILL"E,CALIFORNIA 95965- HONE(916)538-7541 PERMIT APPLICATION, -DATA SHEET OWNER (/ / !/ A. P. -No. / -/ `fD r/- Proposed Building Use Building Inspector Date At time of permi ication, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 41 1. All items have been submitted . ......................................... 2. Plot plans, 3/4 sets, signed by preparer of plans. .......................... 3, .4. 5. 6. 7. 8. 9. 10. 11. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. Complete plans, 3/4 sets, signed by preparer of plans . ...................... Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. Hazardous Material Form. ........ ............... . Energy Design Compliance and supporting documentation . ................... Statement of Intent for Non -Heated and A/C Buildings: ........................ Engineered truss details and layout in duplicate (required prior to plan check). ... . Mobilehome data and manufacturer's installation instructions, 2 sets. ........... Feesof $......................................... Impact fees as shown on attached schedule. ............................. . California Department of Forestry plan approval/fees. ....................... . Flood elevation letter (100 year flood) by California Engineer . ................. . Sanitation and plot'plan approval Health Department . ............ City of Chico plumbing permit . ......................... ........... . Plot plan and business license approval from City of Biggs/Gridley.............. Planning approval for (A) Use: (B) Parking: . ........ Contact Land Development about (A) Improvements (B) Drainage. .......... . Driveway permit (construction approval required prior to occupancy). .. ... . uest Pre -inspection for to Bui ding Ins re for p required. . to Building Inspector (Date) Contractor's license information. (No., Name Style, Classification) . .............. Certificate of Workmans Compensation Insurance . .......................... Owner -Builder Verification (Given to owner , Mail to owner ............ Recorded copy of Agricultural Acknowledgement Statement . .................. Letter of signature authorization . ........................................ Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . Letter of intent on building use . ................:........................ . Mobilehome utility clearance . ........................................... Documentation of legal access . ..................... :.................. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... Existing violations/expired permits Plan check list. ......; '..': . When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other y, Parcel Creation /- Acreage Applicant 4 Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution D6,re( Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance 1. Index permit for above items No. 2. Additional items required: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date' Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT • 3:3 � ac ASSESSOR PARCEL NUMBER/) ,—C/�//��.'^�- ZONING BUILDING PERMIT OWNER � , I TE ONE �Z SQ. FT. OCC. BUILDING VALUATION OWNERS =RESS 04Z (/Y�l CONTRA TORSNAM ^ / TELEPHONE CONTRA ORS MAILING ADDRESS Fireplace CONSTRUCTION LENOER UNKNOWN Total Valuation $ S Filing Fee 20.00 LENDERS MAILING ADDRESS Permit Fee S Q ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee S Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty S BUILDING ADDRESS PERMIT FEE $ as PLUMBING PERMIT Filing Fee 20.00 Eau Each Trap 7.00 Solar or heat pump water heater 23.00, Water piping ,5.00 LOT NO.SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SFA Duplex O Mobilehome O Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G @20.00 TYPE OF WORK New ❑ Addition O Re odel ❑ Utilities O Installation O Other Describe Work: `7 _� / - (/ / PERMIT FEE g Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( BOOVORLESS ) 23.00 200A OR LESS Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. �I- SG. OR ADONS. ( & ACC. SLOS. ) 3.'50 FT. NEW CONST. MULTI -OUTLET •NON.RESID. ( BRANCH CIRCUITS ) @7.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification O I, as the owner, 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) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O 1 am exempt under Sec. Business and Professions Code forthis reason ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES 20 @ 1.00 SAL. .50 Ex. Occup.FIXED APPWS. (OUTLETS IRES .1 EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. O I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation P RMIT FEE S Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accr a agai t said County in consequence of the granting of this permit. X Date (�/ Signature of Applicant ❑Owner O Contractor O Agent An OSHA permit is required for excavations over 5"0" de and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ R ,0 HAZ• D. FEES IMP FLOOD CDF PARCEL PO NO ISSUE 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 PERMIT EXPIRES ON 43 Marel Receipt / / �� WHIT E•O.O..D.S.-8.0. CANA -ASSESSOR PINK -INSPECTOR GOLD ENROD•APPLICANT COUNTY OF BUTTE - Dewar-tment•of Public Works 7 County Center Drive, Orovi-lle, CA 95965 Phone: 916-538-7541 kttention Property Owner: OWNER -BUILDER VERIFICATION: 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 or_ no) . 2. I (have/have not) ,Q' 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 ZA d s Address City PhoneContractors License No. 4. I plan, to provide' portions of this work, .but - I have hired' the' following person to coordinate, sup rvise, and provide the major work: Name Address City Phone Contractors License No:' 5. I will provide some of the work -but I have contracted (hired) the following persons to provide -the work indicated: Name Address Phone Type of Work Signed: Property Owner Social Security Numbe & - Date - u !TOTE:. This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, California 95965 - Telephone: 916.'538-7541 APPLICATION AND PERMIT MIT NO. ASSESSOR PARCEL NUMBER 061-440-003 ZONING -i U s BUILDING PERMIT OWNER BARRY RUBANOFF TE EPHONE SO FT. OCC. BUILDING VALUATION. OWNER'S MAILING ADDRESS 180 MIRAGE LAKE RD BERRY CREEK 95916 RENEWAL CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee n — FEL $ 20 ARCHITECT CR ENGINEER NONE LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Ener Plan Checking Fee 9Y g $ Penalty $ BUILDING ADDRESS i 180MIRAGE LAKE RD BERRY CREEK K Permit fee $ 221.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SFX] Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New f I Addition ❑ Remodel ❑ Uti lities ❑ Installation❑ Other Describe work: 3RD RENEWAL OF BP#1848- 89 —�18T,/,i51¢9 _9.Q,gn/12m-91) Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 Main service 200A TO 1000A1 37.50 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. - License No. Classification 1, 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 fo his eason DWELLING OCCUP.e\ NEW CONST.OR ACDNS, / ( ACC. BLDGS. / 3.6Csq.ft. NEW CONSTFt ULTI.OUTLET NON•RESI BRANCH CIRC ITS @ 5.00 POWER APPARATUS & (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 76d FIXED APPLNS. OR Ex. Occup. OUTLETS IRESID.1 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. byirin g 15.00 Permit Fee $ or -— WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury check one): ❑ The permit is for $100.00 va ua Ion 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 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. Contractor MECHANICAL PERMIT Filing Fee 1 15.00 Heating Cooling g Hood 6.50 IVentilation perrnit 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. I 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 ainst said County in consequence of the granting of this permit. //�� K Date `q"1f7 - l Z Signature of plical — n r Contractor ❑ Agent ❑ An OSHA ion of structurestoverr 39stories ineheight Ions over deep and emolition or construct- Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE i TOTAL FEE $ 221.00 I HAz DFEEs IMP I FLOOD CDF I PARCEL I PO HD Iss This permit is hereby issued under the sions of the utte County ode and/or work 7,nat d ab which fe IRE F P BLI By PER RES Date applicable provi- resolutions to do j h e been paid. KS Date Receipt No. TI �� n E9 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT _ r u n COUNTY OF BUTTE - Department of Public Works 7 County Center Drive., Oroville, CA 95965 Phone: 916-538-7541 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 progessing 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. aterials for construction .of the proposed property improvement (yes or-.-no:)5. 2. I (have/have not) J� A\f G signed -an -application for a building permit . for the proposed work. 3.. I have contracted with the f lowing person.(fir to provide the proposed construction: Name Address City Phone Cqj3,ef,actors icense No 4.. I plan to provide portions of t is work, but Piave hired the following person to coordinate, supervise, and pro e the jor work: -Name Address Phone C o n_tractors: Lice e 5. I will provide some of work but I have contr persons to-providethe. work. indicated: Name Ad ess Ph Signed: Property Owner Social Security Numberl)- - - Date �►- �l'� _ City No. ,9ted (hired) the following ne Type of Work NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. ,COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER OWNER T. RA ZONING BUILDING PERMIT TEL HONE SO. FT. OCC. BUILDING VALUATION OWNER'S G 19Y S at 9*AJA CONTRAC 'S TELEPHONE CONTR AC O AILING ADDRESS ' Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing FeeLENDERS $ 155,00 Permit Fee y $ ARCHITECT OR ENGINEER LICENSE NO.- Plan Checking Fee $ bR ARCHITEC ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS tl Permit fee - $ 221.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 1 7.00 USE OF STRUCTURE SF [ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New! Addition RemodelC Utilities❑ Installation❑ Other Describe work:_#14}1d#il,.. ♦ r 1 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 1 8.50 Main service 200A TO IOOOAI 37.50 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. License :Jo. Classification Lf 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 r NEW CONST. (DWELLING OCCUR.&\ OR ACDNS. ACC. SLOGS. // 3.60sQ.ft. NEWCONSTRMULTI-OUTLET NON .RESI BRANCH CIRC ITS @ 5.00 POWER APPARATUS e (SINGLE OUTLET CIR. Ex. OCcup(OUTLETS OR FIXTURES 20 @ 76d FIXED APLNS. Ex. Occup. OUTLETS (RESID,IREA.T I 3.00 Temporary service 15.00 ' Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ — 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 Ccnsent 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 becomesubject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FilingFee.. \ 15.00 Heating ! Cooling g i Hood 6.50 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. I 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. X Date Si natuA Applicant re of g pp - Owner Contractor Agent ❑ ❑ ❑ 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 S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 221+ 00 HAz 1 DFEES I IMP FLOOD COF PARCEL I PD 1 HD 1 ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS ate Receipt No. 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: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 61-44-03 ZONING �I BUILDING PERMIT OWNER BARRY RU'RANOFF TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS Rd-' Bprry Crepk, CA 1st Renewal CONTRALTO SHAME TELEPHONE nwnpr CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER Nnnp UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 1000 Permit Fee i $ 00 ARCHITECT OR ENGINEER Nnnp LICEN206 SE NO. Plan Checking ee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit tee $ 216.