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HomeMy WebLinkAbout028-040-008a I A.P. 28-04-g REDRO RUIZ e/s Palermo Honcut Hwy. app. 502, so. Central House Rd., Honcut Permit 1575-73ByPIE (bathroom addition) 028-040-008 #98-2348 RIJIZ, PEDRO'-. 9823 PALERMO HONCUT H'wW NIELSON ]BUILDING' REROOF,,//N6 028-040-008 05-1652 WALLEY, CHARLES 9823 PALERMO HONCUT HWY, ORO VILLE CONT: OWNER DEMO & REMODEL i Co5 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION.V (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 BECOME NULL AND VOID 1 YEAR FROM THE DATE OF 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. License Class : License Number: 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 applica o ;nsation, penalty of not more than five hundred dollars ($500).): of the property, or my employees with wages as their 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 P'rofe'ssions 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: b -_?/-0�7Owner: 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. ❑ I 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 #: \ 11-1certify 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:" 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. PERMIT NO. BP051652 OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. Issued Date: 08/31/2005 APN: 028-040-008-000 Site Address: 9823 PALERMO HONCLIT HWY HON Map Index: Description: addition (840) Owner: WALLEY, CHARLES 9823 PALERMO HONCLITT HWY PALERMO, CA 95968 Applicant: WALLEY, CHARLES 9823 PALERMO HONCUTT HWY PALERMO, CA 95968 Contractor:. License #: Architect: Engineer: Total Square Ft: 840 S.F. Valuation: $54,600.00 Census Code: CONSTRUCTION LENDING AGENCY This permit is hereby I hereby affirm that there is a construction lending agency for the Resolution t o wo performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By:44 � - Address: EXPIRES 0 applicable provisions of the Butte County Cod and/or fo�j which fees have been paid. 7 / n�fo• �i� ❑ 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 1 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: 40 f 0 yl Signature: Zy" Date: ❑ Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEVELOPMENT SERVICES COMPLAINT FORM This information is not available to the public!!!!!?.?. DO NOT COPY FOR THE PUBLIC OR THE FIELD INSPECTOR!! The following information is required for Housing Complaints and the Complainant MUST BE the person living at the complaint address! Complainant: Address Phone Number: The above information is not available to the public!!!!!!! (2) KAFORMS\Complaint Form revl.doc 3, BUTTE COUNTY DEPARTMENT OF DEVELOPM T SERVICES BUILDING PERMIT APPLICATION— - AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTIONC OROVILLE`. (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds *`PLEASE PRINT CLEARLY** OWNER Last Name ` ir(t, ame Addres `T 23� Hovrcu fi-- Cityoeov' I �e Statee� Zip 9�E Phones -3o —711 2 — / (/'7 1/ Fax S4'r.. E-mail APPLICANT NAME CONTRACTOR Name 0 w e(' Address AZZ City IT State Zip Phone Map Book Fax E-mail Pla er W Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name Cit v, o V Address AZZ City IT State Zip Phone Map Book Fax E-mail Pla er W State License Number APPLICANT NAME Name O I Q A1_4 Me Address Cit v, o V St Zip Phone No E-mail APPLICANT SIGNATURE 00, x f 2?9;��' For office use only: Zoning Property Address z"leirplaQ»cal~ /�w Flood Zone Cross Street ' SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Pla er W Date pproved: 9-3/-o OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BPOs/65 BIN # w LOCATION AP#� zY�G1/0^60M-010i Property Address z"leirplaQ»cal~ /�w City O✓v �j �% Cross Street ' Ho r-�- 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: eowti352 y� (c t F . �, ' (y g,,,, 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: C Z� Bldg � 2n� g SRA Receipt #: I Sheriff "1 'I SMTP ( Other Date: zA Total SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a peymit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK Y 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! GY 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. Imo/ 3. Engineered truss details and layouts in duplicate (if required). No faxes! C� 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). - 0 