HomeMy WebLinkAbout007-240-057007-240-057 PERMIT#97-2239
HELMS, Ray nd" 16-17
3620 Bridle Ln., Chico
Cont: Mark W. Wilson
Reroof/SF _
007-240-057 01-2063
HELMS, RAYMOND
2620 BRIDLE LN. C� CO �T C,v
CONT: OWNER Y_10
COVERED PORCH 12 X 16
HARRINGTON, Sam- 148-72B
- 296-7
300-7F,''
app. 10001 N. of Eaton on n/s of Bridle man
(new single family) y,
U
I
I
NOTES RESIDENTIAL
X007-240-057 01-2063 ,
HELMS, RAYMOND
� 3620 BRIDLE LN. CHICO
CONT: OWNER
COVERED PORCH 12 X 16
II SPECIAL CONDITIONS
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
JOB FINALED (Date) 3, ( 7' 0 2 -
Signature d7, d
Signature
CHECKED
BY
V= OK
0 = Not OK
- = Not Applicable = Not Ready
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
Footings; Size -Spacing -Marriage Line
1.
Zoning Requirements -Setbacks -Easements
4.
2.
Soils; Special MH Support Sketch
Drain; MH Test -Fall -Flex Connector
3.
Sewer; Location -Test -Fall -C/O -Concrete
7.
4.
Water; Location -Test -Easement Needed (Sketch)
Gas and Electricity Tagged
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
10.
6.
Gas; Location -Test -Wrap;-/ /" L'ft.
/ P Nat. or / /"L"ft./ /LPG
Cert. of Occupancy
7.
Well Clearance 8 Disconnect
8.
Utilitv Clearance
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
5.
Drain; MH Test -Fall -Flex Connector
6.
Water; MH Test -Regulator -Connector
7.
Water and Sewer Connected -C/O to Grade -HD Approval
8.
Gas and Electricity Tagged
9.
Tie Downs -Type -Installation Cent.
10.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
12.
Permanent Foundation Only; License Decal
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
MISCELLANEOUS
Date DECKS, COVfeRp, CARPORTS GARAGES (Plans) OK except #'s
ning Requirements -Setbacks -Easements
Fo gs; Soils -Size -Depth -Spacing -Connectors -Steel
3. ecks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Frg-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
Date jk, O7 Card B-1 IL I I, Date Card B-1
Date Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5.
Elec.;.Pool Lighting; 15 Volts-GFI
6.
Elec.; Enclosures; Conduit Entries -Terminals -Listed
7.
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures- Pan elboards-Ins. to Main in Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
t Date Card B-1 Date Card B-1
cDate Card B-1 Date Card B-1
✓ = OK
0 = Not OK
- = Not Applicable
= Not Ready
RESIDENTIAL (;
Date
46.
Underfloor (Plans) OK except #'s
1.
Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth
4.
Ftg., Porches & Decks; Soils -Steel-/ P' Ftg. Depth
5.
Stemwalls, Main; Ste el- Blockouts-Wrapped
6.
Stemwalls, Garage; Steel-Blockouts-Wrapped
6a.
Hold Downs and Special Anchors
7.
Slab, Steel -Wrapped
8.
Piers -Fireplace Ftg.-Steel
9.
D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10.
UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
11.
Water Pipe; Test -Anchors -Regulator -Service Test
12.
Electric Underground
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
14.
Girders -Sills -Anchor Bolts -Joists- Vent s-Crippies
15.
Access & Ventilation
16.
Insulation
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
63.
PLUMBING (Permit) OK except #'s
17.
Water Htr.; Vent -Access -Combustion Air Baffle
18.
Water Pipe; Test & Anchor -Nail Protection
19
D.W.V.; Test Fittings & Anchor -Nail Protection
20.
Shower Pan; Test, First Floor -Tub Access
21.
Test Tub & Shower, Second Floor -Tub Access
22.
Gas Pipe; Sixe & Anchors
70.
Fireplace or Stove, Clearance -Hearth
Date
71.
Card B-1 Date Card B-1
Date
72.
Card B-1 Date Card B-1
Date
73.
ELECTRICAL (Permit) OK except #'s
23.
Fixture & Transformer Clearance -Ins. Protection
24.
Elec. Receptacles Spacing -Lights & Switches at Doors
25.
Size Boxes & No. of Conductors Stapled
26.
Romex Installed Close to Edge of Studs & C.J.
27.
Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
28.
2 Appliance Circuits in Kitchen & Conductor Size GFI
29.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al
30.
Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or AI
Insulated Neutral O Yes O No
31.
Service -Riser Conductors & Ground Main Disconnect
32.
Equip. Clearances Panels-Motors-Mech. Equip.
33.
Clothes Closet Light -Shower Light -Spa Light
34.
Smoke Detector
85.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
Date
86.
Card B-1 Date Card B-1
Date
87.
Card B-1 Date Card B-1
Date
88.
MECHANICAL (Permit) OK except #'s
35.
A.C. Ducts Insulation & Support
36.
Vent Fan, Exhaust above insulation
37.
Condensate Drain & Overflow, Size & Grade
38.
Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet
39.
Attic Access & Platform if Furnace in Attic
94.
Address Posted
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
Comments at Final:
40.
Sills Proper Materials & Anchors
41.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
42.
Bearing Walls over Girders & Floor Nailing
43.
Draft Stop in Walls (rat proof)
44.
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
45.
Headers & Beams -Size & Bearing
jingle & Duplex)
Date
FRAMING (Continued)
46.
Hangers -Post Caps -Anchors -Connectors
47.
Cling. Joist-Rftr. Ties-Purlin-Roff Brac.-Truss-Shting. -Rfng.
48.
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
49.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
50.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
51.
Garage Fire Protection Framing
52.
Property Line Firewall & Openings
53.
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
54.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
55.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
56.
Siding -Nailing Veneer
57.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
58.
Glazing Area -Glass Protection -Skylights -Plastic
59.
Shear Walls; Nailing -Bolts
60.
Brace Interior/Exterior Wall Panels
61.
Insulation -Walls -Ceilings
62.
Inf iltration-Walls- Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
63.
Ext. Steps -Door & Sidelight Protection -Landings
64.
Smoke Detector
65.
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
66.
Bedroom Exiting
67.
G.F.I. & Bath Fixtures & Tub Access -Spa
68.
Elec. Trim & Subpanel, Breaker Sizes & Labels
69.
Stairs & Rails
70.
Fireplace or Stove, Clearance -Hearth
71.
Elec. Outlets at Wood Panel, Int. & Ext.
72.
Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance
73.
Elec. Outlets & Receptacles at Kit. Counter
74.
Garage Fire Door; Swing -Landing -Closure
75.
A.C. Duct in Garage -Damper
76.
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
77.
Plb., Elec. & Mech. Equip. Listed for Location
78.
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
79.
Insulation -Foam -Looked in Attic
80.
Guard Rails & Deck Construction -Post Caps
81.
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
82.
Following Instld./Drive J Yes J No/Walks J Yes J No/Planters J Yes J No
83.
Stucco Brown -Finish
84.
A.C. Unit Disconnect, Electrical -Plumbing
85.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
86.
Water Well, Disconnect, Electrical, Plumbing
87.
Exterior Elec. Trim, G.F.I. Receptacle -Underground
88.
Ventilation Throughout House
89.
Glass Protection
90.
Corrections from Previous Inspections
91.
Gas Test -Meters Tagged, Gas -Electric
92.
Water & Sewer Connected -C/O to Grade -HD Approval
93.
Energy Compliance Certificate -Other Certificates
94.
Address Posted
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-75 gMIT o.
(Rev. 12/96) APPLICATION AND PERMIT i /�
ASSESSOR PARCEL NUMBER
007-24C-057
ZONING
A—SR
BUILDING PERMIT
OWNER
HELMS RAYMOND
TELEPHONE
-34-3-1517
SO. FT. OCC. BUILDING VALUATION
rn_V 2,496-00
AOWNERSMAILING
. ADDRESS
df)90—DRDLE—LANE,—CUT
CONTRACTOR'S NAME TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDERS MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee ,
$ 20.00
Permit Fee
$ 54.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
&IDLELANE,
Energy Plan Checking Fee
$
$
PERMIT FEE
$ 109- 0
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ 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
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: (;g i>
—w ED 12--X 16
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
920.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Fee 20.00
600VOR LESS
Main Service zo.A 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.PSIN
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:
L"l, 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.)
IB' 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
forthwith comply with those provisions.
11
X _ Date iS— /_ D / _
Signa ure of Applicant - Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations ov a and demolition or construction
of structures over 3 stories in height.
TO
Main Service TO 1000A
46.00
NEW CONST. DWELSo
WEE LINOCC SO
OR ADDNS. ( a ACCG. BWS. 3.5¢FT.
=RESIDT. MULTI.OUQLII TS
@7.50
GLOWER E 011T APPARATUS
a J., CIR.
