HomeMy WebLinkAbout005-393-0010
11
5--393-01
MICHAEL HOLLAND
1210 Tackson St., Chico
(two work write-ups)
055-393-001 1"346
D �MIC %
HOLLAND, AL
1210 JACKS ST, H
( 01
UP
14
cl 4'�
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T
bbliESE. E.
1 fir:
1210 Jackson St., Chico
(repair single-fam ily)
CONTR: B R CT 01
UP GRA EXIST CT
WIRE'
005-393-001 01-242
' �242!
HOLLAND, MICHAEL INALE
1210 JACKSON, CHIC
UTIL RM W/O PERMI
ELEC AND HOUSE FA#
4
ti
.'
B07-1855, 005-393-001
MISCELLANEObs" '."�GasRecorinect
REPAIR GAS LiNt.
1210 JACKSON ST
HOLLAND MICHAEL B,,
f
C.9_
A
11
C.9_
A
IX
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
PROJECT INFORMATION
Site Address: 1210 JACKSON ST
Owner:
Permit NO: B07-1855
APN: 005-393-001
HOLLAND MICHAEL B,
Issued Date: 8/29/2007 By GLB
Permit type: MISCELLANEOUS
1724 BEECH ST
Subtype: Gas Reconnect
CHICO, CA 95928
Expiration Date: 8/28/2008
Description: REPAIR GAS LINE
Occupancy: Zoning: AR
Contractor
Applicant:
Square Footage:
MOLESWORTH CONSTRUCTION
MOLESWORTH CONSTRUC1
Building Garage Remdl/Addn
P O BOX 4535
P O BOX 4535
CHICO, CA 95927
CHICO, CA 95927
Other Porch/Patio Total
(530)321-7684
(530)321-7684
FEE INFORMATION
DBP Gas System (enter outlets) $58.00
Total Charged: $58.00 Fees Paid: $58.00
Balance Due: $0.00 Receipt No: B4441
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
MOLESWORTH CONSTRUCTI( C660050 / B / 12/31/2008
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 000) o Division 3 of the usiness and Professions Code, and my license
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in full force a t.
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for
X 8/29/2007
the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
Contract es sici4ature Date
❑ 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
WORKERS' COMPENSATION DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
the work himself or herself or through his or her own employees, provided that such improvements
❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
- ❑❑
I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractor's License Law dows not apply to an owner of the property who builds or improves
My Workers' Compansation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
Carrier: Policy Number: Exp. Dale:
(This section need not a competed if the permit is oris or on�ndred dollars ($100) or less.
I AM EXEMPT under Section B. & P.C. for this reason:
❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation laws of California, and agree that if I should become subject to the workers'
X 8/29/2007
compensation provisions of S tion 3700 of the Labor Code, I shall forthwith comply with those
Owner's Signature Date
provisions.
X 8/29/2007
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Signature Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
injury, including death, and property damage caused arising out of, or in any way connected with
HUNDRED THOUSAND DOLLARS $100,000 , IN ADDITION TO THE COST OF COMPENSATION,
( 1
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
t is riz
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
property o am auth to act o e property owner's behalf.
CONSTRUCTION LENDING AGENCY
]ownner
G e%P � 8/29/2007
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
Name P e SI Print Date
the performance of the work for which this permit is issued. (3097 civ, code)
Owner Contractor OR; Agent for Owner Agent for Contractor
FILE COPY
Lender's Address City State Zip
.`�VTT� BUTTE COUNTY
0 0 DEPARTMENT OF DEVELOPMENT SERVICES
0 o BUILDING PERMIT APPLICATION.
0 0 OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
o _—==�''j o A FEE WILL BE REQUIRED AT TIME OFAPPLICATION
.� Website: w. lw.buttecounty.net/dds �.
OUN'� **PLEASE PRINT CLEARLY**
OWNER INFORMATION
Last Name
First Name
Mailing Address
City
State
Zip.
Phone
Fax
E-mail
CONTRACTOR
Names �—
n ��
Address<75
City
City C� C
State
Zi
Phone_3% 2 76
Fax. ,.
E-mail
Phone
Lic. # /i 6 � S—�
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Fax
E-mail
State License Number
APPLICANT INFORMATION
Name"
Address
City
State
Zip
Phone
Fax
E-mail
APPLI ANT SIGNATURE
X c2Z�a
PROJECT LOCATION
AP# ` :54� t 1
Property Address •12,10 ` G
City CA
d-
PERMIT
NO.
1 -l -t
BIN #
. 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:
ter r Q .
Sq FT- Living Garage . Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
For office wVpw : V
Zoning Flood Zone SRA � No
Occ. Type Const.
\ 6 �,7 (o (
1t' ;•.e .r�; v `•. ..:.- +.... �. .1,.. ,•y...,yr- r ;.r'i^' .- _.... � r • ' '♦f• , +n} � r,' .e''.:.. r.� r�.n t 'n. •r.
1 C • � �•---�-- 01=2429
� s -Q05'
o.�r , . QOLLAND
V HOLLAND,
<� 1210 JACKSON, CHICO
:,z �' : +''�° •^-� T i °-'� . i UTIL. RM W/O PERMIT/MISC_
' - ELEC AND HOUSE`FAN J
OFFICE COPY •
I �• `�� I Addre1
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� 9
r• = � dl— / GAS Date „
Meter By
ELECTRIC
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j Meter By
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i
COUNTY 'ftUTVE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7ounty Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) �, . APPLICATION AND PERMIT 01-2429
ASSESSOR PARCEL NUMBER
005-393-001
ZONING
A{
BUILDING PERMIT
OWNER MICHAEL HOLLAND
TEUN4 -UON .�
"SO. FT. OCC. BUILDING VALUATION
36 R 1,964.00
OWNER'S MAKING ADDRESS
1724 B ST 95928
CONTRACTOR'S NAME
-
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $ 1 944 00
ARCHITECT OR ENGINEER
LICENSE NO.
Flln Fee
$ 20.00
Permit Fee
$ 45.00
ARCHITECT OR ENGINEERS MAILING ADDRESS ..