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. I SYIS ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. { 51 12. Sanitation and site plan approval from the Environmental Health Department. a 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 KAFORMBUILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 Applicant: Wolle , Charles Permit No: 05-1652 Project Type: Demo/Remodel _ 028-040-008 100% 70% Plan Check Fees $ 428.92 $ 300.25 $ 428.92 $ 300.25 WILLDAN Fee $ 300.25 Copies Attached: Qty Chk + Application Site Plan Review FEMA Elevation Certificate 2 Building Plans Truss Calculations 5L— Energy Calculations Structural Calculations I Residential Plan Review Guide j Residential Construction Requirements Other Other Butte County Department of Development Services TtF �v o0 YVONNE CHRISTOPHER, DIRECTOR oo � N o o 7 County Center Drive o'°"' ` o Oroville, CA 95965 cOU '�y (530) 538.7601 Telephone NLO (530) 538.7785 Facsimile CD TO: WILLDAN ' O FROM: Scott Rutherford (530) 538-7160 !� srutherford(cDbuttecounty.net SUBJECT: Plans Transmittal For Review Per Contract O DATE: 6/27/2005 Applicant: Wolle , Charles Permit No: 05-1652 Project Type: Demo/Remodel _ 028-040-008 100% 70% Plan Check Fees $ 428.92 $ 300.25 $ 428.92 $ 300.25 WILLDAN Fee $ 300.25 Copies Attached: Qty Chk + Application Site Plan Review FEMA Elevation Certificate 2 Building Plans Truss Calculations 5L— Energy Calculations Structural Calculations I Residential Plan Review Guide j Residential Construction Requirements Other Other COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISIOM 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: ASSESSOR PARCEL NUMBER �A - /) V/7 - Yfb Proposed Building Use: A-vIJ J 77 6Y-) Permit Technician: Date: P Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. OJ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. &I N 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 4. Engineered truss details and layouts in duplicate. No faxesl 0 5. Letter from Engineer or Architect for truss design review. /n% 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. o 9. 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. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential` builditiov ❑ 12. Hazardous Material Form flJ 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remat ing items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 16. Fire Sprinklers............................................................................................ ❑ 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... ❑ 19. Erosion Control Plan Required........................................................................ \ I' p. j ees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 21. City of Chico Plumbing permit........................................................................ ❑ 22. Site plan and business license approval from the City o.Biggs................... .2. 23. California Department of Forestry p approval paid, Sent bp' (Ryianning approval for A Use: B Parkin C Parcel Check:. �o Contact Land Development about _ Improvements, _ Drainage ........................ EL�� 26. NPDES Form.....................................................................:....................... ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ / 29. Worker's Compensation Carrier and Policy Number .......................................... �i 30.Owner-Builder Verification ( ) ` _Given to owner, _Mailed to owner ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction..........................................................::.............................. ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone 1/�0� Wl& 7y2 and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 1. Index permit application for the above -tem ns ns umbered: � Plan Check Letter 2, Additional items requir Contractor, designer wner as advised of the above data by t6 phone, mail, ❑ counter, by Date: dos - Contractor, designer, ner, was advised of the above data by ❑ phone, mail, ❑ counter, by Dale: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail„ ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed y: Date: Structural approved by: ' 1 �- Date: Note transfer by: Date: . Yellow: Building Division E.H. USE ONLY 'Slot Plan Anachod Floor Man