HomeMy WebLinkAbout026-090-011ol 26-09-11
Iris Nelson
7083 Lincoln Blvd., Oroville
contr: Smith Const., Paradise
Permit #2884-80,B,P,E(repair fire
j damage/SF)
I
026-090-011 04- A
NELSON, PHILIP
7083,;LINCOLN BLVD, OROVI WALE®
Cont: MIKE HURST
RPLC ELEC BOX -
ICS cril
�
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.netldds
PERMIT NO.
BP041709
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under �f
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 06/16/2004 APN• 026-090-011-000
the Business and Professions Code, and my license is in full force and -
effect. ,l
License Class: v License Number: ry Site Address: 7083 LINCOLN BLVD PAL
Date:4 'L - 011 Contractor. Ph H Map Index:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Description: REPLACE ELEC BOX
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: NELSON PHILIP E & JOANN M REVOCABLE -
to its issuance, also requires the applicant for such permit to file a LIVING TRUST
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section NELSON PHILIP E & JOANN M TRS
7000) of Division 3 of the Business and Professions Code) or that he or P O BOX 233
she is exempt therefrom and the basis for the alleged exemption. Any PALERMO CA 95968-0233
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 Applicant: NELSON PHILIP E & JOANN M REVOCABLE
such work himself or herself or through his or her own employees, LIVING TRUST
provided that.such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one NELSON PHILIP E & JOANN M TRS
year of completion, the owner -builder will have the burden of P O BOX 233
proving that he or she did not build or improve for the purpose of
sale.). PALERMO, CA 95968-0233
❑ 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.).
Contra-'—
❑ I am Exempt under Article 3 of the Business and Professions Code r OFFICE COPY
i
Date: Owner:
Address
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 GAS
workers' compensation, as provided for by Section 3700 of the Licen: Meter By Date
Labor Code, for the performance of the work for which this permit
is issued. ELECTRIC
❑ 1 have and will maintain workers' compensation insurance, as Meter By Datet!
required by Section 3700 the Labor Code, for the performance of Archil
the work for which this permit is issued. My workers' compensation _ , -
insurance carrier and policy number are: Engin _.___ _ — — ---
Carrier:_ /
Policy #:
Oil I certify that in the performance of the work for which this permit is Total Square Ft: 0 S.
issued, I shall not employ any person in any manner so as to Valuation: $ /
become subject to the workers' compensation laws of California, Census Code:
and agree that if I should become subject to the workers' I
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
�^ /6_o�
_ �
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 pe t i her y s e un er t nw
e provisions of the Butte County Cody anwor
I hereby affirm that there is a construction lending agency for the Resolu on o w a fees ave been paid. D
performance of the work for which this permit is issued (Sec 3097 Civ.)
gy; i Date:
Name:
PERMIT EXPIRES ON:
Address: Date
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte Count to enter upon the above mentioned property for inspection purpo
Print Name: V Signature:
Date: (Q
0 Owner I Contractor ❑ Agent for Owner ❑ Agent for Contractor
- r �
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BP041709
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: 06/16/2004 APN- 026-090-011-000
'
the Business and Professions Code, and my license is in full force and
effect. ''ll
License Class: License Number:
Site Address: 7083 LINCOLN BLVD PAL
Date: G� Contractor. % Yl 14
Map Index:
Description: REPLACE ELEC BOX
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: NELSON PHILIP E & JOANN M REVOCABLE -
to its issuance, also requires the applicant for such permit to file a
LIVING TRUST
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's Slate License Law (Chapter 9 commencing with Section
NELSON PHILIP E & JOANN M TRS
7000) of Division 3 of the Business and Professions Code) or that he or
P O BOX 233
she is exempt therefrom and the basis for the alleged exemption. Any
PALERMO CA 95968-0233
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
Applicant: NELSON PHILIP E & JOANN M REVOCABLE
such work himself or herself or through his or her own employees,
LIVING TRUST
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
NELSON PHILIP E & JOANN M TRS
year of completion, the owner -builder will have the burden of
P O BOX 233
proving that he or she did not build or improve for the purpose of
sale.).
PALERMO, CA 95968-0233
❑ 1, 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.).
Contractor:
❑ 1 am Exempt under Article 3 of the Business and Professions Code
Date: Owner:
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
License #:
Labor Code, for the performance of the work for which this permit
is issued.