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5,00 Each pas water heater or vent 5,00 USE OF STRUCTURE SF P Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is 10.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other [2 Describe work: lst Renewal of #18L8-8() Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP ORV OR LESS10.00 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.SINGLE License No. Classification 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 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUPM ORADDNS. ACC. BLDGS. , 2/z2sgft NEW CONSTR ULT' -OUTLET NO N.RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS &) OUTLET CIR. Ex. Occu Occup(OUTLETS OR FIXTURES 20050tBAL030 FIXED APLNS. Ex. QCCUp. OUTLETS IPRESID IREA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 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. 1 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 cr this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling 9 Hood 3,00 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. I 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. X t? f�I Date ��—/� ��D Signature af' �!pplicant — ' o ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 storie in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 21b.00 E HAZ CUA PARK SCHL I PAR PD HD IssuE Th;s permit is nereby issued under sions of the Butte County Code and/or work iCate d above for which f DIR OF PU L PERMIT EXPIRES Date the applicable provi- resolutions to do s have been paid. WORKS Date 10/10/90 9 13 91 ani Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE- Department. of Public Works 7 County Center.Drive, Orov-,ille, CA 95965 .. OWNER -BUILDER VERIFICATION Attention Property Owner: Phone: 916-538-7541. 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 or no) 2. I (have/have not) 1A�� signed an appZicatlon for a building permit for the proposed wore. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address _ _ City Phone Contractors 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 Address City Phone Contractors License No.. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Property Owner Social Security Numb Date - NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. . This verification must be completed and returned to our office before we are per- mitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT s.aat ;71ra C:E- NUMBER y— OW 211NIN BUILDING PERMIT SQ. FT. OCC. BUILDING VALUATION JnR t TE EP NE OWN R'S Al N,��qOORE. CONTRACTOR'S NAME 0- .'l TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace Total Valuation $ CO UCTION LENDER UNKNOWN LENDER'S MAILING ADDRESS ARCM TEC( OR ENGINEER LICENSE NO. Filing Fee $ 10.00 Permit Fee Plan Checking Fee $ (�061 ego a RCHITECT OR ENGINEER'S MAILING ADDRESS BUILDING ADDRESS / Ot L� Energy Plan Checking Fee $ Penalty Permit fee $ $ PLUMBING PERMIT Filing Fee 10.00 ' LOT NO. SUBDIVISION NAME PARCEL MAP Each Trap 2.00 Solar or heat pump water heater Water piping 20.00 5.00 Each qas water heater or. vent 5,00 USE OF STRUCTURE SF Duplex[] Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G I W O.00e TYPE OF WORK New ❑ Addition ❑ Re pdeI ❑ Utilities ❑ Installati/on❑ Ot r Describe work: b1" / QCYC1ttza Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8000 AMP ORV OR LESS10.00 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. License No. Classification ❑ 1, 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 Main service EA. ADD'L 100 AMP 2,50 NEW CONST. DWELLING occuP.e OR ADDNS. ( ACC. BLOCS. '/z¢sgft NEW CONSTRMULTI-OUT LET NON-RESIO BRANCH CIRC ITS 2.50 ea (POWER APPARATUS tl\ SINGLE OUTLET CIR. / EX. OCCUp(OUTLETS OR FIXTURES 20@50t BALM 30 FIXED TS (RES. OR EX. OCCUp. APPL (RESI'D.) ID.) EA.) Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 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 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. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 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 Count or Butte to enter upon the above-mentioned property for inspection purposes. y I 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. XThis Date Signature of Applicant — Owner ❑ Contractor ❑ _ Agent ❑ 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 S Energy Inspection Fee $ 75E TOTAL FEE $ O`f c D� PARK SCHL FLD PAR PD HD IssuE permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date / C :� —/T,G] I Receipt No. WHI♦E-D.P.W.. YELLOW-ASSESSO, PINK-I49Pe CTOP, GOL R DENOOD-APDL I CANT 'COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, California 95986 - Telephone: 910/538-7541 APPLICATION AND PERMIT PERMIT O 3 61-44-03 U BUILDING PERMIT wN R BARRY RUBANOFF ¢ H 0 NIV SO. FT. OCC. BUILDING VALUATION 2ND RENEWAL OWNER'S MAI ING ADDRESS 180 MIRAGE LAKE RD BERRY CREEK, CA 95-916 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NON UNKNOWN Total Valuation $ Filing Fee $ 1000 LENDER'S MAILING ADDRESS Permit Fee @i FEE $ 206.00 ARCHI��T��ECT OR ENGINEER ONE LICENSE NO. I Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHIiTECT OR ENGINEER'S MAILING ADDRESS - Penalty $ BUILDING ADDRESS 180 MIRAGE LAKE RD BERRY CREEK Permit fee > , $ `216.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 1 2.00 Solar or heat pump water heater LOT NO. SUBDIVISION NAME PARCEL MAP Water piping Each qas water heater or vent USE OF STRUCTURE SF MK Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets A10-00ea� Building sewer Mobile Home S G W TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other U Describe work: 2ND RENEWAL 012 BPil-848-89 Penult Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 LE00V ORSS Main service 100 AMP 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Buslnes$ and Professions Code and my license is in full force and effect. License No. Classification. 1, 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 CONST. DWELLING OCCUP.5d OR ACDNS. (ACC. BLDGS. , ft h(Csga NEW CONST R. ULTI.OUTLET NON•RES'D BRANCH CIRC ITS 2,50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES eALo90 30 SAL@ FIXED APPLNS. OR Ex. Occup. OUTLETS (RESI0.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �yirin 9 15.00 Permit Fee $ 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. Notto 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. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 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 County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte againstz. all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. _ Signature of pplicant — O Contractor ❑ Agent ❑ An OSHA permit is required f e Cavations over 5'i)" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ P.ATCUTA CONSTYPE TOTAL FEE $ 216.00 PARK I SCHL I FLD cDF PAA I PD 1 HD• ISSUE. This permit is hereby issued unaer the applicable provi- sions of the Butte County.Code and/or resolutions to do work indicated abor which fees have been paid. D)/�FROF PUBLIC WORKS Date PERMIT EXPIRES Date 9/13/92 ,�By Receipt No. kO745T7 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Dr iveQroville, CA 95965 Phone: 916-.538-7541 '. 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 improvement (yes or no) 2. I (have/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 Address City Phone Contracto ense No. 4. ,I plan to provide portions of this work, but I hie hired the following person to coordinate, supervise, and p ide the major,Gfork: Name Address Phone Contractor City nse No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . ,Phone Type of Work Signed: Property Owner U.SGw Social Sec rity Numbe Date _ /D ' NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. T-11 COUNTY OF BUTTE - DEPARTM4ENT OF PUBLIC WORKS PERMI N .4L7 County Center Drive - Orovllte, CalifIF_ornia 95965 -Telephone: 916/538-7541. f V t APPLICATION AND PERMIT / UUU �0 ASS SS R PA C NUM R� P- ZONIN BUILDING PERMIT ow E rl'iPA04101,_ E SQ. FT. OAC. BUILDING VALUA ION p WNER'SM LIN ADD SS 1 f r NTRACTOR'S hfAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace / , CONSTRUCTION LENDER UNKNOWN Total Valuation $ c Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ o ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee Energy Plan Checking Fee $ 1 CIE) ARCHITECT OR ENGINEER'S MAILING ADDRESS /` Penalty $ BUILDING ADDRESS Permit fee PLUMBING PERMIT Filing Fee 1 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 S� Each qas water heater or vent 5.00 USE OF STRUCTURE SF k Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 S• Mobile Home S I G I W O.00ea TYPE OF WORK New 1� Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: d A t - j Permit Fee $ 44 dQ Contractor ELECTRICAL PERMIT Filing Fee '.0.00 Main service 8001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): El am I'icensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 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 CONST. I DWELLING OCCUR.e` OR ADDNS. % ACC. BLOGS. / , vzsq ft C NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. I Ex. OCCUp OUTLETS OR FIXTURES EAL0S30 FIXED APNS Ex. OCCup. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring . g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): The permit is for $100.00 (valuation) or less. r_,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 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. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 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 County of Butte to enter upon the above-mentioned property for inspection purposes. I 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 inst said Count in consequence of the granting of this permit. X Date Ignature of A cant — Own e tractor ❑ Agent ❑ An OSHA permit is required for ezca i over 5'0" deep and demolition or co truc,,{ - ion of structures over 3 stories in height U9 Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE&Y-1 r $ RC P. KK5 CON ST.TYPE SCMO rico PARCE PD NO 139U E/ 'V// This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which I EC OR F PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date i 3 W l2 Receipt No. WNITE-O.P.W., YELLOW-ASOCeSOR. PIN IN P C OR. GOLDENROD -APPLICANT COUNTY+OF BUTTE - DEPARTMEOkR' PQIBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT 'APPLICATION DATA SHEET ' `T 5 UA / 1 OZ -,Permit No. / OWNER Yi�iJ .A.,P., Noj-,o-L -4�/ Proposed Building Used 0 I13 SL Building Inspecto�rw_ Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have u . mitted..................................... 2. Plot plans i replicate, igned by preparer of plans........ - l -e Complete plans in / ti�fl�cate, signed by preparer of plans .. 6 - 1�j - 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation _instruction���'- ��......................................... C�� Fees of $ — 10. Chico Urban Area fees paid C (� 03 _ ........................................ 11. Park fees paid ..................................................... a 12. School, District fees paid ................. 13. Sanitation approval from i ! -' Health Department Cl—t* > 14. City of Chico plumbing permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre -Inspection forrequired .... Pre-Inspec. request to Building Inspector (Date) 20. Contractor's license information (No., Name Style, Classification) ....... ' 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ...... • �23. Recorded copy of Agricultural Acknowledgment Statement ............ Letter of.si nature authorization ..................................... .w 26. - , w Wheou issue the permi�., process as follows: Mail to owner. Mail to contractor. .