HomeMy WebLinkAbout026-280-006A.P. 26-28-6 Of
EMIL ZABOKRTSKY 7/rl `
1844`" Wi ll'iams Ave . Palerm�
Permit 336-74B,E (add a liv.rm.)
026=280=006 :PERMIT#95=1320 i
HUDSON,. Joy. ;
1844` Williams,, Oroville
Cont;'George Roofing
Rarnnf/0,F
026;280-006 05-2417
HUDSON, JOY
1844.,WILLIAMS AVE, PALERMO
Cont:' DANIEL: HEAL PLUMBING
GAS LINE
N
Y �► CV � i
PERMIT NUMBER _ B 336-74B . E
P
E
PERMIT EXPIRES cZ
OWNER Emil Zabokrtsky
CONTR: owner
LOCATION (A.P. 26-28-6
1844 Williams Ave., Palermo
•
COUNTY OF BUTTE
Department of Public Works
BUILDING INSPECTION RECORD
—
0�
Zoning
Setback
Forms -�-
Foundation
_ Piers & Girders
Fireplace
Rgh. Plumbing
Bond Beam
Lath & Plaster
Rein. Steel
Gas Piping & Test
Found. Vents "
Framing —/J '-
Plmg. Topout
Rough Elec,
Wtr. Htr.
Furnace
Kitchen Vent
Firewall
Garage Vents
Sanitation & Water
ELECTRIC
GAS
BUILDING
Temporary _
Temporary
Cert. of Occu .
Final
Final
Final y ''
DATE REMARKS OR CORRECTIONS
i
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORK
7 County Center Drive — Orovi Ile, California 95965
Telephone: 534-4541 T,
APPLICATION AND PERMIT
auulu,ze lwtI St1nlQllyeS of me County or Butte to enter upon the
above-mentioned property for inspection purposes.
X *,ate s
$ig ature o ermitee or Agent
Receipt No. ,,�,�,���%
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF UBLIC WORKS
�_
BY Date 2 7— 2V'
Building permit expires Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mai I i ng Address Lam'
cTv
Telephone No.
33—/o 9s
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
p
Permit Fee $
$
Building Address
PLUMBING No.1 @ FEE
PERMIT FILING FEE $2.00
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No.
Zoning & Planning
Z
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Rees
W__e-
Sa�yt'e1Ton
I FI re Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Improvements
P
Lawn sprinkler system 2.00
Bldg. �Rec'd
Parcel val
Pla proval
Permit Fee $
$
NEW ❑ ADDITION UTILITIES ❑ OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 3
.
Main service incl. 1 meter
Additional meters, each 1.00
Sub -panel (12 or less) (more than 12)
Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑
Range, Cook -top or Oven 1.00
- _
Water Heater or Space Heater 1.00
20 Light fixtures ball 4(11�0 ✓�'
'
CONTRACTORS LICE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
R s., swi es & fix ou O Zif�S
Hood, Ex. Fan or F. A. Furn. Motor 1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
10-1-amexempt from the Contractors License Laws of the State of California.
Permit Fee $ G O
$ G
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No.1 @ FEEPERMIT
FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
TOTAL PERMIT FEE
T -37-70--F
auulu,ze lwtI St1nlQllyeS of me County or Butte to enter upon the
above-mentioned property for inspection purposes.
X *,ate s
$ig ature o ermitee or Agent
Receipt No. ,,�,�,���%
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF UBLIC WORKS
�_
BY Date 2 7— 2V'
Building permit expires Date
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUAN
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
the Business and Professions Code, and my license is in full force and
effect. �2
License Class: 3 (,� License Number:J-9313 i
Date:. P-/^ 5contractor: � Yl 1 ie_ C, 'Aa I
77 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.). .
❑ 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:
❑ 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; cq_� l -kP— -V— Vk v-, a
Policy #: bt) t) n --) Is oL ',-), (2> c-)
❑ 1 certify that in the performance of the work for which this permit is
issued, 1 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:
Applicant: _ , pJ �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
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
Address:
• PERMIT NO.