Aftachad Sent to S.D. TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance L),tj Wo ) L a ) CAS -Z)2 — Owner j\\ Location AP# Plan Approved for: Sewage Disposal , Water'.Supply: a Pugic Private WOII�,,— Clearance for dwelling. Other1��1n1 Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist Date 8/96 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE -(530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER PROPRO D P4Q!!?J BUILDING USE 1. BUILDING PERMIT FEES --- Balance Due ..................... $ (i --- FEMA Flood elevation review ... $ Additional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES ® 120 `� (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... X $0.03 = $ �iq.rtg. �j n 4. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ V6SRA RTH CHICO SPECIFIC PLAN (per dwelling) Zoning FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) A. P. # 10 '7 0_0'Ve DATE 4 —2-3� RECEIPDATE REC. T # 7. WATER TENDER FEES BATTALION # 00.00 (paid at Building Division) 8. SMIP 9. OTHER 10. OTHER 11. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT DATE (0-2Y-05' Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in GovemmenfCode Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 3/05) A �� 5 �Uc wdc 1 Department of Public Vlorks J. Michael Crump, Director LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville. CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phasel Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement (LESS TH�IV 1 A Project Description: Q � 2 X 35—� - Project Location andlor Parcel Number: 99'z3 o le�w, ,� —ro- _et l` I �� aivl/rle c�%Sy66 By signing below, L the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that L therefore, do not need to apply for a Construction Storm Water Permit tioI the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project. that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: Acf-tet 'ta own 60' Date: Z r/ 6 S— Butte County Department of-Development Services O103.1 0 7 County Center Drive ° Oroville, CA 95965 (530) 538-7601 Telephone cOUIN (530) 538-7785 Facsimile BUILDING PERMIT APPLICATION WITHOUT. REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development; County Fire, and Agriculture. I hereby acknowledge: 0 I need to submit applications for septic and/or well to Butte County Environmental Health immediately. I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained. I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not .limited to, verification the parcel was legally created, adherence.to.all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, fegal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: — Applicant Name: .49 I'd 14 `vO /l'e Y / APN: 0 0 Z(�-0 yD--©o�^000 Building site address: yk � 3 e0 I err" o rfoA, u t Humy Permit No.: O ro V ,`"1 1 & (-,4, 95-i6F, I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: SIGNATURE OF APPLICANT DATE Copy to Applicant/ER/File K:Forms/BldePermitwithoutClearances 020705 Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this infonnation 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 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: 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— d S NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2DD4 Butte County Department of bievelopment Services ADMINISTRATION t BUILDING' GIS `PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile 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 Califomia 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 othbr 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 insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not cant' 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 contractors is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by 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. �' cereIy, Mic 1 C. Vieir C.B.O. M ager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. N47 WILLDAServing Public �N August 26, 2005 Scott Rutherford Butte County Building Department 7 County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX BUTTE COUNTY PLAN REVIEW REPORT Status: Jurisdiction Job No: Assessor's Parcel No: Description: Willdan Project No: Dear Mr. Rutherford: Approved 05-1652 028-040-008 Walley Demo/Remodel 14353-1754 117 