�� and hold for pickup=a office. Deliver w/inspector. Other Applicant�� _PP/ A6 Date ef Copy of plans sent Health Dept., Fire Dept„ Other " Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. c 2. Additional itams/ulred): e A C - Contractor, designe , own was advised of above required data by_phone—mail 4counter byDL4 —date 6~G (L� o Contracto , designe , owner, was advised of above required data by_phone ma c ntef by-�9date Plans checked by _DC e-- Date (10-15 10 Plans approved by Date a 3 Sets of plans on hold in File cabinet AsP ffolgerd Copy—DPW / TO Buildina Department FROM:., Environmental Health SUBJECT: Sanitation Clearance ci Dr, J f Owner. Location AP# Plan Approved for.: Sewage Disposal �_ Water Supply Hold final for: Water Supply Final c_earance O.K. for: Water Supply Clearance for bedroom mobile ome. Other NOTE **� Sanitarian Date e e COUNTY OF BUTTE.- Department_of .Public Works 7 County Center -Drive, Orovi.11e, CA 95965 Phone: '916-538-7541' 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 improvement (yes or no.) 2. I (have/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 Address _ City Phone Contractors 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 Address City _ Phone Contractors License.No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed.: Property Owner _ Social Security Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. 7 COUNTY OF BUTTE - DEPART2�`ENT OF PUBLIC WORKS 7 County Center DrV Croville, CA 95965 PHONE: 916-538-7541. 5 DATE 6/13/89 Barry Rubanoff RE: Building Permit #1848-89 Star Route, Box 27D Berry Creek, CA 95916 A.P. # 61-44-03 With reference to the above subject: [� Attached is: Application for permit w �.. P Mobilehome Utilities Inxastallation�.Sheet Building Plans Mobilehome Installation Information Sheet Engr. Calcs Typical Plan Sheet Owner -Builder Verification Form List of Codes Enforced OTHER L1 We need the following information: Permit application signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. :Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement. Complete plans in including plot plans. Plot plans in Structural details in Complete plans and calcs in by registered engineer or architect. Energy design including Street and drainage improvement plan approval from Land Development Section (DPW). __ sets of plans in accordance with the changes marked in red. Sanitation approval from Butte County Health Department at: 196 Memorial Way,' Chico ' 7 County Center Dr., Oroville Skyway & Elliott Rd.,.Paradise Planning approval from Butte County Planning Department, 7 County Center Drive., Oroville, for Completed Owner -Builder .Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. X OTHER Provide copy of recorded gift deed or contact Land Development section .of Public Works for certi icate ot comp lance or parcei creation. Should you have any questions concerning the above, please contact this office.. Yours very truly, William Cheff Director of Public Works .F. Glander JFG/aj Chief Building Inspector 7 County Center Drive - Orovllle, Callfornia 95965 - Talepncne: 916/538-7541 APPLICATION AND PERMIT A33Z03 R PAA7=NUM5ZFII Z NIN BUILDING PERMIT OWNER, 61-44-03U r i HONi9 SO. FT, OCC. BUILDING VALUATION OWN&RR'3 MAILING AOOR633 CONTRACn( OR'3 N��A���M ��J.���,t cm-01, 1� l,! I'' 01 AXE A- r TfiLi:PHON6 i i IVilkri -Ul CONTRACTOR'3 MAILING AOORE33 OWER Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation S Filing Fee 5 '0.00 LENDER'S MAILING ADDRESS NONE, Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan CheCKing fee, Energy Plant"CtreC Wd Fee $ S ARCHITECT OR ENGINEER'S MAILING ADDRESS KCR? Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Fi ' 10.00 180 �URAGB LAKE RD BERRY CPMK Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SU801 VISION NAME PARCEL MAP Water piping Each oas water heater or vent 5.00 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other - SPECI FY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobi le Home S I G I W 110.00 ea TYPE OF WORK New Addition C] Remodel❑ Utilities[ Installation❑ Other❑ Describe work: !!� 2ND UNCRAL OF BP#164$--89 Permit $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 3rV9-nV Main service 8100100'AMOPR ORRss LESS 10•00IST Main service EA. ADO•L too AMP , 2.50 I 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. License No. Classification. 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 R�ON( IcuP.a'OAON.DEL8LD I21_¢softi NEW CONSTR. • ULTI-QUTLE- NON.RESIC. BRANCH C:RC' ITSPOWER j2•SOeai APPARATUS h` (SINGLE OUTLET GIP. J Ex. Occup(OUTLETS OR FIXTURES I;:L., , FIXEEx. OCCuo. OUTL aS PIRESID IREA.) I 2.00 Temporary service • 10.00 Mobile Home Facilities 15.00 j Misc. ';lirin g ,5.00 Permit Fee $ 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 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. Contractor MECHANICAL PERMIT FiiingFee 10.00 Heating Cooling j Hood 3.00 Ventilation Permit Fee $ Lcontractor 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. I 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. :t Date ii9nature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA oermlr is required for excavations over 5'0" deep and demolition or construct- nn at srructures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee S OCC I CONSTTYPE - TOTAL FEE 5.1` tiAL ' CUA I AHK I DCHL_ �O I COF " 11'F* -C - Th's permit is hereby issues uraer sions or the Butte County Code and/or work Indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date 0113/02 the appiicaote provl- resolutions to co fees have been paid. WORKS Date eceiot No. j �I S•O.r.'v., 'r,LLJW• 5a1!370A, 2141 45P!COR, :OIG CMPOa-AP-IICAMf L COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDINGZDIVISI7 CountyCenter Drive • Oroville, California 95965 • Telephone (530) 538 -NO. (Rev.12/96) APPLICATION AND PERMIT`� ASSESSOR PARC _NUMBER 061-44-0-003 ZONING BUI G PERMIT OWNER RUBANOFF, BARRY TELEPHONE 589 4102 SO. FT. OCC. BUILDING VALUATION OWNERS MAIUN3 ADDmPO BOX 112 BERRY CREEK, CA 95916 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS NAILING ADDRESS CONSTRUCTION -ENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 15.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 180 MIRAGE Energy Plan Checking Fee $ BERRY CREEK $ PERMIT FEE $35.00 LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF J7 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 ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: 3RD RENEWAL OF 95-2324 Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I s I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service zo.A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commercing 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 WORKERS' COMPENSATION DECLARATION 1 hereby a firm 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 Main Service 200A TO 1000A 46.00NEW CONST. DW ELLNG UP. OR ADDNS. 8 ACC. eLDS. SO 3.52FT. NOµgeSID. T. MULTI -CUTLET @7.50 APPARATUS 8 SINGLP OUTLET CIR. Ex. Occup.OUTLET OR FIXTURES 20 @ 1.00 �,L @ .50 Ex. Occup. ours RESIDUNS.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE _ 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.) I ceitify 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 wod(ers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. �� / L X Date Sigrfature o plicant- Ow a Contractor ❑ Agent An OSHA per It is required for c a ' ns over 60" deep and demolition or construction of structuees over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. 11 TOTAL FEE $ 35.00 HAZ. D FEES IMP FLooD CDF PARCEL I PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON ;4�ai the applicable provisions Resolutions to do work been paid. �--z1- l _ Date ate Receipt No. WHITE-D.D€S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 1 � I � I I �I �� �I I � i ' I I � - ---- _ , � i _-._____- -- OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder' building permit has been applied for in your name and bearing your Si Please complete.and return this information at your earliest opportunity to avoid unnec .. essarY delay in processing and issuing your building permit. No building permit -will be issued until this verification is received.; t� 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement YES NO O �?� 2. I HAVE HAVE NOT signed an application for a building permit for the ro p . posed work. 3. I have contracted with"the following person (firm) to provide the proposed construction;_ NAM E: ADDRESS: CITY. �s PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide of this `wor but I have ' p portions k; hired the'followiag person to 000rdiaate; supervise, and provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO.` S. 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'a SIGNED: PROPERTYOWNER: ,X SOCIAL SECURITY NUMBER: DATE: NOTE: This Owner -Builder Verification is required by Section 198.31 and 19832 of* California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER I OWNER BUILDER INFORMATION . .1 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 parry ofirecord on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible' liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should'. be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. T ♦ 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.r ♦ 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. -1 ♦ For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. -i 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. 1 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 sighed by property owners unless they are performing their own work personally. Information about licensed contractprs 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" Dn 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. r rely, Mic el C. Vi ira, C.B.O. M ger, Building Inspection NOTE. This Owner-Builder,lnformation is required by Section 19830 of the CalUbmia Health and Safety Coda OVER w- g--7 &ME; COUNTY 3UILDING DEPARTMENT APPPOVFn a P� 1-010 -71: -75V/S IS I-IA14 IfefemFv A/w Z,/ 10 ws- T -2) coo Y BUTTE COUNTY 8UILD[NG DEPARTMENT AppRpv •v �� tl ►� A��MpCNM �, L �A� 1� j `,4/, -- 11 25 i1i� N J i DItA �b vJ Pcu. ILI 000 � nn :N eko 910AI 6 Ivr, 3 - Sp-�- 71500 Psi �Ala' occ-,o wee h — IN% Il� j Q�pFESSIp\ Georgi No -24578 � rn i �9p CIVIL OF .. - .. ..{ O i �. ':i� R. x- o'S.t S ?. X.; ,. .,,.`e. .t• .?.. �-�u..�i.,- :2., , y, 4 � 1 a � ..� ,r 7 AL x � J V 5 »> �3r�ta � 4ti' �s � li • x �eQ z ANAL, WAle) �owt�2 VJPr►�. ��� r �5 .F� m I;R=Sup4 :Fw _ / � 00.22 x .. 