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026-080-072
JACE RASH 26-08-73. 7042 Upper Palermo Rd, Palermo (SPECIAL INSPECTION 32-83) 26-08-72 1393=ij 89B "- MOSBY, MUREL R 7042 Upper Palermo Rd:,, ovlle % (pri. det. garage)��' 26-08-72 1358-90 MOSBY, MUREL. `.-� -�� 11 7042 Upper Palermo d- Orovil.le (lst renewal/139 -89) 026-080-072 06-2002' MOSBY, MUREL , 04 _ 72 UPPER PALERM�O(RD, PALERMO o Cont: OWNER RE ROOF e�71-"Y R- Ig-oe 0 � �'_ \ -- 0 i L�� i o I _ Y 026-080-072 - - 06-2002 MOSBY, MUREL 7042 UPPER PALERMO RD, PALERMO NOTES Cont: OWNER 1 RE ROOF RESIDENTIAL APN: Permit No. " Owner. Site Address- Contractor_ Type of Permit rt ' ,f f SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FINALED: q 2 w . SIGNATURE: r L r SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FINALED: q 2 w . SIGNATURE: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS 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 Issued Date: 08/21/2006 APN: 026-080-072-000 the Business and Professions Code, and my license is in full fofce and effect. License Class: License Number: Site Address: 7042 UPPER PALERMO RD PAL Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior 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 State 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).): '® I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code Date: ' Z Owner: "ZJ J, V n� 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 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 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. Date: — 2 (— D 4 Applicant:Me��� WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in. Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Name: Address: Map Index: Description: RE -ROOF (20 SQ) Owner: MOSBY MUREL & LULA 7042 UPPER PALERMO RD PALERMO, CA 95968 (530) 532-0206 Applicant: MOSBY, MUREL & LULA 7042 UPPER PALERMO RD PALERMO, CA 95968 (530) 532-0206 Contractor: License #: Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: This permit is hereby issued under Resolutions.'to do work indicated -al PERMIT EXPIRES ON icable provisions of the Butte County Code and/or which fees have been paid. Date: N-21 l J ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25,533, and 25534 of the California Health and Safety Code, which regulate the storage. handling and use of hazardous materials. O Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: Ik(U AK-•- . a s_; ,y. a i Jl / Signature Dater ,ll Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01=16-04 pg 1 +=OK 0=1401 MANUFACTURED HOMES DATE U PERMANENT FOUNDATION U SOFT -SET 1 Zoning -Setbacks -Easements 2 Soits; Special MH Support Sketch 3 Sewer, Loctn Test; FaIUC/OConcrete 4 Wtr; Loctn Test-Easeinent Needed -Regulator 5 Elec Loctn-Cimcs-Gmd ' Amp -Concrete 6 Yard Gas; Loctn-Test Wrap Nat ❑ or LP❑ Inch Sz Ft Lngth 7 Blckng, SzSpacing-Marriage Ltne 8 Gas; MH Test -Demand Vatve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Cirncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -CIO to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Label/insignia Numbers Serial Numbers Drawing MISCELLANEOUS- 3ECKS-COVERS-CARP0RTS'GARAGES 1 ZonfngSetbacks-Easements 2 Ftgs; SoilsSz-DpthSpacing-CnnctrsSteel 3 Decks, GirderslJoists-Dcldng-Brcing Stairs-DuardlHandrails 4 Wood Awn; Posts-Beams-Rflrs-CnnctrsShthg. Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enctsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-Rftrs Tnisses '9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof, Shthg-Roofing " 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls 1 Setbacks -Easements _ 2 Soits;"CompactionStrucbrre Stability _ 3 Pool Structure; St_egl-Cnnctns Thickness Dead Men -Lining 4 Elec Rcptds/l.ting; Distance -GR _ 5 Elec Pool LXIpg; l5 volts-GFI _ 6 Elec.Encfsrs; Conduit Entries-Terminals4Jsted _ 7 Elec Bonding; Metal wfS*-Crdtrrg Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes-Enclsrs-pnlboaids-Insulin-to Main Conduit 9 Health Dept AppM 10 *Pimb; Cir Test4 tr Supply Test 11 tt Niche _ 12 Endsr, Fencing Alarms 13 Bonding, Diving board or Slide = tree RESIDENTIAL (Single & Duple UNDERFLOOR 1 Zoning -Setbacks -Easements -Flood -Slope 