❑ I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
Architect:
the work for which this permit is issued. My workers' compensation
Engineer:
insurance carrier and policy number are:
Carrier:
Total Square Ft: 0 S. F.
Policy #:
I certify that in the performance of the work for which this permit is
Valuation: $0.00
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
Census Code''
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.
to_ 0
Date:l(J"""""
Applicant:_ A-"_" —
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
This pe t i hery s e un er t app yca le provisions of the Butte County Cods anedor
Resolu on o w I i t a whkh fees ave been paid. D
performance of the work for which this permit is issued (Sec 3097 Civ.)
By: I Date:
Name:
r.
PERMIT EXPIRES ON:
Address:
Date
O 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 Count to enter upo the above mentioned property for inspection purpo
r
Print Name: V Signature:
Date:
❑ Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor
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
PERMIT NO.
BP041709
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' 06/16/2004 APN' 026-090-011-000
'
the Business and Professions Code, and my license is in full force and
effect. ''ll
License Class: V License Number: J
Site Address: 7083 LINCOLN BLVD PAL
Date: G -/ - o't Contractor. �l H
Map Index:
Description: REPLACE ELEC BOX
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
NELSON PHILIP E & JOANN M REVOCABLE
Owner,• REVOCABLE -
to its issuance, also requires the applicant for such permit to file a
LIVING TRUST
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
NELSON PHILIP E & JOANN M TRS
7000) of Division 3 of the Business and Professions Code) or that he or
P O BOX 233
she is exempt therefrom and the basis for the alleged exemption. Any
PALERMO, CA 95968-0233
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
Applicant: NELSON PHILIP E & JOANN M REVOCABLE
such work himself or herself or through his or her own employees,
LIVING TRUST
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
NELSON PHILIP E & JOANN M TRS
year of completion, the owner -builder will have the burden of
P O BOX 233
proving that he or she did not build or improve for the purpose of
sale.).
PALERMO, CA 95968-0233
❑ 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.).
Contractor:
❑ 1 am Exempt under Article 3 of the Business and Professions Code
Date: Owner:
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one ofthe 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
License #:
Labor Code, for the performance of the work for which this permit
is issued.
❑ I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
Architect'
'
the work for which this permit is issued. My workers' compensation
insurance
Engineer:
carrier and policy number are:
Caner:
Policy #:
Total Square Ft: 0 S. F.
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
Valuation: $0.00
become subject to the workers' compensation laws of California,
Census Code:
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply those provisions.
with
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 s provided for in Section 3706 of the Labor
%1
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This her y s e unper t app'cz Ie provisions of the Butte County CodA anrVor
I hereby affirm that there is a construction lending agency for the
Resow a h fees ave been paid:Dperformance
pf
of the work for which this permit is issued (Sec 3097 Civ.)/�Name:By:
Date: l!�
PERMIT EXPIRES ON:
Address:
Date
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte Count to enter upo the above mentioned property for inspection purpo
1
Print Name: l� LJ Signature:
Date: A � C—)
0 Owner Contractor 0 Agent for Owner ❑ Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (5 30) 538-7636 • CHICO: (5 30) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
OWNER
Name n
Address
City ��,- rte✓ ,
State
Zip EV 68
Phone .. ��
Fax
E-mail
Q APPLICANT SIGNATURE
X v
For office use only:
CONTRACTOR
Name M. -H
I't v-►� 3�
Address
SRA
City
No
State
Zip
Phone
Map Book
Fax
E-mail
Planner
Lic. #
Class
Q APPLICANT SIGNATURE
X v
For office use only:
ARCHITECT/ENGINEER
Name
Sd in
Address
SRA
City
No
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
Q APPLICANT SIGNATURE
X v
For office use only:
APPLICANT NAME
Name
Sd in
Address
SRA
City
No
State
Zip
Phone
Map Book
Fax
E-mail
Planner
Q APPLICANT SIGNATURE
X v
For office use only:
Zoning
Flood Zone
SRA
I Yes
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
BIN #
LOCATION
AP# Z 6— <)
Propel J
Address
ddres�s� :
11 ,r, ccs ✓, ll
Cross Street , I�,/`Th L %
Al � U�
WORKER'S COMPENSATION
Policy Number
Carrier
F
ng anyone other than license contractors, a certificate of worker's
ensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work: I
Sq.
❑ 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
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are"not
refundable.