BPO52417
IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
Issued Date: 09/08/2005 APN: 026-280-006-000
Site Address: 1844 WILLIAMS AVE PAL
Map Index:
Description: GAS LINE & METER RELOCATION
Owner: HUDSON JOY K SS
1844 WILLIAMS AVE
PALERMO, CA
95968
Applicant: HEAL, DANIEL PLUMBING
CHRISTINE HEAL
12206 MERIDIAN ROAD
CHICO, CA 95973
(530) 345-2142
Contractor: HEAL, DANIEL PLUMBING
12206 MERIDIAN ROAD
CHICO, CA 95973
(530) 345-2142
License #: 393518
Architect:
Engineer:
Total Square Ft:
Valuation:
Census Code:
ishereby issued under
Oo work indicated a.
PERMIT EXPIRES
0 S. F.
$0.00
'(557 -
Cdr
provisions of the Butte County Code and/or
fees have been paid.
Date:
❑ 1 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 psol-,
Print Name: ",K -h r \S C �.P c �C1Signature:1 �J
❑ Owner
❑ Contractor
❑ Agent for Owner
Agent for Contractor
STT€ BUTTE COUNTY
p\I / ° DEPARTMENT OF DEVELOPMENT SERVICES
p
° BUILDING PERMIT APPLICATION
o o AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2534
p==—='a'- p OFFICE #: (530) 538-7541
-� A FEE I-VILL BE REO UIRED AT TIME OFAPPLICATION
Website: www.buttecounty.net/dds
'''PLEASE PRINT CLEARLY**
CONTRACTOR
ARCHITECT/ENGINEER
NIP
C�/� -
4
Address
SRA
City
Cityc_\r'-` C>
State
Statp.
ZilicM -7
om
'�— is
CONTRACTOR
ARCHITECT/ENGINEER
Name
C�/� -
4
Address
SRA
City
Cityc_\r'-` C>
State
Statp.
ZilicM -7
Phone3
ZL
Fax 5_
I
E-mail
Lic. #
Cl�ss
APPLICANT SIGNATURE
For office use only:
ARCHITECT/ENGINEER
Name
C�/� -
4
Address
SRA
City
I No
State
Zip
Phone
oZ I Z
Fax
E-mail
Planner
State License Number
APPLICANT SIGNATURE
For office use only:
APPLICANT NAME
Name
t ��
Address
SRA
City C
I No
Stat y�
ZpT5O 73
(�
Phone �—
oZ I Z
Fax
E-mail
Planner
APPLICANT SIGNATURE
For office use only:
Zoning
Pr ert Ad res
I
Flood Zone
Cross Street
SRA
I Yes
I No
Occ.
Type Const
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
PERMIT
NO.
BIN #
LOCATION
AP#
Pr ert Ad res
I
Cross Street
WORKER'S COMPENSATION
Policy Number
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:
Sq. Footage
❑ 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
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: Amount: Gv Bldg
SRA
Receipt #: 435G0 Sheriff
(f r� ( /S 7 0 W—y SMIP
Date:
Other
s'� c0
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 Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down' or fnd plans, all in
duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
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.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑
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
e
A",
026-280-006 PERMIT#95-1320
HUDSON', Joy
1844 Williams., Oroville
Cont; George-
Reroof/SF'
i
i
i
4
_ A
1
_. ..- •. ,r.__-.--._.. -�---'f'r•-•"w1'°SG,"1'`-"'.."^""m"-"`^...+-.. ...::fiwv.••...;T a•r..r•--r-'o,
r
COUNTY OF BUTTE - DEPARTMENTOF,DEOPMENTSERVICES- BUILDINGDIVISI N
7 .County Center Drive - Oroville, Calif a 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION SND PERMIT
ASSESSOR PARCEL NU QE //`` /,(Jn
V— OL"'
ZONING
BUILDI PERMIT
OWNERTELEPHONE..