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 3 Ftg Garage; SoilsSteel-Elec Grnd Ftg Dpth 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 5 Stemwalls Main; Steel-Blockouts-Wrapped 6 Stemwalls Garage; Steel -Blackouts -Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz AnchrsSz Test 11 Wtr Pipe; Test-Anchrs-RgltrService Test 12 Elec Undrgmd 13 Plenums & Ducts; Cirnc-MaterialSupport-Insulin 14 GirdersSills-Anchr Bolts-Joists-Vnts-Cripples 15 Ace & Vntitn 16 Insulation DATE IrRAMING 17 Sills Proper Materials & Anchrs • s. 18 Walls Studs-Nailirig Spacing & Braces-PlatesSound 19 Bearing Walls ovef Girders 4 flr Nailing 20 Draft Stop In Walls (rat proof)- 21 Fire Stops; Furred Ceilings -Stairs -Chasers Tubs 22 Headers & Bea .bi &-Bearing' 23 Bangers-P-osi•Caps-Anchrs:nctns 24 Ceiling Joisf-Rffr Ties-Puriir�-Roof Bray TnusShthg 25 Frplc Tie's"or Type A Flue=F•T�'-!c Throat Clrnc t•,: 26 Attic Act; Sz&: Rmz prtctn-Draft Stop -Ins Baffles 27Bdnn Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtdri Frdming-RC Charinel 29 Prprty Line Firewall ' rewall & Opngs. 30 Ext Doors -One 3' -Check Is 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landi'ng-Fire Pdctn 32 Plywd an itoof Ovrhng-Attic Vnts-Rftr 0'U'h7s 33 Siding -Nailing Veneer - 34 Stucco Lath Weep Screed-Fndtn Vnts-Undrfir Ace 35 Glazing Are PrtctnSkyLts-Plastic - 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnls 38 Insultn-Walls-Ceilings 39 Infiltration Walls-Wndws oma. DATE ELECTRICAL 40 Fxtr & Tmsfrmr Clmc-Ins Prtctn 41 Elec Rcptcls Spacing -Cts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFl 47 Subfeed Wire Sz Q, ❑ct1 or ❑AL AC Wire Sz , ❑ CU or ❑AL 48 Range Ckc rA ❑CUor❑AL Oven Circ Q, ❑ Cu or DAL Insulated Neutral ❑ Yes ❑ No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Cimrs pnls-Motors-Meth Eqp 51 Clothes Closet LtShwr Lt -Spa Lt 52 Smoke Detector PLUMBING 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr-Nai! Prfctn 56 Shwr Pan; Test, First fir -Tub Ace 57 Test Tuti & Shwr, 2nd fir - Tub Ace 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping DATE MECHANICAL 61 AC Ducts Insulin & Support " 62 Vent Fan, Exhaust abv Insulin 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace Vent Acc-Comb Air RhmMent 115 Outlet 65 Attic Ace & Pltfrin if Furnace In attic DATE FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Clmc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFl & Bath Fxtrs & Tub AccSpa 71 GFl Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, GuardlHandratls 74 Frplc or Stove, Clmc-Hearth 75 Efec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Gmd-Air-Gap-Cooking Clmc T7 Elec Outlets & Rcptcts ai Ktchn Counter T8 Garage Fire Door, Swing -Landing -Closure 79 AC Duct in Garage -Damper. 80 Wtr Htr, Vnts-Clmc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFI) Ramex Prtcbr 83 Insults -Foam -Looked in Attic 84 Guard Rails & Deck CnstrcbrPost Caps 85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth 86 Clmc Dmge Planters ❑ Yes ❑ No 87 Stucco Brown -Finish 88 AC Unit Dscnnck Elec-Plmb 89 Vnts abv Roof, PImb.Appinc-Frplc-CImc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFl Rcptcl-Undrgmd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous Inspdns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP062002 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS 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 Issued Date: 08/2112006 APN: 026080-072-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 7042 UPPER PALERMO RD PAL Date: Contractor: Map Index: tion: RE -ROOF 20 SQ Description: ( ) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: MOSBY MUREL & LULA to its issuance, also requires the applicant for such permit to file a 7042 UPPER PALERMO RD signed statement that he or she is licensed pursuant to the provisions of PALERMO, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95968 she is exempt therefrom and the basis for the alleged exemption. Any (530) 532-0206 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).): 40 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 Applicant: MOSBY, MUREL & LULA Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does 7042 UPPER PALERMO RD such work himself or herself or through his or her own employees, PALERMO, CA provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 95968 year of completion, the owner -builder will have the burden of (530) 532-0206 proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code ^ z 41/Zd ;791 Date: Owner: License #: 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 Architect: is issued. ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 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: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 1 certify that in the performance of the work for which this permit is Census Code: 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. .2 Date: —� Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in, Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under Jhe applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resoluti n o do wok indicateve fo which fees have been paid. of the work for which this permit is issued (Sec 3097 Civ.) 4performance _ BY 9 Date: Name: l - PERMIT EXPIRES ON: Address: 1.Date) ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County` to enter upon the above mentioned property for inspection purposes. Print Name: IWCj �t l Signature: ciz t� Date: ,a Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01=16-04 pg 1 Ix BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" APPLICANT INFORMATION OWNER INFORMATION Last Name City i t N e( Address City City State State Zip Phone a 0 6 Fax E-mail Lic. # APPLICANT INFORMATION CONTRACTOR Name 6117d City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE For office use only: Zoning Property Address 7e Z/-0 r Flood Zone Cross tr© n SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc y PERMIT NO. BIN # PROJECT LOCATION �lJ / Property Address 7e Z/-0 r City �e�✓c�cr Cross tr© n jENSATION WORKER'S COM,P Policy Number�j' Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Rood 2IJ Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. I I Received by: �. Amount: 00 Bldg I I Page 1 of 2 Receipt #%095 ;71 Sheriff Date: Q�.� Other $ Uu r O 10 Total REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of In for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B). Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from:.the Public Works Dept. (construction approval prior to occupancy) ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. X 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer , or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid .the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 v 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 material for construction of this proposed property improvement: YES .[%] NO [ ]. 2. I HAVE [L..] HANE 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: I nk�t1�VJ12 ADDRESS: PHONE: CONTRACTOR'S 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: 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: WNER DATE: 9- 2,>— 2 d G 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 Butte County Department of Development Set -vices OTT ADMINISTRATION ° BUILDING t GIS ° PLANNING o o o o o 7 County Center Drive Oroville, CA 95965 a o (530) 538-7541 Telephone c011 N� (530) 538-2140 Facsimile OWNER -(BUILDER INFORMATION Dear Property Owner: 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 your plan to subcontract; you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o 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 incnrance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o 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 their own employees, without a licensed 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 in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from 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, Scott Rutherford Chief Building Inspector NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. N ?,, r 26-08-72� - ,' s� MOSBY, MUREL�� r 7042 Upper Palermo Rd., Oroville (pri. det. garage) PI 1 � PERMIT EXPIRES 4+ OWNER CONTR. ASSESSOR PARCEL LOCATION Temp. Power Pole Called PG&E' Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOB FINALED (Date) Signature r�x PKA-0 • .R. V _ ,. ,�., r. •. . .