Received by: ICI Amount: l Bldg
SRA
Receipt #: 4-D4o 3M Sheriff
SMIP
Date:
Other
(Pl j 4,/per
i • ^ Total
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 4-30-04
SUBMITTAL REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply
fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE
LEGIBLE AND IN INK.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER!
❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed
calculations.
❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 5. Letter from Engineer or Architect for truss design review.
❑ 6. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to
mobile or modular homes.)
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 8. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 9. Sanitation and site plan approval from the Environmental Health Department.
❑ 10. Metal Buildings: (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.
Mobile, Manufactured, or Modular Homes:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line information.
❑ 4. 2 Floor plans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.
❑ 6. Sanitation and site plan approval from the Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑
1.
4 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑
2.
4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑
3.
2 Engineered truss details and layouts (if required) (NO FAXES!).
❑
4.
Letter from Engineer or Architect for truss design review.
❑
5.
2 Energy compliance design and supporting documentation (if required).
❑
6.
2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑
7.
Statement of Intent for Non -heated and A/C (if required).
❑ '
8.
Metal Buildings: (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.
❑
9.
Letter of intent.
❑
10.
Hazardous Material Form.
❑
11.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F6RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04
O.B.-1
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.
0 I personally plan to provide the. major labor and materials for construction of the proposed
property improvement : YES NO ❑
I HAVE 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.:
NAME:
ADDRESS: Criy..
PHONE:
CONTRACTOR'S LICENSE NO.
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:
PHONE:
CITY:
CONTRACTOR'S LICENSE NO.
I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
ADDRESS PHONE TYPE OF WORK
SIGNED:
7X PROPERTYOWNER:
7(DATE:_
NOTE. This Owner -Builder Verfficafion is required by Section 19831 and 19832 of the
California Health and Safety Code. This venftcation must be completed and
returned to our office before we are permitted to issue the permit
OVER
OWNER BUILDER MTORMATION
Dear Property Owner.
An application far a building permit has been submitted in your name listing yourself as the binder of property
improvements specified.
For your Protection, you should be aware that as "owner bm'Ider" you are the responsible party ofrecord on such
a permit Building permits are not requn ed to be signed by property Owners unless they are personally performing their
own worm If your work is being performed by someone other than yaurseh; you may protect yourself from possible
liability if that person applies for the proper permit is 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 worm with time exception of various trades that you plan to subcontract, you should
be aware of the following information for your benefit and protection:
d If YOU employ Or Otherwise engage any persons other flM your immediate family, and the work (nchuling 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.
♦ If you are an employer, you must register with the State and Federal Govemmeats as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social secmity taxes,
wogs
mpensabOn insurance, disability ins rm= costs, and unemployment compensation contributions.
There may be financial rids for You ifyou do not carry out these obligations, and these risks are especially serious
with respect to wO11mes compensation Insurance.
♦ For more specific information about your obligations under Federal Law, camtract the Interval Revenue Service (and,
if you wish, the U.S. Small Business . ' ). 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 ova 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► en'oneously implying that the property owner is providing his or her own labor and material personally.
permits are not required to be P >'. Building
signed by property owners unless they are perkrming their own wow personally.
Infimatim about ceased contractors may be obtained by contracting the Contractors State License Board m your
comnrmify or at 102D N Street SaCramentD, CA. 95814.
Please complete the "Owner Builder Verification" on flee reverse side of this forum so that we can confirm did you
are aware of these matters. The building permit will not be issued until the verification is retume&
ly,
tuft 1 G Vi nra, C.B.O.
, Building Inspection
NOTM M's 0wiw-Bum Intonation is required by Section 19930 oftke Cdgorida Health =d Safety Code
PRE -INSPECTION REPORT
OWNER: J e7ts� 4 DATE: 14.04
LOCATION: 7083 ��� �� �w o� T� ��� A.P. # -40 It
CONTRACTOR: ZONING:
REASON FOR PRE -INSPECTION F L -EG _54X c HA,+ & E &-t t. T
DATE TO INSPECTOR: 04- PERMIT HISTORY ( ) NONE ( SEE ATTACHED
BUILDING INSPECTOR'S REPORT
Building Description:
Commercial/Usage:
Residential # of Units: Mobile home # of Units:
Currently Occupied Yes () No
Abandoned/Vacant:
Electric:
Electric Currently
Condition of Electric
Gas:
-V On ( ) Off
Currently On () Off
Condition
Sanitation:
Plumbing Working () Yes ( ) No
Obvious Sewage Problems ( ) Yes ( ) No
ACTION RECOMN[ENDED: ISSUE Yes O No
Hold for permits or verify: _ 1
Inspector:
Date: �S
CKFTC.H BTTTT,DTNG.9 ON REVERSE AND INDICATE LOCATION ON PROPERTY.