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Sec. 91.2801 DIV. 28• REFERENCE STANDARDS DIVISION 28 - FOUNDATION AND RETAINING WALLS SEC. 91.2301 — GENERAL (a') Definitions. For the purpose of this Division, certain terms are defined as follows: Cast -In -Place -Pile. A concrete column cast in place without forms in an excavation. Clay. A fine grained Inorganic soil possessing sufflclent co- hesion when dry to form hard lumps which cannot readily be pulverized under finger pressure and when moist can be rolled into threads '% Inch In diameter, three inches long, which will support their own weight when suspended. Compact Gravel, Compact Sand, And Compact Silt. Deposits requiring picking or difficult hand shoveling for removal. Expansive Soil. A fine grained cohesive soil undergoing large volume changes with changes In moisture content, and when dry, cracking Into wide, deep blocks. The laboratory criterion for expansive soil shall be that a laterally confined undisturbed sample of soil or a sample compacted to 90% of the maximum density shall expand at least 5% from air dry at 100 degrees Fahrenheit to saturation (while under a normal load equivalent to 400 pounds per square foot. Fine Sand. Sand consisting chiefly of grain sufficiently large to be retained upon a No. 270 mesh sieve but passing a No. 60 mesh sieve. Footing. That portion of a structure whicn rests upon the foundation. Piles• caissons and piers shall be considered a por- tion of the footing. Foundation. The ground upon which a structure Is supported. Gravel. An uncemented mixture of mineral grains 'A Inch or more in diameter. Ground. The materials of the earth. Inorganic Loam. A mixture of sand and silt In nearly equal proportions, with small amounts of clay. Inorganic Silt. A fine grained inorganic soil consisting chiefly of grains passing No. 270 mesh sieve, and forming lumps when dry, which can be pulverized by the fingers, and when wet cannot be rolled into thin threads which will support their own weight when suspended. - " - ' i avel, Loose Sand. And Loose Silt. Deposits ca7lh re- movahle by hand shoveling. Metal -Cased Pile. Concrete pile in a driven metal casing. Peat. Peat, humus and swamp soils with a highly organic tex- ture and generally containing fibrous vegetable matter. Per Cent Compaction shall mean the dry density of the ma- terial as present in the fill divided by the maximum dry density as deten-nined in accordance with * ASTM Designation D1557. E. Pile. Column Inserted Into a foundation. Sand. An uncemented mixture of mineral grains less than '/i inch in diameter and retained on a No. 270 mesh sieve. Soft Clay. A clay which, when- freshly sampled, can readily be molded by light finger pressure. Stiff Clay And Stiff Stlt. A day or silt which can be removed by either picking or hard hand shoveling but which Is difficult to z;,id by finger pressure. Underpinning. Footing Introduced beneath an existing footing. • Excerpts from 1972 Edition. City of Los Angeles Building Code. VII -15 (b) Fills and Excavations. No fills or excavations shall be made In such a manner as to increase the stresses In or the pressure upon the foundation of any building or structure be. yond those permitted by this Code. (See Section 832 of the Civil Code of California for Rights of Coterminous Owners as to Excavations.) SEC. 91.2309—RFTAINiNG WALLS (a) Design. Retaining walls shall be designed to resist the later. al pressure of the retained material determined in accordance with accepted engineering principles. The soil characteristics and design criteria necessary for such a determination shall be obtained from a special foundation In- vestigation performed by an agency acceptable to the Board. The Board shall approve such characteristics and criteria only after receiving a written opinion from the investigation agency to- gether with substantiating evidence. EXCEPTION: Freestanding walls which ore not over 15' in height of base. ment wolfs which have spans of 15' or less between supports may be designed in accordance with Subsection (b) of this section. (b) Arbitrary Design Method. Walls which retain drained earth and come within the limits of the exception to Subsection (a) of this section may be designed for an assumed earth pressure equi- valent to that exerted by a fluid weighing not less than shown in Table 23-E. A vertical component equal to one-third of the hori- zontal force so obtained may be assumed at the plane of applica- tion of the force. The depth of the retained earth shall be the vertical distance below the ground surface measured at the wall face for stem de. sign or measured at the heel of the footing for overturning and sliding. (c) Surcharge. Any superimposed loading, except retained earth, shall be considered as surcharge and provided for In the design. Uniformly distributed loads may be considered as equiva- lent added depth of retained earth. Surcharge loading due to con- tinuous or isolated footings shall be determined by the following formulas or by an equivalent method approved by the Superinten- dent of Building. TABLE NO. 23-E Surface Slope of Equivalent Retained Dtaterial• Fluid WeightHoriz. to Vert. _. Ib/ft' LEVEL —'------- - - 5 to to 1 32 4 to l 3 to 1 35 2 to 1 38 1'A to 1 43 ct i 80 Where the surface slope of the retained earth varies, the design slope shall be obtained by connecting a line from the top of the wall to the highest point on the slope, whose limits are within the horizontal distance from the stem equal to :he stem height of the wall. (d) Bearing. Pressure and Overturning. The maximum vertical bearing pressure under any retaining wall shall not exceed that allowed in Division 23 of this article except as provided for by a special foundation investigation. The resultant of vertical leads and lateral pressures shall pass through the middle one-third of the base. (e) Friction and Lateral Soil Pressures. Retaining walls shall be restrained against sliding by friction of the base against the earth, by lateral resistance of the soil, or by a combination of th,� two. Allowable friction and lateral soil va:ues shall not exceed those allowed in Division 23 of this Article exc:•pL as provided by a special fry!:ndation investigatiun. When used, keys shall be assumed to lower the plane )l f-ic- lional resistance and the deuth of lateral bearing to the level of the bottom of the key. Lateral bearing pressures shall be assumed to act on a vertical plane located at the toe of the footing. (f) Construction. No retaining wall 'shall be constructed of wood. ZZZ coo moo �'4o FM TOA%V�� 07W144cr-f , "Oo ('01- 44-s" ". s7k-3�NOL 70QTF-O aa* A- ?AW10 i�Twz tom SATE n�2�G George 0l. �• \C �ti• z 1 cwr_ ' F CF CN V6616N cc x t k di n OZ -68 NPO..' t--� Was-; 100 4 V E S S1�•Y w 0 73 M sic", 1;1 NPO..' t--� Was-; 100 4 V E S S1�•Y w 0 73 M �tl:.-►� L00 v its moo 10 ® Z, oil oo LT Z� (o 9--ol-b \M LA 000 ccc oho 2 ci-1&,� SuOin>z, � P 0O�t� .T Z Ir 42.381 SO SHEETS S SOUARE I `2•JB1 100 SNEfiS S SOUwRt A 7..JB 2 Nf ETS S DARE Z i'L- 5b -*5' Sotto aekm ps (` A_ w% ol � e 4N J CON C C4 UA .. .i6A Css Nay^` I `77.: JBi787'. 30 SHEETS 5 SOUAPE 4 100 SHEETS 3 SOUAgE A �7.38V 700 SHF ET5 3 SOUARE 11 0 ;p 7b 2 c wow 14 z U-0 "T -3b N►C,, ZZ. 000 z �a 60rt.3 I I 9-Z-66 191i C�6� s olI I�'o %2,s = SIT (nj sr Z �E S`��►�. �cStGr�, Ass : f3As�� ESSIO,�A o Z 578 n °`07 .1 l OF ,U- w V ESS/ 50 CrLw 4578 u-6 Civil. OF CAO ooc N W okml J Os -�b kb"-: ?A&C"l ot%i OQ()kmmn zz 3933" sem' i July 31, 1990 Barry Rubanoff RE: Refund (Permit #1348-891) 180 Mirage lake Road (A.P. #61-44-03) Berry Creek, CA 9.5916 Dear Mr. Ruhanolff: With reference. to the above subject andyour request for refund of permit fees, before we can process this request we would need to review the property with you to resolve whether'' or- not a permit is regt:ired for the existing 14Ning Linit and if any work was done with the subject permit. Please contact this office at your earliest convenienc'e and arrange to meet a Building Inspector for this review. Should you have any questions concerning this matter, please contact this office. JFG:ds cc: Building Inspector r� 6 y`��� Yours very truly, William Cheff Director of Public Works J.F. Glander Chief Building Inspector - - �-�� --- -AZA >c -r-_- A - - - - - ' _- `-�.._ - -, _ _ _ ` - - - - - _ - _- - - -- - '-_ .. � - , �{�. J �' Lt•,,_.+tet.\ �.y., .T...�.� =+� � � � --. _ - X A lql� .......... `� � ` . � � � .. i � f> - � - .tri--_ �. 4,j` � � .� . �' m � . v--^ , . .. t �� � t � _ � t �. �`� ',' f - - - . � _ - r ' ti `� � ` . � � � .. i � f> - � - .tri--_ �. 4,j` � � .� . �' m � . v--^ , . .. t �� � t � _ � t �. �`� ',' f - - - . � _ - . 7 O `�� V"!' �7 V l 1.,� ► -"� ��Jti UCS ZZ 744417 f S l 1U C--ECIE L 1 z� c Owner: Permit No. ENERGY CERTIF ICAT ION LOCATION A.P. No. DESCRIPTION OF INSULATION ROOF Material Thickness(inches) EXTERIOR WALL Material Thickness(inches) CEILING Batt or Blanket Type Thickness(inches) Loose Fill Type Minimum Thicknes$(Inches) Area covered(ft.ZZ) 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 Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) Brand Name Number of Bags Wt. per bag lb. 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 in conformance with the State of California Ener& Requirements. FIRM NAME/OWNER STATE CONTRACTOR'S LICENSE NO. SIGNATURE OF INSTALLATION APPLICATOR DATE t I hereby certify the above.insulation and all required items as shown on the Building Department approved plans and attachments have been installed as required by the State of California Energy Requirements. All equipment, devices and materials -are of the qualityprescribed or are specifically approved by the State of California. FIRM NAME/OWNER (Please print) STATE CONTRACTOR'S LICENSE NO. SIGNATURE OF GENERAL CONTRACTOR OWEER DATE THIS,CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. January 1984 Ju eoutd* of ✓ fte OROVILLE, CALIFORNIA GENERAL CLAIM CLAIMANT: ADDRESS: CITY & STATE: IMPORTANT: SEE INSTRUCTIONS DATE OF CLAIM: ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT TOTAL I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this clam is true and �correct as stated. j j Dated this .. day of J. u. ........ 199...a Calif. .../y��.. .......F r Si re of Claimant I, *.he undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de- livered and that there is a Budget Appropriation Q or Specific Board Approval ❑ (Check one) for the same. Dated this .................................... day of ............................. 19......, at .............................. . Calif..................................................................................... Department Head or Authorized Deputy Dept. Exp. Cod eCode PAYABLE FROM ........................... .................................................... I............ FUND ............................................................................................ DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. INSTRUCTIONS to CLAIMANTS All claims against the county must be itemized, giving dates and character of service rendered or work performed, quantities, de- scription and unit prices of articles furnished or delivered. Claims must be certified by the claimant and submitted to the De- partment head for approval. Upon approval the Department head will forward claim to County Auditor for payment procedure. Do not file with the County Auditor first. Claims should be presented to officials for approval immediately upon completion of services requested or material ordered. Claims are paid every Tuesday; however, same must be approved by officials and in Auditor's office before preceeding Wednesday noon. Compliance with above will expedite payment of claim, failure to do so may delay payment considerably. Y COUNTY OF BUTTE - DEPARTr,ENT OF PUBLIC WORKS 7 County Center Drive, c.-roville, CA 95965 PHONE: 916-538-7541, DATE 8/10/89 Alan Brown RE: Barry Rubanoff Residence 1881 Robinson — Suite A A.P. # 61-44-03 Oroville, CA 95965 With reference to the above subject: L1 Attached is: Application for permit Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet Engr. Calcs Typical Plan Sheet Owner -Builder Verification Form List of Codes Enforced OTHER 1� We need the following information: Permit application signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement. Complete plans in , including plot plans. Plot plans in Structural details in Complete plans and calcs in by registered engineer or architect. Energy design including Street and drainage improvement plan approval from Land Development Section (DPW). sets of plans in accordance with the changes marked in red. Sanitation approval from Butte County Health Department at: 196 Memorial Way, Chico 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville, for Completed Owner -Builder Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. OTHER Should you have any questions concerning the above, please contact this office. 4 JFG/a j Yours very truly, William Cheff Director of Public Works .F. Glander Chief Building Inspector w Regarding retaining wall designs, provide additional information and/or make revisions as follows: Revise slope of grade on detail notin 2DmaxPerUBC 7009 and 7010. L,2/Revise flexure design of walls to comply with UBC Chapter 24. overturning stability moment.is taken about. base of footing - Revise. n-/ Calculate max. soil pressure at toe of footing. for each wall 5 Clarify reason fo 80 PCF E.F.P. ed at seven foot wall. :.