�`-n ! j , . �,•�
,
5 r _�°iA`+�
SQ.(FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS I n
/
- `� `J ♦ r , • �J
,r �p �.I
CONTRACTOR'S NAME' '
TELEPHONE
CONTRACTORS MAILING ADDRESS) -�
;11/ fa < ` t (4
Fireplace
CONSTRUCTION LENDER 7UN
OWN
Total Valuation $
1 �.i,• 1- 0
LENDER'S MAILING ADDRESS
Filing Fee
$ 20,00
Permit Fee
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty
$
BUILDING ADDRESS ,r
X -( UJ
PERMITFEE
$
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
Solar or heat pump water heater
23.00
USEOFSTRUCTURE
SF E' Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: T� v '+ y r ; , . , „ •: -. t ... » : 7
,,
Mobile Home IS I GI W 1
920.00
PERMITFEE
$
Contractor
ELECTRICAL PERMITFilin
Fee 20.00
Main Service / a OR LESS
2ooA OR LESS )
23.00
Main Service ( 200A TO I000A )
46.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect. 7 .l (c
License Class t Lic. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUR
OR ( d ACC. BLAS. )
s0.
3.50 Fr.
CNS.
NEW CONST. MULTI -OUTLET
NON.RESID. ( BRANCH CIRCUITS )
07.50
POWER APPARATUS )
d SINGLE OUTLET CIR
Ex. Occup. ( OUTLET OR FIXTURES)
B20 @ 1.00
50
EX. Occup. O FIXEDrs PPLNS. OR
( )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$
Contractor
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
Policy Number ? ; — ' 1
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X f\. '� Date _�' ' �+
Signature of Applicant - ❑ Owner ❑ Contractor ❑Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee is
OCC
CONST. TYPE
TOTAL FEE $ S O
HAZ
I D. FEES
I IMP
I FLOOD
CDF
PARCEL PD HO
ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
BY ("
the applicable provisions
Resolutions to do work
been paid.
f
Date h s Cf5
(D e)
ReceiptNo.. �!� l� 1,-;tPERMITEXPIRESON�
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
t I'
COUNTY OF BUTTE- DEPARTMENT OF DEL
,O SERVICES - BUILDING DIVISI
7 County Center Drive - Oroville, Cal omia 95965 - Telephone (916) 538-7541 �/ PERMIT NO.
APPLICATION AND PERMIT
ASSESS P ;ELN V— oo(p
ZONING
BUILDI PERMIT
OWNER So ��N c�S On
TELEPHONE
5-33-10-7j_
SO, T OCC. BUILDING VALUATION
�o•"
3Co ,pP
owN�R y4 �Wi��i9v✓IS oro�;l - c� 5'S -9r6
CONT11 CTOR'S NAME
e�►� �oa 01
TELEPHONE
.5 X33-6393
CONTRACTORSIU�N�G/�DRESS 1 I
% W °tN�a �1olro✓/ 9-5-9,6 4
Fireplace
CONSTRUCTION LENDER
UNMOWN
Total Valuation $
3 , O,O
Filing Fee $
20.00
LENDER'S MAILING ADDRESS
Permit Fee $
S
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING �p� ss ' 1 i I f `q� S o rO✓, I ¢ CA 9S^ C6
YY W IJ
PERMITFEE $
35,E
PLUMBINGPERMIT
Filing Fee 20.00
Each Trap
7.00
LAT NO.
SUBDNISION'S NAME
PARCEL MAP
Solar or heat pump water heater
23.00
USEOFSTRUCTURE
SF B Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ rte 4fr•
Describe Work: Over 19, com Po s 1r sur► $ vl / ///r
/
0\/Q.r dg-,—A�- �-tq Q 6(>WLJL ,
Mobile Home IS I GI W1
@20.00
PERMITFEE $
Contractor
ELECTRICAL PERMIT
Filina Fee 20.'00
Main Service 0 OV oR LESS
( z00A OR LESS )
23.00
Main Service ( 200A To I000A )
46.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in 11111 f rce and effect. SZ Z
License Class — Lic. No.g
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUR \
OR ADDNS. ( 8 ACC. /
So.