Ex. Occup. CUTLET ORFD(TURES BAL so
Ex. Occup.GFIxuT AESIODEA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE _
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEI S
Mobile Home Installation Fee $
Energy Inspection Fee $
DCC
CONST. TYPE
TOTAL FEE $
HAz. D. FEES IMP
D
CDF PARCEL PD
H
ISSU
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.
Dote
24�Z_11
pate)
ReceiptNo.
WHITE-D.D.S.-B.D. CANARV-ABBE R PINK-INSPE R GOLDENROD -APPLICANT
"��� ✓ k•.f'►w.: �irY:..w.^ti:. + 3'�ar'_r,-.�.�wr. } .rk�✓i-.^�v'G_. -.�:1: � � .n ..
CR,U.NTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER: ASSESSOR PARCEL DD
Proposed Budding ding Use: Building Inspector: Date:
At time of permit application, Ias advised the following data must be ub a prior to permit processing and/or issuance:
Date Received By
1. All items have been submitted .-------------------------------------------------------------------------------------
tplans, 3/4 sets, signed by the preparer of plans . ------------------------------------------------------------
mplete plans, 3/4 sets, signed by the preparer of plans. -----------------------------------------------------
4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. --------
❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------
E16.
-----------------
❑6. Energy Design Compliance and supporting documentation. ----------------------------------------------------
E-1 7. Statement of Intent for Non -Heated and A/C Buildings. ---------------------------------------------------------
❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------
❑9. Manufactured Home data and installation instructions including Tie Down Specifications -------------------
0 10. Fees of $-------------------------------------------------------------------------------------
❑ 11. Impact fees as shown on the attached schedule. -------
❑ 12. California Department of Forestry plan approval/fees.
so od elevation certificate. anitation and plot plan appro�
Ell 5. City of Chico plumbing permit.
Department.
❑ 16. Plot plan and business license approval from the City of Biggs.
❑ 17. Planning approval for (A) Use: (B) Parking: -------------- ------------
❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. --------- -------------
❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). -------------�------------
❑ 20. Pre -inspection for required. Request to Building Inspector on
❑21. Contractor's license information. (Number, Name Style, Classification). ------------------------------------
0 22. Workers' Compensation carrier and policy number. ---------------------
023. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑).
1:124. Letter of signature authorization. ------------------------------------------
❑ 25. Recorded copy of Agricultural Acknowledgment Statement. -----------
❑26. Letter of intent on building use. --------------------------------------------
E127.
-------------------------------------------
❑27. Manufactured Home utility clearance. -------------------------------------
1128. Existing violations and/or expired permits. -------------------------------
❑29. ❑433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $
030. Other:
(Date)
en you issue t, pyo e� s follows ❑ Mail to owner, �1/,contractor.
Telephone4and hold for pickup at V i office. ❑ Deliver with inspector.
Applicant: Date: �2 a
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By:
Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By:
1. Index permit application for the above items numbered: ❑ Plan Check List
2. Additional items required:
Contractor, designer, owner, was advised of the above required data by o 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 advised of the above required data by ❑ phone, ❑ mail, o Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Buildm iv'Sion counter, by Da :
Plans reviewed by: Date: Plans approved by: Date: Z,
Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date:
Yellow Copy - Department of Development Services, Building Division.
CH. USE ONLY
Plot Plan Attached
Floor Plan Attached D
Sent to B.D.
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Ae%ns mz0 8r�ic k 4n 7 -zoo -oS`7
Owner Location AP#
Plan Approved for: Sewage Disposal x
Clearance for ftelling. Other Cd
Hold final for:
Final clearance O.K. for:
NOTE:
Supply: Public Private Well X
�6
Environmental Health Specialist Date
8/96
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT
SERVICES
7 County Center Drive - Oroville, California
- BUILDING DIVISION
95965
- Telephone (530) 538-754
(Rev. t2/96) APPLICATION AND PERMIT
RMIT NO .
r��
BUILDING PERMIT
A.aeaaoRPARCdNII
OWNER
N!
e -' 7
OW •
BUI N V A
so TION(
Fireplace
COM
TELgPMNE
COWV*C 7 WIRING ADDA09
COMTgICTpN lE►OeJI
LENDER's W" M ADDRE1119
Total Valuation = `.
ARCHITECT OR ENGINEER
LICENSE No.
Filin Fee = 20.00
Permit Fee = r
ARCHITECT Oft eN°a'e:As IN<1No ADORtta
SUaOMO Aaoie -
r
Plan Checkina Fee =
Energy Plan Checking Fee =
v=
PERMIT FEE _
LOT ND.