C Street ;arysville; California 95901 530/749.2373 fax 530/749.2199 www.willdan.com Willdan has completed a plan review of submitted plans and documents for the above referenced project and recommends your approval with the conditions noted on the 2nd page of this letter. The plans and documents provided for this review that have been found in compliance with the applicable codes are: * Plans: Two (2) revised copies sheets IA, 1 through 3 and S1 dated 06/06/05, by Dick Miller. * Truss Calculations: Two (2) copies dated 06/10/05, by Longfellow Lumber Co. Inc. * Eneray Calculations: Two (2) copies dated 06/13/05, by Donna Wallace. The plans have been stamped with the Willdan approval stamp and dated. According to our previous letters relating to this project, the superseded plans and documents will be discarded within 10 days unless, we receive other instructions. On the pages to follow is the identification of the codes and standards applicable to the project, a code analysis, conditions -of -approval and identification of any deferred submittals. 1 N W I LLDAN V� ��/ Serving Public Agencies APPLICABLE CODES Our .review was based onrequirements of the 2001 California Building Standards Code found in the California Code of Regulations, Title 24: • Part 2, known as the California Building Code (CBC) • Part 6, known as the California Energy Code, and Energy Commission Standards (CELS) CODE ANALYSIS Specific Type of Type of Stories 1" Floor 2" 'Floor Total Sq Ft Use Occup'anev Construction _ . _ - S Ft Sq 'Ft Dwelling R-3 V -N 1 840 NA 840 Demo & Remodel CONDITIONS OF APPROVAL 1. Approval is contingent upon the review, requirements and approval of other departments and/or agencies that have jurisdiction over this project. 2. Revisions and notes as'redlned on'the plans. SPECIAL INSPECTION NEEDS Our plan review reveals no special inspection needs pursuant to CBC 1701. i DEFERRED SUBMITTALS Our, plan review 'rev6als no deferred "submittals. Sincerely, Richard Essenwanger Plans 'Examiner II M. Kisabuli,,P.E:; Plan Check Engineer Cc: Alice Mefford, amefford@buttecounty.riet Dion and Charles Walley, 9823 Palermo Honcut Hwy, Oroville, CA 95966, Fax (530)742-1474 Page 2 of 2 County of Butte 05-16.52 Willdan 1=1353- 1754.PC2.F A Oq 21 'r)2A BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District 0720 r V H Building Department No. t D�16 5 A.P. Number �r f�a Jurisdiction: � City �✓ County Property Owner f✓y /Ty`'c / Property Location/Address 9�z 3 / `� h'ew4f vT h'/' i D)'>-0 Subdivision Lot No. Residential Development Q Q EQ Sq. Footage e�1,9 No of Living Mobile Home AdPffiont 'Supplemental to (Group. R) Units Installation Conversion Permit # *(No foundation inspection) ........................................................................................ Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document), Commercial/Industrial 0 Sq. Footage -----,New Addition (Including Exterior Roofed Areas) Building Dep'artme Representative Date District Identification No. 060042 (�i I, I� School District certifies that 2 n (State) has complied with the requirements of Resolution No. 2+0 square feet. K1 School District Representative Paid by Check # �� Remarks: ('Ow-a� I Applicant) 7 y0- 1 / ,/-- (Phone Number) (Zip Code) t by payment of $ 0 B 2926 $ PULL MITIGATION $ yrJ/ Date Notice: You may protest the Imposition of the fees identified above by submitting a written protest to the District, In compliance with Government Code section 66020(a), within 90 days from the date fees aro paid. Failure to submit a timely written protest wtil prohibit you from challenging the Imposition of the fees In any court action. N, subsequent to the School District Representative signing this Butte County schools Impact Fee Certification Form, the School District Is notified by the applicable Local Planning Agency that this project Is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate iti Impact on the school district's schools. White (school district), Yellow (building department), Pink (applicant) %eform.xls (3/05Wnm SITE PLAN REVIEW APPLICATION Date: �� AP# Permit Number (if applicable) p S Tz_ Bin Number APPLICANT INFORMATION / Parcel Size: Owners Name: Owners Address: Telephone No.: Situs Address: Proposed Use: Email: Residential ❑ New Single