3.5¢ F7.
NEW CONST. MULTI -OUTLET
UTLE
NON-RESID. ( BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
8 SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES)
20 Q 1.00
SAL 0 .so
FIXED AP
Ex. Occup. ( OUTLETS (RESID.OEA)
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE $
Contractor
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' Qomppensgtinin urance carrier and policy number are:
Carrier S -rgTe- r41 ✓l
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE $
Contractor
Policy Number Z85`5_0ci
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
_
X . _ Date �1/G/ 9.5
Signature of Appli t - ❑ Owner OeZontractor &-;(gent
An OSHA permit Is required for excavations over 50 deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPEO
TOTAL FEE $ 3 5-, O
HAZ.
D. FEES
IMP
FLOOD
CDF PARCEL PO HD
ISSUE
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated above for which fees have been
BY Date
(k
PERMIT EXPIRESON
(0
provisions
to do work
paid.
5
e)
Receipt No. 'r
WHITE-D.D.S.-E.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
Status: JISSUED_„_ APN: JU6-MQ.0O6-000
Site Address: 11844 WILLIAMS AVE PAL
Map Index:
Owner (Title): HUDSON J Project Title:
Contractor: JKALODANIELPLLIMBING I Applicant:Id
EAL,_DANIELPLUM_B-1-NG-. J
Contr Phone: F(5-30) 3452 Architect:
Z14_ _I
Contr. Lic. # 35-3518--i Engineer: --J
Description: IGAS LINE & METER RELOCATION
Fee Summary
Permit Issuance Fee:
Travel/Documentation: DF---$UQ0-
Investigation Fees: n[�To-.�00
TOTAL FEES: F--$55,-00
Fees Paid:
Balance Due: F- =0r00
Mechanical Fees: QQ
Plumbing Fees: 00
Electrical Fees: $0.00
Total MPE Fees: F —$55.00
Key Dates
Applied: 109408/2005 BP Renewal: 1_I L=
Approved:�—j
A Expired: F JI
Issued: FQ9�-QRMQM
J Voided: _l_ —LL
Finaled:
Census Data
Census Class Code:
�1 jjpditeLH+ Kt [E
Permit Type: PT�UM-B=
Commercial (Y/N):
Required to Issue
Contractor Lic:
Pre-Insp:
Planning: ri
Owner/Builder:
Health: r!
L–A
Water:
Fite: L
NPDES:
PW -Land DvImt:
Workers Comp:
PW Encroach:
Sign Authorization: r]
Plan Check:
Special Districts
Tax Rate Area 1pgZQQQLZ,_
High School District: ORO HI
Elementary School District: JP411ER140,
Water:
Sewer:
Rec Dist:
Intialized: 09/0812005:' TPOWELL�
Wednesday, September 20, 2006 Development Services
1 BUILDING DIVISION
Counter Tammie
Person
Payment Date
Permit Number
Receipt Number
Check Number or Cash
Parcel Number
Applicant
Received From
Total Received
Total Fees To Collect
Notes:
9/8/2005
05-2417.