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6 9-11
Iris Nelson
tt1 ` - . a < Z. a 7083 Lincoln Blvd Oroville i ct
contr : Smith Const. , Paradise
t! Permit #2884-80,B,P,E(repair fire +` �
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2884-80B,P,E
PERMIT NO.
PERMIT EXPIRES �:/ / 0/r/
Iris Nelson
OWNER
CONTR. Smith Const., Paradise
26-09-11
LOCATION (A.P. )
7083 Lincoln Blvd., Oroville .
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
Called PG&E
J 0 B
FINALED / (J
(Date)
t
(Signature)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
StemwalI
Sidino
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
StemwaI I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
fro
Footings
Slab
Prov. for phsically
handica ed
Conformance of ex.
structure
Final
Appliances
Gas Piping & Test
Temp. Gas
Sanitation
Patio
FIREPLACE
Final
Footings
Footino
FLFrTRIrnl.
Relnf. Steel
Final
Fixtures V
Bond Bea
FIRE SPRINKLERS
Motors
Framing jyo
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heatina
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
MOBILEHOME UTILITIES ------------------Elec.
Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
BI E OME INSTALLATION - - - - - - - - - - - - - -
Support
Elec. Continuity
Water Piping
Drainage
Gas Piping
• A- MAR OR CORRECTIONS
i
i/
(NOTE: An entry must be made on this form each time you visit the job site.)
i
PERMIT NO. 2884-80B, P,E
PERMIT EXPIRES 610/81
OWNER IRIS NELSON
CONTR. Smith Const, Par
LOCATION (A.P. 26-09-11 )
7083 Lincoln Blvd, Palermo
Temp. Power Pole
Called PG&E _
Temp. Elec. Ser
Called P E
Temp. Gas erv. _
Call PG&E
LEDIW711P
(Date)
(Signature
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING I BUILDING (Cont'd) I PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Sidin
To out
Slab
Roof Sheath in /-5
Water Piping
Piers
Roofing %
Sewer
Garage
Fdn. Vents
Fixtures
Footings
StemwaII
Garage Vents
Insulation '%2,
Water Htr. cclf
Heaters
Slab
Carport--
p
Footings
Prov. for physically
handica edy
Conformance of ex.
re 4
Appliances
Gas Piping &Test
Temp. Gas
Slab
Fin
Sa on
Patio
iR LACE
-anal
Footings
Footing
E-UCTRicOL
Masonry Walls
Throat
Rou h Y -f 1111,
Refnf. Steel
Final
Fixtures W f�
Bond Beam _ / /
FIRE 6PRINKI ERS
Motors
rramin / o Test Water Htr.
Stucco Final X4
Subpanels -
Mesh I MlfCHANICAL Gird. Fault Prot.
scratcn
Heating
Service
Brown
-Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
PgaNineph
Door Closer
MOBILEHOME UTILITIES ------------------
Final
Elec_ Service'—&e—c.
ena
Pe stal
Water Piping
Sewer
Gas Piping
MOBILEHOME INSTALLATION - - - - - - - - - - - - - -
Support
Elec. Continuity
Water Piping
Drainage
Gas Piping
DATE REMARKS OR CORRECTIONS
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
ASSES OR PARCEL NUMBER_
—0L-
._ ® —
ZO ING
— Z-
BUILDING PERMIT/FJ 71je,
WNE �fs .e
O Say
—�r
TELEPHONE
SO. FT. OCC. L, BUILDING VAON
OWN 'S MAILING ADDRESS
01 3 e o
CONTRACTOR'S NAE
75- d G
TE,I.FP` ONE
VLt7777TTi
CONTRACTOR'S MAILING ADDRESS G
CONSTRUCTION LENDER
cc
UNKNOWN
Fireplace
Total Valuation $
(Z Oo . ��
LENDER'S MAILING ADDRESS
Permit Fee
$ O�
ARCHITECT OR ENGINEER oe
� �
LSE NO.
ICEN
Plan Checking Fee
,$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ Gb
BUILDING ADDRESS 709 3 / , `v
Gam!