SUsoRAID"WM
PAacel y�
PLUMBING PERMIT Fling Fee 20.00
Each Trap 7.00
USEOFSTRUCTURE
SFO Duplex O Mobllehoms O Other
Solar or hent um water heater 23.00
svearr
W 1
ater i in
Each ns water heater or vent t 5.00
TYPE OF WORK
New ❑ Addition ❑ Remodel O LNR*w O installation O Other O
Gas I In stem 1 - eta 15.00Building
15.00
Describe Work:
a Home S G I W (gi20.00
PERMIT FEE _
ELECTRICAL PERMIT Filing Fee 20.00
-- — ----
Main Service eoaoovw oR OR LL u� sa
23.00
MainService 1ooA TO I—A 48.00
Z.
NEW COM a4m. O OCCUP.
OR ADDM. a AM �8. 3.5e
NON•RBiD. MULTFOUTLbT
POWER APPARATUS -
S SS40U OUnET CSL
Ex. Occup. ovrLEr oR :OfTNREf 200 I•00
SAL .50
I
iDCFO
EX. OCCU - qua ,D. G 5.00
Temporary,Sqzvi e 23.00
1
Mobile Home Facilities 20.00
Misc. Wiring 23.00
/0
PERMIT FEE S
*PERMIT FEE_ PAID
MECHANICAL PERMIT Filing Fee 20.00
SRA - -
Heating .
Coolin '
u
SHERIFF
Hood 8.50
ventilatic
OTHER
'
PERMIT FEI _
Mobile Home Installation Fee =
Energy Inspection Fee =
----
ocC
my.1, TOTAL FEE $
AMOVNT RECEIVEDs. ( i
MAL D. FE® MAP
This permit is hereby Issued under the applicable provisions
•
of the Butte County Code and/or Resolutions to do work
*REQ. NUMSER g_
Indicated above for which fees have been paid.
_
* TO k PVT INTO COMPVTER
By
Date
PERMIT EXPIRES ON
OWNER -BUILDER VERIFICATION
.Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay
in processing and issuing your building permit. No building permit will be issued until this
verification is received.
1. I personally plan to provide the major labor and materials for construction of the proposed
property improvement: YES L9� NO 0
2. I HAVE C3' HAVE NOT 0 signed an application for a building permit for the proposed work.
�a. I have contracted with the following person (firm) to provide the proposed construction:
NAME:
.ADDRESS:
PRONE:
CITY:
CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following person to coordinate,
supervise, and provide the major work:
NAME:
PHONE:
CITY:
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
PROPERTYOWNER:
DATE_:
.A107E. 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.
0
OWNER BUILDER INFORMATION I
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 parry 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 California and to have a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should
be aware of the following information for your benefit and protection: _
♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
♦ If you are an employer, you must register with the State and Federal 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.
♦ There may be financial risks for you if you do not cant' out these obligations, and these risks are especially serious
with respect to worker's compensation insurance.
♦ For more specific information about your obligations under Federal Law, contract 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 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.
+Micel
16i�,
Vi ira, C.B.O.,uilding Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code
OVER
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RANCHO. ARROYO CHICO
Assessor's Mop No. U 7
Countyof Butte, Calif
June, 1984
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Assessor's Map No. 0.7
Countyof Butte, Calif
June, t-984
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Assessor's Map No. 0.7
Countyof Butte, Calif
June, t-984
I
007-240-057 PERMIT#97-2239
HELMS, Ray
3620 Bridle Ln., Chico
Cont: Mark W. Wilson A 79
Reroof/SF
10// (ell
IJ
4
M
. A -7t
COUNTY OF BUTTE - DEPARTMENT OF.DEVEtLOPMENT SERVICES - BUILDING DIVISION/
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
ZONING
BUILDI PERMIT
OWNER
RAY TIETAS
TELEPHONE
SO, FT, OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
3620 BRTDTE TW. CHICO CA 95973
30 squares 2800•
CONTRACTOR'S NAME
14ARK W. WILSON
I TELEPHONE
342-3393
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filen Fee
$ 20.00
Permit Fee
$ 41.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
Energy Plan Checking Fee
$
CHICO CA 95973
$
PERMIT FEE
S 6
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ® Duplex ❑ Mobilehome ❑ Other
- SPECIFY
Each Trap
1 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 ❑ Other 4
Describe Work: RBROOF
Gas piping system 1- 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
@20.00
PERMIT FEE
$
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service 1100,V
.,. 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.