435550 �,
17845
026-280-006
JOY K. HUDSON
DANIEL HEAL PLUMBING
$55.00
$55.00
Ver. 1.0
Fund 10 (Bldg Permits)
SRA Fees (Fire)
SHR Fees (Sheriff)
SMIP
Copies/Document Sales
CUA (Chico Urban Area)
TUA (Therm. Urban Area)
Water Tender Btln #
West Chico Fire Station
AVA Restitution Payment
Recorders Fees (N.O.C)
Thermalito Drainage
Oroville Area Traffic
NSF (Non Sufficient Funds
Notice of Violation
NCSP Trails System
NCSP Roads/Bridges
NCSP Storm Drainage
NCSP Fire Station
NCSP Parks
Value
I $0.00
$0.00
$0.00
$0.00 I
$0.00 I
$0.00
$0-22J
$0.00
$0.00
$0.00
$0.00 �
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00J
$0.00
Type $0.00
REQUEST FOR
AUDITOR'S CERTIFICATE AND TREASURER'S RECEIPT
DEPARTMENT: DEVELOPMENT SERVICES - BUILDING DIVISION
DATE: 9/9/2005
BAG NUMBER: 329
DEPOSIT NUMBER: 48
RANGE OF RECEIPTS: 435490-435569
MONEY COLLECTED: 9/8/2005
FUND FUND DEPT ACCT CASH
DESCRIPTION TITLE CODE CODE CODE CODE AMOUNT
BLDG PERMITS
BLDG INSPCTN
4210506 10100_i_1
5,39
REMOVE NOTICE OF VIOLATION
GENERAL FUND0010
CfO01044000_1
440001
4350903
101001
_
$
CHRG ON RET CHECK
BLDG INSPCTN
0010
440001
4610105
101001
$ -
AVA COURT ORD RESTIT REIM
AVA CRT ORD
0010
440001
4617252
101001
$ -
COPIES
COPY SALES
0010
440001
4711910
101001
$ 0.92
WITNESS FEES
BLDG INSPCTN
0010
440001
4712523
101001
$ -
RECORDERS FEES
GENERAL FUND
0010
470001
4613701
101001
$
FIRE PLNG APPL FEE (SRA)
FIRE PROTECTN
0100
450001
4617240
101001
$ 475.00
SMIP FEES
SMIP FEES
1001
280
1011298
$ 106.56
SHERIFF DEVELOPMENT (SHR)
SHER DEVL FEE
1800
280
1011811
$ 1,076.01
CHICO URBAN STREET IMPROVEMENT
CHICO URBAN AREA
1800
280
1011815
$
OROVILLE AREA TRAFFIC
OROVILLE TRAFFIC
1800
280
1011817
$ -
CHICO VECINO DRAINAGE TRUST
CHICO VECINO
1800
280
1011821
$
THERMALITO DRAINAGE
THERM. DRAINAGE
1800
280
1011822
$
DRAINAGE DEPOSIT TRUST
DRAINAGE DEP. TRUST
1600
280
1011823
$ -
SUB -DIVISION DRAINAGE TRUST
SUB•DIV. DRAINAGE TRUST
1800
280
1011824
$ -
NCSP • TRAILS SYSTEM
NCSP - TRAILS SYSTEM
1800
280
1011888
$
NCSP - ROADS & BRIDGES
NCSP - ROADS & BRIDGES
1800
280
1011889
$
NCSP - STORM DRAINAGE
NCSP - STORM DRAINAGE
1800
280
1011890
$
NCSP - FIRE STATION
NCSP - FIRE STATION
1800
280
1011891
$
NCSP-PARKS
NCSP-PARKS
1600
280
1011892
$ -
CWIF - GENERAL GOVT. FACILITIES
CWIF-GEN. GOVT. FACILITIES
1808
280
101001
$ 1,579.59
CWIF - GENERAL GOVT. EQUIPMENT
CWIF-GEN. GOVT. EQUIP
1810
280
101001
$ 728.52
CWIF - LIBRARY - FACILITIES
CWIF-LIBR - FACILITIES
1825
280
1011826
$ 572.36
CWIF - LIBRARY - MATERIALS
CWIF-LIBR - MATERIALS
1825
280
1011827
$ 385.02
CWIF - LIBRARY - VEHICLE & EQUIPMENT
CWIF-LIBR - VEH & EQUIP
1825
280
1011828
$ 11.48
CWIF - ROADS & BRIDGES (NCSP/CUA)