�Include surcharge from wall above for lower wall as -required by location and height conditions. Resubmit details for revised wall design. ..w �� ,�?��•, .,:.,.yam Suite, Count LAND OF NATURAL WEALTH AND BEAUTY s� DEPARTMENT OF PUBLIC WORKS WILLIAM (Bill) CHEFF, Director 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 Telephone: (916) 53a-7'266 RONALD D. McELROY Deputy Director July 5, 1989 Barry & Caroline Rubanoff St. Rt. Box 27-D Berry Creek, CA 95916 Dear Mr. & Mrs. Rubanoff: RE: AP 61-44-03 Application for Determination At the regular meeting of 'the Butte County Subdivision Violation Committee held on July 5, 1989, the committee granted a conditional Certificate of Compliance for the above -referenced property. The conditions are: 1. Verify legal access to the parcel from a publicly maintained road. 2. Provide 2 -way traversable access to the parcel from a publicly. maintained road. There is a fifteen -day appeal period before this Certificate can be recorded unless the enclosed.waiver is signed and returned, waiving your right to appeal the committee's decision. If you wish to appeal the .decision, you must do so, in writing, to the Clerk of the Board.of Supervisors. If you have any questions concerning this matter, please contact this office. Very truly yours, William Cheff Director of Public Works hn Mend6nsa sistant Director JM/kk Enc. cc: Planning Department Environmental Health Department Building Department GEORGE ROBISON ATTORNEY AT LAW P.O. BOX 175 OROVILLE. CA 95965 (916) 533-9138 BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS attn: JOHN MENDONSA 7 County Center Drive Oroville, CA'. 95965 re: Conditional Certificate of Compliance. AP # 61-44-3 Dear John: August 31, 1989 Barry Rubanoff .has employed me to pursue obtaining a deeded easement over the as -built road serving his parcel. This has been started by contacting Mid Valley and Bidwell Title and by discussing.the matter with one adjacent property owner.. Other owners between his parcel and the county road will also be con- tacted. In addition, by his.signature below, Mr. Rubanoff will locate the center of the section, which is one of his corners, before commencing construction.. He agrees that the issuance of permits does not constitute agreement by the county that he has satisfied the condition that he show that the access being used is his deeded access and he acknowledges that he must pursue to completion either construction of access which meets the two conditions of the conditional certificate or prove that he has a deeded access over the as -built road and that the road meets the applicable standard. Issuance of permits does not relieve him 'of, those responsibilities. Issuance of permits is for his convenience in commencing construction and does not indicate completion of his obligations under the conditional certificate. Ve y truly ours, jl_ GEORU�ROBISON I AGREE TO AND ACCEPT THE FOREGOING. August 31, 1989 e__;7' BA Y , BAN FF -Darnfiart - --BroOn & Oijociatej A California Corporation Alan G. Brown CE 24578 Richard Barnhart LS 4202 1831 A Robinson Street P. Q BOx /576 Orovi/ie, CA 95965 9/6/534- 19/1 Thomas Odekirk LS 9981 Michael Evans VP CIVIL ENGINEERS . LAND SURVEYORS Thomas Finlayson LS 2900 July. 10, 1.959 Jim Glander Butte County Building Dept. #? County Center Drive Oroville, CA 95965 RE: :harry Rubanoff AP# 61-44-3 J Dear Jim: Wit - h , reference to the proposed retaining walls for Barry `:.fF, tiw, ad vr: c.ut :.i_ .. .t i ��: tre or_iainal around slope .t. ve' the upper wall. dc!es. not exceed2 2::1. If you have any quest o,ns, please feed free to call. Very truly yours, BARNHART-BROWN & ASSOCIATES Alan G. Brown Civil Engineer eGBf t 88-123 -Inc -.Jd)�dOM iln-k', :'o noo aa �0, 89-2'8.944 89-028944 ; R e c Fee .00 Total ,00 Recorded Official Records ; County of RETURN TO: B'u t t e PUBLIC W01113 Public Works Candace J. Grubbs ; Land Development Section Recorder 10:42am 2 -Aug -89 ; BG 1 CERTIFICATE OF COMPLIANCE Issued to: Barry and Caroline Rubanoff Star Route Box 27-D Berry Creek, CA 95916 This Certificate of Compliance is hereby issued by the County of Butte to certify that the land division which created the parcel of property identified below complies with the applicable provisions of the Subdivision Map Act and of Chapter 20 of the Butte County Code. 1. Property location: on the west side of Mirage Lake Road approx. 1100 ft. north of Oroville-Quincy Highway. Lake Madrone area. 2. Assessor's Parcel Number: AP 61-44-03 Description : A1.1 that certain property located in the County of Butte, State of California, more particularly described as follows: The East half of the Northeast quarter of the Northeast quarter of the Southwest quarter of Section 14, Township 21 North, Range 5 East, M.D.B. & M. Together with rights-of-way of record recorded in Book 2730 of Butte County Official Records at Page 644. Issuance of this Certificate is conditional upon the following conditions which have been imposed pursuant to the Butte County Code Chapter 20-167 and Government Code, Section 66499.35 (b), to protect the public health and public. ty: 1.. erify legal access to the parcel from a publicly maintained road. 2, ,Provide two-way traversable access to the parcel from a publicly maintained road. county of Butts - Subdivision Violation Committee LA END OF DOCUMENT END OF DOCUMENT 5/89 RESIDENTIAL PLAN,CHECKING GUIDE MISCELLANEOUS ITEMSTO.LOOK OUTFOR (CONT'D) 4.�terior plaster - weep screeds (Sec. 4706). 5.�xoper roof pitch for roof covering -(Chapter 32)... 6... -"Roof covering .type - -(fire haza.*rd).. 7,el"Rafter ties or bearing ridge.beam. 8,�arage door or porch header sizes., 9,0equate bracing,. .1Q' Living area over garage - complete 1 -hour separation required on garage side 'Acluding supporting walls and posts, etc.. . I -J-- - 1716). 1.r',3wo exits,on three-story dwellings (Sec. 3.303 & see Mezannines- 1_2�_,�tic access and ventilation (Sec. 3205)., 15.,Underfloor access and ventilation (Sec. 2516). I< Combustion air for fuel burning appliances. requirements on duplexes. ,,Noise 16 Adobe soils - special foundation design. C�v taining walls requiring design* 1usual shape, size, or split t level house requiring lateral design. &.�� 1�f'. Flashing at all,,x e for openings. W PL SNOW04 "S.Reab R C-oFC- 16-r S7AOAIO -T-S OF Pt�44't4 WF�LL Lc S ALL HEWS P 0 ed �' A k. /q 5/89 RESIDENTIAL PLAN CHECKING.GUIDE. (S.F., DUPLEX & MISC. ONLY Bldg. Permit # /e4.16- 6 OWNER �ARR� 1��4/`10F1� A.P. # GENERAL. ! �Zoning requirements.: (sideyards Valuation. P1 ns signed by designer. ergy Design and Compliance. isting violations on property. Items on data sheet. and number of permitted living units). PLOT PLAN omplete parcel size and dimensions. etbacks, sideyards, easements, etc. Other buildings or structures. *.FAU rading, fills, drainage. lood hazard.pecial conditions on creation map or compliance document. & FAS road setback. FLOOR PLAN /Z Complete to scale plan with dimensions. E: Required windows for light and ventilation (Sec. 1205). Required windows for second exit (Sec. 1204). Skylights (Chapter 34 & Sec. 5207). Sf Human impact glass (Sec. 5406). Y Required room sizes, ceiling heights (Sec. 1207). FCIs in baths, garage, and exterior outlets (Article 210-8). �: Light fixtures, switches, receptacles, and exterior receptacles for maintenance /of mechanical equipment. g/ Locations of water heater, heating and cooling equipment, other electrical or l�as equipment, and plumbing fixtures. arage firewall, door size, and closer (Sec. 503(d)(3)). 1 - 3'0" exterior exit door (Sec. 3304(e)). T'2/.oFireplace and wood stove location, alcoves, and clearance. 13: Smoke detectors (Sec. 1210). STRUCTURAL DETAILS K�Voundation plan complete enough to construct building. 2 Floor construction details complete enough to construct building. /� Elevations and wall construction details complete enough to construct building. 4�/Roof construction details complete enough to construct building. Y Fireplace construction details and calcs if necessary. MIISCELLANEOUS ITEMS TO LOOK OUT FOR r/(Guardrail Stairway details: landings, rise and run, head clearance, handrails (Sec. 3306). details (Sec. 1711 & 3306(j)). k Brick or stone veneer (Chapter 30). l� COUNKfY GE BUTTE - DEPAR` I.,r,'l7C OF PUBLIC. WORKS ". 7 County Center Drive, 0roville, CA 959965 P: COUNTY OF BUTTE - DEPARTT;ENT OF PUBLIC WORKS 7 County Center Drive, C:oville, CA 95965 PHONE: 916-538-7541. DATE 6/20/89 Barry Rubanoff RE: Building Permit #1848-89 Star Rte. Box .270 Berry Creek, CA 95916 A•P.# 61-44=03 ; With reference,to the above subject:` L� Attached is: Application for permit Building Plans Engr. Calcs Owner -Builder Verification..Form Mobilehome Utilities Installation Sheet Mobilehome Installation Information Sheet Typical;Plan Sheet List of Codes Enforced OTHER , L�[ We need the following information: Permit application signed and completed where indicated with -.all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Ipsurance or check exemption statement. Contractor's License Law information or' -check exemption statement. Complete plans in including plot plans. T Plot plans in Structural details in Complete plans and calcs in by registered engineer or architect. Energy design including Street and drainage improvement plan approval from Land Development Section (DPW). sets of plans in accordance with the changes marked in red.. Sanitation approval.from Butte County Health Department at: 196 Memorial Way, Chico 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville, for Completed Owner -Builder Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. complete site plan with all dimensions and all structures or areas dd allPd C),it- Mirrage Lake Road does not seem to be in the same location as exceed 2 to 1. (Please have Retainin wall does not_s_e_em to be on lot._(P_l.ease. ver-ify).__ ._ C Provide co of recorded gift deed or contact Land Develo_pment}Secti ----------------------- /of ubric Works -for -Certificate of Com fiance for parcel creation./ - .Shoul ou have any questions concerning the above, please contact this office. JFG/aj Yours very truly, William Cheff Director. of Public Works .F. Glander���,,.` Chief Building Inspector LAND .OF NATURAL WEALTH AND BEAUTY . DEPARTMENT OF PUBLIC WORKS WILLIAM (Bill) CHEFF, Director 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 Telephone: (916)..... 538-7286 O RONALD D. McELROY August 9, 1989 Deputy Director Barry.and Caroline Rubanoff RE: AP 61=44-03 Star Route Box 27-D Certificate of Compliance Berry Creek, CA 95916 Dear Mr. and Mrs. Rubanoff: Enclosed please find a -copy of the the Certificate of Compliance (since you _have already picked up the original at this office) which was recorded by the Butte County Department of Public Works in the office of the Butte County Recorder on August 2, 1989. The Recorder's Serial Number is: 89-2.8944. If you have any questions regarding this matter, please contact this office. Very truly yours, William Cheff Director of Public Works hn Mendonsa ssistant Director JM/ds attachment cc: Building Department Environmental Health Department L I ` A 9-028944 ; R e c Fee e ;r.Ou S Tota 1. .00 Recorded ; Official Records County of RETURN TO: Butte PUBLIC WORKS Public. Works Candace J. Grubbs ; Land Development Section Recorder ; 10:42am 2 -Aug -89 BG i CERTIFICATE OF COMPLIANCE Issued to: Barry and Caroline Rubanoff Star Route Box 27-D Berry Creek, CA 95916 This Certificate of Compliance is hereby issued'by the County.of Butte to certify that the land division which created the parcel of property identified below complies with the applicable provisions of the Subdivision Map Act and of Chapter 20 of the Butte County Code. 1. Property location: on the west side of Mirage Lake Road approx. 