Family Residential Single Family Addition ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other ❑ Septic ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): jj�s110 ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Site PlanStamped pproved By Date Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) ❑ SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: 6 • Flood Panel No.: Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) ❑ Oroville Enterprise Zone Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ---------------------------------------------------- ----------------------------------------------------------- ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: A — T Com) Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. W CDF approval needed for encroachments into SRA setbacks. Page 2of5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front 20 Side 3 00 Side Street Rear 30 ` Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. W CDF approval needed for encroachments into SRA setbacks. Page 2of5 ;. Applicable Development Fees: Standard Fees Amount Formula ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other -------------------------------------- Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By Deeds: Date of Creation: Deed of Reference: Parcel Frontage on Publicly Maintained Road: Complies with County Standards for Deed Crea Comments: 7 .� i� i' 6,1-4- ❑ Parcel Deemed to be legal Legal Access Provided: ❑ No ❑ Yes Legal Access Required ❑ No ❑ Yes ❑ No ❑ Yes, Road Name: ❑ No Yes / SSG /�//�� cca Ge/ oC�ecKC� 14*. 1seJ ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance/Notice of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 ❑ Subdivision Map/Parcel Map: Map Date of Recording: Lot: Book: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Page: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Attached ❑ None ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings. and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. ❑■ Page 4of5 Charles E. Walley 9823 Palenno-Honcut H\N•\. Orovi(le. C'.alifocnia 95966 'j[;;tEC'_EIVEDI( `30)742- 1.474 JUN 3 O 2005 beau��alle�,'�r�direc�+a�.cont WILLDAN M"Ye,VILLE OFFICE Tn whnmAt riiav rnnr.Prn- I Charles E. Walley grant permission to my son Dion D. Walley and my daughter-in-law Tammie L. Walley to apply for and sign any permits and/or do any business or transactions with R„tte.co„nty or others nertainine to the addition to be built on.mv home at my nronertv. Property address: 9823 Palermo-Honcut Hwy Oroville. Ca 95966 AP#: 028-040-008-000 Please feel free to call if you have anv auestions. Sincerely, Sianature �J`� �" ✓ — `� i _ i - _ : : ' I _ 1 : 1 " ---_ .-\.� -- =,—--_=_=_ -_ � -'1 _ __._�-:'- __:1' =�="---=----•-tib• ._. . - -: � ___ - - .. ;: , J , .i Y _ 7. ------------- , - - 77 , 911 ............ _ - Q' v , �.b..... _ - � -�' N�....;,;,� Nom,. � • _ " ly -�� o Al fill' SHEET-4—OF . BUTTE COUNTY PROPERTY RECORD NAME NAME SITUS 5•� , Gti ZONIN %,1EY ❑ County ❑ Assessment Year 20 e2 20 ' 20 20 UTILITIES -SITE IMPS. Year Date PRIMARY BASE SECTION AN 3.0 2OU5 Electricity: Yes ❑ Telephone ❑ i Appraiser ---Al, �-�tTD . -�vtjr-. Gas: Public ❑ LPG ❑ None ❑ DOpO Use Code -Z- �G Sanita Swr: Public ❑ Indiv. ❑ D Units Fixtures Street: Conc. ❑ As h. ❑Dirt ❑Gravel ❑ -welling Building Class Street Lights: Yes ❑ No ❑ Bedrooms C &'G:Yes ❑ No ❑ Baths Sidewalks: Yes ❑ No ❑ Effective YearC,.,. SITE TOPOGRAPHY Area of Residence Level ❑ Rolling ❑ Other ❑ Car Shelter Yes ❑ N ❑ ' Slopes: Up Grade: At [ View: ❑ Of: GPM: Public. ❑ Supplier Aerial Photo o Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ] Down ❑ S -S ❑ Misc. BuildingsGars Above. ❑ BelOw " ❑ POOI Yes � ❑ No ❑ Yes ❑ No E0 -es ❑ . No ❑ Yes ED No Phy. Char. Checked r2r Checked Checked I-] Checked WATER MARKET DATA Depth: Comparable 1 Well ❑ Ditch ❑ Comparable 2 i opo neap Soil Name Comparable 3 Year Sale Date/Price 2 7 �tpoy Year PRIMARY BASE SECTION Index Acres Base Year i Event Date �-�tTD . -�vtjr-. Land DOpO �S Structural Imps. 5WD Growing Imps. Fixtures Personal Property Avg. Soil RatingSECONDARY BASE SECTION LAND REMARKS: Base Year Land Type: Lot ❑ H/S ❑ Acs. ❑ Event Date Size: Land Description: Structural Imps. Growing Imps. Fixtures Personal Property Total Assessment Fee Number Book Page/Block Parcel G U 20 Yes ❑ No ❑ Yes' ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ hecked ❑ Checked ❑ REMARKS .3llld 29 20 1r7— / Rev. 12/C I /w/`�". /1 dU✓rtJ�eb'c? tom'1�l G✓e ._ / ./;t�`�'i3'✓�l �r.