CWIF-ROADS & BRIDGES
1831
280
1011001
$ 2,626.52
CWIF - SHERIFF • FACILITIES
CWIF-SHR - FACILITIES
1840
280
1011841
$ 743.67
CWIF - SHERIFF - VEHICLE & EQUIPMENT
CWIF-SHR - VEH & EQUIP
1840
280
1011842
$ 362.87
CWIF - FIRE - FACILITIES
CWIF-FIRE - FACILITIES
1851
280
1011852
$ 870.46
CWIF - FIRE - VEHICLE & EQUIPMENT
CWIF-FIRE - VEH & EQUIP
1851
280
1011853
$ 1,680.23
WATER TENDER FEE
BATTALION #7
1851
280
1011867
$ -
TOTAL
$ 26,615.21
Revised 7/1/2005 PREPARED BY:
Gwyn Benedict ext 7604
Revised 7/1/2005
DATE
9/9/2005
BAG #
329
DEPOSIT #
48
RANGE OF RECEIPTS:
435490-435569
MONEY COLLECTED:
9/8/2005
DEPARTMENT OF DEVELOPMENT SERVICES
DEPOSIT SHEET - BUILDING DIVISION
Page 1 of 3
10
-0100
-1001
-10
-10
-10
-10
-10
-10
-1800
BUILDING
PERMITS
FIRE - SRA
SMIP FEE
REMOVE NOTICE
OF VIOLATION
RETURN
CHECK FEE
AVA COURT
RESTITUTION
COPIES
PUBLIC SALES
WITNESS
FEES
RECORDERS
FEES
STREET
IMPROVEMENT
PERMIT#
RECEIPT#
4210500
101001
4617240
101001
280
1011298
4350903
101001
4610105
101001
4617252
101001
4711910
101001
4712523
101001
4613701
101001
280
1011815
052378
435490
$
219.96
051469
435538
$
511.41
$
2.21
052176
435539
$
71.49
052410
435540
$
467.42
961207
435541
$
109.98
052411
435542
$
1,886.40
052412
435543
$
219.96
052413
435544
$
110.00
052035
435545
$
109.98
052415
435546
$
887.11
052416
435547
$
285.94
050871
435548
$
54.99
$
95.00
052414
435549
$
109.98
+ 052417
435550
$
55.00
052418
435551
$
450.92
$
95.00
052420
435552
$
467.42
052419
435553
$
494.91
051988
435555
$
329.94
$
15.97
052421
435556
$
137.50
051934
435557
$
1,869.09
$
18.73
051694
435558
$
626.89
$
5.40
052077
435558
$
1,421.92
$
32.26
052242
435559
$
329.94
$
95.00
$
12.09
040908
435561
$
2,134.42
$
19.56
052422
435562
$
329.94
$
95.00
052423
435563
$
60.00
$
95.00
052424
435564
$
329.94
052425
435565
$
1,223.55
copies
435566
$
0.25
050706
435567
$
90.00
$
0.34
copies
435569
$
0.67
$
15,396.00
$
475.00
$
106.56
$ -
$ -
$ -
$
0.92
$ -
$ -
$ -
Page 1 of 3
Revised 7/1/2005
DATE
9/9/2005
BAG #
329
DEPOSIT #
48
RANGE OF RECEIPTS:
435490-435569
MONEY COLLECTED:
9/8/2005
DEPARTMENT OF DEVELOPMENT SERVICES
DEPOSIT SHEET - BUILDING DIVISION
Page 2 of 3
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Page 2 of 3
Revised 7/1/2005
DATEE435490-435569
9/2005
BAG #329
CWIF
DEPOSIT #48
CWIF
RANGE OF RECEIPTS:MONEY
CWIF
COLLECTED:8/2005
CWIF
DEPARTMENT OF DEVELOPMENT SERVICES
DEPOSIT SHEET - BUILDING DIVISION
Page 3 of 3
PREPARED BY:
Gwyn Benedict ext 7604
DATE: 9/9/2005
CWIF
CWIF
CWIF
CWIF
CWIF
CWIF
CWIF
CWIF
CWIF
CWIF
CWIF
Water Tender
F-1800
F-1808
F-1810
F-1825
F-1825
F-1825
F-1831
F-1840
F-1840
F-1851
F-1851
F-1851
SHERIFF - SHR
(JAIL)
GENERAL GOVT.