'
, an CheckingFee
$ 29.95
BUIL ADDRESS 10
10 (211co
Energy Plan Checking Fee
$
•
PERMIT FEE
$ 94.95
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.00 7.00
USEOFSTRUCTURE
SF III Duplex ❑ Mobilehome ❑ Other
sPECFY
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 E 'Remodel ❑ Utilities ❑ Installation ❑ Other ❑,rm
� T V/9 PERMITS, " mm
Describe Work: RM B�m
INSTAM NEW FAN
Gas piping system 1 - 5 outlets
15.00
15-00
Buildingsewer
15.00
Mobile Home I S I G I W
@20.00
PERMIT FEE
_79-00
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service CoA oA .ss
23.00 23.100
LICENSED CONTRACTOR'S DEOLARATION
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 Profess)ons Code,
and my license is in full force and effect.
License Class Lie. No.
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ 1, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
• not employ any person in any manner so as to become subject to workers
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code,\l shall
forthwith comply with those provisions.
X /%� Aro rlkI/akif Date /' � _
Signature of Applicant - JR Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUP. sG
OR ADONS. ( a Ace. BLDs. 3.54?. 46.48
Lpp}REOSID. " MULTI=OUTLET @7.50
POWER APPARATUS
8 SWOLE OUTLET CIR.
Ex. Occup OUTLET OR FIXTURES
® 1.00
i
Ex. Occup. DP'uTLBETS (RRD APPA D.GEA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $ �
MECHANICAL PERMIT FiIng ee 20.00
Heating r
Cooling
Hood 6.50
Ventilation
PERMIT FEt: $ '15.00
Mobile Home Installation Fee $
Energy Inspection Fee $
f Dec
cor FT.TYPE
TOTf L FEE $ 2`j l . 43
HA2.
D. FEES IMP
FLOOD
COF
PARCEL
PD
}!0-
ISSU
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
�
B•` F"
k d �Z
yAf,,Oi r L'y`
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date
ate
ReceiptNo.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR j GOLDENROD -APPLICANT
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
I; 411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
V14�� ok-a
4,
l�
ER PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
• • -COUNTY OF BUTTE • • •
- . - BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530)'538-7541 s:
z<
CORRECTION NOTICE
OWNER PERMIT NO.
• t
A routine insp ion indicates that the following violations of butte county Ordinances exist at the
above ad ss and should be corrected. Please notice this office when.correction. of work is
comp) d. If you have any questions pertaining to this matter, or need additional explanation, "1
pie a contact this office immediately.
Af o 0 IA� ir 6 D L (A) J (;L-;
71 G
k .
T
r�
a f .
Y
S .
r
Date-)?, 2 O'y I Inspector T
o REV 10/92
y.
COUNTY OF'BUTTE - DEPARTMENT OF DEVELOVMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT 03-2499
ASSESSOR PARCEL NUMBER
005-393-001
ZONING
BUILDING PERMIT
OWNER
MICHAEL HOLLAND
TEL&NONE
345-8097
SO, FT, OCC. BUILDING VALUATION
36 R 1,944.00
OWNERS MAIUNG ADDRESS
7224 BEACH ST CHICO 95928
CONTRACTORS NAME
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $ 1 944.00
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ 45.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$ 29.95
BUILDING ADDRESS
1210 K 0
Energy Plan Checking Fee
$
,T
PERMIT FEE
$ 94.95
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF M Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00 7.00
Solar or heat pump water heater
23.00
Water piping
Water
15.00
as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition R Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: UTILITY RM BUILT W/O PERMITS, MISC ELEC
INSTALL NEW FAN
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
QQ
Mobile Home S G W
1@20.00 '
I
PERMIT FEE
$ 79-n
ELECTRICAL PERMIT
I Fling Fee 20.00
LESS
Main Service zo.A OR LESS
23.00 9^
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class LIC. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person In any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X�i/.�'O l�W Date 7-2-46-01
Signature of Applicant - Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service sow To I000A 46.00
NEW CONST. DWELLING OCCUP. SO
OR ADDNS. ( M=UNG 6LDS. 3.5QPT: 46.48
Np gEOSIU T. MULTI.OUTLET RANCH 97,50
POWER APPARATUS
8 SINGLE OTLET CIR.
EX. OCCU OUTLET OR FIXTURES BAIL 1;'
Ex. Occup..OUT�g RES p°� 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring
+_23,00,
PERMIT FEE $ on 1.0
MECHANICAL PERMIT FiIngl=ee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $ 35.00
Mobile Home Installation Fee $
Energy Inspectin Fee $
VIVPE TOTAL FEE $ 292.43
HAZ.
p. PEES IMP
FLOOD
CDF
PARCELpo
H ISSU
This permit is hereby issued under
of
of the Butte County Code and/or
above for which fees have
By
PERMIT EXPIRES ON '� C�
the applicable provisions
Resolutions to do work
been paid.
/ Z D�
to /
Z 02,
et
ReceiptNo. 331693/$291.43
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965.- TELEPHONE (530) 538-7541
PE"IT"PLICA TION DATA SHEET ' /
OWNER: ASSESSOR PARCEL O — 'Q Q 1
Proposed Building Use: Building Inspector: Date:
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
Date Received By
❑ 1. All items have been submitted ---------------------- ------------------------------------------------- ---------------
02. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------
1N3 . Complete plans, 3/4 sets, signed by the preparer of plans. -----------------------------------------------------
04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. --------
rEne,.
ineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------
rgy Design Compliance and supporting documentation. ----------------------------------------------------
.tement of Intent for Non -Heated and A/C Buildings.---------------------------------------------------------
❑ 8. Hazardous Material Form.
119. •.Manufactured Home data and ins ation instrugtions i
❑ 10. Fees of $ 2-4 ��{?_-
411. Impact fees as shown on the attached schedule. -------
❑ 12. California Department of Forestry plan approval/fees.
Specifications.
❑ 13. Flood elevation certificate.-------------------------------
--------------------------------------------------------
t 014. Sanitation and plot plan approval -0 Health Department - -------------------------------------------
Ell 5.