� ..T..i, a e COUNTY OF BUTTE - DE`P�RTMENT OF PUBLIC WORKS , 7 County Center Drive - Orovil-Je, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO t 05 - (r ESSOR P-ARCEL N R 41 . — ZON, NG � yYl HI BUILDING PERMIT OWNE-R�( TELEPHONE SQ. FT. OCC. BUILDING VALUATION ' W ER'G ORESS MAILING AD7 5�� CONTRACTOR'S ME TELEPHONE' ►u? n r -v CONTRACTOR'S MAILING ADDRESS 11 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ "-U ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ B44 ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS j) _ _ (� /�( Permit fee 0-1 $ �a ,� PLUMBING PERMIT Filing Fee 10.00 A `1 Each Trap 2.00 11 1 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets!' 5.00 Q SF ❑ Duplex❑ Mobilehome❑ Other Building sewer / 5.00 sPECI FuY nMobile Home `S G I W 0.00ea TYPE OF WORK New k Addition ❑ Remodel ❑ Utilities ❑ installation[] Other ❑ Perm i Fee $ Describe work: Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW NEW CONST. DWELLING OCCUP.01 OR ADONS. ( / , p /20sq ft I declare under penalty of perjury (check one): ACC. BLDGS. NEW CONSTR. MULTI -OUTLET .- 2.50 ea i ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the BUSIness NON-RESID .BRA CH CIRC ITS . POWER APPARATUS -119 `CIR. c and Professions Code and my license is in full force and effect. SINGLE OUTLET License No. Classification Ex. OCCUp(OUTLETS�O FIXTURES SAL@30 1, as the owner, or my employees with wages as their sole compen- FIXED" APPLNS. OR Ex. OCCUp. OA9TLETS (RESID.) EA.) 2.00 sation, will do the work,and the structure is not intended or offered Temporary service 10.00 for sale. (Sec. 7044) ❑ I, the licensed Mobile Home Facilities 15.00 as owner, am exclusively contracting with contract- Misc. Wiring 9 15.00 ors. (Sec. 7044) 1 am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT FiIingFee 10.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ 1 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. Cooling g I shall not employ any person in any manner so as to become subject Hood �./° 3.00 to the W. C. laws of California. Ventilation 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 permit Fee f provisions or this permit shal I be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ is correct. I agree to comply to all County Ordinances and State Laws relating Energy Inspection Fee $ to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. TOTAL PERMIT FEE $ • I also agree to save, indemnify and keep harmless the County of Butte against OCcUP,CON ST.TYPE SCHOOL :I O�D PARCEL PD ND ISSUE all liabilities, judgments, costs, and expenses which may in any way accrue / �k l ga(nst said County in consequence of the granting of this permit. tI to X This permit is hereby issued under the applicable provi- Date sions of the Butte County Code and/or resolutions to do gnature of Applicant — Owner ❑ Contractor ❑ Agent ❑ work indicated above for which fees have been paid. An OSHA permit is required for excavations over S'0" deep and demolition or construct- I REC+OR F PUBLIC WORKS ion of structures over 33 stories in height. ,i Receipt No. BY Date WHITE-D.P.W.. YELLOW -ASSESSOR, PINK INSPECTOR, GOLDENROD -APPLICANT PERMIT EXPIRES Date f��� ✓O !✓ = OK 0'= Not OK yable MOBILE HOMES = Not Ready MISCELLANEOUS" Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DE S,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements S . Z ng Requirements -Setbacks -Easements Footings; Soils -Size -Depth -Spacing -Connectors -Steel 2. Soils; Special MH Support -Sketch 3. Sewer; Location-Test-Fall-C/0-ConcreteD k���r�ers and/or Joists-Deriki-gg-Bracing-Stairs-Rai ls 4. Water; Location -Test -Easement Needed (Sketch)ts-Beams-Rftrs.-Cpnnec.-Awn Shthg.-Rfg.-Bracing ' i, 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / /"L" ft. / /"Nat. or/ /"L"ft./ /"LPG ns -Connections -Splice -Decal -Enclosures -Doors 7. Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -131 Date Card -B1 Date 10. Roof; Shthg-Roofing Card -131 Date Card -131 Date 11. Ext.; Steps -Doors -Landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s ' 1. Zoning Requirements -Setbacks -Easements Card -131 Card -131 Datebr;,17,,jT9Card-B1 Date Date Card -131 Date 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date POOLS (Plans) OK except #'s 5. Drain; MH Test -Fall -Flex Connector 1. Setbacks -Easements 6. Water; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability 7. Water and Sewer Connected -C/0 to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy 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 Card -81 Date Card -B1 Date Card -131 Date Card -131 Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -131 Date Card -131 Date Card -131 Date Card -131 Date = UK 0 = NotOK RESIDENTIAL (Single and Duplex) - =Not Applicable = Not Ready' Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks; -Easements -Flood -Slope 2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ P' Ftg. De 3. Ftg., �Ga_rage; Soils -Steel-/ P' Ftg. Depth 4. Ftg., Porches & Decks; Soils=Steel-/ /"Ftg. De 5. Strsinwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Card -131 Date Card -131 Date Card -B1 Date Card -B1 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchors -Nail Protection 18. D.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 Pipe; Size & Anchors Card -61 Date Card -131 Date Card -B1 Date Card -131 Date Date ELECTRICAL (Permit) OK except #'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/Mech. Fasteners -Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/G.F.I. 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / 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 Card -131 Date Card -131 Date Card -B1 Date Card -81 Date Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnace in Attic Card -61 Date Card -131 Date Card -131 Date Card -131 Date Date FRAMING (Plans) OK except #'s 39. Sills, 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. Header & Beam -Size & Bearing Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 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-Clg. 60. Infiltration-Walls-Wndws Card -131 Date Card -B1 Date Card -131 Date Card -131 Date Date FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa j 66. Elec. Trim & Subpanel; Breaker Sizes -Labels 67. Stairs & Rails i i 68. Fireplace or Stove; Clearances -Hearth 69.Elec. Outlets at Wood Panel; Int. & Ext. 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 Garage -Damper j 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- 3 In Garage; Above Floor-Mech. Protection j 75. Plb., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 77. Insulation -Foam -Looked in Attic ❑ Yes 1 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 ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation throughout House 87. Glass Protection 88. Corrections from Previous Inpections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates 92. Roofing Certificate Card -131 Date Card -131 Date Card -B1 Date Card -131 Date Card -B1 Date Card -B1 Date Comments at Final: i I 1 (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE 0 OWNER / HERMIT NO. 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 correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. 'L c Date %"�— Inspector COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS f 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 26-08-72 ZONING ARMH1 BUILDING PERMIT OWNER Murel MosbySQ. TELEPHONE FT. OCC. BUILDING VALUATION 1st renewal OWNER'S MAILING ADDRESS 7042 Upper Palermo Rd. Oroville 95966 CONTRACTOR'S NAME owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee @ 1 F E E $ 34.25 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 7042 Upper Palermo Rd. Permit fee $ 44.25 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 nrnuille Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex Mobilehome❑ Other Pvi Det. Garage SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G IEIE� TYPE OF WORK New g3 Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑ Describe work: 1st renewal of BP# 1393-89 _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 ONTRACTORS LICENSE LAW I declare under p of perjury f y (check one): ❑ I am lic sed 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. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. 