FACILITIES
GENERAL GOVT.
EQUIPMENT
LIBRARY
FACILITIES
LIBRARY
MATERIALS
LIBRARY
VEHICLE & EQUIP
ROADS&
BRIDGES
SHERIFF
FACILITIES
SHERIFF
VEH & EQUIP
FIRE
FACILITIES
FIRE -VEHICLE
& EQUIPMENT
Battalion
# 7
280
280
280
280
280
280
280
280
280
280
280
280
1011811
101001
101001
1011826
1011827
1011828
1011001
1011841
1011842
1011852
1011853
1011867
SF
$
257.00
$ 599.81
$ 276.64
$ 217.34
$
146.20
$ 4.36
$
1,206.78
$ 282.39
$ 137.79
$ 330.54
$
638.03
MH
$
257.00
$ 489.89
$ 225.94
$ 177.51
$
119.41
$ 3.56
$
709.87
$ 230.64
$ 112.54
$ 269.96
$
521.10
MH
$
257.00
$ 489.89
$ 225.94
$ 177.51
$
119.41
$ 3.56
$
709.87
$ 230.64
$ 112.54
$ 269.96
$
521.10
SF
$
257.00
$ 599.81
$ 276.64
$ 217.34
$
146.20
$ 4.36
$
1,206.78
$ 282.39
$ 137.79
$ 330.54
$
638.03
MH
$
257.00
$ 489.89
$ 225.94
$ 177.51
$
119.41
$ 3.56
$
709.87
$ 230.64
$ 112.54
$ 269.96
$
521.10
$
305.01
$
1,076.01
$ 1,579.59
$ 728.52
$ 572.36
$
385.02
$ 11.48 1
$
2,626.52 1
$ 743.67 1
$ 362.87 1
$ 870.46 1
$
1,680.23
$ -
GRAND TOTAL TO BE DEPOSITED
$ 26,615.21
Page 3 of 3
PREPARED BY:
Gwyn Benedict ext 7604
DATE: 9/9/2005
DEPARTMENT OF DEVtLUF Wtn I atnvn.ca
7 COUNTY CENTER DRIVE - OROVILLE. CALIFORNIA 95965-3397
TELEPHONE: (916) 538-7541
FAX: (916) 538-2140
12/03/96
GRAVISON RICKETTS
1450 ORO DAM BLVD
OROVILLE, CA 95965 RE: Building Permit # 95-3174
RE: D.E. WHITINGER Expiration Date: 1/23/97
7581 OCCIDENTAL A.P. # 026-280-008.
PALERMO, CA 95965
1 L t
With reference to the above subject, our records indicate that your
building permit expires on the above date and your permit falls into the
category marked below:
[XX] Permit work started, but not completed. Permit may be renewed
for 1/2 the original building permit fee (plus a $20.00 filing
fee). The renewal permit will extend the building permit for
an additional year from the original expiration date. Should
you not renew your permit within 30 days of the expiration date,
all work•must cease until a new building permit has been issued.
For your convenience, we are enclosing a renewal application form
and owner -builder form to be completed and signed by you where
indicated and returned to this office together with the fee
shown. Please return all copies of the application form.
[ ] No inspections have been made on permit work. Inspections are
required to verify code compliance. We are unable to renew a
permit where the work has not been started and inspected prior
to permit expiration. After expiration of your permit, no work
may be started until a new permit has been issued.
If our records are in error or should you have any questions concerning
this matter, please contact the OROVILLE office.
Thank you for your prompt attention concerning this matter.
Yours very truly,
Mic el C. Vieira, C.B.O.
MCV•ahb Manager, Building Inspection
Attachments
Chico Office - 1469 Humboldt Rd/891-2751