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HomeMy WebLinkAbout006-010-094CompLA,n+ y 13 BUTTE COUNTY DEVELOPMENT SERVICES Complainant: Address: Phone Number: Other Comments: iii' dW�ltNEW 111 3# Inspector most draw a plot plan with all binding locations: Additional comments from Inspector: A & S'Ranc hes, Inc. �i YV40 SIS Wilson Landing Rd., app.k mi. W.of Esp]anade," Ctiico t contr: Grage Elec., Chic Permit #813-82E(separate elec. services to 2 meters/MH) i 0 006-010-094/095 999q 118AG -SCHULLER - CHICO•GERALD 4587 WILSON LANDING ROAD AGRICULTURAL EXEMPT PERMIT �� q 5 . { f t 1 i 0 006-010-094/095 999q 118AG -SCHULLER - CHICO•GERALD 4587 WILSON LANDING ROAD AGRICULTURAL EXEMPT PERMIT �� q 5 �• O 1 clol 1 BUILDING DIVISION COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: (530) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT NO. , ff\ -?f -11.9 96/ Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. V & � � �., l" ZONING OWNER - - PHONE NO. 3 f -.ep OWNER'S ADDRESS � k v 9r� LOCATION OF BUILDING USE OF BUILDING SIZE OF STRUCTU ' X 612—, = SO. FT. TYPE OF CONSTRU7N: WOOD FRAME STEEL CONCRETE OTHER (Specify) TYPE OF SIDING R COVERING FLOOR TYPE o, j� ESTIMATED COST OF CONSTRUCTION $ ti'SD ©C7 AG Buildings shall comply with the minimum front, side, and rear yard setback requirements of the applicable County Ordinances as follows: FRONT` SIDES '?"U' REAR AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. It. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. AG Buildings must comply �with I Flood Zone requirements. Finish floor elevation must be at or above elevation USGS Datum._ ����� ���c Qw�c�a CQ��• I declare under penalty of perjury that the building will be used as stated above and the purposed use confirms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date $ -17-el- Signature of Owner Permit Fee - $60.00 Receipt No. Uv The above described AG Building is exemptffom a building permit. j Manager Building Division C��CBy Date / g White — DPW Yellow lAssessor, Pink — B. I., Goldenrod — Applicant ELEVATION CERTIFICATE O.M.B. No. 3067-0077 FEDERAL EMERGENCY`MANAGEMENT AGENCY Expires July 31, 1999 NATIONAL FLOOD" INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a-waivsi of the flood insurance purchase requirement. This form is used only to pro- vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. ' Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I BUILDING OWNER'S NAME POLICY NUMBER GERALD SCHULLER STREET ADDRESS (Including Apt., Unit. Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER 4787 WILSON LANDING ROAD OTHER DESCRIPTION (Lot and Block Numbers, etc.) CITY CHICO STATE ZIP CODE CA 95926 SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX S. FIRM ZONE 6. BASE FLOOD ELEVATION 06007 320 C 6/08/1998 A (in A0 Zones, use depth) 174.0 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ® NGVD '29 ❑ Other (describe on back) 8. For Zones A or V, where no BFE. is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's.. BFE:1 I I I I I .0 feet NGVD (or other FIRM datum—see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions; indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level _8_ . 2(a). FIRM Zones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of l I 1 117 A feet. NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1 -V30, VE, and'V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of I 1 U feet NGVD (or other FIRM datum—see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is U .0 feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is UU.0 feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: ® NGVD '29 ❑ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section B, Item 77, then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: ❑ Yes FAX No (See Instructions on Page 4) 5. The reference level elevation is based on: ❑ actual construction construction drawings (NOTE:' Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is:I I I �I�a feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: I I I I I I .0 feet NGVD (or other FIRM datum—see Section 8, Item 7). 