------------------------------------------
❑15. City of Chico plumbing permit. -----------------------------------------------------------------------------------
016. Plot plan and business license approval from the City of Biggs. ----------------------------------------------
❑ 17. Planning approval for (A) Use: C§ K (B) Parking: --------------------------
0 18... Contact Land Development about ❑ Improvements, ❑ Drainage�$egal Parcel.
❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). --
020. Pre -inspection for
required Request to Building Inspector on
021. Contractor's license information. (Number, Name Style, Classification).
c
022. Workers' Compensation carrier and policy number. -----------------------
`023. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). --
❑24. Letter of signature authorization. --------------------------------------------
025. Recorded copy of Agricultural Acknowledgment Statement.
❑26. Letter of intent on building use. --------------------------------
027*Manufactured Home utility clearance. --------------------------
1128. Existing violation s' and/or expired permits. --------------------
029. 1:1433 A, OGrant Deed, ❑ M.H. Title, ❑ Check to H.C.D $
1-_130. Other: ;
1Z,0
10 -I -p 1
1 � �
(Date)
When you issue,tee ermuo, ro jss as follows ❑ Mail to owner, ElMail to contractor.
Telephone (L�t� JjUUand hold for pickup at �� ( li office. ❑ Deliver with inspector.
A16hM1v&� ? 26--0/
Applicant: Date:
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Depat
Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑
Date: By:
Date: By:
1. Index permit application for the above items numbered: ❑ Plan Check List
2. Additional items
Contractor, design , owner, of the above required dataTy-0—ph—one, mail, o Building Division counter, b� Date: ,�
Contractor, desi er, was advised of the above required data by ❑phone, ❑mail, ❑Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was adyiqed of the above required to by ❑ phone, ❑ mail, ❑ Building Div' ron counter, by Date:
Plans reviewed by: D Date: Plans approved by: /��
Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date:
.'
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Existing House
,
O
Gas
Dryer
3'0° x 3'0°
d.g. slider
6'
0
7�
Laundry Room to
be upgraded to meet
building code requirements.
Existing House
kadroo�
�-- Double 2x4 top plates
2x4 rafters 2' oc typ
Corrugated metal roofing A.
R-19 Ceiling Insulation UUU(f
r
CD 0•C-FiQ
1/2" hardboard siding
1/2" 'drywall
R-13 wall insulation
2 x 4 studs 0 16" oc ty
PT sill typ.
--------�a;,
Existing conc.. slab U'.
(d e
Laundry Room
1210 Jackson St.
Chico, Ca
AP#
3/21 /2001
{.
",,3/21/2
Owner Mich
� ., y „ael Holland
n n; -",B
.rad
FIQ�r ffn ails
;i
Existing House
,
O
Gas
Dryer
3'0° x 3'0°
d.g. slider
6'
0
7�
Laundry Room to
be upgraded to meet
building code requirements.
Existing House
kadroo�
�-- Double 2x4 top plates
2x4 rafters 2' oc typ
Corrugated metal roofing A.
R-19 Ceiling Insulation UUU(f
r
CD 0•C-FiQ
1/2" hardboard siding
1/2" 'drywall
R-13 wall insulation
2 x 4 studs 0 16" oc ty
PT sill typ.
--------�a;,
Existing conc.. slab U'.
(d e
Laundry Room
1210 Jackson St.
Chico, Ca
AP#
3/21 /2001
{.
",,3/21/2
Owner Mich
� ., y „ael Holland
n n; -",B
.rad
FIQ�r ffn ails
N b�
rugated metal roofing
9 Ceiling Insulation
�— Double 2x4 top plates
2x4 rafters 2' oc typ
1/2" hardboard siding
1/2" drywall
R-13 wall insulation
2 x 4 studs ® 16" oc typ.
PT sill typ.
Existing conc. slab
Laundry Room
1210 Jackson St.
l/ Chico, Ca
AP#
3/21/.2001
-6'UTT"FZ
* jOwner Michael Holland
� tr "nb
iaq:. Burtenshaw
-F-lo_Q Plan & [Mails
4 x 4 header
® window
rugated metal roofing
9 Ceiling Insulation
�— Double 2x4 top plates
2x4 rafters 2' oc typ
1/2" hardboard siding
1/2" drywall
R-13 wall insulation
2 x 4 studs ® 16" oc typ.
PT sill typ.
Existing conc. slab
Laundry Room
1210 Jackson St.
l/ Chico, Ca
AP#
3/21/.2001
-6'UTT"FZ
* jOwner Michael Holland
� tr "nb
iaq:. Burtenshaw
-F-lo_Q Plan & [Mails
COUNTY OF BUTTE
Oroville, California
GENERAL CLAIM
CLAIMANT: fftic�AJ Hol( a
413DRESS: 112-4 Bcgc� S+
-ITY & STATE: Ck; t b n Of592$
DATE OF CLAIM: 1-02
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERV/CES
IMPORTANT.•
SEE INSTRUCTIONS
ON REVERSE SIDE
ATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
OWNER HAS DUPLICATE PERMITS: AP 0 5-393-001, BP 0 -0346, IPT# 30
OWNER: MICHAEL HOLLAND
'
i
'OTAL AMOUNT PAID:
159.k
RETAIN REFUND PROCESSING FEE:
25.00
RETAIN PRE INSPECTION FEE:
23.00
TOTAL AMOUNT TO BE RETAINED:
48.00
TOTAL AMOUNT TO BE REFUNDED: TOTAL
111.00
ie undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true
correct as stated. -
ed this day of re- 6 ti�? at Nco ,Calif. _ A'cJta a , f y,(/
GOA d
Signature of Claimant
ie undersigned, hereby certify that, to the best of my knowledge, the servicesor articl ecif)ed above h bee performed 6r delivered and
t there is a Budget Appropriation I I or Specific Board Approval I' I (Check one) for th $a
ad this 8 day of FEB , X.Xg at OROVILLE Caiif.
Depa ment Head or Authorized Deputy
3t. Code 440-002 Exp. Code 4210500 PAYABLE FRO BUILDING PERMITS
)t. Code Exp. Code PAYABLE FROM
)t Code Exp. Code PAYABLE FROM
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
FUND
FUND
FUN
)EPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB.