�.E.f _ i4+� /� �'z ���. 0 7 2 Oc-,) _��/ v/ fJUS AJE_k_ la 7—r� Jy p� .'T�_'/ oyw���" [� S. �I ,/r� l00A✓f" /) -T0f ..- -/ %- e� 7 0 re', U44 l 17A" T i� _7;> 2:ZX("G7 7,7,wli � - PA/ -j "y" � � 9 Gs� ��/ -/ _ 7 _ E /', i A,,_,'8� `i '¢°" .� ,� [.,,1 /i�'��''%.�r 8 c/Z/!3 �✓� �� c,/=„ % r� �c 4 'oil il'r,�fe� i `�i•t'. �� / � 77,A-)5 `A')5 4 iA,b7k ice.. l;"<..ago? )3 ) . RETAINED VALUE EXT. % EXTENDED TO TRANS. DATE PORTION VALUE YEAR VALUE TRANS. TRANS. EVENT DATE VALUE VALUES LAND COMPUTATIONS X = X = X = � � � r r / r / hl�, j�'o'�l'/l�i� .i� ��c:�i�.Z{ ��rp�. ./..✓ ""d/Ce9n+ = X = IMPS ,�cp"�p �� � .�� = X = G/I LAND COMPUTATIONS X. = X = X = LAND IMPROVEMENT COMPUTATIONS X = X R74775- _721) IMPS GROWING IMPROVEMENTS X = X PRIMARY LAND VALUE. COMPUTATION SECONDARY X = ASST. PRIMARY LOT H/S. SQ. FT./ YEAR BASE YEAR VALUE ACRES UNI TVALUE TAXABLE VALUE ADDED VALUE ASST. SECONDARY LU 11 YEAR BASE YEAR VALUE SQ. t- UNIT ACRES VALUE VALUE TAXABLE ADDED VALUE X = X = IMPS GROWING IMPROVEMENTS X = PARTIAL ASST.. OWNERSHIP CHANGE YEAR EXISTING EXISTING PORTION BASE YR. VALUE RETAINED RETAINED VALUE EXT. % EXTENDED TO TRANS. DATE PORTION VALUE YEAR VALUE TRANS. TRANS. EVENT DATE VALUE VALUES LAND COMPUTATIONS X = X = X = LAND IMPROVEMENT COMPUTATIONS X = X = X = IMPS GROWING IMPROVEMENTS X = X = X = G/I LAND COMPUTATIONS X. = X = X = LAND IMPROVEMENT COMPUTATIONS X = X = X = IMPS GROWING IMPROVEMENTS X = X = X = G/I LAND COMPUTATIONS X = X = X = LAND IMPROVEMENT COMPUTATIONS X = X = X = IMPS GROWING IMPROVEMENTS X = X = X = G/I I% i 028-040-008 #98-2348 RUIZ, PEDRO 9823 PALERMO HONCUT HWYA NIELSON BUILDING REROOF r to l Z -9q oaQ� COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION � 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 �PEFWrr:�o. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER !1 R– Gn–flllA ZONING i rt BUILDING PERMIT OWNER P1•' IZ, Pedro TELEPHONE SO. FT. OCC. BUILDING VALUATION Y 5 900.00 .OWNER'S MAILING ADDRESS (1182.3 Palerttio Mncut.t Rury. CONTRACTOR'S NAME Nielson Building T�LEPl�10N1319 J((�� JJ.. JJ CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Film Fee $ 20.00 Permit Fee $ 23.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Cl (,,o J V , j Alf Energy Plan Checking Fee $ $ n n r PERMIT FEE $ �' LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE I SF 'OT Duplex O Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK r New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other O Describe Work: Re-Poof Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service zoOA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.POWER License Class Lic. No. OWNER -BUILDER DECLARATION 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 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations:' ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by.Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed 4 the permit is for work of a valuation of one hundred dollars ($100) or less.) [ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall 7rthith c mpI with ose p ovisions. I . _ , -• X__ DateJa —�Z "ft Signature o Ap0ficant Owner 0 Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction ures over 3 stories in height. Main Service TO 46.00 NEW CONST. DWEWNG OCCI:P. SO EL CL OR ADDNS. ( a ACC. BLDS. 3.5¢FT; Naa,oT' MULTI.OUTLEBRANCH CUINEW @7.50 APPARATUs a SINGLE OUTLET CIS. so @ 1.00 Ex. Occu OUTLET ORFIXTURESBAL.O .50 OR") Ex. Occup. pig gESID.OEp 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HOZ. p: FEES IMP I FLOOD I CDF PARCEL PD HD ISSUEo j This permit is hereby issued under the applicable provisions of the Butte CountyCode and/or Resolutions to do work indicated above for which fees have been paid. + .4 _(& B Date PERMIT EXPIRES ON /o r-(,).tqD.S.-B.D., o. �Sr1ftS7 t CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive Oroville, California 95965 • Telephone (530) 538-754 WRII. (Rev.12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER i_ ZONING BUILDING PERMIT OWNER T?Trj7 • Pedro TELEPHON SO. FT. OCC. BUILDING VALUATION 5 900.00 .OWNERS MAILING ADDRESS 9823 Palermo iTl /11C�-jtf. T -T41\/. CONTRACTOR'S NAME�T ielson Ru.ildino T LEP-MONE -1319 CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 23.