2. Date of the start of construction or substantial improvement FEMA Form 81-31, MAR 97 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION i SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al—A30, AE, AH, A (with BFE),V1—V30,VE, and V (with BFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8 - Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME C . W , BACHMAN LICENSE NUMBER (or Affix Seal) R.C.E. #16803 TITLE P. E. COMPANY NAMEBACHMAN& associates ADDRESS 13647 Garner Lane CITY Chico SIGNATURE NOvWber 2, ' Copies should be made of this Certificate for: 1) community official, 2) insurance COMMENTS: CA STATE 95973 ZIP* ZONE 'Iding owner. c 9 S Z z �O�[1F0R�\�� ON WITH SLAB BASEMENT ON PILES, PIERS, OR COLUMNS A V A ZONES ZONES ZONES A v ZONES ZONES REFERENCE LEVEL c BASE REFERENCE LEVEL REFERENCE FLOOD ;..- ELEVATION LEVEL BASE - FLOOD ELEVATION REFERENCE ADJACENT LEVEL GRADE ADJACENT•.: 'ti' REFERENCE GRADE ,'AAs: LEVEL "?�. BASE FLOOD ELEVATION ,,,,//� . :.. .:i.::•. •:':• ':. .y.,c1•:'r ADJACENT :: ...'.:':'.",i`•::'.':;.':::".. `'::•�''.::�::i':"'+":.'::: GRADE '. The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 ELEVATION CERTIFICATE O.M.B. No. 3067-0077 FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999 NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to pro- vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I BUILDING OWNER'S NAME POLICY NUMBER GERALD SCHULLER STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY MAIC NUMBER 4787 WILSON LANDING ROAD OTHER DESCRIPTION (Lot and Block Numbers, etc.) CITY CHICO STATE ZIP CODE CA 95926 SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX S. FIRM ZONE 6. BASE FLOOD ELEVATION (in AO Zones, use depth) 06007 320_ C 6/08/199 8 A 7 7. Indicate the elevation, datum system used on the FIRM for Base Flood Elevations (BFE): ® NGVD '29 ❑ Other (describe on back) 8. For Zones A or V, where no BF.E.is pr6vided.on the FIRM, and the community has established a BFE for this building site, indicate the community's; BFE�'U feet NGVD (or other FIRM datum–see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions; indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level A . 2(a). FIRM Zones Al -A30, AE, AH,'and.A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of W-1� feet. NGVD (or other FIRM datum–see Section B, Item 7). (b). FIRM Zones V1=V30, VE,�and-V,(With BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of I I I I I I .0 feet NGVD (or other FIRM datum–see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is W .0 feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is w.0 feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: ® NGVD '29 ❑ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: ❑ Yes L. No (See Instructions on Page 4) 5. The reference level elevation is based on: ❑ actual construction & construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: I 1, feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: I I I I I I .0 feet NGVD (or other FIRM datum–see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Form 81-31, MAR 97 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION 1F,\ S SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al—A30, AE, AH, A (with BFE),V1—V30,VE, and V (with BFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8 - Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. If certify that the information in Sections 8 and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal) C.W.BACHMAN R.C.E. #16803 TITLE P. E. COMPANY NAMEBACHMAN& associates ADDRESS 13647 Garner Lane CITY Chico CA STATE 95973 ZIP SIGNATURE NOvWber 2, 9 PHONE Copies should be made of this Certificate for: 1) community official, 2) insurance a r ti Iding owner. COMMENTS: (jQ' F 9 y yn c ,,FOR ON WITH ON PILES, SLAB BASEMENT PIERS, OR COLUMNS A v A A v ZONES ZONES ZONES ZONES ZONES REFERENCE RTEF ERENC- BASE LEVEL c REFERENCE LEVEL FLOOD LEVEL ELEVATION BASE "`' REFERENCE ADJACENT :'; FLOOD ..,.::. . _.f',4:;. ELEVATION ^` REFERENCE ADJACENT GRADE - LEVEL BASE FLOOD ELEVATION LEVEL GRADE •::`�:�::.:.;:: fir:::'�:.:'::':�::•'. :�•>�: ADJACENT:;. + + GRADE. The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 Gerald Schuller 1. Obtain FEMA Flood Elevation Certificate. Finished floor must be 1 ft or above base flood elevation. 