GROSS AMT.
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIV ION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7 41 PER IT NO.
(Rev. 12/96) APPLICATION AND PERMIT G
ASSESSOR PARCEL NU BER q3- 00±TE—
G
BUI G PERMIT
OWNER �qNONE
(wIV(�-�I
SO. FT. OCC. BUILDING VALUATION
KM/Jl
.OWNERS D -
CONTRACTOR' E
C.2iLE&A•y�0(o
TELEPHONE
COM LT MAjL'Qq ADDRESS°
J„[
N'
COTRUCTION LENDER
FirqlAke
LENDER'S MAIUNG ADDRESS
TiAal Allulallon $
ARCHITECT OR ENGINEER
LICENSE NO.
Affing Q91
$ 20.00
P r It ree
$
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
P heckin Fee
$
BUILAINGADDRESS 1
r
rgy Plan Checking Fee
$
$
PERMIT FEE
$
LAT NO.
SUBDNIs�NS NAME
P
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTAUCTURE
OW
SF,)o Duplex ❑ Mobilehome ❑ Other
s
Each Tra
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 y A
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation
Describe Work:
O V
Gas piping system 1 - 5 outlets
15.00 15,
Building sewer
15.00
Mobile Home S G W
@20.00
PERMIT FEE
S 5. ,
° y
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service z�o.0. LEss
23.00 Z3 • 0
LICENSED CONTRACTOR'S DE LARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class — Lic. No. ��
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am ex lusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. +, Business and Professions Code for this
reason /
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain �a certificate of consent to self -Insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work/for which this permit Is issued.
❑ 1 have and will maintain®workers' compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is Issued.
My workers' compensation Insurance carrier and policy number are:
Carrier
Policy Number /
(The above sections need not be completed If the permit is for work of a valuation
of one hundredfdollars ($100) or less.)
rtify that in, t"he performance of the work for which this permit is issued, I shall
notemployany 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' •compensatio rovisions of section 3700 of the Labor Code, I shall
form-mp rth those rovisions.
X Date
Signature o A Ica t - ❑ Ow er ontractor ❑ Agent
An OSHA permit requtl�d-f excavations over 0 ee and demolition or onstruction
of structures over 3 stories in heiglit.
Main Service 200A TO 1000A
46.00
NEW CONST. Ilw= OCCUP. SO
OR ADDNs. a Acc. mss. 3.5¢x:
LNdOhi-REBID. MULTI.OUTLE7 @7,50
RAWH
POWER APPARATUS
8 SINGLE OUTLET CIR.
EX. OCcu . OUTLET OR PD=RES B20 @ +.-
Ex. Occup. ou R °pR,A 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wirin 23.00
Z3+� �.
��—
- PERMIT FEE S Ry a
MECHANICAL PERMIT Fling Fee 20.00
Heating 5 - 1661)
Cooling
Hood 6.50
Ventilation
PERMIT FES $ 36. 00
Mobile Home Installation Fee $
Energy Inspection Fee $
� 3
TYPE TOTAL FEE $ 5q .
,,,,�. IMP
FLOOD
CDF
pgRC0.
Po
HD
SUE
This permit Is hereby Issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date
ate
Receipt No.
WHITE-D.D.S.-B.D. CANARY -AS ESSOR PINK-INSPEqTOR GOLDENROD- PPLICANT
+ . > +•.. ^~ r.- -�. ti+,E.Y r� •cw+i.'l., .ti ..; - .. .^ ltiti, ,*ter 1_- • ,
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT,,SERVICES - BUILDING DIVISION
rA J K: 7 County Center Drive •. Orovllle; Ca'1'08&d 65965` Telephone (530) 538-7 /41� D PERZIT NO.
a (Rev. 12196) APPLICATION AND PERMIT*' ,.C,, !/
rA
ASSESSORPARCEL NUMBERS/S.� ^O
ZONING
BUM GPERMIT
OWNER
TELEPMONE
SO. FT. OCC. BUILDING VALUATION
.OWNER5 IU D S _ j • , ��ws
CONTRACTOR' E��
UYL1-:49a,(4
TELEPHONE
8o
,
MAIL`1 ADORE' •�S'
CONSTRUCTION LENDER N
Fire Ia e
LENDER'S MAILING ADDRESS
T tal V lualion Is
ARCHITECT OR ENGINEER -
LICENSE NO.
Ilin Fee I
$ '20.00
P r4it „ 'Ke
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
PI : heckin Fee
$
BUI'L`DING ADDRESS /"� (J •
1E r Fee
gy Plan Checking
$ .
$
PERMIT FEE
S
LOT NO. T
�
SUBDIVISIONS NAME, - I
`
PAHO /
PLUMBING PERMIT
Filing Fee 20.00
` USEOFSTRUCTURE\
SF,,4 Duplex ❑ Mobilehome ❑ , Other
s '
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel '❑ Utilities ❑ Installation
-Describe Work: .lCJ��i./.1i:
1 �d� &,O%a C4. Lu ,
Gas piping system 1 - 5 outlets
15.00 1 rj
Building sewer
15.00
Mobile Home S G W
(920.00
I LH
I
PERMIT FEE
a
n�
ELECTRICAL PERMIT
Fling Fee 20.00
800v OR LESSL
Main Service 200A OR LESS
I 23.00 Z3 • o
LICENSED CONTRACTOR'S D� LARATION
I hereby affirm under penalty of perjury that I am licq sed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of t e Business and Professions Code,
and my license is in full force and effect.
License Class '� LIC. NO.
ER -BUILDER D�FCLARATI N�
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason: r"
.,0 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 ex rusively 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 X 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 >>workore compensation Insurance, as required by Section
3700 of the LaborCode, for the performance of work for which this permit Is issued.
My workers' compeyisation Insurance carrier and policy number are:
Carrier / "
Policy Number /
(The above sectldns 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 employjany person in any manner so as to become subject to workers'•
compensation laws of California, and agree that 0 1 should become subject to the
workers'-compensatio rovisions of section 3700 of the Labor
jorthw""-I h'b mptty ith those rovi ions.