1100 ft. north of Oroville-Quincy. Highway. Lake Madrone area. 2. Assessor's Parcel Number.: AP 61-44-03 i Description : All that certain property located in the County of Butte, State of California, more particularly described as follows: The East half of the Northeast quarter of the Northeast quarter of the Southwest quarter of Section 14, Township 21 North, Range 5 East, M.D.B. & M. Together with rights-of-way of record recorded in Book 2730 of Butte County Official Records at Page 644. Issuance of this Certificate is conditional upon the following conditions which have been imposed pursuant to the Butte County Code Chapter 20-167 and Government. Code, Section 66499.35 (b),,to protect the public health and public safety: , 1. Verify legal access to the parcel from a publicly maintained road. 2. Provide two-way traversable access,to the parcel from a publicly maintained road. County of Butte . Subdivision Violation Committee .END OF DOCUMENT -fl-1000 A F ?5o " 0.030 5311r, 0, (e-2 l Z-, IZXS�EL- 0,625 -/ Z ,�aDOo o, q07,<,0. � `f v p� r�siv� 0r Alf 6?v -#6G /6eoc . PiD= 3906�� 333 �2es�, l Am X L;--7-p-ooc=- /.s "ell-�G 7. l� gwrTr�:e-5;Te5 /> 1 -� N ., ,; .. �, .. . .� .. , .I eRESIDENTIAL r061-44-0-003 92-4162 B RUBANOFF, Barry i 180 Mirage Lake Road, Berry Creek i (add 2 open decks/SF) 9� 0 JOB FINALED (Date) Signature J=OK O = Not OK Not = Not Ready MOBILE 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/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /"L"ft. / /"Nat. or/ /"L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date 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 5. Drain; MH Test -Fall -Flex Connector & Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 1C. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 s' 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; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beam s-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 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, Distances-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 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK O = Not OK = Not Applicable Not Ready RESIDENTIAL (; = Date UNDERFLOOR (Plans) OK except h'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-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except P's -- ----16. Water Htr.: Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection --- 18. O.W.V.; Test -Fittings & Anchor -Nail Protection - -------------- 19. ------- 19. Shower Pan; Test. First Floor -Tub Access --- --- - -- 20. Test Tub & Shower, Second Floor -Tub Access - - 21. Gas Pipe: Size & Anchors - - -- ---------------------- Date ----------- - ------Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except ft's 22. Fixture & Transformer Clearance -Ins. Protection --------------------- ----------------------------------------- - - - 23_Elec_Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of_Conductors-Stapled 25. Romex Installed Close to Edge of Studs & C.J. --------------------------------------------------------- ---- 26. Equip. Ground made'up w/Meth. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI -------------------- ----------------------------------'-------------- 28. Subfeed Wire Size r r ga. Cu or AI-A.C. Wire Size ! ! ga Cu or AI 29. Range Circ. / / ga. Cu or AI -Oven Circ. r / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No ----------------------------------------------- 30. Service -Riser Conductors & Ground -Main Disconnect ---------- - --------- -------------------------------- 31 Equip Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light --------- ---------- -- -- ----- ---------- ---------- -- 33. Smoke Detector ------------------------- --------------------------------------------------------- Date Card B-1 Date Card B-1 ---------------- -------------------------------------------------------------------- Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except h's 34. A. C. Ducts Insulation & Support 35. Vent -Fan:-Exhaust - - Exhaust above - insulation ------------- ----------------- ----- ----- ----- ---------- --- 36. Condensate Drain & Overflow: Size & Grade 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet -- ------ ---- -- -- ------------------------------------------------ -------------- 38.- Attic -Access-&- Platform if Furnance in Attic ----------------------- ---------------------------------------------------------------------------------- Date Card -B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except ft's 39. Sils. Proper Material & Anchors ------- ------ -------------------------------------------------------------------- 40. Walls Studs -Nailing. Spacing & Bracing -Plates -Sound -- - ---------------- ---------------- -------------------- -- - 41. -Bearing-Walls -over-Girders--& -Floor Nailing ------------ - ------------------------------------ -------------------------- 42. Draft Stop in Walls (rat proof) - - ------------ --- -------------------- ---------------------- ------------ 43. Fire Stops: Furred Ceilings -Stairs -Chases -Tub ----- -- ---------------------------------------------------- 44. Headers & Beam -Size & Bearing 'in& & Duplex) Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties -Pu rlin-root Bra c-Truss-Shthng. -Ring. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52 Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers ------------- --- _ 55. Siding -Nailing Veneer ___________ 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access _ 57. Glazing Area -Glass Protection -Skylights- Plastic -- -_ 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows ------------------------- - Date _ _ Card B-1__ _ Date Card B-1 Date - Card B-1 - Date Card B-1 Date FINAL (Plans) OK except h's 61. Ext. Steps -Door & Sidelight Protection -Landings --- --------------------- 62. Smoke Detector -------------------------- 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa ------------------------------- 66. Elec. Trim & Subpanel: Breaker Sizes & Labels --------------- -------------- ----------- - ------------ 67. Stairs -&-Rai-Is 68. Fireplace or Stove: Clearances -Hearth ---- ------------------------ 69. Elec. Outlets at Wood Panel: Int. & Ext. --------------------------- - 70. ---------------------------70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance -------------- ----------- ----- -- -- ------------------- _71.- Elec. Outlets & Receptacles at Kit. Counter 72. -Garage -Fire Door: Swing -Landing -Closer 73.--A.C.-Duct in Gara a -Damper 74. Wtr. Htr.: Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage: Above Floor -Meth. Protection 75. Plb.. Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 7;. Insulation -Foam -Looked in Attic ❑ Yes ----------------------------------------- - 78. Guard Rails & Deck Construction -Post Caps --------------------------------------- ___ 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.: Drive ❑ Yes ❑ No; Walks Cl Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco: Brown -Finish ----------- ------------------------ _________ __82. A.C. Unit: Disconnect. Electrical, Plumbing 83. Vents Above Roof: Plbg -Appliance-Fireplace.-Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing ------------- - --------------------------------- 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground ------------------ 86. ------- 86. Ventilation Throughout House ----------- ---------------- 87. Glass Protection ------ 88. Corrections from Previous Inspections - ----- -------------- ---- ----- ------------------- 89. Gas -Test- MetersTa99ed; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval --------------------------------- ------ --- 91. Ener Compliance Certificate -Other Certificates ------------------------------------------ ---- - Date Card -1 Date Card B-1 ------------------------------------------ ---- Date Card B-1 Date Card B-1 Date ca -rd -B-1 Date Card B-1 Comments at Final: COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovi,lle, C'Alifori is 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. 2-4162 ASSESSOR PARCEL NUMBER 061-440-003 OWNERSQ. BARRY RUBANOFF ZONIN TE���H�t�F02 C}l�J BUILDING PERM( FT. OCC. BUILDING VALUATIO , OWNER'S MAILING ADDRESS 180 MIRAGE LAKE RD BERRY CREEK 95916 p 312 0 2104 ' CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ 45.00 ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ 22.50 ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING180 MIRAGE LAKE RD BERRY CREEK - Permit fee $ 82.50 PLUMBING PERMIT Filing Fee 1 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDI VISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SFO Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition}f Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: 2 OPEN DECKS Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El am licensed under provisions Of Chapt. 9, Div. 3 of the BUS Ines$ and Professions Code and my license is in full force and effect. License No. Classification 1, 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 Main service 200A TO I000AI 37.50 NEW CONST. / DWELLING OCCUPM OR ADDNS. l ACC. BLDGS. 3.60sq.ft. NEW CONSTFL ULTI.OUTLET NON•RESID BRANCH CIRC ITS @ 5.00 (POWER APPARATUS e) (SINGLE OUTLET CIR. EX. OCCU p OUTLETS OR FIXTURES 20 76 FIXED APPLNS. OR EX. Occup. OUTLETS IRESID.) EA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring -15.00 Permit Fee $ 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. Notce 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. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling Hood 6.50 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. I 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. X Date Zl ZS-4qZ Signature of Applicant — ner Contractor ❑ Agent ❑ An OSHA ion of structures toverr3gstoriesoin height Ions over 5'0" deep and demolition or construct- Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ 82.50 HAz 1 DFEES I IMP FLoo cOF PARCEL PD HD s This permit is hereby issued under the sions of the Butte Count ode and/or work indica above which fees I C OF PUBLIC By "` P EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date/Z--I-4 Receipt No. 12c'J �G / WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - Department'of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 '. 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 improvement (yes or no) LIF 2. I (have/have not) 1W, 10 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: P Name 1 Address City Phone Contractors 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 U / h, Address City Phone Contractors License No. 5.* I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Property Owner :?: O Social Security NumberO Date 4/- Z!!;:: — 'rf- NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. .. ,,,.y. t r,,`_.,�,..�'.JL•.Y.-....�fYi+'....kFti�+.t'r-!t�"YY :rok.... w�ti.�.--.,.5...�;,/�1'-r'�t•yrti/'tr�r��K'ly'l.l'�.-1 y�• - ,rhf-. .... r '►4. - � COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER /%� `i �y ���� A. P. N . l4 -DIfO Proposed Building Use Building Inspector Date / At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3, Complete plans, 3/4 sets, signed by preparer of plans . ...................... .4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ........................................... . 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $........................................ . 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 3 -Flood elevation letter (100 year flood) y California Engineer.. . 4. Sanitation and plot plan approval 6U Health Department . ............ 15. City of Chico plumbing permit. ........................................ . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Developmental (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. .. .. . 20. Pre -inspection for required. .. o Build �9 i�sp aor ' (Date 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance. 23. Owner -Builder Verification (Given to owner , Mail to owner ............ 24. Recorded copy of Agricultural Acknowledgement Statement . ..................� 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance: ..................:...................... . 29. Documentation of legal access . ..................... :.......... 30. Documentation of 50% subdivision developed or (A) Road improvements,completed and (B) Parcel meets zoning area and frontage requirements. ....(........... . 31. Existing violations/expired permits. Plan check list... -- - /S:r/1 R2 !J W%'..D AG. ,���ItiS ............. -34. h, . W�hepyou issue the .ermit, process as follows: Mail wrier Mail to contractor. ((//'' Telephone and hold for pickup at - F D office. Deliver with inspector. Other Parcel Creation Acreage Applicantr'�1 ��'i5a`'-moi Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution 'B/atV Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter "y _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail ou r by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works E.H. USE nXl_ Hol Plan Attached a Hoor flan Atlachrd Scat to B.1). TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Y- ra -z 47- k -z Ow er Location AP!# Plan Approved for: Sewage Disposal Water Supply: Public Private Well / Clearance for bedroom mobile home. Other / 0 A -.)--q -tie % 1— {�C12-- Hold 2 -- Hold final for: Final clearance O.K. for: NOTE: / Environmental Health Specialist 8/92 Date �_..12 Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT :2 . S FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. The property described herein is adjacent ; to land or included within an area zoned g9-021266 Rec Fee 5.00, for agricultural purposes, and residents Cash 5.00 of this property may be subject to incon- Recorded veniences or discomfort arising from the Official Records use of agricultural chemicals, including, County of but not limited to herbicides, pesticides, I Butte ` and fertilizers; and from the pursuit Candace J. Grubbs of agricultural operations including, Recorder but not limited to cultivation, plowing, 2:34pm 9 -Jun -89 JJ i j spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. - All that real property situate in the County of Butte, State of California, described, as follows : 'EAST Date: State of SS. County of ) PROPERTY OWNERS: On this the 19 .7X day of 195 before me, the undersigned Notary Public, personally appeared ® Personally known to me. M Proved to me on the basis of satisfactory.evidence. to be the person(s) whose names) 6T,�A— subscribed to the within instrument and acknowledged that' executed the same for the purposes therein contained. IN WT'NESS WHEREOF, I hereunto set my hand and official seal. OFFICIAL SEAL DOROTHY A WISE NOTARY D1JBLtC-CALIFORNIA bum COUNTY MY coMMISSION EXP AUG. 21,1992 Present A.P. No i �'/'`tl` �' Notary Public END OF DOCUMENT cn Lu � M 0 co ro 0 LL Q -.:t 0 z LL DO " ....., ••vy-• �•'�� Number of stories S. Infiltration (Air Leakage g) Interior Thermal Mass - t TTvs 1 12• Cooling System .=posts .tab) .. R -value One Two Three Specification 10 0 0.2 0.6 0.6 10X 0.2 0.4 0.6 0.8. 20X 0.] 0.6 O.a 1 1 1.1 1.7 1.5 1.9 1.9 1 1.2 1.4 1.6 1.9 21 12 1.1 Points 29 32 l4 3.6 3.6 It 33 15 17 4 11076 itSx u0x 125•. 4 4.2 4! 4.6 4.a S S] 4.2 40% 0.I 0.9 1.1 11 _ 24 27 29 3.1 2a 3a 13 1S 17 3.9 1.1 4.1 42 3.24.3 R-0 -120 -59 _40 Standa..d ' � 4.7 4.9 5.1 5.3 SS 5.7 59 " S1. 51 5.5 5.7 5.9 6.1 p 0.9 1.1 1.4 1.6 60% 1 12 1.4 1.7 65X 1.1 1.3 1.3 1.7 ,:a<t�erior Slab Floor Raised Floor Mass Stories 3 32 3.5 3.7 11 3.3 3.5 3.t 12 14 J SEER 4.9 S1 SZ S6 5.6 6 62 S 5.2 5.4 " 5.5 5.9 R-19 R-30 -10 -2 .5 -1 3 -1 6.1 6 ] 5.1 S.3 S S 5.7 5.9 6.1 6 4 6t S.t 6:6 tia '6 6.2 6.4 55.2 5.S ti0% 1.4 1.6 1.8 2 tn% 1.4 1.7 1.9 2.1 95% 1.5 1.7 2 22 22 2/ 26 19 3 13 23 25 '2.7 29 J.1 33 24 26 23 3 3.S i7 19 1.1 3.5 is 4 42 /CFA One Two Three One Stories Two Three (assumes ducts in attic) 3.2 J.a 25 27 29 11 3.3 3.5 2S 28 3 32 3A 16 J.6 3.a t,t 4.3 17 19 4.1 41 11 4 11 38 0 p p 26 26 3 13 3.S 3.7 27 13 3.6 3.6 42 4.4 3.9 4.1 4.3 4.5 4 1.2 !.t t.6 4.6 4.9 &1 S.3 Ss 4.7 1.9 S.1 5.4 5.6 t.a 5 6.4 6.7 69 S.7 S.9 i3 6.S 6.7 7 5.6 6 i2 6.4 6.6 68 7 0.0 -10 1i .4 2 1 1 1.1 1.3 4.5 t.7 4.1 4A 4.6 4.6 Sum of 7-10 5.9 it 6.3 QS 6.7 69 7.t s.9 6.2 6.4 is 6.a 7 7.2 6 i2 6.S U -value 4.2 4A 4.6 4A 5.1 13 S.5 5.7 5.9 6. Glass Heat Loss Point System Summary: Climate Zone 16 o'1 g 5 3 1 0.3 0 0 25 or SEER less 7.4 to -14 to 4 ro +6 to 16 or 1 0.50 200 -99 -66 Total I. Ceiling Insulation` Measures -. U -value oint Scores .8 -4 -2 0 0.5 -7 3. -1 1 1 1 2 2 U -value (0.0301 - - 16 -5 +5 +15 8.0 -6 more ' , ( 0.30 -118 -59 39 Percentst ro .41 to .31 ro 0.30 0 0.7 -6 2 -1 2 2 3 U -value [0.037] -5 3 2 1 8.5 -2 0 4 0.10 32 -16 -11 Glass Single Double .60 .50 .40 less 0.9 -5 -1 0 2 3 4 8.9 0 0 p 0 0.06 _14 7 -11 -8 50 _190 -85 -63 -41 _20 1 1.1 S 1 1 3 1.3 4 0 4 4 0 0 00.08 9.0 1 0 0 0 0 0 • ..- 00.02 '0 '5 -2 s -2 40 141' 59 35 42 25 8 8 2 4 1.5 -3 1 3 5 5 6 6 6 9.5 3 3 2 1 1 10.0 6 p 5 2 .4 -117 -46 i 30 -93 34 -31 -21 -17 -9 -2 3 12 16 20 -i 3 4 6 7 g 4 3 2 1 10.6 8 6 5 3 2 •o�� C'j �' 0.00 -_ X 4 Z - Z i" �! 02• o -t= ' 29 -88 . 31 -19 -7 6 16 2.5 0 4 6 8 3.0 1 9 g 11.0 10 8 g p 9. Interior Thermal Mass O TYPE 1 MASS AREA a O a • 10. Exterior Wall Masson IntenorWv'u;xiCFA COND. FLOOR TYPE 2 MASS 28 84 29 17 6 6 17 5 7 9 3,5 S 10 10 120 13 10 8 5 3 p 2. Wall Insulation - - Sum 7-10 27 -79 -z6 26 75 24 -15 13 -4 3 7 8 17 8 10 4.0 3 7 9 11 11 12 12 13 130 16 13 g 0 3 0 it N ) '7E -OF [8.9] Duct Efficiency [0.74] --Single Single 13. Water Heating 25 -70 -22 24 35 19 -11 -1 9 18 19 14.5 4 8 11 12 5.0 6 9 11 13 13 14 14 Effective SEER R -value Family Detached Family Attached Multi- Family 23 -61 -17 9 -7 1 2 10 11 19 20 5.5 6 10 12 14 6.0 7 14 15 15 (SEER x duct efficiency) R-0 -102 77 51 22 -56 -14 21 62 12 -5 3 4 s 12 13 21 22 11 12 15 6.5 7 11 13 15 16 16 16 16 Sum of 7-10 Effective -25 or -24 1 R-11 R-13 -11 -8 -5 20 -47 -9 -1 7 15 22 7.0 8 12 13 16 7.5 8 17 17 to -14 to -4 to +6 to SEER less 15 5 +5 16 or R-19 -8 0 -6 0 :-4 0 19 -43 .7 18 39 5 1 3 8 10 16 17 i 8.0 8 12 14 16 17 17 17 18 +15 5.0 -16 -13 10 6 3 more p U -value 17 34 -2 4 11 18 24 24 8.5 9 13 14 17 18 18 6.0 5 =4 -3 -2 .1 6.6 p 0.80 212 160 107 16 -30 0 i 15 -25 2 6 8 13 14 19 20 25 26 0 0 0 0 0 2 1 1 p p 0.50 -132 -100 37 ( 14 -21 5 10 16 21 269.0 8.0 g 5 4 2 0 0.30 -74 -56 37 1 13 -17 7 12 17 22 27 10. Exterior Wall Thermal Mass . 17 11 8 5 • 3 0 0.10 . 0.08 11 -5 8 -3 6 -2 12 12 9 11 -8 12 14 16 19 20 23 28 1 Exterior Single- Single- 0 ' 10 7 3 11.0 20 16 12 8 4 0 2 1 1 10 -4 14 18 21 24 25 28 29 Wall 1 Mass 120 23 18 14 9 5 p .., p 0.04 9 6 4 9 0 16 19 23 - 26 30 Detached Attached Family 13.0 25 2U 15 10 5 0 i 0.02 0.00 15 22 11 8"' 8 -4 18 21 24 27 30 ' 0.00 p 0 0 Zonal Control Adjustment "-- 16 11 1 0.20 2 0.40 5 2 4 1 10 8 4 2 0 f r 3. Raised Floor Insulation 0.60 7 6 0'80 2 4 _6 -._. _.. No Cooling System Installed 7. Shading (Shade Open) P ) 10 8 1.00 5 : -- Insulation in Floor 13 10 1.20 16 12 6 8 0 U 0 0 [13 0 I Effective Percent Glass '' 1.40 19 14 g 1 5 4 3 2 1 - 0 T� Number of stories (percent glass x SC) 1.60 22 16 11 "Water He;tting R value One Two Three Effective 1'80 22 19 200 22 12 Single-Family'_Oetached and Attached- `j R-0 R-11 -24 5 -12 -8 %Glass North East South West Skylight 21 14 - i UnitSize"(sQ I R-19 0 2 0 1 0 18 10 6 16 9 12 4 na Water 1199 1200 1700 2200 Heater Credit or 2700 R-30 4 2 1 6 14 7 6 11 10 4 4 na na 11. Heating System ro to to Type Type less 1699 2199 2699 or more .,� U -value 12 6 6 11 5 9 4 na SG None 0 0 p 0 I .0 i, 0.60 0.50 218 -180 10.9 61 5 10 4 5 8 8 4 q na 4 SE or HSPF or Solar 12 8 6 5 HP HWR 9 6 ' l 0.40 -142 -85 -67 -55 9 4 4 7 _ 4 5 (assumes ducts in attic) 4 3 WSB 17 12 9 7 .3 -"J) 0.30 -103 -49 -44 -327 8 3 2 3 5 4 5 Sum of 1-6 POU 9 6 4 3 6 3 i Ii 0 20 0.10 64 24 31 -12 -20 -8 6 2 3 4 3 5 t -25 or -24 to -14 to -4 to SE HSPF less 15 +6 to 16 or SE None -moi -26 195 -15 13 0.08 0.06 - 9 -s 5 5 1 2 4 1 1 3 2 2 1 6 5 +5 0.72 6.60 0 0 0 0 +15 more Solar 2 -1 -1 1 HWR -18 -1 0 -9 1 -4 1 3 3 0 0 0 0 6 5 0.75. 6.88 4 4 3 3 0 0 3 2 -12 -9 •7 WSB 2 2 1 1 -6 0.02 6 3 0 2 2 .1 -2 1 -3 _2 4 0.80 7.33 11 10 9 8 7 6 POU -18 -12 -9 -7 1 -6 0.00 14 7 . 5 1 4 0 6 3 3 0.85 7.79 16 15 13 12 to 9 s -2 -6 -11 -6 0 0.90 8.25 21 19 17 15 13 11 IG -2 1 -1 1 -1 " Controlled Ventilation Crawlspace na = not allowed 0.95 8.71 26 24 21 19 16 14 SNone olar 3 3 _ Effective SE or HSPF POU 7 5 3 2 R•value Number of stories One Two Three (SE or HSPF x duct efficiency) Effective -25 0r -24 to -14 to IE None -28 -19 -14 R-0 -16 8. Shading g (Shade Closed) -4 to SE HSPF less -15 -5 +s +6 to 16 or +15 more Solar 10 7 5 4 4 -7 3 3 3 R-5 4 -10 -5 _7 .d 0.30 2.75 •94 -85 .76 -68 -59 -5p ._,_._._.POU -_5 3 Multi -Family (individual units) _2 R-11 -1 -3 _2 Effective Percent Glass na 3.41 -57 -52 -46 -41 -36 .31 R-19 0 -2 .2 (percent glass x SC) ' 0.40 3.67 -43 -39 -35 31 -27 23 Unit Size (sfj I -"' - -~--- -- --~ 4. Slab Effective 0.50 4.58 -13 -12 -11 -10 0.56 5.13 0 0 0 0 -8 0 Water 699 700 1200 1700 Heater Credit ' to 2200 _ . _ Edge Insulation .% Glass North East South West -Skylight 0.60 5.50 76 6 5 0 4 q or to to Type Type less 1199 1699 2199 or more • t R•value Number of Stories One Two 18 9 32 16 46 45 0.70 6.42 21 19 17 15 0.80 7.33 32 29 26 13 11 SG None 0 0 0 0 0 R-0 -13 -8 Three 8 27 14 -6 .23 32 -38 -31 na 23 0.90 8.25 40 37 33 29 20 17 P5 22 or Solar 14 7 5 3 HP 5 3 R -s -1 .1 O 12 -5 -18 -25 -24 na n a 1.00 9.17 47 43 38 34 30 25 WSB 29 3 7 6 F2 factor 0 0 0 10 11 -4 .14 .19 _18 63 Zonal Control Adjustment POU 10 5 3 3 2 0.90 13 6 8 3 -13 -10 -16 14 -15 13 -54 System T Type t' SE None -46 -23 -15 -12 Solar 2 1 -9 0.80 0.10 -14 0_ 9 -5 7 3 -8 6 -11 -11 46 -38 Resistance. 10 9 7 6 5 1 0 HWR .23 -11 -8 -6 0 -5 0.60 4, -6 3 -2 3 5 -1 -8 -8 30 Other 6 5 4 4 3 2 WSB 22 11 7 5 4 0.50 p 3 0 -1 0 -4 4 -1 -2 -5 -3 -6 3 .23 POU -23 -11 -8 -6 -5 0.40 5 3 2 2 0 j 1 -1 -17 -11 IG None -2 -1 -1 0 0 1 1 1 2 7 Solar 'II 0 4 y 2 - 2 0 1 4 3 4 -3 POU 8 4 3 2 2 . 4 6 0 • ' na = not allowed IE None 28 14 -9 -7 -6 Solar 22 11 7 6 4 POU -4 -2 -1 -1 -1 Interior Mass/CFA n. r•o uc•.. � � t •rte 0". - t TTvs 1 MASS (VUC 6 4.2, is, .=posts .tab) .. OX S% 10% 1S% 20% 2S'% X% 3S% 40% 45% . SOX 55% 60% 66k 70X JS% 80% w% t10X 9sx 10076 tosx 10 0 0.2 0.6 0.6 10X 0.2 0.4 0.6 0.8. 20X 0.] 0.6 O.a 1 1 1.1 1.7 1.5 1.9 1.9 1 1.2 1.4 1.6 1.9 21 12 1.1 21 23 25 27 23 26 27 2A 29 32 l4 3.6 3.6 It 33 15 17 4 11076 itSx u0x 125•. 4 4.2 4! 4.6 4.a S S] 4.2 40% 0.I 0.9 1.1 11 1.6 1.6 2 22 1.5 1.7 1.922 21 26 24 27 29 3.1 2a 3a 13 1S 17 3.9 1.1 4.1 42 3.24.3 4.t 4.6 4.6 S S 2 S t 4.3 4.5 IA 5 52 5.4 56 SO% 0.9 1.1 1.3 1.5 M 1.7 1.9 21 Z3 25 27 -3.2 3.4 3 32 14 3.6 i6 1a "IS 1a 4 4.2 4.4 4.6 4.7 4.9 5.1 5.3 SS 5.7 59 " S1. 51 5.5 5.7 5.9 6.1 0.9 1.1 1.4 1.6 60% 1 12 1.4 1.7 65X 1.1 1.3 1.3 1.7 1.6 2 22 24 2.6 26 1.9 21 23 25 27 2.9 1.9 22 24 25 26 3 3 32 3.5 3.7 11 3.3 3.5 3.t 12 14 J 19 4.1 11 4.S 4.7 ! 1.2 I.t 4.6 4.a 4.9 S1 SZ S6 5.6 6 62 S 5.2 5.4 " 5.5 5.9 75% 1.2 1.4 1.6 1.9 1SX 13 1.6 1.7 19 2 22 23 27 2.9 11 ti C6 23 27 3 12 6 3.a 13 15 17 3.9 1a 16 1a t 1 4.] a.s 4.7 a.9 4.1 4.2 4.6 4.6 S 4.2 4.4 4.6 6.1 6 ] 5.1 S.3 S S 5.7 5.9 6.1 6 4 6t S.t 6:6 tia '6 6.2 6.4 55.2 5.S ti0% 1.4 1.6 1.8 2 tn% 1.4 1.7 1.9 2.1 95% 1.5 1.7 2 22 22 2/ 26 19 3 13 23 25 '2.7 29 J.1 33 24 26 23 3 3.S i7 19 1.1 3.5 is 4 42 4.6 6.1 4.3 4.S 4.7 4.9 5.1 4.4 4.6 4.11 52 5.7 3.9 6.1 6.3 65 S! 5.6 SQ 6 62 64 66 961. 1.6 1.6 2 22 f00% 1.7 to 21 23 3.2 J.a 25 27 29 11 3.3 3.5 2S 28 3 32 3A 16 J.6 3.a t,t 4.3 17 19 4.1 41 11 4 4.S 4.7 4.9 55.1 53. 