2/,z¢sgft NEW CONSTR ULT' -OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS & (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES SOC 8AL AL®30 Ex- Occup. OUTLETS P(RESID )LINIS REA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �Virin g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare and penalty of perjury (check one): ❑ T 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. Q 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 g 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 agan said County in consequence of the granting of this permit. %� Date S' na ure of Applicant — Owner Contractor Agentwor An OSHA permit is required for excavations over 5'0" deep and demo ition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE E TOTAL FEE $ 44.25 HAZ CUA PARK SCHL PAR PD HD issuE under This permit is nACout sion f t e Buttde and/or i di ted hich fees DIRUBLIC BY PERMIT EXPIRES Date — — the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. O -C& �J WNI TE-D.P.W., YELLOW-ASS[SSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - Departplent of Public Works 7 County Center'Drive, Orovil.le, CA 95965 OWNER -BUILDER VERIFICATION Attention Property Owner: 40,t� a( 8P i393 85 Phonei 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) 61 2. I (have/have not) „� �j,(L[,c_P� signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construct on• Name Address City— Phone( Contra tors License No. 4. I plan to provide portions of this work, to coordinate, supe vise, and provide t Name Address but I have hired the following person major work: Phone Contractors License No. City 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 , DatefJ, 0?7— j99D 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 - DEPARTMiENT OF PUBLIC WORKSPERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 1 _ APPLICATION AND PERMIT SSOR P CEL N �x ZO " ( BUILDING PERMITT-.) OWNER b TELEPHONE SQ. FT. OCC. BUILDING VALUATION 'S MAILING ADORE,Pq -e i./n O T ACTOR'S ME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS4^ Q)� r-7tn(Awt&- MZVKX1 Permit fee $ p� PLUMBING PERMIT Filing Fees 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 qas water heater or vent .00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehome❑ OtherI -PASPECI Gas piping system 1 - 5 outlet 5.00 Building sewer 5.00 Mobile Home S I G I W [10.00 ea TYPE OF WORK New K Addition ❑ Remodel ❑ Utilities ❑ installation[] Other ❑ Describe work: P t Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00- 0.00Main Mainservice e00V 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 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- El, ors. (Sec. 7044) 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUPM , OR ADDNS. ACC. BLDGS. I h2sgft NEW CONSTR. MULTI—OUTLET —2.50 ea NON.RESID .BRANCH CIRCUITS)__ POWER APPARATUS-& SINGLE OUTLE,;riCIR. Ex. Occu 20050t p OUTLET R FIXTURES _BAL@321— IFDPR EX. Occup. OIX LETS IRESID IEA.) 2.00 Tempor service 10.00 Mo a Home Facilities 15.00 Misc. Wiring15.00 Permlt Fee $ Contractor 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. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ve ion 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 nst said County in consequence of the granting of this permit. / Date Rgnature 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 $ Energy Inspection Fee $ TOTAL PERMIT FEE $ �P- OCCUP. JCONST.T PC J scNOOL �— P D PARCEL P11 No ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which MR:EPUBLIC By ---]Date PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS j� ;iI o �'u/ 7 Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT .. .,�-s: , .. ,.r. � , .n..'.�i A"'^a�,'+{�!�!':%. �'�'.._—srrNF,;. -.4..1 � ` "'1 -- .•- . - .t • r- _ COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS - BUILDING D ISION 7 COUNTY CENTER DRIVE -eOR'OVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET f �_ Permit No. j OWNER ' ' o 1 W A. P. No. � -n ST -~I o� Proposed Building Use 0 Building Inspector Date v �l 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 been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans 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 instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ..................................................... p12�. � Ntrict School fees paid ................. :2V sanitation approval from -Health Department .. . 