License Class ' t Lic. No. `t 7 7
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
Main Service ( 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( a ACC. BLDS.
so
3.52FT.
NE
NON-RESNDT STI -O I, I
97,50
POWER APPARATUS
& SINGLE OIITLEr CIR.
EX. OCCU . OUTLET OR FIXTURES
z0 p I.00
BAL @ .50
Ex. Occup. ouiLEt-Drs AFwslo.oew
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wirina
23.00
PERMIT FEE
$
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
hof 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 prIsions of section 3700 of the Labor Code, I shall
forthwith comply with those, provisions.
X t f� _�_ l �j} Date / 0/14�f i _
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
structures over 3 stories in height.
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 61 00
HA2.
D. FEES IMP
FLOOD
CDF
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^
I
the applicable provisions
Resolutions to do work
been paid.
1/,/dof
ateReceipt
Dere
No. 7Z Ll y 4`j
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISIO
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 ERMIIT 0.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER 007-240-057 '
ZONING
BUILDIN! PERMIT
OWNER
RAY HELMS
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
30 squares 1800.
OWNERS MAILING ADDRESS
0 CA 95973
CONTRACTOR'S NAME
MARK W WILSON
I TELEPHONE
342-3393
CONTRACTORS MAILING ADDRESS
CA 95928
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
41.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS '1690 BIRTI)TY. LN_
Energy Plan Checking Fee $
C14TCO CA 95973
$
PERMIT FEE $
61.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF K] Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other IR
Describe Work: REROOF
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home SG W
@20.00
PERMIT FEE S
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service zoonoa'.ss
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 IQ full force and effect. p,!
License Class 151— 1 Lic. No. / 1� q
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
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & ACC. BUDS.
SO
3.5¢-_
NEW CONST. MULTI -OUTLET
NON•RESID. ,=OUTLET
TS
@7.50
POWER APPARATUS
8 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FOITURES
20 Q 1.00BAL @ .50
Ex. Occup. ouriFrs gESlo.oEA.
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE $
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
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEt $
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
�f one hundred dollars ($100) or less.)
0' 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 Califor ia, and agree that if I should become subject to the
workers' compensation pr, sions of section 3700 of the Labor Code, I shall
forthwith comply with thos rovisions.
X �_ ~ Date _/C 14 _
Signature of Applicant - ❑ Ow er ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 61 -on
HAZ.
D. FEES IMP
I FLOOD
I CDF I
PARCEL PO
HD
ISSUE
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.
�/J /6
By �� � L ate
PERMIT EXPIRES ON / 0// b 7
(Dh6)
Receipt No. �%Z t� �-
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
(Rev. 12/96)
COUNTY OF BUTTE -DEPARTMENT OF DEVEL.OPMENTSERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMB,, _ .QLAO r OSS
ZONING
BUILDINGPERMIT
Ow R P 0—
r
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS io ORES11 rr I �. >~ c L, C .0 CA
CONTRA/LC'GTOR NAME
IN1a r ) , tom.) ;
TELEPH NE
COXQppCTOR MAI��ADffESS C� G `GQ
VVYY 11•
CONSTRUCTION LENDEA
Fireplace
LENDER'S MAILING ADDRESS
'
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ ( . _00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDGGZDREoSSCk(C CA 9,E n'�
Energy Plan Checking
$
PERMIT FEE
S r , O 0
LOTNO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
'Filing Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
— /
SF (D Duplex ❑ Mobilehome ❑ Other
SPECIFY
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 ❑ Remodel ❑ lilies ❑ Installation ❑ Other 0-11
Describe Work: K
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home ISI G1 W
(920.00
PERMIT FEE
t
ELECTRICAL PERMIT
Filing Fee 20.00
600V OR LESS
Main Service 200A 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.
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.
❑ 1, 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
Main Service TO
46.00so
WEE200A
CCU000A
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( a ACC. UDS.
SO
3.5¢xCONST.;
D. MULTI.OurtET
NON .SID
@7,50
POWER APPARATUS
a SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FIXTURES
20 @''O0
B w
Ex. Occup. on APP oEk
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
_
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEL:
S
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
forthwith comply with those provisions.
X Date
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.
Mobile Home installation Fee
$
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ (p I • 0 0
HOZ.
D. FEES IMP
FLOOD
I CDP
PARCEL
PO
1 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 _
0810
ReceiptNo.
WHITE-D.O.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD•APPLICANT