X Date451*
Signature of Ap�lica� - ❑ •O09n r • Contractor ❑ Agent
An OSHA ermit is re uired-for excavations over 0 ee and demolition or construction
of structures over 3 stories in height.
Main Service 20A TO 1000A 46.00
NEW CONST. oWEG OCCUR LLINCSo
OR ADDNS. a ACC. S.3.50F
WT
"NpµRplp, ' MULTI.OtmET (97.50
PowER APPARATus
8 SINGLE OUR.ET'CIR.
00
•Ex. Occu . ounEroR 0. 20 SAL 0 .50
FI7(ED APPLNS. OR
Ex. Occup. OLmETS RESID. EA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00 `
Misc. Wirina 23.00 73.
R IL Z 23100 13•'00
PERMIT FEE i
MECHANICAL PERMIT Filing Fee 20.00
Heating 15.60 1600
Cooling
Hood 6.50
Ventilation
PERMIT FEt $ :_3 t�
Mobile Home Installation Fee $
Energy Inspection Fee $
OCc
� . 3
coT_,TVPETOTAL FEE $ 1 �q . U0l..11-.
D.� IMP
FLOOD
Cof PARCEL
Po
HD TISSUE
This permit is hereby Issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date
Te
Receipt No. " Q9y ����9 !%�+�
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK' -INSPECTOR GOLDENROD=APPLICANT
0
r '
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev.12/96) APPLICATION AND PERMIT C�""��
ASSESSOR PARCEL NUt4BER r�+ � + A�
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
SO. FT. OCC.,BUILDING VALUATION
- OWN ERSrLI D SS .�. n
{•tel
CONTRACTOR'S'NAME
TELEPHONE
/
CONTRACTORS MAIF/CJALING D�
P" � .
,
CONSTRUCTION LENDER
Fire lace
LENDER'S MAILING ADDRESS
Total ValuMlon $
ARCHITECT OR ENGINEER
LICENSE NO.
.Pilin Fee/
$ 20.00
' Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan,. Checking Fee
$
BUILDING ADDRESS .
1 a 10 �� X13 t
'L 1
Energy Plan Checking Fee
$
C 4MO-J' it 1&_ in Ilk, �/ �
� PERMIT FEE
S
LOT NO.
SUBDIVISIONS NAME ` PARCEL MAP ( j
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE \\ y
n
SF,I Duplex ❑ Mobilehome ❑ Other 5 /
SPECIFY4 `
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
l
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities 13Installation'%0 Other,,0'
Describe Work: t(J) G ictc% Q �C /(? �r4t f l n f`_r,
h/ �_ r
-h.,) ,loD w.7r.,aJ.� A �.L
Gas piping system 1- 5 outlets
15.00 1 ,5. �
Building sewer
15.00
Mobile Home I S I G I W
(920.00
PERMIT FEE
$
e
ELECTRICAL PERMIT
Filing Fee 20.00
r
Main Service .A OR LESS
23.00 Z3-()()
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect. ��
License Class �.'� 1)"1 Lic. No. , _ i7
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason: f
❑ 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.A
❑ 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 permitis 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.)
hcertify 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
,forfhwith'cgmply with those provisions.
X [jt'��
.�"f I [\ i 1'-1',l �1Date
Signature -of Applicant - ❑ Owner O'Contractor ❑ Agent ' �l
toe
An OSHA permit is required for excavations over 60"Aaep and demolition or.construction
of structures over 3 stories in height.
Mein Service To ,000A
46.00so
WEE200A
NEW CONST. DWELLING OCCUP. SO
OR ADDNS. a ACC. eLDS. 3.50FT;
NCHO@7.50
NO*RESID. BRANCH
POWER APPARATUS
a sINOLE ovn ET aR.
.00
EX. Occup. OUTLET OR FIXTURES BAL 20 @ I. 0
Ex. Occup. oflinLEis A� � o�w 5.00
Temporary Service 23.00
Mobile Home Facilities
20.00
Misc. Wiring 23.00 .fi)
Z 3,C� Z3• C3
1PERMIT
FEE $
MECHANICAL PERMIT Filing Fee 20.00
Heating ,AT) 1,5vo
Coolingi� f3
Hood 6.50
Ventilation
PERMIT FEt $ W
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
F,
c4NsT, TYPE
0J, TOTAL FEE $ . oo
MAZ. D. FEES IMP
I FLOOD
I CDF
I PARCEL
I PD
I HD
ISSUE
This permit is hereby Issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
I
the applicable provisions
Resolutions to do work
been paid.
Date
Date
Receipt No. ot) U - I U. 0' (k ,
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK --INSPECTOR GOLDENROD -APPLICANT
0
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Orovitle, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96') APPLICATION AND PERMIT C.
ASSESSOR PARCEL NUMBER— 393-001
,i/.lI 93..,.0v1
ZONING -
BUILDINGPERMIT
OWNER Mlr`
t ° F
r�/y
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
. OWNER'S NNG ADDRESS
CONTRACTOR'S NAME
TELEPHONE
CONTiRAACTORS MAIUNG ADDRESS (0 °
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filinn Fee.
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
%
Plan.`Checkin Fee
$
BUILDINGADDRESS j t
j 9 (c) \fa �� ,�. � l 1 � �„ � s \ 1
Energy Plan Checking Fee
$
PERMIT FEE
$
LOT NO.
SUBDNIS IONS NAME f PARCEL MAP
�..
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE �� V
'
SF ,b Duplex ❑ Mobilehome 13 Other ►. 1 ��
SPECIFY
Each Trap
7.00
Solar or heat um water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition l❑ Remodel ❑ Utilities ❑ Installation ❑ Other O
Describe Work: ! t-11 it
-, t �> L /f t 'I! " ' r
/ [c Ino n h: J r (,cJ� / t ii i l�U J +' 1 r ' n�-.
Gas piping system 1 - 5 outlets
i 15.00 j -�, e,a
Building sewer
15.00
Mobile Home S G W
QG 20.00
PERMIT FEE
ELECTRICAL PERMIT
Fling Fee 20.00
OOOV OR LESS
Main S@NICs zoOA OR LESS
I 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.�y /
License Class C 1 r-, Lic. No. (-) _+l r' �.X — J
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason: I
❑ 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 If the permit is for work of a valuation
of one hundred dollars ($100) or less.)