2. . Provide plot plan, foundation plan, framing plan. 3. Apply for standard building permit and pay fees of approx. $385. i a, IF 0 �lz gel'. %fid f �• � G G fj/jQ r to�F e J u COUNTY OF BUTTE - DEPARTMENT OF PUBLICiWOKKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT �•��� PERMIT NO. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER - TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAI/LING ADDRESS CONSTRUCTION LENDER _ UNKNOWN Fireplace Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME -PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS100 AMP OR LESS .x.00 - J Main service EA. ADD'L 100 AMP 2,50 NEW CONST. ( DWELLING OCCUP.51) OR ADDNS. ACC. BLDGS. 20 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m license is in full force and effect. y License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR '-OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS NEW CONSTR (POWER APPARATUS 6) NON-RESID. SINGLE OUTLET CIR. @ 28¢ Ex. Ex. Occup OUTLETS OR FIXTURES BAL@1 FIXED APPLNS 2.00 Ex. Occup. 2.00 (RES] D.) Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. ` Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shat l be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee S Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST, PARCEL PD HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTT, - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. AORPPARCE NUMBER W— —C- ZONING BUILDING ERMIT OWNER ^� TELEPHONE 932 SQ. FT. OCC. UILDING VALUATION OWNER'S M !,AG ADWOX D CONTRACT •S "0 TEL PHONOE S CONTRACT MAIL DDRESS , Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDJNqf ADDRESS ✓ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 bF= t'S to Lr / /0, Water piping LOT NO. SUBDIVISION NAME Y PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition Remodel ❑ Utilit'e X Instal tion[-] Other ❑ Describe work: — o ��p r 4 / ' ' ` • Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6101 OR LESS 100 AMP OR LESS --0C /0— f�' 7 "el�+ Main service EA. ADD'L 100 AMP 2.50 c;2 NEW CONST. (/ DWELLING OCCUP.5) OR ADONS, l ACC. BLDGS. / 20 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ' I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in fullforce and effect. License No. /�� Classification &—le ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR U'.OUTLET 2,50 ea NON-RESID BRANCH CIRC ITS NEW CONSTR. POWER APPARATUS S NON-RESID. (SINGLE OUTLET CIR. / 51 @ 26¢ Ex. Occup OUTLETS OR FIXTURES BAL@1 TS XEI P(RESID )REA. 2.00 Ex. Occup.(.0 TLE Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 /0 Permit Fee V $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and h by aut ze representatives of the Countyot Butte to enter upon the ab o ent,ion roperty for inspection purposes. I also agree to save mnnd ep harmless the County of Butte against all liabilities, ju me ts, expenses which may in any way accrue again sa' y in eque of the granting of this pe Tmit. X / Date /"�- Signature of Applican - l Owner Contractor[] ❑ AgentA An OSHA permit i required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ S� OCCUP. GROUP I TYPE OF CONST. I PARCEL PD I ND I ISSu pe This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIR TO F UBLIC ,t - By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. (0/-32-3. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DI=FA`E TiMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET Permit, No. OWNER �`t i� J / A. P. No /V`/ -az 93 Proposed Building Use r Permit Fee Based Upon: --'Complete Contract JPrice DPW Valuation • /IO her (Explain) n • Building Inspector `\ W Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or Issuance: Y} DATE RECEIVED APPROVED 1. All items have been submitted. . . . ... r . . . . . . 