PLUMBING PERMIT
Filing Fee 3.00
Each Trap
2.00
Repair drainage or vent piping
2.00
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
2.00 2,C9,C�"
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF $? Duplex ❑ Mobi lehome ❑ Other
SPECIFY
Building sewer
Lawn sprinkler system
—4:
2.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities [:1Instaliation ❑ Other,K
Describe work: T�n� PcC6f�f�lcAO
Permit Fee
$ j 60"
Contractor
ELECTRICAL PERMIT
Filing Fee 3.00
Main service 600V OR LESS
100 AMP OR LESS
5.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONSTDWELING
OR ADDNS. ` ACCLBLDGS.CCUP.&)
20 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No.�Z.1�— �6 P 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 CONSTR. MULTI -OUTLET
NON.RESID BRANCH CIRCUITS)
2.50 ea
NEW CONSTR POWER APPARATUS &\
NON.RESID, SINGLE OUTLET CIR. /
Ex. Occup(OUTLETS OR FIXTURES 50@�
BAL�10S
Ex. OCCU //FIXED APPLINISTS (RES, OR \
p•\OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
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 3.00
Heating
Cooling
Hood
2.00
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 County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs,and expenses which may in any way accrue
against s id County in co equerice f the granting of this permit.
' s—
X Date
Signature Applicant — Owner ❑ Contractor oRKI. 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 $
Land Development Fee $
TOTAL PERMIT FEE Z
occOP. GROUP
I TYPE OF CONST.
PARCEL
PD
F-771779U—E
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTO PUBLIC
BY
PERMI X IRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date ,//J'�`�
Receipt No. go
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
SPECIAL INSPECTION REPORT
Owner: A.P.
Address: �O, DX 2 3 7� Date of Inspection
Tenant: Inspector L�„ �r •. U
Building Location: -7 o
Type of Inspection requested:
1. Housing / / 2. Financing / / 3. Change of Occunancv to
4. Other (spec
Present use of bui
,' a
A. Sanitation (Housing) ;
1. Water closet:.
2. Lavatory:
3. Bathtub or shower:
4. Kitchen sink:
5. Hot and cold water to fixtures:
6. Heating'facilities:`
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. Connection'' to sewage disposal:
12. Connection to water supply:
13. Rubbish and garbage facilities:
14. Comments:
B. Structural
1. Piers and footings:
2. Floor construction:
3. Wall construction:
4. Ceiling and'roof construction:
5. Fireplaces:
6. Comments:
C. Electrical
1. Service and
2. Receptacles:
3. Fusing:
4. Comments:
ground:
D. Plumbing
1. Fixtures connected and vented:
2. Gas water heater:
3. Gas heating vents:
4. Cosa ents
(rnnti"110A nn )%nnle%
E. Other .
1. Maintenance and repair:
2. Fire hazards:
3. Safety hazards:
4. Weather protection:
5. Underfloor and attic ventilation:
6. Comments:
F. Commercial Buildinfis
1. Roof covering:
2. Distance to property lines: _
3. Physically handicapped:
4. Rest-oom floors and walls:
5. Exits:
6. Improvements:
7. Zoning:_
8. Comments:
G. Field Probl.eps or Violations
1. Problem or, violation (give completg descript.�4)n) :,—/
2.
3.
7� information only - fi ,e.
/ / B. Hold for te:i (10) days, then write letter.
/ / C— Write letter.
/7D. Other:
T
f
Smith ,Construction
CLIFF SMITH - GENERAL CONTRACTOR
License No. 224-208
5911 Sawmill Road - Telephone 916/877-3334
PARADISE, CALIFORNIA 95969
DATE 1911
"Under the Mechanic's Lien Law any contractor, laborer, supplier or other person who helps
to improve your property' but is not paid for his workor supplies, has a right to enforce a claim
against your property. This means that, after a court hearing, your property could be sold by a
court officer and the proceeds of the sale used to satisfy the indebtedness. This can happen even
if you have paid your own contractor in full if the subcontractor, laborer, or supplier remains unpaid."
2-'
IV
W V �Y- 0-4
doory
"Under the Mechanic's Lien Law any contractor, laborer, supplier or other person who helps
to improve your property' but is not paid for his workor supplies, has a right to enforce a claim
against your property. This means that, after a court hearing, your property could be sold by a
court officer and the proceeds of the sale used to satisfy the indebtedness. This can happen even
if you have paid your own contractor in full if the subcontractor, laborer, or supplier remains unpaid."