I'certify that in the performance of the work for which this permit is Issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that If I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
,forttiwith comply with th'ose'provisions.
X L / ~ Datek1
Signature of Applicant - ❑ Owner O -Contractor ❑ Agent I
An OSHA permit its required for excavations over 5'0" deep and demolition or construction
of structures over 3 stories in height.
Main Service TO tOooA 46.00so
WEE200A
NEW CONST. DWELLING OCCUP. SO
OR ADONs. a ACC. BLns. 3.5¢FT;
NEW
FpµgESID.NUT' MULTI.OUTLET @7.50
POWER APPARATUS
S SINGLE OUTLET CIA.
EX. Occup. CUTLET OR FD(TUREs Bq ®I w
UNS
Ex. Occup. oFimtTs REES,6.GEEA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring J 23.00 '`,•t
�A a -f t - a-
PERMIT FEE
MECHANICAL PERMIT Fling Fee 20.00
Heating 6 'S+—)
Cooling{'.'i
Hood 6.50
Ventilation
PERMIT FEt S f93
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
f, -
CONST. TYPE
TOTAL FEE $ �{ . O o
HAZ.
D. FEES IMP
FLOOD
coF
PARCEL
PD
HD
ISsuE
This permit is hereby Issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date
Dere
Receipt No. "I r7 �r y �/! ' _'- 3 , AI
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
L
'File No
BUTTE COUNTY
Public Works Dept.
,(Fri- Action 1, 21 3,
(For Information /I)
Director
1
Dep. Dir.
J
Sec.
•
Rd. & Br. Mtce.
Shop & Yards
Bldg. Insp. Admin.
•
a•
1
Design Engr.
r3ridge Engr.
Constr. Engr.
Surveys
Mopping
Transp.
Land Dev.
Drng. /S.I.
Sub. & Pcl. Maps
Permits
Addr.
P / 14*gc- f!oNge7a,07 v
ConlTAT OoNNr'leLY � ASS oc,
,r-Z)EtiTIF/�o ON PGC-WSP,
A!
A-7&1- (P7 Ted J 6WAC— r-rtNOtAko - ,
v J��
•
1
•
1
r
f.
PRE -INSPECTION REPORT
OWNER: DATE:
LOCATION: 1 CZ I A.P. # 005•- 393— no
CONTRACTOR: l'�Cd/l 6�� ��, ZONING:
PRE-INSPETION FOR U40 CM)O-C& _Q�
DATE TO INSPECTOR ,QL 'off PERMIT HISTORY:( ) NONE (PI -AS FOLLOWS:
BUELDING L PECTOR'S REPORT
Building Description:
Commercial/Usage: -
Residential/# of Units: i
Currently Occupied�
Abandoned/Vacant
Electric:
yes No Electric currently On_ 5 Off
Condition of Electric as �✓ '' k
e,412 jo.
e,> 14w,(15 b� �ee.')e&,, cirl-
Gas: �.l Allp
Natural I//
Propane None Currently On // Off
Obvious Problems: us,qfe/ /3�a fei /oca�irel o��'s t ol,�J�o e.✓r�/os c��
Sanitation:
Plumbing Working 1�e S
Well Working Potable Water 9 C 5
Obvious SewageProblems
Co/mments: ,5',wU/l bus, Az &A- -off. y -O0-4i i4
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*MON RECOMMENDED: ISSUE: HOLD FOR 'A_t
Inspector: Date 2l ZS
Sketch buildings on reverse and indicate location on property.
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 dela;
in processing and issuing your building permit. No building permit will be issued until this
verification is received. .,
1.` I personally plan to provide the major -labor and materials for construction of the proposed
property ' vement : YES >.. NO
2. I HAVE 9 HAVE NOT 0 signed an application for a building permit for the proposed work.
3. I have contracted with the following person. f Srmt) Ua Ipwvio the.proposed constr= ion:
NAME:
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work; but . have hired. the following person to coordinate,
supervise, and provide the major work:
NAME:
ADDRESS: CITY
PHONE: CONTRACTOR'S LICENSE NO. }
S. I will provide some of the workI have contracted (hired) the following peirsons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED:
PROPERTYOWNER:
SOCIAL SECURITY NUMBER:
7ZDATE: 7-2-�,"O1
NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the
California Health and Safety Code. This verification must be completed and
returned to our office before we are permitted to Issue the permit.
OVER
OWNER BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of property
improvements specified.
For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such
a permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by soutedne*other than yourself, you may protect yourself from possible
liability if that person applies for the proper'permit in his or her name.
Contractors aro required by law to be licensed and bonded by the State of California,and to have a business
Ikmse from the city or county. They are also required by law to put their license number on all permits for which they
apply. {
Ifyod ptad to ddim(t r own'woik whh the w6eption of various trades that you plan to subcontrvA you should
be aware of the following Information for Yourbenefit and protection: '
e If you employ or otherwise engage any pets other than your immediate family, and the work (including materials
and other costs) is 5300 or more for the en�r' a project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer. W.
If you are an employer,. you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security. taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
0 There may be financial risks for you ifyou do not carry out these obligations, and these risks are especially serious
with respect to worker's compensation insurance.
® For more specific information about your obliphons under Federal Law, contract the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administnition). 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 contracting the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is returned.
rely,
Mic el C. Vi ira, C.B.O.
Ma ger. Building inspection
NOTE. This Owner -Builder Information Is required by Section 19830 of the Calt(ornla Health and Safety Code -
OVER
E.H. USE NLY
_ Plot Plan Attached
Floor Plan Atta hadT—
] <) n Sant to B.D.
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
/.--N-d
Owner Location AP#
Plan Approved for: Sewage Disposal ter' Water Supply: Public Private Well
Clearance for dwelling. Other
nvru 1311431 v, .