2. Plot plans in duplicate/triplicate. . . . . . . . . . 3. Complete plans in duplicate./triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ .. . . , , , , 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑) - 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Datal. Pre -Inspection for • (Date) Fre-Inspec. request to V 17. Pre -Ins p U ' ec �i�fjuired. Building Inspector n� 18. Other When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at off.i6.i /57 Deliver w/inspector. Other __ i"_T l/ // Appl Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) _ 1. Index permit for above Items No. 4-t ,t .t 2. Add-itionaIl items required: ,r t k ` (Contractor, Designer, Owner) was advised of above required data by Telephone Mail By Date Plans checked by �. Date Plans approved by Date Other: Copy—DPW Other COUNTY OF BUtTr - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 A- APPLICATION AND PERMIT ALS�S�E7lS/57O/R »PARCELL NI�MBER - / / ✓.><. 1, i ZONING BUILDING PERMIT OWNER �� TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MA 1 G ADDRES� , CONTRALTO TELEPHONE • CONTRACT MAIL GDORESS - (�' (� Fireplace Total Valuation is ' CONSTRUCTION LENDER-- UNKNOWN Filing Fee $ 10,00 LENDER'S MAILING ADDRESS 1 Permit Fee $ ! ARCHITECT OR ENGINEER - I LICENSE No. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS _ Permit fee $ i BUILDFNqr ADDRESS '• Zi. ' 2 e2 PLUMBING PERMIT Filing Fee 10.00 e, Each Trap 2.00 Repair drainage or vent piping 5.00 /171 I W 0/ 0 Water piping ' LOT NO. SUBDIVISION NAME1A'PARCEL MAP Each qas water heater or vent 5.00 Gas pipi g system 1 - 5 outlets USE OF STRUCTURE SF [:1 Duplex❑ MobilehomeK, Other SPECIFY Buildin Lawvjprinler tygrern 5.00 rmit Fe Ir $ TYPE OF WORKrr��11 New ❑ Additio&:3. �emodel ❑ Utiliti�es �l Instab do ther ❑ Describe work: - 1� ' o •-7r• 7 .A - � /^ C� � 8- '�7 ; j �' ��/�' /l _ ontr LYRICAL PERMIT Filing Fee 10.00 n service 000v OR LESS 100 AMP OR LESS —5.06 s/ l7 ' CONTRACTORS LICEN E I declare under penalty of'perjury (check one): I am licensed under provisions of Chapt 9, Div. o he Business and Professions Code and my license is in full ce and effect. '� License No. �� �c.� %f� Classification --"/C1 ❑ I, as the owner, or my employees with wages as their sole compen• sation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason a Service EA. ADD'L 100 AMP 2,50 UEli CONST. / DWELLING OCCUP.tl1 20 Sq ft ADDNS. `ACC. BLDGS. / NEW CONSTR U ou L T NON.RESID BRANCH CIRCUITS) 2.50 ea NEW CONSTR POWER APPARATUS 6\ NON-RESID. %SINGLE OUTLET CIR, 1 sD@zg¢ Ex, Occup OUTLETS OR FIXTURES BAL@10¢ EX. OCCU IXED APP E S. OR p•�OUTLETS (RESID.1 EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring .'_ 7.50 /0 Oermit Fee V $ Contractor k'� WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ® I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating#. i Cooling` Hood 3,00 Ventilation_: Permit Fee S Contractor' I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relatingt to building construction, and hereby authorize representatives of the County of Butte to enter upon the aboy_e-jnentionf jproperty for inspection purposes. I also agree to save Jini�n� ,4nd/k/eep harmless the County of Butte against all liabilities, jud�ent CpZs,�an6 expenses which may in any way accrueF (j agains _sa1�5t�rffy in- equeno6 of the granting of this pe mit. 1 %�-�° ' �f ' Date Ni S Signature�f Applicant - t Owner ❑� Contractor ❑ Agent/K, An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion ol.atructuies over 3 stories in height. Mobile Home Installation Fee $ TOTAL PE_R_ MIT FEE $ S� OCCU P. GROUP TYPE OF CONST. " PARCEL PD HD ISSUE This permit Is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date f R'ec'eipt No. (1) / _3 33• _ _ f WHITE-D.P.W.. TEL LOW -ASSESSOR, PtN&- 'r OR, GOLDENROD -APPLICANT 1 _