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 9 �/ b �VI1 0 Q v Energy Plan Checking Fee $ $ PERMIT FEE _ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF 101 Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Re–Roof Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 V OR LF Main Service 200AORLESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under proyisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.POWER License Class _V[ Lic. No. 2 ?7�77 OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ I am exempt under Sec. Business and Professions Code for this reason Main Service 200A To 1000A 46.00 NEW CONST. DW EwNG OCCUP. OR ADONS. a Acc. eLDS. SO 3.50FT: Ip=R�I.T' MULTI.11 OUTLET 97.50 APPARATUS a SINGLE oLlTLlT CP, Ex. Occup. OUTLET OR FIXTURES @ I'50 BAL_ @ .so Ex. Occup. De s R '., D.o& 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE t WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that f I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forth ith c mpl it ose ovisions. X Date Sign at e o p0tt6ant V0 Owner 11 Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ E TOTAL FEE $ E.A EDFEESIMP FLOOD CDF pggCQ pp D U 11 This permit is hereby issued under of the Butte County Code and/or indicated above for w ch es have By PERMIT EXPIRES ON I the applicable provisions Resolutions to do work been paid. to �o 0 r0 — I ate ReceiptNo. WHITE-D.D.S.-B.D. -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 1 PERMIT NUMBER _ g 1575-73B,P,E y P a E s PERMIT EXPIRES 74— OWNER Pedro Ruiz CONTR: owner. 'LOCATION (A.P. -28-04-8 . •r e/s Palermo Honcut Hwy. app. 5001 so. Central House, Rd., Honcut e r L � l " Y r T ak— O COUNTY OF BUTTE Department pf Pu.blic Works i ' BUILDING INSPECTION RECORD Zoning Setback Forms Foundation Piers & Girders Fireplace Rgh. Plumbing Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing Plmg. Topout Rough Elec. Wtr. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. Final Final Final DATE REMARKS OR CORRECTIONS ak— O COUNTY OF BUTTE — ©EPAF)_TMENT OF PUBLIC WORKS 7 County Center Drive — Orgville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT aurnunce representanves of the County of Butte to enter upon the above-mentioned property for inspection purposes. JJ� % A / �ra-e- zz- Q� Date '"1ig ature of Permitee or Agent Receipt No. 1 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 PUBLIC WORKS By Date Building permit expires Dafe .�.�..:�..� BUILDING Owner -SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address e G ' Telephone No. z Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ $ Building Address PLUMBING No. @ FEE PERMIT FILING FEE J$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 )' //v A. P. No. ct Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Eves -Ake' anita FireDept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma p 60' R/W Im rovements p Lawn sprinkler system 2.00 Bldg. Pla�Rec'd Parcel AVrTo-vol Plans Approval Permit Fee $ on $ Z/ loe NEW ❑ ADDITION UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00. ffd p�jN1 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (morethanl2) Single Family Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures ba"25's_Receps., swit hes & fix outlets 2bo CONTRACTORS LICENSE 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: Hood, Ex. Fan or F.A. Furn. Motor Evap. cooler, gar. lisp. or D.W. Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring -- I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ Q 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. I certify that in the performance of the work for which this Tpermit is issued I shall not employ any person in any manner o -as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT 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 $ aurnunce representanves of the County of Butte to enter upon the above-mentioned property for inspection purposes. JJ� % A / �ra-e- zz- Q� Date '"1ig ature of Permitee or Agent Receipt No. 1 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 PUBLIC WORKS By Date Building permit expires Dafe .�.�..:�..