Final clearance O.K. for:
NOTE:
C:i
8/96
C
nmental Health Specialist
Date
ertr� �" II;I
Tki5 lavkJ vo fats
Fy-�L APPROVED
qLae County
irmmw"
lot
6
LIM
rDUAkEOAUVV-
fro -fu
R(Ddj Environmental Heal h
-1:-. JUN - 8 2001
inch:= 10I Chico, California
`
Existing House
El %%"
Gas
Dryer
6'
4 x 4 header
@ window
Envlronn?ental Health
JUN _ 8 2001
Chico, California
N
�o»tal Health
P-
o
y X
(D (,)
O 1
t Laundry Room to
be upgraded to meet
building code requirements.
-------------------------
Existing House
Double 2x4 top plates
2x4 rafters 2' oc typ
metal roofing
R-19 Ceiling Insulation
"t C, 9'k I I ('�cP
— 1/2" hardboard siding
— 1/2" drywall
R-13 wall insulation
— 2 x 4 studs @ 16" oc typ.
—PT sill typ.
— Existing conc. slab
Laundry Room
1210 Jackson St.
Chico, Ca
AP#
3/21/2001
Owner Michael Holland
Drawn by
Brian Burtenshaw
Flnrur Plan & (b6tails
N
HOU S T NG F=AT R PROGRAM
CONNERLY & ASSOCIATES, 2215 21ST STREET, SACRAMENTO, CA 95818
6jt 2 q 3,3
. P 410
<918> -4784
:::eii r:
.. ..;.
.•................ AT:I�}PI .:4.... K. Pg... F.. .
........................•..............................•........................•.•.•...•.•.•.•.•.•.•...•.....•...•.
- WORK WRITE-UP - �/d.�►w� �•+� �
L
APPLICANT Michael Holland
PROPERTY ADDRESS 1210 Jackson St
CITY, STATE, ZIP Chico, Ca 95928
MAILING ADDRESS 1724 Buch St
CITY, STATE, ZIP Chico, Ca 95928
PHONE NUMBER Days (916) 345-7655
Eve (916) 345-8097
DATE : June 2, 1992
The following work is to be performed by licensed contractors and/or the
homeowner for the purpose of bringing the subject property, which has
been found to be substandard, into compliance with local housing/building
codes and regulations. The contractor or owner, in the case of an owner
performing his/her own work, shall be responsible for determining the
applicable code requirements and for performing work in compliance
therewith.
Estimates shall be based only on the work specified in this work write-
up. Contractors discovering or suspecting an error or omission in either
this write-up or plans (when applicable) shall promptly report to the
Housing Rehabilitation Consultant (916-456-4784) so that items in
question may be investigated for possible addition to required work.
All work must be performed in compliance with published "grades and
standards". Materials must match, be of equivalent quality, or exceed
those published on "materials list". If not listed, "medium grade"
should be assumed.
Owner's preference for style and color should be followed wherever
possible. Allowances, when listed, are guidelines for purchases. All
items purchased as "allowances" must be approved by the homeowner.
Any measurements and drawings attached hereto are to be considered
approximations unless otherwise stated. The responsibility for
determining the exactness of structural measurements and other
specifications shall be that of the contractor and shall be a condition
implicit in all bid or proposal submittals.
1
HOUSING REPAIR PROGRAM
- WORK WRITE-UP
11100043-TIMMM
I
A copy of the building permit will be required BEFORE construction begins
and shall be provided by the contractor. The contractor will secure all
necessary permits to complete the entire project and must submit to the
local entity a signed -off building permit at the completion of the
project.
IT IS THE CONTRACTOR'S RESPONSIBILITY TO ASCERTAIN, OBTAIN, AND MAINTAIN
RECORDS OF ALL REQUIRED PERMITS.
Provide dumpster service or daily removal of construction debris for
duration of contract. Premises to be left in a broom clean condition on
a daily basis. •
H
9 %).,.....•i
Remove the existing concrete footing.
Install a new perimeter foundation system for the existing residence.
All new work -to be to current UBC and local jurisdictional codes.
El
,NTI_
Strip and dispose of existing deteriorated roof covering over residence
to bare wood sheathing. Remove all nails or pound flat. All holes over
1/2" in diameter shall be covered with metal flashing.
Provide and install all materials necessary to replace deteriorated wood
members where needed.
Provide and install 3/8" CDX plywood sheathing over entire roof area.
Nail and space as per manufacturer's specifications.
Provide and install a 240 lb, 25 -yr, Class "A" fire rated fiberglass
composition roof shingles per manufacturer's specifications. Install
over a layer of 30# non -perforated roofing felt.
REPLACE ALL SHEET METAL WITH NEW: including roof jacks, crickets, saddles
and or flashing/edge strips.
NOTE: ALL ROOFS TO HAVE A 5 YEAR WARRANTY ON LABOR/INSTALLATION AND A
SUPPLIERS WARRANTY ON ALL MATERIALS INSTALLED.
(APPROXIMATE NUMBER OF SQUARES: 15 )
E
2
I
0
HOUSING REPAIR PROGRAM
- WORK WRITE-UP -
----------------------------------------
----------------------------------------
Replace the main service entry panel with 100 amp CB main service in a
rain -tight entrance panel b -ox, (Crouse -Hinds 3C -002 -AR or any approved
equal).
Check for re -use of existing weather head/periscope or provide new
weather head/periscope. Service feeds to meet all current local and
national electrical codes for replacements. Reconnect existing circuits
to new panel. Balance loads for existing circuits.
New circuits: GFCI breaker of the same amperage on circuits feeding the
bathrooms, kitchen counter outlets, one in garage, one in laundry, and
any exterior outlets; a 20 amp circuit breaker for the laundry outlets,
one 30 amp 240V for the water heater (if existing); one 50 amp 240 V for
the stove; four 15 amp 120V lights/general purpose; three 20 amp 120V
dedicated for the kitchen; one 20 amp 120V general purpose outlet
circuit; two blank spaces.
Provide and install No. 8 bare copper hard drawn ground wire from the
grounding terminal of the service entrance box and fastened to the street
side of the metallic water service pipe and to a rod 1/2" x 8' copper
ground set 1" above grade. Use a bronze grounding clamp. Ground wire
must be in conduit where exposed to any external damage. ID all existing
and new circuits at service panel/sub panel(s) in ink.