4.5 4.8 S 5.2 S.4 54 5.6 S9 6.1 63 6S 67 S S 3.7 5.9 6 2 6 4 6 6 6 6 5.6 S.a 6 6,2 6 105% 1.6 2 22 2.1 110% 2 21 23 25 its% 2 22 26 26 3 13 3.S 3.7 27 13 3.6 3.6 42 4.4 3.9 4.1 4.3 4.5 4 1.2 !.t t.6 4.6 4.9 &1 S.3 Ss 4.7 1.9 S.1 5.4 5.6 t.a 5 6.4 6.7 69 S.7 S.9 i3 6.S 6.7 7 5.6 6 i2 6.4 6.6 68 7 24 2.a 1�x 2 23 25 2.7 125% 21 23 25 2.8 3 3.3. 2a 9 J.2 it 3.a J.a 29 11 13 15 3.7 19 3 32 3A 16 18 4 1.1 1.3 4.5 t.7 4.1 4A 4.6 4.6 5.2 S.4 5.7 4.9 S.1 S.3 S.S 5.7 S 5.2 5.4 5.5 58 5.9 it 6.3 QS 6.7 69 7.t s.9 6.2 6.4 is 6.a 7 7.2 6 i2 6.S 4.2 4A 4.6 4A 5.1 13 S.5 5.7 5.9 6.7 6.9 7.1 7.3 it i3 6.5 U 7 7.2 7.4 Point System Summary: Climate Zone 16 SCORE CARD I. Ceiling Insulation` Measures -. oint Scores 2. Wall Insulation or R -value 81 R U -value (0.0301 - - or R -value ue [ 19] - U -value (0.066] - 3. Raised Floor Insulation_ �. r �%' - or R -value [ 19] U -value [0.037] 4. Slab Edge Insulation7 = " - --- S. lltration .... or R value [ ] Standard F2 factor [0.51 ] .... 6.^.\Glass Heat Loss 0 Type (doub 1 7. Shading (Shade open) U -value 10.65F % Total Glass [ 16] Sum 1-6 - a. 'North . 4%,Glass X SC . _. - - -. ' `77 - Eff. %Glass 3.3 6 - b. East C. South - 7• ( -� q 3. ,q,,2' X p2•oo . ... _ `.G, . .%. -. .�3 d. West 5 2 (s - 3/ ... e� _ 3 e. Skylight . X 0 S. Shading (Shade Closed) fi "a. North. % Glass. 02 • SC R- Eff. % Glass - Z,1, �� 1 '-b.. East - •o�� C'j �' - C. Sou -_ X 4 Z - Z i" �! 02• o -t= . d. West! a e. Skylight p X 0 • ' 2 = 2.O1 = 1 _12_4 l 'd •+ 3 t,3 X 9. Interior Thermal Mass O TYPE 1 MASS AREA a O a 10. Exterior Wall Masson IntenorWv'u;xiCFA COND. FLOOR TYPE 2 MASS AREA AREA Exterior Wall Mass ND. L OR AREA 11. Heating System - - Sum 7-10 Zonal Control? ( Y / _ N ) SE or HSPF Duct Eff-- ici=cy (0.781 (0'72/6'61 Effective SE or 12. Cooling System / - o E1 Z_ HSPF [0.5615.151 - Zonal Zonal Control? ( Y / N ) '7E -OF [8.9] Duct Efficiency [0.74] Effective SEER [5,59] 13. Water Heating G_ Q TA' IsG] Grdu (none] �OTQ " Certificate of Compliance: Residential S Project TlUe t ( ProjectAddren Documentadon � BUILDING DATA Condi ' Floor Area Zoic S sed Single Family Detached (SFD) [ Single Family Attached"(SFA) [ ] Multi -Family (MF) 0 bots Number of Stories 2 Number of Units [ ] Addition Alone [ ] Existing Building [ ] Existing -Plus -Addition �Climate�Zone.�16 - !n=RP la —. Bermit +t Checked By/ Data Fnfonaanew Agency Use Only Glass Area 4b North ! East 3 South _ West Skylight O_ Total BUILDING SHELL INSULATION Component _ Insulation LocatiorWComments Type R-QValue (attic. to garage. typical etc.) �'�-�--`-`--- 4ex"'n VJAJ- (.,..S Wall r ............. Roof .............L Roof............. ... - Floor ............. Floor ............. 41— Slab Edge..... GLAZING _ Shading Devices Glazing Area Glass Type Interior • - Exterior Overhang Framing Type Orientation s (sin t:, double)(roller blind; etc- (shadesereen. etc_) estno) (metallwood) North �t 4i c O Ail North (' S E3SL 17 East ) i South Sou eh West / West. ( ) "" Skylight......: THERMAL MASS Ty/Coveting Area - Thickness -- (s)ab/exposed, tile, etc.) (s f) (inches) Location/Description (kitchen, bath etc.) �.. �% HVAC SYSTEMS Minimum Duct Type (furnace, air Efficiency Location Duct Output Manufactupa N k�fo eek`", _ conditioner. conditioner, heatpump) (SE, SEER-HSPF) (attic. etc.) R -Value tuh ora 9th CA3c-36DSla-este 0 L 4�) �•^, Maximum Furnace Heating Output: Btuh HOT WATER SYSTEMS _ Tank Manufacturer/Model # System Type (storage gas, etc:). Capacity (or approved equal) Special Features) 1 SPECIAL FEATURESIREMARKS (Add extra sheets if necessary) Mandatory Measures Checklist: Residential MF -IR NOTE. l Owrite rrsidcncal buildings aabprt to the Starhdands must contain tine tncaann re card of themrnPliama ' approach used. Items marked with an asterisk (') may be wperscded by more stringent compliance taqui emeaa Gamed on the Ccnifieate of Compliance when this checklist u irrorpea ted into the permit documents, the futures noted Sauer be considered by all parties as binding minimum component perforrnance spooficaticrts for the mandatory measures whether they arc shown elsewhere in the documents or on this checklist only. DFSCUPI10N DESIGM VOORCEMENr Building Envelope Memores • §2.5352(a): Minimum ceiling euuluion R•19 weighted average. 02.5352(b)- Inose roll insulation manufactures labeled R•value • 12.5352(c), Minimum wall insulation is framed walls R-11 weighted average (does not apply 0 estutor mass wafts). 12-5352ft Slab edge insulation- water absorptim rue no gteatu than 0.3%. wua vapor transmission rate no grater than 2.0 pen VLnch. 12.5311: Insulation specified or installed mats California Energy Commission (CEC) quality sundardt Indicate type and form. 62.53520Vapor barriers mandatory in Climate zones 14 and 16 only. §2-5317: InfcltruioiVEarcltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air Icakagc. b. Door and windows eenified e Doors and windows weathenaipped: all pinus and penctimaons Caulked and sukd 12.5352(e): Special infiltration barrier installed to comply with 12.5351 meeu CEC quality standards. 12.5352(d)- Inualtation of Fueptaces 1. Masonry and factory -built futplaces have: it. Tight fitting• closeable metal or glass door b. Outside air intake with damper and control c flue damper and control 2 No continuos buming itis pilots allowed. HVAC and Plumbing System Measures 52-5352(8) and 2-5303: Space conditioning equipment sizing: attach calculations. 12-5352(h) and 2.5315: Setback dncrrnostat on all applicable hewing systems. - • §2-5316(a): Ducts constructed. installed and insulated per Chapter 10, 1976 t1MC:. 12-5316(br Exhaustsy==have damper controls. §2.5314(c)- Gas-fired space heating equipment las intermittent ignition devices. §2-5314: HVAC equipment• water heaters, showenccads and faucets certified by the CEC. 12-5352(): water hcata insulation blanket (R-12 or grater) or combined interiorjwerior insulation (R-16 or great=): fust 5 feel of pipes closest to tank insulated (R-3 or grater). <- §2-5312(Eacep6on 1): Pipe insulation on steam and steam condcnsatc return & recirculating piping §2-5318(d}. Swimming Pool Heating 1. System has: a_ On/off switch on heater. b. weatherproo( insuuctien plate on heater. t Plumbed to allow for solar_ 2. 75 percent thcrrnal ell-ceieney. 3. Poel cover. 4. Time clock. 5. Diroctional waw inlcL Lighting and Appliance Measures o 12-5352(1): 'Lighting - 25 lumcns/watt or greater for general lighting in kitchens and bathrooms. 12.5314(cr Gu fired appliances equipped with intermiaertt ignition devices. 12-5314(a): Refrigerators, refriSera Lor- frecrer• frecurs and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This ctrdflcwe of compliance lists the building features and performance specifications needed to comply with Title 24. Chapter 2-53 and TStle 20. Chapter 2. Subchapter 4. Article 1 of the California Administrative code. Thi certificate has been signed by the individual with overall design responsibility and the building owner. who shall retain s copy of it and transmit the certif)cate to any subsequent purchaser of the building. Designer Name: Tak./Firrm Addres : Tekphorae Lic. 1: (sitnamire) - Documentation Author Name: Tatk/Funr (date) Building Owner Name - Tttk/F m_ Tekphone - _� (sitnnttae) (date) Enforcement Agency Name: At—r- AN AG. BUILDING FOR: BARRY RUBANOFF 180 MIRAGE LAKE ROAD BERRY CREEK CALIF. 95916 A.P.#: 061-440-003-000 DRAWN BY BARRY RUBANOFF PO BOX 1123 BERRY CREEK. CA. 95916 TELEPHONE (530):389-41 ti a A O ar ` 'o s m c AN AG. BUILDING FOR: BARRY RUBANOFF 180 MIRAGE LAKE ROAD BERRY CREEK CALIF. 95916 A.P.#: 061-440-003-000 DRAWN BY BARRY RUBANOFF PO BOX 1123 BERRY CREEK. CA. 95916 TELEPHONE (530):389-41 11 L3� V�` ce— . .iiiKI! I ." "t #I-. � I", '';, Lf, If I 11 I , �, L I , i .l ,'.. 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I I , 1 I , ,�, , , , , 1 � i% r , �l , � , �, � , I f 'I �, r, � , I, I , I F � , I . , , I , , 1 :1 , �i 1 l I I 11 1 . .1 r , , I I , I � . � � ; I , I I 11i, I I � I ,I , I I , ,, t , l , , I ,� , I f � ' r , , I , , . . I I I I . I ' � 'I I !` ' 11 I . . I, 11 , I I , l i i , . lf. f ; , I , � � � , � i � , * , I I, , ',-.,J�it � : , ',', , , . i , . ,. t , A " I . . , . I , . , ! I I I 11 I , , , , , I , � , �, � I � ,,, I , � I i� : t , , i , , I I � ' I ' ' r� - ' ' - 1 � I I . . I I . ! : I - , ,�' , " , il ,, ,i -YI'l.i , 'F � , 1, rr, t� I , , .f I . I it, I 11 , , � , �� :� , � : Ii I :, , ; ,� , .� , c!, q� 11, , ':v �, I � , 41 I ,� I . , f , , t I 'r l �� , , I � � I , . , , ��� �1 , 'r � , �I,ij �� I , � , _,. � . � I:, I � � , , I', ., � , , " , , , - , , , � � I , , I . l , . 1, , :I r , , F ,l� 1, � ,� I , 1 , , , � � .l )il I, l , ' : , i r , I ,� l � . . I li- , i " - I , I � i I � I �. I " . r' I , I, , , , :� 'l , . 1, I , , F 1, , , , l - . I I i I l I ". 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' 'I , ' r l " I , I ' ] , i . 4 l , , �, I �,� l ,, r ,f � t , i l l ,, � , , : , , " , , . , . , ' , 1, I l I ( I ' ' ' I � , ' I , � I I , , ' I . . � I 1; I , � "I , l . , , I , . , I I � , I L , , l I �� 11 . I .1 I� I ,, , I I , I , , I , , " �' � i , il , " I it l , . I I I � .... , " , , , �, I � , , , , . , 'l . I " I . I . I , . 1, I I , ,. I i * ��, � I . I . . . . , �� I � 1 I 1 ,! , , , � 1 I , " . i , ,, i �� " : � i� , � � . I I F I ,li, � ', , I . I I � ,, o , , , � I ; 1, I I � I I 1. ! 11 , Ii I I I , , l 1 l ,f � , � � ,,, I � � , , , � . . . _ ,', I , I " , r , I 1, 1; , - I �' , I. , , .� , � i, �F , ,", " I , , � , ' 1 4 'r � , I ' ' 1 t� � , � I ,,, , �F , " . I .. , , , I [ . I t � : � I i , I .1 � ", , , , l, f ' I ' . I' ' 'I I I� I , � I , , / �, l � � l � , � , I ', � " I , V� , �: I . 1, l I I 1 I " . , I , , , I ,' � I . , I , I- ; I 1, , , t", 'I I . 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I , t ; , l, � i ,,, r� , I , T � , - , IF I I I , � , , ;�, I , I , , I ( , , , , ,'.t", , �: I , l , - . , I , , , I " i . I - I � I I , , I , , , - , � , I , I � I , � , ov, � I I 1w I , I � , - ; . . . . . . . . 4 , , " ,it , - I., , ", , l F, , I I I I , , � I , 4 1 " F , , , - ! , t i , . ,,, �t i , 4 . � , : I I ' i '. , . I , , . � it I -, ll", 11 I il� Vlfrl , , .1 . I " - I i I � : � I , � , . I I - , , l "il, " I : 4 1 i l F l � , 'Fl. , :� � I I . I I 1 � ,I, . ., - t , , : ' 1 , , i, _ , 1: I I I , I , , I I , 4 I . � � � r ;, , I , ,;; � I l l , �, - il� ; I " , r . , � , I , I I , 4. 4 , 11 11 I I . , , , If "" , I I 1, � I 1 , : I l , I F-1- , � ,;, . ,�� � , , :I , :, , I , , � i -. , , t � , I I I I , i : I I I I 1 : � , , I , , . I , I ; l I I I - I l I I I � , , " i , ; , � , i i � , , � , � ) ) � I I , , , , I I , I I � � , � , � , , , , � I I . � . I I , . . t I , " , t ol It, I l , , 1 , I i . , r �� � - � , , I I I . 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I , I I I I ,,I , �,jF' � , �t . V,:, � ii ,, i I l � � I; : , , ", , , , l , - , � I , " � 1, 'I I I I . I I t " . .I , . , � . ", � � " , ,, I ", , ; . , ' , : , l � 1�, I 'r ; � , , " . - : � I,l � f , ' , , ' , , I l ' , ,� 'I �4' ,, r, , I � � . . t , . . I I . I I I I I � l � � � , F F : , , I ,. . � l 1 l , , I , , � � I I � I , I , , 1 I I I . , IF j� I ; . . t I � I I � I ;., I � ,; ,�i` , I, � i l , , I Ill ! �: I 1. , I r .1 1. I j I, I I I ;, � , I - , ,, ','� , , I , , . � , I , ,, 1 " z I '), . I , . , l , , : � I - -, �; ,, � � I ' ' 'I� ' , I . 1 ,� 1, , - I , � � , . , l , I � , � ., I I � � j I , , I, , , I I . I . , , I I I , , r ' I I I .�, . , , i , , ; I 11 � l , I: : 11 I I I , i i � F� I I , , 11, �, .1 , I ( : 7 � : il��I, -F , , , , , I ,:l " I I �, l . , I , ,' + 1, F � , I � i I , , , I , � , " 1 I , I " . , I , , I I I , I I , I ,- , I i 1 , . I , I , I I r: I ��, 41 � , � 1 I ,: 11 , I . 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