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) ... Pre-Inspec. request to 19. Pre -Inspection for required ...... Building Inspector (Date) 20. Contractor's license information (No., Name Style, Classification) ....... jk 21. Certificate of Workmans Compensation Insurance .................... i 22. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ........ ' 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature authorization ..................................... 25. 26. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone�--Ega%and hold for pickup at aa, -.-office. Deliver w/inspector. Other Applicant ez Date i -,S- 9 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. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone--nail—counter by date Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by date Plans checked by Date Plans approved by e- Date S-60 Sets of plans on hold in File cabinet AP folder Copy—DPW .......•:�3:�s:ie�:i.+�..,.�'w�S.F..rL..s,.;o� _ v �.:..__.... _. �...__.........-. .-:.... -.. °.:J..�..._. - - ....w�-......,-..:'..�..: :..._:.._moi. _.a. _ x_.._. ,. _ ._s.. ___._.^ � _.......•:.�.::.,s. .r+..w..n-�_...�. . TO Huildinv Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Locati n ,,� AP# Plan Approved roved for: Sewage Disposal Water Supply Hold final for: Final clearance O.K. for: Clearance for bedroom mobile home. Other's NOTE * * * Water Supply Water Supply U _.._.�. _ Date Sanitarian COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oro.ville, 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 Number / 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. P nn Imn r4l �!mcs cnd i$ is unlavAl i pP on Svmo td' gul -1,17 ►}c�ri��s -- gOrt rnGnshipr ACCOM zntc rw �� �. � n� �a¢;��Q� ���® in filo -Y ��•.. rzz . -- mlami 2, }rarr° The 0 d ase prop fi r® �c\nor o{._. _^ - -sOl -Mferg A. s L .6 _ NINA Az SNOW s ` 12X4-µrm� N � 3 . Az SNOW s ` 12X4-µrm� N �6 June 21, 1983 Jace Rash RE: Special Inspection 032.83 P.0. ; 526 - AP #26-08.73 .1 Pali:, CA 95968 Deat lir. Rash With reference to the above subject and your proposal to move the :louse 2ocdted at 74342 Upper Palermo Road in Palermo, the requested Inspection was meal& 'on 6/20/83: After discussi6nwith you concerning your proposal to completely rewire and replumb the building, we will also require the following to be done or resolvoid: '(1) Provide foundation and ,pier and girder system per code requirements. (2) Provide -adequate bracing and/or trussing to support rafters and ceiling joist system.- . .. '(3) Matte the building weathertite. "(4) Remove and replace all dry rotted and/or deteriorated materials. (5) Provide attic and underfloor -access and ventilation. (6) The now wood stove and flue to be installed per code requirements. (7) Recommend installation of,attic insulation. (8) Provide smoke detector in hallway access to bedrooms. (9) Obtain Health Department approval of water supply and sewage disposal systems for new location. (10) The wall material mound the bathtub must be replaced with'an approved material. t ' r 9ace Rash (RE: Special Inspection 02=83, AP 026-08-73) June 21, 1983 Page 2 It is now in order for you to submit two complete seta of plans including plot plan, floor plan and structural details, apply for the required permits and pay the appropriate fees. Should you have any questions concerning this matter, please contact me. Yours very truly, Clay Castleberry. Director of Public Works . r Original signed by J. F. Glander J.F. Glander JBG:a Chief Building Inspector COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS :7 ''? ��•� 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APIPLICATION FOR SPECIAL INSPECTION _ Owner T-qrE? ! l�_S V1 A. P. No. 2G -0X'- I Mailing Address ,� ��;'� ( �) �Y !nn �� Telephone No.,{�n -7) . - Applicant Y`,.. j� C �„ Telephone No. Mailing Address uilding Location ' I hereby request a special inspection of the following building: 1. Dwelling (if only a portion, specify) �,C r 1 01 2. Apartment House (if only a portion, specify) 3. Commercial (specify present occupancy) 4. Other (specify) I am requesting a special inspection for the purpose of: 1. Moving the building. / / 2. Financing (specify agency) / / 3. Change of occupancy to / / 4. Other (specify) Case No. I hereby certify that I will obtain the necessary permits and make any necessary corrections, alterations, or repairs required by the County of Butte, as a result of this inspection, to comply with building and housing code requirements. I also certify that prior to the use or occupancy of this building, I will complete the above required corrections, alterations, or repairs, or, if the building is presently occupied, I will complete the above required corrections, alterations, or repairs within thirty (30) days. I certify that I have read this application and state the above information is correct and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Date ature of Owner r&D Fee paid $ .!M Receipt No, 1st -DPW - 2nd -Inspector- 3rd -Applicant BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECTION REPORT (,F&4 Owner.:�,cI-tee i 3z— b/ -z,,?A.P. Address:" ` Date Tenant: of Inspection':: Inspectors 'fes Building Location: / 6,L—L, J % n ���.,�- :1 vim; Type of Inspection requested: { T7 1. Housing. .2.`Financing 3. Change of Occupancy to - . 4. Other (specify)—! ... , x `2t- '. Present use of building:(�INc- A. Sanitation (Housing) .1. Water closet: 2. Lavatory: 3. Bathtub or shower: 4. Kitchen sink: 5. Hot and cold water to f ixtures ✓ ..6' Heating'facilities:`cA 7. Natural light and ventilation: ✓ 8. . Room and space requirements: •9.. Bedroom window or door for second exit: 10. Infestation of insects, vermin, or rodents: .11. Connectior.to sewage disposal: 12. Connection to water.supply: 13. Rubbish and garbage facilities: 14. .Comments: 'JAI e, B. Structural 1. Piers and footings: 2. • Floor construction:7,X c1 -3 o•� 3: Wall construction: . 4. Ceiling and:roof construction: L X ;�-�_� 2- —_ s� r h 5. Fireplaces:� 6. Comments: C. Electrical. 1. Service and ground: e:�Lc_ 2. Receptac: es: ' 3. Fusing: 4. Cmanent s: • e D. Plumbing . 1. Fixtures connected and vented: W eA,.2 2. Gas water heater: 3. Gas heating vents: 4... Coments E. Other 1. Maintenance and repair: 2. Fire hazards:• s. Safety hazards: 4. Weatl?er protection: 5. Underfloor and attic ventilation: 6: Corm:tents: F. Corrmrercial Buildings 1. Roof covering: ' .'2: Distance to property lines: 3. Physically handicapped: 4. rest -room floors and walls: 5. Exits: 6:- Improvements: 7. Zoning:_ 8. Comment G. Field Probl.ras or Violations 1. Problem or :►iolation (give complete description): ?. Writ action taken ( give complete-.i.escript:on) : .3. What action recommended: 77A. "Infoniation only - fil-2. B. Hold for ten (10) days, then write Letter. C. Wxi.te letter. /7D. Other: ► COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION ' 7 COUNTY CENTER DRIVE - OROVILLE:_CALIFORNIA 9,5965 - TELEPHONE: 916/534-4541 DE OWNER Proposed Building Utile. Permit Fee Based Upon Building Inspector I APPLICATION DATA SHEET n b I Peit N I"►�'7 A. P. No. 1.-1 , Complete Contract Price 11M DOWSVdllaation) L)2�.� Iain) Date 14 _n At time of permit application, I was advised tpie following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2. Plot plans in duplicate./triplicate. . . . . . . . . . . 3. Complete plans in duplicate./triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . 5. Plans with Vn rgy Design Compliance Statement. . . 6. State Energy Forms -No. 7 Statement of Intent for Non -Heated and AC Buildings, 8. Fees of $ ✓ . . . . . . 9. Letter of signature authorization. 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) `Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner0, Mail to owner ❑-) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . .. •Pre-Inspec. request to 1 ,Pae lns�ect on4for Required- Building Inspector 18. Other When you issue the permit, processus follows: Mail to owner. _ Telephone and hold for pickup at office. Other 4 L�l,y.eb '� 2xb Applicant (Date) Mail to contractor. —Deliver w/inspector. J >m'. ! is Date V Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other By Date Plans checked by + Date Plans approved by �G�.J /''`"�%''-�j % 'Date 1 Other: Copy—DPW