Rewire the existing runs in the attic. All existing switches, outlets,
receptacle "boxes, and junction boxes need to be checked for
serviceability and replaced as necessary. All receptacles within 6 ft of
all sinks or bathtubs shall be GFCI protected. Exposed wiring in the
garage [ below 7'] must be encased in walls or in approved metal tubing.
$
Provide and install R-30 Kraft paper -faced fiberglass batts insulation in
the attic over the living area of residence.
NOTE: PROVIDE CANT STRIPS AT EAVES WHERE RIGID INSULATION IS USED.
(APPROXIMATE SQUARE FOOTAGE: 1,200 )
Provide and install all materials necessary to hook washing machine to
sewer line. All work to be done to code.
Provide and install a temperature and pressure relief valve. Relief
valve shall have a 3/4" diameter copper drain pipe extending to the
exterior of the building and shall point downwards.
3
HOUSING REPAIR PROGRAM
- WORK WRITE-UP -
8. CARPENTRY
Provide and install all materials necessary to replace deteriorated front
and rear porch covers. All new work to be done to code.
$
Provide and install all materials needed to construct a water heater
room. All work to be done to code.
Provide and install all materials needed to construct a step for front
entry.
SUBTOTAL
OVERHEAD/PROFIT
TOTAL $
Any deviation from this bid in cost, materials, labor or scheduling shall
be documented in a change order in accordance with the provisions in the
owner/contractor agreement.
PREPARED.BY TODD CELIZ
Inspector
4
DATE
HOUSING REPAIR PROGRAM
WORK WRITE-UP -
----------------------------------------
----------------------------------------
The undersigned hereby certifies that the above information is accurate
to the best of his/her knowledge, and that he/she has the authority to
legally bind and negotiate for:
COMPANY NAME:
ADDRESS:
TELEPHONE:
CONTRACTOR
LICENSE:
EXP. DATE:
DATE
I ACCEPT THIS PROPOSAL SUBJECT TO LOAN APPROVAL AND EXECUTION OF
OWNER/CONTRACTOR AGREEMENT.
OWNER DATE
OWNER DATE
5
HOUSING REPAIR PROGRAM
- WORK WRITE-UP -
----------------------------------------
----------------------------------------
Tem Reid
Division of Environmental Ilealth
Jim Glander.
Building Inspection Division
7 County Center Drive
Oroville,-Californ,ia 95965
Gentleman:
1/We request an inspection of the property identified below for the purpose of
obtaining financial assistance for home repairs under the County's Community
Development Block Grant Rehabilitation Program. I/We understand that if 'this•
inspection uncovers health and safety. violations, we may be required to remedy
these problems whether or not we receive financial assistance under this program.
SIGNED:
Owner
Date
OwnDate
er
Property Address
34.5'— CJorLC 3VS- ?o7
Phone T— —
iS?;-r
rC �: -J
lig o ® I CONNERLY & ASSOCIATES, INC.
CONNERLy 2215 21ST STREET
SACRAMENTO, CA 95818
& ASSOCIATES y
(9]6)456-4784
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C)46 - I k - `3 po I 0
Sid 861 I r ,
ngyO� o �o
WINN HOUSE MOVERS
Highway 45 -- Road 24 0 Phone 826-3322
P. O. Box 578 • Hamilton City, Calif. 95951
PROPOSAL SUBMITTED TO: PHONE-
lL�� IliG7l7` %IL �� I
We h
dstimateVsf
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DATE
JOB NAME/C;;?/O
STREET I;/1�t4
CITY & STATEZ
1
Aov 7 1W
N° - 0'617
Moving S
or S
Raising S
Concrete $F4
7d
S
s
Sub . Total $
Permits $
TOTAL $
V1-`'"'C./`'a.11 ITEMS NOT INCLUDED IN THIS CONTRACT
1. Electrical. 2. Plumbing. 3. Steps or sidewalks. 4. Carpenter work at new site. S. Cost of utilities, wire raising or removal to move over
eight structures. 6. Building permits required to relocate structures. 7. Building permits required to raise structures for foundations.
NOTICE TO OWNER
"Under the law, you may protect yourseit againsT such claims by filing, before commencing such work or improvement, an original
contract for the work of Improvement or a modification thereof, In the office of the county recorder of the county where the property is
situated and requiring that a contractor's payment bond be recorded in such office. Said bond shall be In an amount not less that fifty
percent (50 percent) of the contract price and shall, In addition to any conditions for the performance of the contract, be conditioned for
the payment In full of the claims of all persons furnishing labor, services, equipment or materials for the work described in said
contract."
"Weereby opos t fur ish bor and m en Is, c plete in ac dance wahthe above specifications, for the sum of:
>:r-dellars ($ QQ-with payment to be made as follows:
Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will
become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our
control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation
Insurance. All costs of utility wire removal and raising at customers expense.
Time allowed for completion of job is 30 days. After 30 days co must a aid ' full. n to not completed in 30
days a rental fee of $5.00 per day will be charged for equipment r ntal. After d rent fee of 0.00 per will be
charged.
Authorized Signature
NOTE: This proposal may be withdraw y us i not accepted within days.
,�rrrp#amz of 1roprizal
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work
as specified. Payment will be made as outlined above.
ACCEPTED: Signature
Date _ Signature
Late or "FINANCE CHARGE" will be added on overdue accounts at the rate of 1%% per month which is an ANNUAL PER-
CENTAGE RATE OF 18%.
n
Kristine Taylor
Connerly and Assoc.
2215 21st. St.
.Sacramento, Ca. 95818
Dear Kristine:
The estimate for re -roofing and re -wiring the residence located at 1210
Jackson St. in Chico Ca. is as follows:
1. Remove existing roof' covering, reframe porch areas, sheath and
place fiberglass roofing, and cleanup. $3006,00
2. Remove exi.sting.wir.ng in attic area and re -wire, place new load
center, and place ne'v-i electrical outlets, $2000.00
Thank you for your patience concerning this matter.